BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

Objective To evaluate the clinical value of transesophageal echocardiography (TEE) on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect (ASD) and 38 patients with ventricular septal defect(VSD) were selected by transthoracic echocardiography (TTE) prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On 1 week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventrieular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defects, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.

Objective:To compare the efficacy and safety between direct anterior approach (DAA) and posterior approach (PA) in total hip arthroplasty.Methods: This study evaluated postoperative results of 92 consecutive total hip arthroplasties performed by a single surgeon;44 from the DAA,and 48 from PA.The age,body mass index,operation time,blood loss,hospital stay,positioning of the artificial hip,postoperative Harris score and postoperative complications were recorded and analyzed.Results: Both the average age of the patients separately (58.0±11.9) years in DAA group and (61.0±10.4) years in PA group and the body mass index (25.1±3.7) in DAA group and (24.7±3.3) in PA group,showed no significant difference between the two groups.The DAA group had significantly reduced the hospital stay (3.8±1.7) days vs.(4.9±2.3) days for the PA group (P<0.05) and operation time was (76.0±17.4) min in DAA group,and (71.0±14.3) min in PA group (P>0.05).The amount of blood loss: in group DAA (238.0±55.3) mL,and in group PA (387.0±61.2) mL (P<0.05).There was no statistical difference in the positioning of the artificial hip: the cup anteversion in DAA group and PA group was 17.3°±5.3° vs.18.6°±5.1°,the cup inclination was 38.5°±5.7° vs.37.7°±5.2°.In DAA group,there was significantly less use of assistive devices [(24.6±7.8) d vs.(31.7±10.2) d,P<0.05],and the pain was significantly lower.Harris score at the end of 6 weeks of the follow-up: in DAA group 85.7±5.4,and in PA group 81.3±6.1 (P<0.05);at the end of the last follow-up: in DAA group 93.4±4.7,and in PA group 92.3±5.3 (P>0.05).Complications were encountered in the two groups.There were two intraoperative complications (4.4％),1 great trochanter fracture and 1 lateral cutaneous nerve injury in DAA group.No dislocation was observed in DAA group.One dislocations and 1 groin pain were recorded in PA group.No prosthesis loosening,deep vein thrombosis,sciatic nerve injury and other complications occurred in the two groups.Conclusion: Total hip arthroplasty using the anterior approach allows for superior recovery and better stability.

Objective To explore the significance of serum cytokine interferon-gamma (IFN-γ) ,interleukin-4(IL ) ,transforming growth factor-beta 1 (TGF-β1) ,interleukin-9 (IL-9) ,interleukin-17 (IL-17) in detection of youth first-episode depression .Methods Ninety cases of youth first-episode depression as the experimental group were equally divided into 3 groups according to different disease courses(<6 months ,6 months to 2 years ,>2 years)and other 30 normal persons served as the control group .The levels of serum cytokines were measured by ELISA .The level of each cytokine and Hamilton Depression Scale (HAMD) score were per-formed the Spearman correlation analysis .Results The IL-9 level in the 6 months to 2 years group and > 2 years group was high-er than that in the control group (P< 0 .05);the IFN-γlevel was negatively correlated with psychic anxiety (P<0 .05);the IL-9 level was positively correlated with the somatic anxiety and systemic symptoms (P<0 .05);the IL-17 level was positively correla-ted with the depressive mood and suicide (P<0 .05);the IFN-γlevel was positively correlated with difficulty falling asleep ,early a-wakening ,work and interest in the 6 months to 2 years group ,while positively correlated with somatic anxiety (P<0 .05);the IFN-γ level was positively correlated with depressive mood and block in the >2 years group(P<0 .05);the IL-4 level was positively correlated with the depressive mood (P<0 .05) .Conclusion Different cytokines play different roles in youth first-episode depres-sion ,cytokines may involve in the occurrence and development of depression .

Objective To investigate the correlation of the middle cerebral artery stenosis (MCAS) and the mild cognitive function impairment (MCI),and the clinical efficacy of statins in patients with MCI. Methods Six hundred and thirty-six patientse,who received transcranial color doppler ultrasound (TCD)assay, were enrolled in our hospital hospitalization or outpatients. The simple mental state examination (MMSE) and clinical dementia rating scale (CDR) were used as cognitive function assessment indexes. Forty-four cases of MCI with MCAS and 58 cases of MCI with NMCAS were used as the treatment group , who received the atorvastatin 20 mg every day , 56 cases of MCI with NMCAS were used as the control group , who only received the routine and basic diseases treatment. One yearlater,we determined the changes of MMSE and CDRagain. Results We detected 124 patients with MCAS, 512 patients with NMCAS, and 44 cases of MCAS patients with MCI, the prevalence was 35.5%,114 cases of NMCAS in patients with MCI, with the prevalence of 22.3%, the prevalence between the two groups was statistically different. One year later, the patients in the treatment group, MMSE score was improved, the score of MCI of the MCAS group improved more significantly. Conclusion The middle cerebral artery stenosis correlated with the occurrence of MCI. Atorvastatin could improve cognitive function in patients with MCI, especially for MCI which was caused by middle cerebral artery stenosis.

OBJECTIVE To analyze the values of drug-resistant Pseudomonas aeruginosa pneumonia in the older patients using thymosin ?1 combined with Sulperazone.METHODS The thirty five older patients with drug-resistant P.aeruginosa pneumonia were divided into two groups,one group was treated with thymosin ?1 combined with Sulperazone,the other group was treated with Sulperazone alone.We observed the changes in clinical symptom of the patients,results in culture of sputum,routine blood test,C-reactive protein(C-RP),albumin,pre-albumin,and T cell subset before and after drug use.RESULTS The clinical symptoms of the patients were improved,days of disappeared drug resistance of P.aeruginosa,reconverted normally days of routine blood test,decreased concentration of CRP,albumin,and pre-albumin reconverted to normalize,increased percent of CD4+,decreased percent of CD8+,CD4+ /CD8+ were more prominently reconverted to normalize in thymosin ?1 combined with Sulperazone treated group than in Sulperazone alone group.CONCLUSIONS Thymosin ?1 can improve immunological function,inflammation condition and protein metabolism.Its application with Sulperazone has a coordinated effect on drug-resistant P.aeruginosa pneumonia in the older patients.

Objective To compare the effects of fresh amniotic membrane (FAM), glycerol-preserved amniotic membrane (GPAM), alcohol-preserved amniotic membrane (APAM) and amniotic membrane preserved under vacuum drying condition (VXAM) on rabbit corneal alkali burn and to observe the outcomes of the grafted amniotic membrane. Methods Thirty-six New Zealand rabbits were used to establish corneal alkali burn models and then divided into 4 groups according different preserved amniotic membrane they received (FAM, GPAM, VXAM and APAM), with 9 rabbits in each group. After transplantation, we observed the changes of amniotic membrane graft, corneal opacity, corneal neovascularization (CNV) with slit lamp microscopy. The amniotic membrane graft was examined by HE staining 10 d, 14 d and 1 month after transplantation. Results One month later, FAM graft, GPAM graft and VXAM graft showed better curative effect than APAM graft. Ten days after transplantation, the amniotic membrane graft began to dissolve and desquamate, and disappeared completely till 14 d after transplantation. Amniotic membrane tissues were not found under light microscope in any rabbit. FAM graft dissolved most quickly, and APAM graft was the most slowly. The dissolution of GPAM graft and VXAM graft had no significant difference. Conclusion After amniotic membrane transplantation, it dissolves and sheds instead of fusing with recipient tissues. Corneal epithelium grows under amniotic membrane graft. Amniotic membrane graft transplantation should be called as amniotic membrane patching.

AIM:Recently,amnion transplantation has been one of effective methods for curing corneal alkali burn,but its biomechanism is unclear.This study was to discuss the efficiency of different kinds of amnion on rabbit corneal alkali burn and to find the bioactive functions of the amnion.METHODS:The experiment was carried out in the Central Laboratory of Experimental Animals at Chongqing University of Medical Sciences between January and July in 2004.All the disposals were in accordance with the ethical standard of animals.①Placenta from healthy puerperants underwent uterine-incision delivery were offered by Department of Obstetrics in the First Affiliated Hospital of Chongqing University of Medical Sciences.A total of 45 New Zealand rabbits were used for corneal alkali burn models and divided into fresh amniotic membrane(FAM),glycerin preserved amniotic membrane(GPAM),vacuum xeransis amniotic membrane(VXAM),alcolhol preserved amniotic membrane(APAM) and control groups,every group had 9 rabbits.②The FAM was prepared within 24 hours,and the preserved amnion were transplanted after 1 month.③The corneal opacity and corneal neovascularization were observed everyday during days 2-21 after operation and once every three days after days 21;corneal fluorescein staining was conducted to observe the repair of corneal epithelium on days 14,30,60 after operation;2 weeks,1 month and 2 months after operation,we did histopathological examination and scanning electron microscope observation.RESULTS:Forty-three rabbits were involved in the result analysis.①There were no significant differences in the corneal opacity and repair velocity of corneal epithelium among FAM,GPAM and VXAM,which were remarkably superior to APAM and controls.APAM group and control group had not distinct difference.②FAM had better effects on inhibiting corneal neovascularization than GPAM and VXAM.CONCLUSION:After transplantation,VXAM,GPAM and FAM can all accelerate corneal epithelial healing and lighten inflammation.FAM containing more bioactive materials,plays best.

ObjectiveTo observe and compare the efficacy of two types of microencapsulated rat islets xenotransplanted into diabetic mice. MethodsThe mice diabetic model made with injecting 3% Streptozotosin through tail vein. Four groups were assigned: control group, naked islet transplantation group, alginate-BaCl2 microencapsulated islet transplantation group, agarose-PSSa microencapsulated islet transplantation group.300 islets were transplanted under the renal envelope of each diabetic mice respectively. ResultsThere were no significant difference in mean level of the blood glucose before transplantation among four groups. One week after transplantation, the respective mean level of the blood glucose in four groups were (7.26±1.56) mmol/L in alginate-BaCl2 microencapsulated islet transplantation group, (7.14±1.04) mmol/L in agarose-PSSa microencapsulated islet transplantation group, (7.42±1.52) mmol/L in naked islet transplantation group and (22.54±1.24) mmol/L in control. There were significant difference between the two encapsulated islet groups and the other two groups. The survived period of the two encapsulated islet transplantation groups were longer than that of the other two groups. The survived period of the alginate-BaCl2 microencapsulated islet transplantation group was longer than that of the agarose-PSSa microencapsulated islet transplantation group (92 d vs 56 d),the same as the time of keeping nomal blood glucose level (76 d vs 41 d). ConclusionMicroencapsulated rat islets with this two materials can survive in diabetic mice with their biological activity, and the alginate-BaCl2 microcapsules are better than the agarose-PSSa microcapsules.

To prepare virus-like particles containing FluA/B mRNA as RNA standard and control in Influenza RNA detection, the genes coding the coat protein and maturase of E. coli bacteriophage MS2 were amplified and cloned into D-pET32a vector. Then we inserted 6 histidines to MS2 coat protein by QuikChange Site-Directed Mutagenesis Kit to construct the universal expressing vector D-pET32a-CP-His. In addition, the partial gene fragments of FluA and FluB were cloned to the down-stream of expressing vector. The recombinant plasmid D-pET32a-CP-His-FluA/B was transformed to BL21 with induction by IPTG. The virus-like particles were purified by Ni+ chromatography. The virus-like particles can be detected by RT-PCR, but not PCR. They can be conserved stably for at least 3 months at both 4 degrees C and -20 degrees C. His-tagged virus-like particles are more stable and easier to purification. It can be used as RNA standard and control in Influenza virus RNA detection.
Escherichia coli ; genetics ; metabolism ; Influenza A virus ; genetics ; metabolism ; Influenza B virus ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; RNA, Viral ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Ribonucleases ; chemistry ; Virion ; genetics ; metabolism