Total hip and knee replacements, which have developed for abou t forty years, have been widely used as effective surgical treatments for severe hip and knee diseases. This article discusses the recent advance in techniques of hip and knee replacement Chiefly in the aspects of hip or knee prosthesis des ign, improvement of materials and surgical techniques. In total hip replacement, second-generation cementing technique, new types of metal-on-metal prosthesi s and minimally invasive technique have been applied to enhance the stability, r educe the wear rate and facilitate the functional recovery. In knee replacement, mobile bearing and high flexion are great advancements made in design. The comp uter-aided operational technique has greatly improved the replacement.

Objective To investigate the clinical value and pathogenic mechanism of virulence genes of Helicobacter pylori from different sources of digestive diseases patients.Methods From January 2015 to July 2016,628 cases of gastric biopsy samples were collected from gastroscopy room of People′s Hospital of Wuwei City,through separating and culturing of Helicobacter pylori,detecting of viral virulence genes,to explore the relationship between Helicobacter pylori and chronic atrophic gastritis CAG),chronic superficial gastritis(CSG),peptic ulcer(PUD).Results Among the 628 gastric biopsy specimens,214 cases of Helicobacter pylori were successfully isolated,and 172 strains were serected to extracting DNA,which contained various virulence genes of cagA,vacA,dupA,iceA,oipA and luxS.VacA s1m1 was a risk factor for CSG,VacA s1m2 and iceA1+/iceA2+ increased the incidence of PUD,DupA + increased the risk of duodenal ulcer.Conclusion Different digestive diseases and Hp infection were related closely,dupA was considered as Hp induced duodenal ulcer marker gene,vacA s1m2 and iceA1+/iceA2+ increased the risk of PUD.

Objective To konw the Legionella contamination in the central air condition system and secondary water supply system in the public places of Jiangxi province. Methods 145 water samples were collected from the public places with central air conditioning system and secondary water supply system, in July to September in 2005-2006. Bacteria culture, hemagglutination test and duplex PCR test were used to identify Legionella. Results 15 Legionella strains was isolated from 145 samples, the positive rate was 10.34%, 7 Legionella strains was isolated from 78 samples of central air conditioning system, the positive rate was 8.97%, 8 Legionella strains was isolated from 57 samples of secondary water supply system,the positive rate was 14.04%. Conclusion It is necessary to strengthen the surveillance of Legionella in central air conditioning system and secondary water supply system.

Objective To observe the Smad5 gene knockout and induced-changes of auditory physiology and cochlea morphology in mouse, to explore whether Smad5 gene is a new gene related to hearing function. Methods Double blind control methods were used to detect the auditory threshold of auditory brainstem responses (ABR) in the mouse of Smad5 (+/+) to Smad5(+/-) and the cochlea morphology (cochlea paraffin-cut section and basal membrane spreading section). The hair cell count was also taken. Results As shown by ABR audiometry, the average hearing of Smad5 (+/-) mouse (aged 24 weeks) is 90.63?17.65 dB (SPL) and that of Smad5(+/+) mouse is 63?19.94 dB(SPL), which are of significant difference (P0.05). Conclusion Smad5(+/-) gene knockout can cause the mouse a auditory threshold decline in moderate or severe extent. Cochlea morphology indicated that hair cells (mainly outer hair cells) in mouse cochlea basal membrane became deficient. A mechanism of Smad5 gene knockout to caused the deafness and the deficiency of hair cells remained to be further studied.

BACKGROUND:Pain is the extremely common disease in clinic. At present, acupuncture provides good therapeutic effect on it. But, there are many methods in acupuncture with various advantages individually.To understand the differences in therapeutic effects on pain with various needling techniques is significant in clinic. In 1999, the relevant observation was carried on in the demand of Ecuadorian Medical Pain Association.OBJECTIVE: To observe the differences in therapeutic effects on pain with various needling techniques.DESIGN: Randomized controlled observation was designed.SETTING: Department of Pain, Hospital General de las FF. AA. Quito, Ecuador, Department of Traditional Chinese Medicine and 1st Department of Surgery, General Hospital of Chengdu MilitaryArea Command of Chinese PLA.PARTICIPANTS: Totally 360 cases of lumber strain and hyperplastic spondylitis were selected in Department of Pain, Clinic of Ecuadorian 3rd Military General Hospital from May 1999 to November 2000, in which,179 cases were lumber strain and 181 cases were hyperplastic spondylitis.The groups were randomized in two kinds of diseases, named for lumber strain, dermal-needling group (88 cases) and body-acupuncture group (91cases); for hyperplastic spondylitis, dermal-needling group (92 cases) and body-acupuncture group (89 cases).METHODS: Dermal needling and body acupuncture were used to treat the diseases respectively and the symptom changes were observed before and after treatment simultaneously. The treatment was given once every two days. 5 treatments made one basic course for lumber strain and 7 treatments for hyperplastic spondylitis. The treating results were evaluated according to Budzynski grading criteria on pain. MEPS statistical software was used for statistical management of data.MAIN OUTCOME MEASURES: Pain relieving before and after treatment with dermal needling and body acupuncture for lumber strain and hyperplastic spondylitis was evaluated. Correlative analysis on therapeutic effects and course of treatment for different diseases with same therapy and on same disease with different therapies were carried on.RFSULTS: Altogether 366 cases were observed and 6 of them were excluded. Totally, 360 cases finished the experiment. ① The severity was alleviated in pain grading after treatment with dermal needling and body acupuncture compared with that before the treatment (P ＜ 0.01). ② In treatment of lumber strain and hyperplastic spondylitis with dermal needling, the therapeutic effects on lumber strain were more remarkable (P ＜ 0.01). The therapeutic effects of dermal needling on lumber strain were superior to that of body acupuncture (P ＞ 0.05). ③ The therapeutic effects of body acupuncture group on pain of Ⅰ grade in hyperplastic spondylitis were remarkably better than that of dermal needling group,but the significant difference in the total therapeutic effects of two techniques did not present (P ＞ 0.05). ④ When pain grading was reduced by 1 level in two groups, the average times of treatment in dermal needling group were less than that in body-acupuncture group (P ＜ 0.05).CONCLUSION: Good therapeutic effects of dermal needling and body acupuncture are achieved for both hyperplastic spondylitis and lumber strain,in which, the therapeutic effects of dermal needling are remarkable on injury of soft tissue and achieved swiftly; body acupuncture improves pain in hyperplastic spondylitis more radically compared with dermal needling.

OBJECTIVE:To study the effect of paroxetine combined with low dose of olanzapine on sleep process and architec-ture of depression patients with insomnia. METHODS:84 depression patients with insomnia were randomly divided into control group and observation group. Control group was given 20 mg Paroxetine tablet,once every morning;observation group was addi-tionally given 2.5 mg Olanzapine tablet,once before going to bed. Sleep quality [Pittsburgh Sleep Quality Index(PSQI)],depres-sion scores [Hamilton Depression Scale (HAMD)],sleep process [sleep latency (SL),awakening times (AT),the actual total sleep time (TST),sleep efficiency (SE),rapid eye movement (REM) sleep latency (RL)] and sleep architecture [sleep stage 1 (S1),2(S2),3(S3)and the proportion of REM to sleep] in 2 groups before and 3,6 months after treatment and the incidence of adverse reactions(ADR)were observed. RESULTS:After treatment,PSQI and HAMD scores in 2 groups were significantly lower than before,and gradually decreased by time,and observation group was lower than control group;TST in observation group was significantly higher than before and control group,S1 in observation group was significantly lower than before,SE,S3 and REM in 2 groups were significantly higher than before,and observation group was higher than control group,SL,AT,RL and S2 were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). There were no obvious ADR in 2 groups. CONCLUSIONS:Paroxetine combined with low dose of olanzapine can sig-nificantly relieve depression,optimize sleep process and sleep architecture,then impove sleep quality.

Objective To evaluate the accuracy of vasopressin (VP) secretion in the late phase of septic shock for predicting patient outcomes and further investigate its relationship with the prognosis of septic shock.Methods Fifty-five patients presented at late phase of septic shock,who were admitted to the intensive care unit of our hospital,were enrolled.Their VP secretion was measured.The method for measurement was as follows:3％ sodium chloride solution 600 ml was infused over 2 h,serum concentrations of VP and sodium were measured before and after infusion,the difference in VP before and after infusion (△VP) and in Na before and after infusion (△Na) was calculated,and △VP/△Na was used to reflect VP secretion.The patients were divided into either abnormal secretion of VP group (△ VP/△ Na ≤ 0.5 ng/mmol) or normal secretion of VP group (△VP/△Na＞0.5 ng/mmol) according to △VP/△Na ratio.Immediately before testing VP secretion,venous blood samples were collected for determination of serum lactic acid and C-reactive protein concentrations.The consumption of vasoactive drugs at the moment of enrollment and 28-day fatality rate were recorded.Results There were 30 cases in abnormal group (54％) and 25 cases in normal group (46％).Compared with normal group,the serum lactic acid,C-reactive protein concentrations and consumption of dopamine or norepinephrine were significantly increased,and the 28-day fatality rate was increased (67％ vs 40％) in abnormal group.ROC curve analysis showed that when △VP/△Na 0.5 ng/mmol was used as the criteria for determining prognosis,the sensitivity was 66.7％,specificity was 64.0％,and the area under the ROC curve was 0.828.Conclusion VP secretion in the late phase of septic shock may affect patient prognosis.

OBJECTIVE:To investigate the effect of Bidouyan oral liquid(BOL) on granulocyte-macrophage colony-stimulating factor(GM-CSF) release,ultrastructure changes of eosinophil and epithelial cell proliferation in cultured tissue of nasal polyps METHODS:Nasal polyp tissue was cultured in medium containing different concentrations of BOL The growth of epithelial cells surrounding tissue block and ultrastructure changes of eosinophil in culture tissue were observed The content of GM-CSF in supernate was detected by ELISA RESULTS:In comparison with control,the neogenetic epithelial cells cultured in medium with BOL were fewer in number The contents of GM-CSF were decreased with the increase of the concentrations of BOL with significant differences(P

Objective To investigate the effects of inhibiting ubiquitin proteasome pathway(UPP) on proliferation of gastric carcinoma cells and the possible mechanism was discussed. Methods The gastric carcinoma cell strain SGC 7901 was treated with MG 132 to inhibit its UPP specially. The effect of growth suppression on cells was evaluated with MTT assay. Cell cycle and apoptosis were detected by flow cytometry(FCM). DNA fragment analysis was used for confirming the presence of apoptosis. The activity of telomerase was examined by TRAP PCR ELISA. Expression of p27kip1 was detected by immunocytochemical technique. Results MG 132 had great inhibitory effect on the growth of SGC 7901 cells. The FCM analysis showed that the ratio of G0/G1 phase of control group was (46.3?4.1)%, the ratio of G0/G1 phase of SGC 7901 cells treated with MG 132 increased to (72.1?5.0)% ( P

Objective To explore the clinical characteristics of the elder patients with the invasive fungal infections (IFI) in gerontal hematological malignant. Methods 38 patients with IFI during Jan 2000 to October 2007 were enrolled to analyze retrospectively. Results A total of 38 cases of gerontal hematological malignancies were diagnosed IFI. Occurrence of IFI correlated with agranulocytosis persistence >5 days, broad - spectrum antibiotics using >7 days, complicating diabetes, the hospitalized day longer than 20 days,chemotherapy scheme combined with glucocorticoids. IFI clinical manifestation varied with different infection sites and different fungal species. Lung was the frequently fungal infection site(25 cases, 65.8 %). The most common fungal subtypes were Candida albicans (14 strains, 38.9 %) and aspergillus (7 strains, 19.4 %).Although amphotericin B and itraconozole were adopted to treat IFI, but there were still 10 cases of patients died because of severe respiratory failure. Conclusion Elder patients with gerontal hematological malignant with a marked increasing mortality of IFI, prognosis was poor. Morbidity concerned with many factors, early prophylaxis or empiric antifungal treatment should be adopt.