ObjectiveTo probe into the dependability of trochlear line (TL) as the reference axis for femoral component rotation in total knee arthroplasty.MethodsEighty-nine healthy adults had computed tomography (CT) scan for knees to position the surgical transepicondylar axis (STEA),posterior condylar line (PCL) and TL on the transverse sections.In the meantime,the angles including angle between TL and STEA (TSA),angle between TL and PCL (TPA) and angle between PCL and STEA (PCA) were measured and compare the dependability of TSA and PCA.ResultsThe TSA,TPA and PCA were (6.77 ± 3.12) °,(4.22 ± 2.64) ° and (2.95 ± 1.77) °,respectively.Three types of angles showed no statistical differences between males and females or between right knees and left knees (P ＞0.05).Rank sum test displayed significant differences in the overall distributions of three kinds of angles ( HC =66.837,P ＜0.01 ).The coefficient of variation of TSA was insignificant,but the standard variation was significant (3.12°).ConclusionTL can be considered only as the subsidiary femoral rotation osteotomy axis in total knee arthroplasty.

0 05). No adverse reaction was seen in all patients. Our results suggest that intravenous Pantoloc is a good proton pump inhibitor in patients with duodenal ulcer combined with upper gastrointestinal bleeding, and it is similar to Losec in effectiveness and safety.

BACKGROUND: Centrifugal force is a contributing factor inducing osteoblastic differentiation from bone marrow stroma cells.OBJECTIVE: To explore whether centrifugal force promote osteoblastic differentiation from rabbit marrow stroma cell seeded on polylactic-co-glycolic acid (PLGA) scaffolds. METHODS: Rabbit bone marrow stroma cells were isolated and cultured by whole bone marrow method, purified by attachment method, and digested by trypsin-EDTA at 80% confluency. The cell concentration was adjusted to 1×10~9/L. PLGA was cut into pieces, 5 mm×5 mm, soaked in serum-conditioned culture medium for 24 hours. The third passage of bone stroma cell suspension at a density of 300 μL was respectively seeded into the PLGA material. The scaffold/cell compound was placed in centrifuge tube, with cell at the upper layer and cultured in osteoblastic induced medium containing antiscorbic acid, β-sodium glycerophosphate, and dexamethasone respectively under centrifugal force every 12 hours (1 000 r/min for 30 minutes, relative centrifugal force 132 g) and static condition. Alkaline phosphatase activity, osteocalcin content and calcium content as well as observation by light microscopy were used to evaluate osteoblastic differentiation. RESULTS AND CONCLUSION: After 16 days of in vitro culture, the scaffolds of centrifugal force group were coated by multiplayer cells and mineralized matrix, but only a thin layer of cells were observed on the scaffold of control group. The centrifugal force system resulted in a significant decrease in alkaline phosphatase activity at day 2 (P < 0.05) but significant increase at day 4 compared with the static culture condition (P < 0.05). During the whole culture time, osteocalcin secretion remained low in control group. At days 12 and 16, a significant enhancement in osteocalcin secretion was observed for centrifugal force culture compared with static culture conditions (P < 0.05). Moreover, after 16 days of culture a significant increase in calcium deposition was observed in the scaffolds subjected to centrifugal force compared with static culture condition (P < 0.05). Centrifugal force can enhance osteoblastic differentiation and mineralized matrix production of bone marrow stroma cell seeded in PLGA.

Objective To compare the clinic effect of the locking compression plate (LCP) fixation and the anatomical plate in treatment of high-energy distal tibial fractures. Methods The study involved 42 patients with high-energy distal tibial fractures treated between May 2003 and May 2009. The anatomical plate group included 24 patients ( 16 males and 8 females, at average age of 39 years), of whom there were 13 patients with type A fractures, five with type B and six with type C according to the AO/ASIF classification. The LCP group included 18 patients ( 15 males and 3 females, at average age of 40 years), of whom there were 11 patients with type A fractures, three with type B and four with type C according to the AO/ASIF classification. All the patients were followed up for 8-17 months. Their functional and radiographic outcomes were collected. The operation time, intra-operative blood loss, X-ray exposure, bone healing time, post-operative complications and therapeutic effects were compared between both groups. Mazur's criteria was used to evaluate the function of the ankle. Results The LCP group was followed up for average 11.6 months and the anatomical plate group for average 14.2 months, which showed fracture healing in all the patients. The bone graft in the anatomical plate group was used more frequently than the LCP group, while the X-ray exposure in the LCP group was much more than that in the anatomical plate group. The operation time, incision size, blood loss, postoperative complications and radiographic bone healing time in the LCP group were significantly less than those in the anatomical plate group. Conclusions Both the LCP and anatomical plate are effective methods for the high energy distal tibial fractures. LCP has advantages of less trauma, quick fracture healing and less complications, is consistent with the biomechanics of internal fixation and hence is an ideal method for the treatment of the high-energy tibial fractures.

Objective To determine the reference intervals for thyroid function tests during the second half of pregnancy (20-40 gestational weeks),and to assess the relationship between thyroid peroxidase antibody (TPOAb) levels and the incidence of gestational thyroid diseases.Methods Levels of thyroid stimulating hormone (TSH),free thyroxine (FT4),TPOAb and urinary iodine excretion were determined in 4 729 pregnant women,who received prenatal health care at First Affiliated Hospital of Nanjing Medical University from July 2011 to August 2013.Among these women,2 568 were selected using the recommendations of the American National Academy of Clinical Biochemistry,and were divided into five groups according to their gestational age:≥ 20 to ＜24 weeks (682 cases),≥ 24 to ＜28 weeks (1 322 cases),≥ 28 to ＜32 weeks (178 cases),≥ 32 to ＜36 weeks (185 cases) and ≥ 36 to ≤ 40 weeks (201 cases).Reference intervals of thyroid function tests in the second half of pregnancy were calculated.The reference values of thyroid functions in different gestational weeks were compared,and the reference intervals of thyroid functions in the second half of pregnancy were determined.The effects of maternal age and positive TPOAb on gestational thyroid diseases were analyzed.A non-parametric test,analysis of variance or Chi-square test was used for statistical analysis.Results (1) Reference intervals for maternal thyroid function in the second half of pregnancy in our hospital were established [TSH:0.65-5.27 mU/L and FT4:8.74-14.84 pmol/L].(2) The percentage of thyroid diseases was higher using the non-pregnancy reference intervals (TSH:0.27-4.20 mU/L and FT4:12.00-22.00 pmol/L) than using the pregnancy reference intervals [64.0％ (3 025/4 729) vs 16.1％ (763/4 729),x2=47.465,P ＜ 0.01],which manifested as a higher rate of clinical hypothyroidism and simple hypothyroxinemia [5.4％ (255/4 729) vs 0.4％ (20/4 729),x2=14.321;54.1％ (2 560/4 729) vs 9.1％ (429/4 729),x2=47.108;both P＜0.01] and a lower rate of subclinical and clinical hyperthyroidism [1.2％ (58/4 729) vs 3.3％ (155/4 729),x2=6.650;0.3％ (13/4 729) vs 0.6％ (27/4 729),x2=2.062;both P＜0.05].(3) The incidence of clinical hypothyroidism and simple hypothyroxinemia in pregnant women aged ＞30 years was higher than in those aged ≤ 30 years [0.7％ (10/1 377) vs 0.3％ (10/3 352),x2=4.257;11.7％ (161/1 377) vs 8.0％ (268/3 352),x2=16.102;both P＜0.05].The incidence of clinical hypothyroidism and clinical hyperthyroidism in TPOAb positive women was higher than that in TPOAb negative women [2.7％ (9/335) vs 0.3％ (11/4 394),x2=44.009;3.9％ (13/335) vs 1.2％ (52/4 394),x2=16.784;both P＜0.01].Conclusions The established pregnancy-specific reference ranges of thyroid function tests can reduce the missed diagnosis and misdiagnosis of gestational thyroid diseases.Maternal age ＞30 years and positive TPOAb may increase the risk ofgestational thyroid diseases.

Objective To observe the clinical outcome of modified posterolateral approaches for the treatment of posterolateral tibial plateau fractures. Methods From January 2012 to January 2015,13 patients with posterolateral tibial plateau fractures were identified in the Second Hospital of Changzhou Affiliated to Nan?jing Medical University. All the posterolateral fractures were fixated with a plate. The knee function was evaluated at the last follow?up by the Hospital for Special Surgery( HSS) Score,and the occurrence of postoperative compli?cations were observed. Results Thirteen patients were followed up for an average of 14. 4 months,all patients obtained bony union. There were no significant differences regarding the mean HSS score among 3 months, 6 months and 1 year post?operation((71. 6±1. 5) points, (76. 4±1. 6) points, (83. 2±1. 1) points;P=0. 154) . There were no significant differences regarding the tibial plateau angle and posterior slope angle on radiograph?ies of inside and outsideamong immediate,6 and 12 months postoperation((83. 7±1. 7)°,(84. 3±1. 5)°,(85. 1 ±1. 4)°,(85. 4±1. 5)°;(7. 7±1. 5)°,(7. 7±1. 4)°,(7. 7±1. 3)°,(7. 6±1. 8)°;P=0. 223,0. 191). No com?plications associated with the approach were observed and there was no infection,no malunion or fixation failure either. Conclusion In the treatment of posterolateral tibial plateau fractures,the modified posterolateral approa?ches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating.

Objective: To investigate the influencing factors and population attributable risk percent (PAR%) of low back pain in automobile assemblers. Methods: A total of 634 assemblers from 11 automobile manufacturers in Shiyan City, Hubei Province were chosen as research subjects using judgment sampling method. The prevalence of low back pain in the past one year was investigated using Musculoskeletal Disorders Questionnaire. PAR% was used to analyze the contribution of influencing factors to low back pain. Results: The annual prevalence of low back pain was 68.8%. The results of multivariate logistics regression showed that length of service>15 years, high school or secondary college education or above, standing most of the time, sitting most of the time, the proportion of cumulative time of poor posture in work shift time ≥1/8, and bending for insufficient height of working space were the risk factors for low back pain (all P<0.05). The PAR% of the proportion of cumulative time of poor posture in work shift time ≥1/8 was 43.0%, 37.8% for standing most of the time, and 12.8% for bending for insufficient height of working space. Conclusion: The annual prevalence of low back pain was higher in automobile assemblers. The influencing factors included individual factors and occupational factors. The proportion of cumulative time of poor posture in work shift time ≥1/8, standing most of the time and bending for insufficient height of working space should be taken as the priority intervention factors to reduce the prevalence of low back pain among assemblers in this enterprise.

Objective To describe the current status and associated risk factors on child abuse in children aged 7-12 in rural areas of Ningxia.Methods Using multistage sampling method to select townships and villages.Children aged 7-12 and their guardians were selected by random sampling method in those villages.Current status on child abuse was described under related percentage while logistic regression model was used to evaluate the risk factors associated with child abuse.Results A total number of 704 children aged 7-12 from 15 villages in two counties were interviewed.Among them,359 (50.2％) children had experienced child abuse (include physical abuse,negligence,emotional/ physical abuse and sexual abuse) in the past year.Physical abuse (44.6％) was the most frequent one in all the child abuse cases.Only 10 (1.4％) children had a comprehensive understanding of ‘child abuse’.55.5％ of the children had ever reported this problem to their parents or teachers when suffered from abuse episodes.Results from the logistic regression model showed that factors as:being boys (OR=1.37,95％ CI:1.01-1.85),under Han nationality (OR=1.49,95％CI:1.06-2.08),at younger age (OR=1.16,95％CI:1.05-1.28),staying with single parent (OR=2.05,95％CI:1.16-3.64) and from wealthy family (OR=1.55,95％CI:1.03-2.33) were at risk for child abuse.Conclusion Child abuse in rural areas in Ningxia was a serious problem,Children' s cognitive to child abuse was very low.More attention should be paid to children with the following characteristics as:being boys,under Han nationality,at younger age,staying with single parent.

Objective: To study the effect of noise on hypertension and hyperglycemia among occupational workers. Methods: Total 670 workers in an automobile manufacturing company were selected as the subjects of physical examination in 2017. According to the noise exposure or not, the subjects were divided into control group (no noise exposure) 143 and contact group (noise exposure) 527. Questionnaire survey and physical examination were conducted. The measurement data were analyzed by t-test, and the count data and grade data were analyzed by χ² test. The influence of noise on blood glucose, heart rate, blood pressure and other indicators was analyzed by logistic regression, and the OR and 95%CI of each risk factor were calculated. Results: The average age of the control group and the contact group was no significant difference (P>0.05) . There were 139 (20.7%) cases of high systolic pressure, 154 (23.0%) cases of high diastolic pressure, 63 (9.4%) cases of hyperglycemia, 29 (4.3%) cases of tachycardia. Compared with the control group, there were significant differences in systolic blood pressure, diastolic blood pressure and blood glucose in the contact group (P<0.05) . Compared with the control group, the systolic blood pressure, diastolic blood pressure and blood glucose of the subjects in the corresponding age contact group increased significantly (P<0.05) . The years of noise exposure were protective factors for systolic and diastolic blood pressure (OR=0.970, 0.973) . Conclusion Noise exposure may increase blood pressure and blood sugar of occupational workers, but the effect on heart rate can not be determined.

Objective To study the physical activities for myopia in children. Methods ICF theory and literature research were used to analyze the current status of myopia in children, as well as the related factors, and mechanisms of formation and improvement, and discussed the physical activity for their visual function and overall development. Results Myopia was epidemic and began in low ages. The related factors mainly included focus time, less in physical activities, stress in education and poor vision environment. Myopia happened through the ciliary muscle spasm and synergistic dysfunction. Physical activity played a role like adjustment function training to improve the function of ciliary muscles, and promote the development of vision.Conclusion Development of special physical activities based on the theory of ICF may improve the visual function in children and promote their overall development.