BACKGROUND:Posterior stabilized femoral knee prosthesis needs additional condyle osteotomy to accommodate the tibial post and femur fossa structures. Intercondylar fossa on both sides connected at the femoral body with concentrated stress is a place easily affecting fractures. Differences in bone mass between different models of different brands did not have specific data, which was not convenient to select prosthesis for clinicians.
OBJECTIVE: To compare the difference of intercondylar osteotomy data among clinical commonly used posterior stabilized knee prostheses (six imported and domestic brands), and to provide basis for the selection and application of the prostheses.
METHODS:The current commonly used posterior stabilized knee prostheses (six imported and domestic brands) were used, including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, Depuy PFC Sigma, Smith & nephew Genesis-2 PS, United-U1 and Wego GKPS. According to the osteotomy template, the osteotomy-surfaces consisting of femoral condyle starting section and cross section, distal section of femoral condyle, and back-oblique section were identified. The corresponding femoral prosthesis diameter lines included condylar ambilateral and anteroposterior diameters, width and depth of femoral intercondylar fossa. The above data were compared and measured.
RESULTS AND CONCLUSION:The six kinds of knee femoral prostheses were different in ratio of ambilateral diameter and anteroposterior diameter, bone resection of intercondylar fossa, and geometry. Imported prostheses carry shorter diameters in femoral starting and cross sections, so it can catch more posterior condylar osteotomy. With increasing prosthesis sizes, the ratio of bone loss causing by width of intercondylar osteotomy is decreased among six brands. In al sizes, Stryker Scrorpio NRG Knee-Flexed catches shorter width of intercondylar osteotomy. Knee prosthesis osteotomy among six brands is different. The result of this study is not sufficient to evaluate the pros and cons between different prostheses, but as reserving bone is concerned, the design of less intercondylar osteoomy catches more advantages.

Objective To explore the effect of prognostic nutrition index (PNI) on the overall survival time of patients with brain metastases of lung adenocarcinoma.Methods A retrospective analysis was performed on the clinic data of 274 patients who were admitted to our hospital and confirmed with brain metastases of lung adenocarcinoma from May 2013 to May 2016.The prognosic factors for brain metastases such as PNI,gender,age,smoking history,epidermal growth factor receptor (EGFR) mutation status,Karnofsky performance status (KPS) score,the number of brain lesions,treatment of brain lesions,extracranial metastases and the status of primary disease were analyzed.The receiver operating characteristic (ROC) curve was drawn to determine the optimal cut-off value of PNI,and the patients were divided into high PNI group and low PNI group.The univariate and multivariate prognostic analyses were performed by the Log-rank test and the Cox proportional hazards model.Results The patients were divided into high PNI (＞ 50.45) group (n =72) and low PNI (≤50.45) group (n =202).The median overall survival (OS) was 11.20 months in all patients with brain metastases,and the median OS of the low PNI group and high PNI group were 10.13 months and 15.17 months respectively.The univariate analysis results showed that gender (x2 =5.459,P =0.019),age (x2 =3.986,P =0.046),smoking or not (x2 =6.878,P =0.009),EGFR mutation status (x2 =20.484,P＜0.001),KPS score (x2 =126.573,P ＜ 0.001),extracranial metastases or not (x2 =4.403,P =0.036),treatment on the brain lesions (x2 =40.444,P ＜ 0.001) and PNI (x2 =7.972,P =0.005) were related to the prognosis.The Cox multivariate analysis results showed that age (HR =1.580,95％ CI:1.104-2.295,P =0.012),EGFR mutation status (HR =0.549,95％ CI:0.408-0.738,P ＜ 0.001),KPS score (HR =0.077,95％CI:0.045-0.134,P ＜ 0.001),treatment on brain metastases (HR =0.882,95％ CI:0.789-0.987,P =0.029) and PNI (HR =0.614,95％ CI:0.437-0.861,P =0.005) were related to the prognosis.Conclusion PNI is an independent prognostic predictor of brain metastases in patients with lung adenocarcinoma,and the high-PNI is correlated to the long OS of patients with brain metastases of lung adenocarcinoma,which has certain clinical practical value.

Objective To explore the application of new-type cardio-pulmonary resuscitation (CPR) marking table in CPR teaching and assessment of new students.Method The students were divided into five-year group and four-year group based on different cultivation durations;the five-year group received conventional teaching while the four-year group received targeted teachingfocusing on key points on that basis.The assessment of both groups applied this marking table to compare average score,failure rate,full mark rate and error rate of 13 operations in marking table between the two groups.With the help of SPSS 19.0 software,the results were analyzed by t-test and chi-square test.Result The four-year group was higher than five-year group in average score and full mark rate (t=3.118,P=0.002;x2=26.798,P=0.000),but it was lower than five-year group in failure rate (x2=14.159,P=0.000),the difference was statistically significant.The error rate of 9 operations in five-year group,including on-sitesafety assessment (x2=44.764,P=0.000),calling for help (x2=8.854,P=0.003),press part (x2=10.236,P=0.001),press depth (x2=140.775,P=0.000),press interruption＜10 s (x2=7.377,P=0.007),opening airway (x2=20.209,P=0.000),twice effective artificial respiration (x2=37.669,P=0.000),evaluation (x2=20.898,P=0.000) and humanistic care (x2=45.673,P=0.000),were higher than that in four-year group;the difference of error rate of 4 operations between two groups was not statistically significant,including recognizing sudden cardiac arrest (x2=3.316,P=0.069),press frequency (x2=0.234,P=0.629),full resilience (x2=0.18,P=0.671) and press point movement (x2=3.614,P=0.057).Conclusion The new-type CPR marking table objectively reflects students' operation,summarizes operation errors and gives feedback of guidance teaching,so it is applicable for mass assessment with convenient use and less teaching load.