Objective To analyse the causes of complications and accidents of arthroscopy and a discussion of the preventive measures. Methods 1 540 cases of arthroscopy were carried out from May 1980 to May 1999, including 1 426 cases of the knee, 59 of the ankle, 17 of the wrist, 21 of the first metatarsophalangeal joint, 8 of the hip, 6 of the elbow and 3 of the shoulder. Results Surgical instruments (blade, tip of forceps) broken in the articular cavity took place in 8 cases, injury of the normal tissue including the cartilage, meniscus, and ligaments happened in 40 cases, nerve branch and vascular injured around the inlets in 11 cases, water seeping out in 13 cases, infection following the formation of hematoma in 5 cases, refracture of patella during operation in 1 case, myocardial infarction after operation in 1 case, totally, complications and accidents were seen in 79 cases (5.1％ ). Conclusion Arthroscopic complications are mainly related to unskillful manipulation of the instruments, poor team work, inadequate exposure of intra-articular structure and negligence of timely replacing the nearly worn parts of the apparatus. The complications can all be prevented by improving above mentioned points.

OBJECTIVE:To observe therapeutic efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute decompensated heart failure (ADHF). METHODS:129 ADHF patients admitted in our hospital during Jul. 2013-Jul. 2015 were randomly divided into observation group(69 cases)and control group(60 cases). Control group was giv-en routine treatment. Observation group was additionally given rhBNP 1.5 μg/(kg·d)vein shock(d1),and then rhBNP 1 mg+5%Glucose injection 100 ml by 0.007 5 μg/(kg·min),ivgtt(d2-4). Treatment courses of 2 groups lasted for 7 d. Therapeutic efficacy and heart function indexes [left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDd)] were observed in 2 groups as well as NT-proBNP level,medication fluid intake and urine volume 24 h after medication. The occurrence of ADR was observed. RESULTS:3 cases dropped out and 66 cases were included finally in doservation group. Total effective rate of AD-HF therapy in observation group (96.97%) was significantly higher than in control group (86.67%),with statistical significance (P<0.05). There was no statistical significance in LVEF,LVDd and NT-proBNP between 2 groups before treatment(P>0.05). Af-ter treatment,LVEF of 2 groups were increased significantly while LVDd were decreased significantly;LVEF of observation group [(42.3±3.6)%] was significantly higher than in control group[(37.9±3.3)%],while LVDd of observation group [(55.5± 3.6)%] was significantly lower than in control group[(61.3 ± 3.4)%]. NT-proBNP levels of 2 groups were decreased significant-ly,and the observation group [(1 389.5±29.6)pg/ml] was significantly lower than the control group [(2 778.0±26.8)pg/ml]. 24 h after medication,urine volume of 2 groups were significantly higher than medication fluid intake,and urine volume of observation group [(1 781.4 ± 89.7)ml] was significantly higher than that of control group [(1 372.6 ± 78.3)ml],with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (3.03%) and control group (5.00%),without statistical significance(P>0.05). CONCLUSIONS:rhBNP is significantly effective for ADHF,promotes heart function recovery and reduces renal function injury with good safety.

Objective Onto investigate the indoor quality control method for qualitatively detecting the laboratory indicators of TORCH infection (rubella virus IgG ,cytomegalovirus IgG and IgM ,toxoplasma IgG and IgM ) .Methods The statistical method , normal distribution data ,ratio and standard deviation of positive rate detected by the ELISA method were adopted ,1+2s was set as the out of control rules ,the semi Lerey‐Jennings quality control chart was drawn;the direct probability calculation method was a‐dopted for the non‐normal distribution data and small probability event .The testing data of 57 batches were retrospectively ana‐lyzed .Results The positive rate of rubella virus IgG was 86 .66% ,cytomegalovirus IgG/IgM positive rates were 98 .87% and 0 .13% ,toxoplasma gondii IgG/IgM positive rates were 2 .43% and 1 .71% ,the data of 151 ,3 ,5 ,176 ,27 samples had the critical value range of five indicators .The number of out of control was once for cytomegalovirus IgG ,once and 4 times for Toxoplasma gondii IgG/IgM .Conclusion The indoor quality control for the ELISA qualitative detection of TORCH infection can adopt the data of daily detection positive rate or negative rate for monitoring the false positive .The critical value range of specimens should be fur‐ther conducted the recheck or confirmation experiment .

BACKGROUND:The comfortable shoes can absorb or reduce the impact force from the ground. Is the damped system is absent in shoes to relieve the impulse,the feet will be extremely tired,even damage the human knee joint,waist,back and brain. OBJECTIVE:To measure the changes of human plantar pressure by different sole hardness through the measurement system of plantar pressure. DESIGN,TIME AND SETTING:An observation experiment was performed in the Shanghai University of Sport between December 2008 and February 2009.PARTICIPANTS:Six volunteers wearing the experimental designed shoes were recruited from Nanjing Institute of Physical Education.METHODS:Three pairs of experimental shoes weighing 103 g were measured with shore hardness tester,as 51,62 and 69 hardness values. Accordingly they were named soft shoes,medium hardness shoes and hard shoes. The subjects were asked to do a 60-minute walk test at the speed of 2 m/s on the running platform with the experimental designed shoes,and they were determined using the insole plantar pressure measurement system of German's Novel style series of Emed-pedar.MAIN OUTCOME MEASURE:The pressure,contact area and impulse in the sole of foot.RESULTS:With the increase in hardness soles,the pressure of center plantar was shown to move from the medial first metatarsal outwards by turns. Compared with barefoot walking,the trail length of the center plantar was prolonged in subjects with medium hardness shoes and hard shoes,while shortened in subjects with soft shoes. The total pressure when you walked with soft shoes and medium hardness shoes were reduced than barefoot walking,and the pressure of walking phase wearing these two types of shoes were also reduced,while total pressure and walking phase pressure with hard shoes were both increased compared with barefoot walking. The contact area was similar between soft shoes and medium hardness shoes,but the smallest in the hard shoes. Except the increase in the initial 10 minutes,the soft shoes had no change with the medium hardness shoes. The hard shoes were firstly increased but then declined. The total impulse of medium hardness shoes was the closest to bare feet,while that of soft shoes and hard shoes were increased compared with bare foot.CONCLUSION:The plantar pressure was the greatest in the hard shoes,then medium hardness shoes and last soft shoes;the contact area was the greatest in soft shoes,then medium hardness shoes and last hard shoes;the impulse was the greatest in hard shoes,then soft shoes,and last medium hardness shoes.

Objective To explore the clinical characteristics of localized peritoneal mesothelioma by the retrospective analysis of the clinical data and its relationship with asbestos exposure.Methods A total of 22 cases with localized peritoneal mesothelioma confirmed by pathological test and they were selected as our subjects in the Central Hospital of Cangzhou from Jan.2007 to Dec.2012.The information of all cases was collected.The incidence,asbestos exposure history,clinical manifestations,imaging studies,pathological type,immunohistochemistry and tumor markers of peritoneal mesotheliom patients were recorded or measured.Results Of 22 cases,female accounted for 68.18％.The periods from onset symptoms to treatment time was from 2 days to 1 year with an average of 83 days.Clinical symptoms were verified including localized abdominal pain (11 cases,50.00％),abdominal mass (8 cases,36.36％),abdominal distension (6 cases,27.27％),ascites (10 cases,45.45％).Patient was with increased platelet and carcinoma antigen 125.Abdominal computerized tomography showed that local mass was seen and 12 cases were with asbestos spot.Ultrasound-guided peritoneal biopsy was confirmed as the main diagnostic method followed by Laparotomy.Epithelial type was the main pathological type (19 cases,86.36％),following the fleshy tumor type and mixed type.Eighteen cases had asbestos exposure history.Conclusion Localized peritoneal mesothelioma is a rare disease.However,the incidence is high in the current region due to asbestos exposure.Abdominal pain and local mass are the main clinical symptoms,and the main pathology is epithelial typeas well as surgery is the main therapy.

Objective To investigate the change of serum CA724, CA242 and AFP levels before and after transcatheter artery chemoembolization (TACE) treatment of primary hepatic carcinoma(PHC)patients as well as its clinic significance. Methods Patients of PHC (n=45) and healthy adults (n=40) were enrolled. Serum samples were collected from each healthy people and PHC patients 2 days before TACE,l week and 1 month after TACE. Electrochemiluminescence Immunoassay (ECLI) was used to determine serum CA724, CA242 and AFP levels, and correlations among three indexes as well as their relationships with clinical data were also analysed., Change of serum CA724 and CA242 levels before and after TACE were compared in AFP<400μg/L group and AFP≥400μg/L group. Results Serum levels of CA724, CA242 and AFP in PHC group were significantly higher than that in healthy control groups before TACE therapy(P<0.05). Positive rates of serum CA724 and AFP were higher in PHC group(P<0.01)than that in healthy control group. AFP decreased significantly at both 1 week and 1 month upon TACE treatment compared with that at before teratment(P<0.01). CA724 was significantly lower at one month after treatment than that at before treatment(P<0.05). But there was no significant difference in CA242 before and after treatment(P>0.05). CA724 and AFP expressions are associated with tumor size(P<0.05). After one month of therapy, serum CA724 level was obviously decreased in both AFP<400μg/L and AFP≥400μg/L groups. Before and after TACE therapy, there was a positive correlation between the expression of AFP and CA724(r=0.754,P<0.05). Conclusion Serum CA724 can be used as one of the tumor markers to assist the evaluation of curative effect of TACE on PHC.

Objective To investigate the association between serum level of secretory type Ⅱ phospholipase A2 (sPLA2 Ⅱ a) and carotid intima-media thickness (CIMT) in elderly patients with metabolic syndrome (MS).Methods A total of 124 consecutive MS patients aged over 65 years were enrolled and another 90 elderly non-MS subjects were served as controls.The serum concentration of sPLA2 Ⅱ a was measured by enzyme-linked immunosorbent assay.Blood pressure,blood lipids and blood glucose levels etc.were also measured.The carotid intima-media thickness was examined by color Doppler ultrasonography.Results Serum level of sPLA2 Ⅱ a was significantly higher in elderly MS patients than in control group [(4.41±1.55)μg/L vs.(2.39±0.97)μg/L,P＜ 0.05].Compared with the control group,elderly MS patients showed CIMT was significantly increased [(1.17±0.24) mm vs.(0.89±0.24)mm,P＜0.05].Serum level of sPLA2 Ⅱ a were higher in elderly obesity patients than in normal BMI subjects [(4.76±0.99)μg/L vs.(2.84±0.54)μg/L,P＜0.05].Multiple regression analysis indicated that sPLA2 Ⅱ a level was an independent risk factor for CIMT in elderly MS patients after adjusting for the effects of BMI,IL-6 and high sensitive C-reactive protein (hs CRP) on CIMT(r=0.38,P＜0.01).Conclusions Serum level of sPLA2 Ⅱ a is increased in elderly MS patients and is independently correlated with CIMT,which has a predictive value for atherosclerosis,sPLA2 Ⅱ a may be involved in the process of vascular endothelial injury.

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.

Objective To detect the level of CD64 and serum procalcitonin (PCT ) and investigate the diagnosis value of CD64 and serum PCT in cirrhosis patients with spontaneous bacterial peritonitis (SBP) .Methods Participants were categorized in‐to three groups including liver cirrhosis with SBP(45 patients) ,liver cirrhosis without SBP(93 patients) and health personnel(50 persons) .CD64 was detected by flow cytometry and serum PCT was measured by electroc hemiluminescence immunoassay .The li‐mosis vein blood samples were obtained from the patients with SBP at the time of 24 h after admission ,before antibacterial drugs use and 7 days after the effective treatment of antibacterial drugs .The CD64 and serum PCT were detected with the limosis vein blood samples .At the same time ,the complete blood count ,liver ,kidney and blood coagulate functions were tested .The participants in other two groups were detected the CD64 ,serum PCT ,complete blood count ,liver ,kidney and blood coagulate functions at the same time .Results The level of CD64 and serum PCT in cirrhosis patients with SBP were significantly higher than those in liver cirrhosis without SBP and normal controls (P< 0 .01) .ROC curve analysis showed that the sensitivity and specificity of CD64 and serum PCT were 95 .5% ,93 .8% and 96 .1% ,85 .2% respectively .Conclusion CD64 and serum PCT can be determined as the im‐portant indicator in early diagnosis and efficacy criterion .

Objective To study the relationship between the risk of malignant tumor and occupational radiation factor among medical diagnostic X-ray workers in Jiangsu province.Methods The retrospective and prospective cohort studies were adopted to investigate the incidence of cancer.Eligible medical diagnostic X-ray workers from the department of radiology in hospitals were selected and assigned into exposure group,while other medical workers from the departments of Internal Medicine,Ear-NoseThroat (ENT) or Pediatrics who attended work at the same period in the same hospital but not engaged in radiation work were regarded as control group during 1950-2011 in Jiangsu province.We calculated the total person-year and analyzed the relative risk (RR) of malignant tumor using Poisson regression model.Results 7 703 participants (3 961 in exposed group and 3 742 in unexposed group) were recruited and followed up,with a total of 315 309 person years and the lost follow-up rate was 6.92％ (533/7 703).During the follow up period,a total of 819 tumor cases were identified (771 were malignant tumors).We found the significant relationship between the risk of malignant tumor and occupational radiation factor,and the RR of solid cancer and total malignant tumor were 1.31 (95％ CI:1.11-1.55) and 1.33 (95％ CI:1.13-1.57),respectively.In addition,the risk of lung cancer in medical diagnostic X-ray workers was significantly higher than that in control group (RR =1.45,95％ CI:1.00-2.09).Conclusions The incidence risk of lung cancer,solid caner and total malignant tumors in medical diagnostic X-ray workers was significantly higher than that in the control group,which might be associated with occupational exposure to ionizing radiation.