BACKGROUND: With the development of new materials and the improvement of prosthesis design, total knee arthroplasty(TKA), a commonly used surgery, has exhibited satisfying effect on the treatment of rheumatoid arthritis and osteoarthrosis. However, many problems still remain a headache to operation performers.OBJECTIVE: To discuss how to select the prosthesis for total knee replacement and to summarize the key factors that affect the curative effect.DESIGN: A controlled study of the effect before and after the operation.SETTING: Department of Orthopedics, First Hospital of Xi'an Jiaotong University.PARTICIPANTS: Thirty-six patients(24 males and 12 females) who received TKA in the Department of Orthopaedics, First Hospital of Xi'an Jiaotong University during February 2000 to September 2003 were included in this study.METHODS: A retrospective study was carried out. Thirty-six patients(48knees) underwent total knee replacement, and the knee joint function was evaluated with American John N Install scoring system. The post-operation effect was evaluated by comparing the scores of each diseased knee before and after the operation.MAIN OUTCOME MEASURES: The function of knees and the score of every knee before and after operation were evaluated.RESULTS: The mean score before operation was 39, but it was 85 after follow-up visit. Totally 95% of them were up to the standard. The pain was reduced after the operation. The flexion-extension function and mobility of the knee joints improved obviously.CONCLUSION: TKA with posterior stabilized prosthesis and resection of posterior cruciate ligament(PCL) improved the function of the diseased knees after the operation. And the operation was simple and without complications. The key factors that affect the curative effect include the mechanical balance of the soft tissues during the operation, perioperative anticoagulant treatment for the prevention of deep vein thrombosis(DVT) and postoperative rehabilitation training. Peripheral tissue of knee joints should be released adequately; otherwise, it may cause unstable joint or limitation of joint activity.

OBJECTIVEThe purpose of our study was to evaluate the predictive factors of the presence of invasive carcinoma associated with intraductal papillary mucinous neoplasm (IPMN) of the pancreas on MDCT and MRI.

METHODSPreoperative MDCT or/and MRI of 27 consecutive patients (19 men, 8 women, mean age 61.3 years) who had undergone surgical resection and had a pathological diagnosis of IPMN were retrospectively assessed. The type of ductal involvement, solid appearance of the lesion, location, tumor size of branch duct type and combined type lesions, maximum diameter of the tumor, caliber of the main pancreatic duct and the extent of the common bile duct dilatation were assessed on CT and MRI and correlated with the pathological findings of the invasive carcinoma. Two abdominal radiologists reviewed all the images, and when discrepancies of the findings were found, the consensus was reached by discussion.

RESULTSPathological analysis revealed carcinoma in situ in two patients and invasive carcinoma in 19 patients arising from the IPMN. The type of ductal involvement (P = 0.038), a solid mass (P = 0.003) and the common bile duct dilatation ( ≥ 15 mm, P = 0.004) were correlated with the presence of associated invasive carcinoma. For the finding of solid and cystic mass in predicting invasive IPMN, the sensitivity was 66.7% (8/12) and specificity was 100.0% (8/8), and for bile duct diameter ≥ 15 mm, the sensitivity was 47.4% (9/19) and specificity was 100.0% (8/8). However, no association was found between the location of the lesion and associated invasive carcinoma. The caliber of the main pancreatic duct of patients with associated invasive carcinoma was significantly larger than that in the cases without invasive carcinoma (8.07 ± 2.23 mm vs. 4.86 ± 1.86 mm, P = 0.002). When using the main pancreatic duct dilatation ≥ 4 mm as the threshold, the sensitivity and specificity in predicting invasive IPMN were 94.7% (18/19) and 37.5% (3/8), respectively. For the branch duct type and combined type, the size of the tumor with associated invasive carcinoma was significantly larger than these without invasive carcinoma (41.35 ± 12.58) mm vs. (23.76 ± 8.06) mm (P = 0.003). When the maximum diameter was ≥ 40 mm, the sensitivity and specificity in predicting invasive IPMN were 50.0% (6/12) and 87.5% (7/8), respectively.

CONCLUSIONSThe findings of CT and MRI are helpful to predict invasive carcinoma associated with IPMN, which may play an important role in the preoperative evaluation, surgical planning and predicting the prognosis of IPMN.

Adenocarcinoma, Mucinous ; diagnosis ; Bile Duct Neoplasms ; Carcinoma, Pancreatic Ductal ; Carcinoma, Papillary ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; Pancreas ; Pancreatic Neoplasms ; diagnosis ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Objective:To investigate the cultural construction of Traditional Chinese Medicine(TCM) hospitals in Hunan province, for reference in their cultural construction.Methods:A questionnaire was designed according to TCM Hospital Cultural Construction Guidelines by the National Traditional Chinese Administration.From May to June 2020, the questionnaire was used to survey the present situation, existing problems and development suggestions of TCM cultural construction at TCM hospitals of and above the county level in Hunan province. The data were analyzed by descriptive analysis.Results:The survey covered 117 public TCM hospitals in the province and 87 questionnaires were recovered, a rate of 74.4%. In terms of cultural construction in these institutions, various programs were in place at a relatively high proportion in the core cultural value construction. The development of behavioral norms teaching and inheritance was in place at a relatively low proportion, namely 78.8% at tertiary TCM hospitals, 51.8% at secondary TCM hospitals, and only 16.7% at secondary level-B TCM hospitals. In terms of environmental image construction, various programs were in place at a relatively high proportion, yet focusing on themed cultural wall posters culturol bulletin board and other forms of display. At present, the main problems were insufficient funding(86.9%) and talents(82.1%).Conclusions:TCM hospitals in Hunan province highly value the construction of cultural core value and environmental image, but their development in the code of conduct system and other connotation was weak.

ObjectiveTo compare the effects of topical application of Modified Sanhuang Powder （加味三黄散， MSP） combined with cold compression versus cold compression alone on swelling and pain after knee arthroscopy through a retrospective cohort study. MethodsMedical records of 134 patients with knee arthroscopy-induced knee swelling and pain were divided into non-exposure group （51 cases） and exposure group （83 cases） based on whether they used MSP for external application after surgery. The non-exposure group received simple cold compression therapy in addition to functional exercise and routine treatment after surgery， while the exposure group received topical MSP on the basis of what were given in the non-exposure group. The Visual Analog Scale （VAS） scores were compared between the two groups before and 7 days after treatment， and knee swelling measurements were taken before and 3， 5， and 7 days after treatment. The clinical effective rate was compared between the two groups. ResultsThe VAS scores in both groups were lower after treatment （P＜0.05）， and the exposure group had lower scores than the non-exposure group （P＜0.05）. On the 3rd， 5th， and 7th days of treatment， the scores on swelling at 2 cm above the superior pole of the patella， at the midline of the patella， and 5 cm below the inferior pole of the patella significantly decreased after treatment in both groups （P＜0.05）， and the exposure group had lower scores than the non-exposure group （P＜0.05）. The total clinical effective rate in the exposure group was 91.56% （76/83）， which was higher than 78.43% （40/51） in the non-exposure group （P＜0.05）. ConclusionTopical application of MSP combined with cold compression is effective in relieving postoperative swelling and pain after knee arthroscopy and is superior to cold compress alone.

We report a complete genomic sequence of rare isolates (minor genotype) of the SARS-CoV from SARS patients in Guangdong, China, where the first few cases emerged. The most striking discovery from the isolate is an extra 29-nucleotide sequence located at the nucleotide positions between 27,863 and 27,864 (referred to the complete sequence of BJ01) within an overlapped region composed of BGI-PUP5 (BGI-postulated uncharacterized protein 5) and BGI-PUP6 upstream of the N (nucleocapsid) protein. The discovery of this minor genotype, GD-Ins29, suggests a significant genetic event and differentiates it from the previously reported genotype, the dominant form among all sequenced SARS-CoV isolates. A 17-nt segment of this extra sequence is identical to a segment of the same size in two human mRNA sequences that may interfere with viral replication and transcription in the cytosol of the infected cells. It provides a new avenue for the exploration of the virus-host interaction in viral evolution, host pathogenesis, and vaccine development.
Base Sequence ; China ; Cluster Analysis ; Gene Components ; Genetic Variation ; Genome, Viral ; Genotype ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; SARS Virus ; genetics ; Sequence Analysis, DNA ; Severe Acute Respiratory Syndrome ; genetics