A total of 118 patients (138 knees) who received total knee arthroplasty at the Department of Orthopedics, Guizhou Province People's Hospital between June 2000 and January 2007 were included in this study. These patients comprised 45 males and 73 females and were averaged (61±8) years old (range, 52-81 years). Of them, 28 (34 knees) suffered from rheumatoid arthritis, 6 (6 knees) from traumatic arthritis, 84 (98 knees) from severe osteoarthritis, 14 (18 knees) complicated by extraversion, and 25 (28 knees) complicated by inversion. Link Gemini knee prosthesis was used in 38 knees, Zimmer Nexgen knee prosthesis in 68 knees, and Depuy pfc sigma rotation platform knee system in 32 knees. All patients were followed up for an average of 28 months (range, 10 months-6 years). Prior to replacement, the mean knee score, according to the Hospital for Special Surgery (HSS) rating scale, was (34.00±7.65) points, and at the latest follow-up examination, it was (81.00±6.89) points. HSS score was excellent in 87 knees (63%), good in 43 knees (31%), and fair in 8 knees (6%). The excellent and good rate was 94%. Of 118 patients, 4 presented with infection and 3 showed deep venous thrombosis in lower limb following unilateral total knee arthroplasty and healed after anticoagulation and symptomatic therapy. There were 3 patients presenting with knee joint pains 2 months following knee joint arthroplasty. No knee joint red swelling and tenderness were found. Range-of-motion was basically normal. X-ray photograph indicated good position of prosthesis. Pains were relieved after femoral nerve block. All these findings suggest that total knee replacement is an effective method of treating severe knee joint diseases. INTRODUCTIONTotal knee arthroplasty (TKA), as an important part of artificial joint replacement for treatment of severe knee joint diseases, initiated from the first knee joint prosthesis developed by Cunstno in 1960s and was put in use. But following TKA, large-scale severe complications appear due to condition limitations, which results in failed surgery. With development of molecular biology and materials, as well as further research of installing technique and knee joint biomechanics, TKA has been shown to be gradually perfect theoretically. A novel prosthesis better corresponds to the physiological standards of human body in terms of structure design, material strength, and shape. These improvements greatly enhance prosthesis survival rate and markedly decreases complication incidence following TKA. TKA has been shown to be an efficient method of treating severe knee joint diseases. It can effectively relieve joint pains and improve joint functions, and is mostly used in elderly populations (over 60 years old) who complicated by other diseases, such as diabetes mellitus, hypertension, heart disease, phlebitis of lower extremities. In addition to above-mentioned, poor body resistance enhances surgery risk and difficulties, and complications would be correspondingly increased following TKA. The present study retrospectively analyzed a total of 118 patients with severe knee joint diseases who underwent TKA at the Department of Orthopedics, Guizhou Province People's Hospital between June 2000 and January 2007.

Objective:To evaluate the effects of erythropoietin (EPO)on the proliferation and osteogenic differentiation of human dental pulp cells(hDPCs)in vitro.Methods:Isolated hDPCs were cultured and identified.The cells were treated by EPO and the proliferation of the cells was determined by CCK-8 assay.After incubation with EPO at 20 U /ml in osteogenic induction medium for 7 and 1 4 days,the mineralization of hDPCs was observed by alkaline phosphatase (ALP)activity assay and alizarin red staining.Real-time PCR was utilized to detect the expression of odontogenesis-related genes.Results:EPO enhanced the proliferation of hDPCs in a time-and dose-dependent manner.After treatment with EPO,ALP activity and the minerialized nodes of the cells increased(P <0.05);the expression levels of odontogenesis-related genes DSPP,OCN,OSTERIX and RUNX2 were upregulated(P <0.05).Con-clusion:EPO can promote proliferation and differentiation of human dental pulp cells.

Objective To investigate the effects of continuous nursing quality improvement on emergency care of parturient with preeclampsia.Methods The parturient with preeclampsia in the First Affiliated Hospital of the Medical University Of Anhui from January 2010 to December 2015 were chosen.The effects of continuous nursing quality improvement on the emergency care of those parturient were analyzed and the maternal and infant health outcomes and patient satisfaction were contrasted.Results The surgical complication rate of the observation group patients was significantly lower than that of the control group (P＜0.001).The overall health outcome of maternal and infant patients in the observation group was significantly better than that of the control group (P＜0.000) Patient satisfaction of the observation group was significantly higher than that of the control group (P＜0.000)Conclusion Continuous nursing quality improvement model can not only ensure the quality of eclampsia patient care but also keep on improving the care quality so as to improve maternal and infant health outcomes and patient satisfaction.

Vitrectomy combined with internal limiting membrane (ILM) peeling and vitreous tamponade is a conventional method for treating macular hole (MH),but the visual acuity and MH closure rate remains to be further improved.After removal of posterior vitreous cortex,the ILM is grasped with an ILM forceps and peeled off in a circular fashion for approximately 1 disc diameters around the MH.During the circumferential peeling,the ILM is not removed completely from the retina but is left attached to the edges of the MH.The ILM was then massaged gently over the MH from all sides until the ILM became inverted and then peel all other ILM within vascular arcades.Inverted ILM flap technique is one of the important improvement methods in MH vitrectomy,especially for MH with large diameter and unhealed MH after ILM peeling.Compared with conventional vitrectomy combined with ILM peeling,inverted ILM flap technique can enhance MH closure and improve visual acuity.Due to lack of large sample observation in clinical trials of inverted ILM flap technique,we still need more cases and longer follow-up of this technology to more accurately evaluate the effectiveness and safety of this technique.

The Roles of the clinicians in different medical models are quite different,which not only led to the change of the relationship between the clinicians and the patients, but also had a significant clinical effect. The authors compared the clinicians'role in different medical models and showed the humanism underlying this change.

Mammalian target of rapamycin (mTOR)is an atypical serine/threonine protein kinase,which is a key protein kinase regulating cell growth,proliferation,translation,metabolism and autophagy.It's first known beca- nuse inhibited by rapamycin.Research indicated that mTOR plays a key regulating role in physiological and patho- logical process of cardiovascular system.The present article mainly reviewed research progress of mTOR signal path- way effect in cardiovascular system.

Objective To observe the therapeutic effect of endometrium minimally invasive pretreatment on non -pregnant PCOS patients who are on ovulation induction treatment.Methods According to the digital meter method,divided 66 non -pregnant PCOS patients who were with abnormal endometrial echoes or abnormal thickening by ultrasound in follicular phase in natural periodwith into testing group(33 cases)and control group(33 cases).All patients were treated with drospirenone and ethinylestradiol tablets treatment for 3 to 6 cycles,and then with clomi-phene citrate(CC)for induction of ovulation.In the testing group,endometrium microresecting was given by disposa-ble uterine cavity tissue suction tube device within 3 ~5days after menstrual onset.Patients in the control group were not performed with endometrium microresecting.All patients of the two groups were given estrogen and progesteroneas well as detection of ovarian folicle and endom etrium with B -modeult rasonography.Results Intimal thickness in the testing group was(8.78 ±1.56)mm,the pregnancy rate was 36.36% and the abortion rate was 16.67%,there was no obvious pain and unwell during the operation and the patients were free from infection.Intimal thickness in the testing group was(6.32 ±0.74)mm,the pregnancy rate was 24.24% and the abortion rate was 12.50%.There were significant differences between the two groups of endometrial thickness,pregnancy rate(t =8.184,χ2 =4.60,all P <0.05).Conclusion Endometrium microresecting by endometrial sampling device can increase the endometrium, thickness and the pregnancy rate,and at the same time it doesnot increase the rate of early spontaneous abortion.And it is easy to perate,convenient,less trauma,less pain,easy to acceptand and some other advantages,it has better clini-cal application value,so it deserves to be applied in basic hospital.

Notch signaling pathway plays a vital role in cell fate decisions. Notch signals are transferred among adjacent cells through Notch receptors and their ligands, which can regulate differentiation, proliferation and apoptosis of many cell types including stem cells. They can also influence organ formation and morphopoiesis. Genetic mutations in the Notch signaling pathway are related to the emergence and development of many diseases. Notch signaling pathway is increasingly becoming important drug targets for cancer, hereditary disease such as CADASIL and other related diseases. It is also used to develop stem cell therapeutics to treat age or trauma related degenerative diseases such as Alzheimer's disease, Parkinson disease and diabetes.

Objective To evaluate the CT manifestation of pancreatic carcinoma proved by patholoical results. Methods The patients were supine. Both plain and three-phase dynamic contrast-enhanced CT scan were performed. 100 ml of Ominipaque was injected at a rate of 2～4ml/s, with 5~10 mm slice thickness and interval. Results CT scanning clearly showed the direct signs or indirect signs of pancreatic carcinomal, which include: pancreatic mass, obstructive dilatation of the bile duct and pancreatic duct, the visualization of the abnormal large peripancreatic vessels, lymph node metastasis, etc. Conclusion Plain CT scanning shows clearly manifestation of pancreatic carcinomal and the surrounding tissue, and three-phase dynamic contrast-enhanced CT scan can clearly display the tiny changes of pancreatic parenchyma. Therefore it is valuable for diagnosis of pancreatic carcinomal.