BACKGROUND:With the continuous development of minimal y invasive techniques and computer navigation assistive technology, they have powerful attraction and development prospects in theory and practice. But there are controversies and misunderstandings in the application and efficacy of total knee arthroplasty.
OBJECTIVE:To summarize and evaluate the definition indications, contraindications and complications of minimal y invasive total knee arthroplasty, as wel as the advantages and disadvantages after replacement and the application of computer navigation assistive technology.
METHODS:A computer-based retrieve was performed in CNKI database and PubMed database for the articles on minimal y invasive total knee arthroplasty from 2003 to 2013. The key words of“minimal y invasive total knee arthroplasty, minimal incision total knee arthroplasty, computer navigated total knee arthroplasty, computer assisted total knee arthroplasty”in English and Chinese were put in the title and abstract. The articles on the minimal y invasive total knee arthroplasty and computer assisted total knee arthroplasty were included, and the old and repetitive articles were eliminated. Final y, 44 articles were included for review according to the inclusion criteria.
RESULTS AND CONCLUSION:Knee joint diseases can seriously affect the life quality of the patients. Minimal y invasive total knee arthroplasty is a newly developed technique in recent ten years, which can provide a new choice for the patients. Studies have shown that minimal y invasive total knee arthroplasty has the advantages of reducing postoperative pain, decreasing the direct cost and fastening the recovery. The computer navigated total knee arthroplasty can make the force line more precise after replacement. But there exist many problems according to the reports at home and abroad, especial y the life and prosthesis and time for revision, those are the fatal factors for the patients. But minimal y invasive surgery is the developing trend of orthopedic surgery.

Anhedonia is the loss of pleasure or lack of reaction to pleasurable stimuli, which is a promising phenotype of depression. In order to explore the potential biological mechanism, the recent ad?vances were summarized from researches focused on depression with anhedonia from neuroanatomy,inflamma?tion and immunology,and molecular genetics. The structural and functional brain imaging showed that the ac?tivity in reward?related brain regions of the depressive disorder with an anhedonia was changed during re?ward?related tasks.In addition,some other genetic studies based on the related neurotransmitter,such as do?pamine, together with the findings from the researches on immunological inflammation, may shed light on finding the potential targets for novel antidepressants,besides the 5?HT.

After a description of the basic situation of medical literature retrieval course for foreign undergraduates studying in Sun Yat-sen University, the problems in their teaching contents and teaching methods were pointed out with measures proposed for improving the teaching of their medical literature retrieval course.

Objective To explore the susceptibility of epilepsy in rat with cerebral trauma. Methods An impact-acceleration head injury model was established with rats. After trauma, the electroencephalograph was recorded. Epileptic model wad established by injecting pentylenetetrazol (PTZ) intraperitoneally and the dosage of PTZ was recorded. Results The wave of delta and theta increased after trauma, alpha and beta decreased and there was significant difference among the power of delta, theta and alpha (P＜0.05). The dosage of rats with cerebral trauma was less than that in normal rats (P＜0.05). Conclusion The susceptibility of epilepsy in rat with cerebral trauma increases.

Objective To investigate BRAFV600E mutation and sodium iodide symporter (NIS) expression and its clinical significance in papillary thyroid carcinomas (PTC).Methods BRAFV600E mutation was evaluated by direct sequencing and BRAFV600E mutation was determined in 40 cases of PTC.NIS expression was examined by means of immunohistochemistry.The relationship between BRAFV600E mutation and the clinicopathologic features of PTC was analyzed.The relationship between NIS expression and BRAFV600E mutation in PTC was analyzed.Results Positive BRAFV600E mutation was determined in 23 of 40 cases of PTC (57.5％),whereas positive NIS expression was showed in 7 of 40 cases (12.5％).BRAFV600E mutation was associated with extrathyroid invasion and a high risk of disease recurrence in PTC (P ＜ 0.05).Positive NIS expression was found in only one of 23 cases of PTC with BRAFV600E mutation,and positive NIS expression was associated with a statistically significant lower BRAFV600E mutation in PTC (P =0.011).Conclusions BRAFV600E mutation might be associated with higher aggressiveness,higher disease recurrence and a poorer prognosis.Lower NIS expression may be responsible for poor 131I uptake in

The expression of Rap1 GAP protein was detected in 69 cases of papillary thyroid carcinoma and adjacent normal thyroid tissues with immunohistochemistry method.Methylation of Rapl GAP gene was analyzed by methylation-specific-PCR (MSP) in these tissues.The immunohistochemistry results indicated that the Rap1GAP protein was down-regulated in tumor tissues of 54 ( 78％ ) cases compared with normal thyroid tissues.Statistical analysis demonstrated that the decreased level of Rap1 GAP protein expression was significantly correlated with the tumor stage T according to American Joint Committee on Cancer ( AJCC,P =0.043 ).The MSP results demonstrated that 46 cases of Rap1GAP gene methylation were detected in 54 cases with down-regulated expression of Rap1GAP (66.7％),but only 1 case of methylation was found in 15 cases without obvious change of Rap1GAP expression (6.67％),showing significant difference ( P＜0.01 ).There was no methylation in normal thyroid tissues.These results suggest that raised methylation of promoter region may contribute to the low expression of Rap1GAP protein in papillary thyroid carcinoma.

Equipment Failure ; Humans ; Stents ; Ultrasonography, Interventional

Objective To develop a pathway management system for nucleus-related special service recuperation to enhance efficiency and extend function in the pathway management.Methods The system was developed on the basis of military sanatorium information management platform,and constructed with modular and object-oriented method,B/S mode,Oracle 8 database and Java programming languages.Results The system solved the problems of paper pathway management in time consumption,supervision,statistics,regulation and etc.Conclusion The system contributes to the standardization,convenience and precision of the pathway management for nucleus-related special service recuperation,and thus is worthy promoting in the nucleus-related military sanatorium.

Objective To summarize the clinical course of acute interstitial pneumonitis (AIP) associated pediatric acute respiratory distress syndrome (PARDS) in 8 recipients after liver transplantation,and further discuss the potential risk factors and therapeutic highlights.Methods A total of 476 pediatric patients received liver transplantation in Tianjin First Center Hospital from January 2012 to September 2016.Among them,8 cases of AIP associated PARDS in ICU were recruited in this study.Medical data including clinical presentation,ICU management and outcomes were analyzed retrospectively.Results The onset time-window of AIP associated PARDS was (2.67 ± 0.77) months after liver transplantation,and the time interval between initial symptom and ICU administration was (6.75 ± 5.82) days.Five cases had the history of acute rejection therapy,and 5 cases had CMV and/or EBV viremia history.All 8 cases received mechanical ventilation,2 cases given nasal non-invasive ventilation and the rest 6 cases given invasive ventilation,3 of which were switched to high frequency oscillatory ventilation (HFOV) combined with inhaled nitric oxide.At the stage of hypoxic climax,the fraction of inspired oxygen (FiO2) was up-regulated to 1.0 to maintain the oxygenation index (OI) of (25.24 ± 5.94).Temporary replacement of immunosuppressants with intravenous glucocorticoids was implemented in all 8 cases without acute rejection episode.Of 8 cases,2 cases died from PARDS,1 case died from portal thrombosis associated hepatic failure,and the rest 5 cases survived.Conclusion AIP associated PARDS is a critical complication with high mortality in pediatric patients after liver transplantation.Excessively strong immunosuppression therapy at early post-transplant stage shows a risk factor for AIP.Lung protective ventilation strategy and HFOV are recommended to reduce ventilator induced lung injury in pediatric patients.Temporary intravenous glucocorticoids may reduce acute inflammatory reaction in PARDS patients without increasing the risk of acute rejection.

Objective To explore the relationship between the levels of plasma coagulation factors (F) and acute myocardial infarction (AMI) in low age period (<60 years old) and their diagnostic value in diagnosing AMI in low age period.Methods One hundred and sixty inpatients with low age AMI in the cardiology department of the Heze Municipal Hospital were selected as the case group,and contemporaneous 160 cases of low age non-AMI served as the control group.F Ⅱ,FⅦ,FⅧ,fibrinogen (Fg) and von willebrand (vWF) were measured with enzyme-linked immunoabsorbent anti-sandwich assay.The relationship between coagulation factors and low age AMI was analyzed with univariate and multivariate analysis,and their value for diagnosing low age AMI was evaluated with diagnostic test and receiver operating characteristics (ROC) curve.Results The univariate analysis showed that FⅡ,FⅦ,FⅧ and Fg levels had significantly statistical difference between the case group and control group(P<0.05),and the vWF level had no statistically difference(P>0.05).The multivariate analysis indicated that the FⅡ level≥ 14.27 μg/L and FⅦ level ≥22.99 μg/L were the independent risk factors for low age AMI.The value of FⅡ for diagnosing low age AMI was lower,and the optimal cut off value of Fg for diagnosing low age AMI was 22.99 μg/L,its area under ROC curve was 0.709 with a moderate diagnostic value,and the sensitivity (91.88%) and negative predictive value (86.02%) were higher,the false negative rate (13.98%) was lower,and the accuracy (70.94%) was moderate.Conclusion The FⅡ level ≥14.27 μg/L and Fg level ≥22.99 μg/L are the independent risk factors for low age AMI,and detecting the Fg level could have hint significance in diagnosing low age AMI.