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.

The management of periprosthetic fracture following total knee arthroplasty (TKA) remains a challenging problem. Periprosthetic fractures are increased with increasing TKA times,aging,and increased activity after TKA. Periprosthetic fractures after TKA involves the femur,tibia,or patella,in particular at the supracondylar region of the femur. In addition,periprosthetic fractures can also occur in operation. According to fracture morphology,various cause factors,and the timing of fracture,a number of treatment options are available to treat this complex problem. Appropriate fracture classification would assist clinical physicians to evaluate fracture site,type,bone loss and prosthesis fixation. Because of the complexity,periprosthetic fractures often require tailored treatment to attain a more individualized treatment strategy to promote fracture healing,reconstruct bone mass and maintain joint function. Recently,with improving internal fixation materials and surgical techniques,the methods of surgical treatment of periprosthetic fracture have made great progress.

Objective In order to know preoperative gastrointestinal cancer patients' quality of life and the related factors. Methods A cross-sectional study was conducted in 356 preoperative gastrointestinal cancer patients. The data were analyzed using descriptive, linear correlation and multiple regression analysis. Results The total number of valid return was 323, and the valid usable return rate was 90.7%.The preoperative gastrointestinal cancer patients' quality of life reached the middle level and varied with gender, age, residence, income and psychological state. Emotional function, physical function and fatigue were influencing factors of total quality of life. Conclusions Anxiety and emotional function were the main influencing factors of preoperative gastrointestinal cancer patients' quality of life.

There are many problems about multiple breast cancer (MBC),such as whether it results from intramammary spread of a single tumor, or from two or more separate neoplastic events? Whether MBC has inferior outcome compared with unicentric lesions? Whether MBC is suit for conservative surgery and the sentinel lymph node biopsy, and so on. Thus: We reviewed the prospect for diagnosis and therapy of MBC.

[Objective]To investigate the treatment and results of reconstruction with composite type metal raiser block of proximal tibia AORI type Ⅱ bone defect in total knee arthroplasty(TKA).[Method]Nine patients(12 knees)of reconstruction with composite type metal raiser block of proximal tibia AORI type Ⅱ bone defect in TKA were followed from August 2004 to May 2008.There were 3 males with 3 knees and 6 females with 9 knees.The average age was 69 years ranging from 48 to 76 years.[Result]The average follow-up time was 26 months,ranging from 6 to 42 months.All genu varum and genu valgum were corrected.Pain disappeared and the motion of the knee was satisfactory.The HSS knee score improved from preoprative 14.5(range 10-25)to postoprative 85.5(range 74-95).The movement range improved from preoprative 74.6?(range 15?-100?)to postoprative 110.3?(range 80?-155?).[Conclusion]The appliance of composite type metal raiser block for proximal tibia AORI type Ⅱ bone defect in total knee arthroplasty is helpful for the constancy of prothesis and the achievement rate of opration.

Objective To investigate the expressions of COX-2 and p53 in human colorectal carcinoma and their correlations with clinicopathological features of colorectal carcinoma. Methods The expressions of COX-2 and p53 were determined by immunohistochemical staining in 72 surgical specimens of colorectal carcinoma and 21 normal mucosal tissues. Results The positive rates of COX-2 and p53 in colorectal carcinoma were 70.8 % and 62.5 %, respectively. The differences between carcinoma group and normal tissues group were statistically significant(P

Objective To investigate bone nutritional status of neonates and their mothers as well as the correlation between them by estimating the concentrations of 25-(OH)D3, calcium and phosphorus in maternal blood and cord blood at birth, and by measuring the bone speed of sound (SOS) of neonates and their mothers with quantitative ultrasound within 3 days after birth. Methods The concentrations of 25-(OH)D3, calcium and phosphorus in the serum were estimated both from 32 pregnant women who had a term delivery and from the umbilical cord at birth. Within 3 days after delivery, the bone SOS values of the mothers measured from their radius and neonates from their tibia were estimated and the correlation between the mothers and their neonates was analyzed. Thirty-nine non-pregnant healthy women who at the same age as the pregnant women were selected as control group and had their bone SOS measured. The difference of bone SOS between pregnant and healthy non-pregnant women was compared. Results There was positive correlation between cord blood and maternal blood 25-(OH)D3 concentration [(14. 7±7. 8) nmol/L and (30. 3±10. 2) nmol/L, r= 0 . 680, P=0. 000]. The calcium and phosphorus concentration in cord blood [2.36±0. 28)mmol/L and (1.57±0.76) mmol/L] were significant higher than that in maternal blood E(2.09± 0. 17) mmol/L and (1.04±0. 28) mmol/L], but no correlation was found (r=0. 146, P=0. 467; r=0. 148, P=0. 445). No significant correlation was shown in the bone SOS between the infants and their mothers[(3054±76)m/s and (4170+241)m/s, r=0. 223, P=0. 220]. The concentration of 25-(OH)D3 in cord blood was closely correlated with the bone SOS of infants(r=0. 412, P=0. 026). The SOS of healthy women was obviously higher than that of pregnant women [(4258±100)m/s vs (41704±241)m/s, P=0. 043]. Conclusions There are close correlations between fetus and their mothers in vitamin D status and also between vitamin D status and fetus bone development. Some pregnant women may be short of vitamin D in autumn and winter in Shanghai and we should monitor the bone nutritional states for pregnant women.

The paper analyzes deficiencies in traditional manual screening of critical values , telephone notifications and manual record-ing of critical value reports , as well as problems existing in current critical value reporting systems in China .It designs a stable , timely and accurate reporting system for test critical values and mainly introduces the system design , system function and application features .

Objective To compare the efficacy, tolerance and cost of interferon (IFN) α-2b and adefovir (ADV) in patients with chronic hepatitis B (CHB) for two years. Methods The treatmentnaive outpatients with CHB were treated with IFN α-2b or ADV according to intention to treat.Among 77 patients, 34 were treated with recombinant IFN α-2b 5 MU once every other day subcutaneously (IFN group), 43 were treated with ADV 10 mg/day orally (ADV group). The medications were stopped or the regimens were changed due to intolerant adverse reactions or without effects according to intention to treat. The patients were followed up for 24 months. The therapeutic effects, adverse reactions, compliance and cost of two initial treatments were compared. The data were analyzed by Fisher exact probability test. Results The complete virological response (HBV DNA＜500 copy/mL) rates after 12 months of therapy in IFN group and ADV group were 41.2% (14/34)and 67. 4 % (29/43), respectively, while the alanine aminotransferase (ALT) normalization rates were41.2% (14/34) and 93. 0% (40/43), respectively. The rates in ADV group were both significantly greater than those in IFN group (both P＜0.01). There were no statistically significant differences of HBeAg negative rate and HBeAg seroconversion rate between the two groups. In IFN group, the expulsion rate was 23. 5% (8/34), the therapy was discontinued in 8. 8% (3/34) of patients due to adverse reactions and the medication was changed in 47.1% (16/34) of patients. In ADV group, there were no adverse reactions associated with medication during 2-year therapy and patients were well tolerant, the expulsion rate was 7.0% (3/43) and the regimen in 9.3% (4/43) of patients was changed (P＜0.01). The comparison of therapeutic cost between the two groups showed that the cost of anti-viral therapy, management with adverse reactions and laboratory examinations in IFN group were all higher than those in ADV group. The average cost per person of two years was increased with RMB 4855 yuan in IFN group. Conclusion In HBeAg-positive CHB patients, ADV is cost-effective and suitable choice for initial antiviral treatment.

Bacterial cellulose (BC) is a new kind of natural biological nano-materials which displays unique physical, chemical and mechanical properties. It has high bioactivity, good biocompatibility, and biodegradability. BC fiber has a nanoporous structure and certain nano-pore size distribution, and a large number of nanopores can be used as a "template". BC can be used as a template to synthesize nano-composite materials with three-dimensional network structure through biomimetic synthesis. BC can also be used as a template to stabilize and disperse the polymers which are easily assembled into a cluster or bundle in the ultra-fine fiber network structure. The BC template could be removed in order to change or optimize the properties of the composite material. The process can make use of the synergy between the BC template and inorganic materials to make a new type of hollow molecular sieve. It can synthesize a variety of nanoscale metal oxides with the hollow network. The present study of template svnthesis based on BC is introduced in this paper.