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.

BACKGROUND: Most of the displaced fractures of calcaneus reed operation treatment. Because early postoperative dirigation is sometimes ignored,most patients receive only good anatomic reduction but less pleased functional reduction.OBJECTIVE: To compare the effect of different starting time of the postoperative dirigation on the functional recovery of the joint of the foot after the operation of the fracture of calcaneus with joint surface displacement.DESIGN: Non-randomized and concurrently controlled retrospective analysis with blind evaluation.SETTING: Orthopedic Department of Renji Hospital of Shanghai Second Medical University.PARTICIPANTS: Cases with the fracture of the calcaneus with joint surface displacement, in the Orthopedic Department of Renji Hospital of Shanghai Second Medical University were chosen from October 2000 to June 2003. There were totally 64 cases(72 sides), male 40 sides and female 32sides, whose ages varied from 22 to 68 years old. According to the starting time of the postoperative dirigation, the cases were divided into two groups,the 1-week dirigation group with 34 cases(38 sides), male 20 sides and female 18 sides, and the 6-week dirigation group with 30 cases(34 sides), male 20 sides and female 14 sides.METHODS: Totally 64 cases were involved in the result analysis. In the two groups, the same operative therapeutic methods and postoperative dirigation were taken except the starting time of the dirigation. The dirigation was started respectively 1 or 6 weeks after the operation and lasted for 6weeks. Six months later, follow-ups were done according to the Maryland Grade(excellent 90-100, good 75 -89, moderate 50 -74, poor ＜ 50) to evaluate the activity of the talocrural joint and the stability of the anterior half of the foot and the gait as well.MAIN OUTCOME MEASURES: Primary results: the postoperative function of the injured foot of the two groups. Secondary results: the adverse events and side effect.Maryland Grade: In the 34 cases(38 sides) of the 1-week dirigation group,the average mark was 87. 8, and in the 30 cases(34 sides) of the 6-week dirigation group, the average mark was 73.2, and the difference had signifigroup, 3 cases had poor healing of the incision, and achieved the healing after 2-week medication. And 2 cases had injury of the lateral dorsal cutaneous nerve of the foot. In the 6-week dirigation group 2 cases had poor healing of the incision and achieved the healing after 2-week medication, and 1 case had injury of the lateral dorsal cutaneous nerve of the foot. There was no significant difference between the two groups.CONCLUSION: After the operation of the fracture of calcaneus with joint surface displacement, early application of dirigation is beneficial to the functional recovery of the foot and talocrural joint without unsafety.

Objective Construction of a predicting model of uncertainty in illness based on Mishel's theories of uncertainty in illness in a sample of the postoperative patients with digestive system tumors undergoing chemotherapy.Methods By convenient sampling method,MUIS-A,MSAS,SSRS were used to evaluate 484 postoperative patients with digestive system cancer during chemotherapy period,and then AMOS 17.0 software was used to perform analysis.Results The score of uncertainty in illness of postoperative patients with the digestive system cancer undergoing chemotherapy was in the medium level (89.86+11.84) points; Structure provider (social support,economic income) could not only reduce the uncertainty directly,but also had an indirect effect on the uncertainty by stimuli frame (symptoms pattern,event familiarity).Conclusions Structure equation model can be applied to the uncertainty in illness model construction,so as to help medical staff manage uncertainty in illness pertinently.

ObjectiveTo study the state of depression emotion,personality and quality of life of patients with digestive system tumor undergoing chemotherapy, and the correlation of depression emotion with personality and quality of life.MethodsUsing cross-sectional survey methodology, 261 digestive system tumor patients were investigated by schedule table SDS, EPQ-RSC and EORTC QLQ-C30. These cases were also used to study the correlation of depression emotion with personality and quality of life.ResultsThe digestive system tumor patients undergoing chemotherapy investigated had a high score in depression than domestic norm, and the incidence of depression of these cases was 19.5％.The cases were divided into two groups(the depression group and the non-depression group). There were significant differences in N and P dimensionalities of personality and in physical function, role function, cognitive function, emotional function,and overall well-being, fatigue, economic difficulties, nausea and vomiting, pain, insomnia, loss of appetite,constipation and diarrhea. There were various degrees of difference in depression, personality and quality of life.ConclusionsDepression, personality and quality of life are closely related in digestive system tumor patients undergoing chemotherapy. The medical staff should pay more attention to the patients quality of life and personality to make a better nursing intervention and improve their quality of life.

Objective The purpose of this study was to investigate the occupation stress and quality of life among teachers in medical university,and analyze the correlation between the occupational stress and the quality of them.Methods Totally 249 teachers in medical university of Anhui province were investigated with the instruments of the occupational stress scale and the Chinese version of World Health Organization Quality of Life Brief(WHOQOL-BREF).Results The findings showed that:The coefficient of correlation was-0.374 between occupational stress and quality of life in teachers in medical university(r =-0.374,P ＜0.001).Conclusion The score of social relations dimension,the environment dimension and utilization of support have statistical significance with different sex and age of teachers in medical university.There was negative correlation between the occupational stress and the quality of life in teachers in medical university.

Objective To evaluate the effects of breastfeeding behavior through the implementation of family-centered empowerment education in primiparas.Methods According to random digit table,128primiparas in our hospitals were divided into the experimental group and the control group with 64 cases in each group from August 2014 to April 2015.At last 58 patients in the observation group and 59 patients in the control group completed the research.Those primiparas in the experimental group were given the familycentered empowerment education.The control group received conventional methods.Results The scores of breastfeeding self-efficacy,perceived social support and breastfeeding behavior of primiparas in the experimental group were 129.64±12.94,58.94±8.97,89.84±11.32,higher than the control group,101.78±78.67,50.27±10.56,71.56±12.03,the differences had statistical significance between two groups,t=9.656-10.487,P ＜ 0.05.Conclusions Using the family-centered empowerment education can effectively improve the breastfeeding self-efficacy,perceived social support and breastfeeding behavior in primiparas.

Objective To discuss on the effect of simulation training of vocational protection among nurses with lower age and services seniority in trauma surgery department. Methods The training of vocational protection was divided into the curricula content and simulation training, 37 nurses were trained with the method of combining theory with practice,the items before and after the training were tested with t test. Results The mastering degree of occupational exposure knowledge after the training significantly improved compared with that before training. After simulation training various protection technique greatly alleviated. Each score of comprehensive clinical evaluation after the training also increased. Conclusions We should strengthen occupational protection in clinical work in order to prevent nosocomial infection.Detail education and situational education should be paid attention to during the training according to their ability,so that satisfactory results can be achieved.

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.