Orthopaedic postoperative pain not only brings a lot of side effects to patients, but also directly affects early rehabilitation after surgery. Effective preoperative pain management mainly includes three-stage individual pattern analgesia, which refers to preoperative, intraoperative and postoperative analgesia. The purpose is to reduce pain in multiple planes and three-dimension, strengthen the effect of analgesics and reduce dosage and side effect of single drug. This paper summaries new progress on individual-multiple-pattern analgesics, pain assessment method and various therapies.
Analgesia ; methods ; Humans ; Orthopedics ; methods ; Preoperative Period ; Treatment Outcome

Patellofemoral complications are the most common complications after total knee arthroplasty. The rotational alignment of the femoral component during operations is related to the occurrence of the patellofemoral complications, and is extremely important for the clinical outcomes of total knee arthroplasty.
Arthroplasty, Replacement, Knee ; methods ; Humans ; Knee Joint ; surgery ; Knee Prosthesis ; Patella ; surgery ; Postoperative Complications ; prevention & control ; Rotation ; Surgery, Computer-Assisted ; methods

The study was aimed to investigate the strategy of transfusion of allogeneic hematopoietic stem/progenitor cells (HS/PC) into marrow cavity of mouse model in sensitized transplantation. A sensitized BALB/c mouse model was established by repeated transfusion of allogeneic spleen cells. The normal BALB/c mice were used as non-sensitized controls. The non-sensitized or sensitized recipients were transplanted by transfusion of allogeneic HS/PCs into bone marrow cavity. The survival rate and hematopoietic recovery were monitored. Moreover, non-sensitized and sensitized sera were obtained and incubated with allogeneic HS/PC respectively, the percentage of dead cells was calculated using complement-dependent cytotoxicity (CDC) tests. The results showed that non-sensitized recipients got long-term survival after the transfusion of HS/PC into marrow cavity, and the hematopoietic recovery increased along with time. However, among the sensitized recipients, one mouse died of anesthetic accident, the other 9 mice (9/10) died within 2 weeks after the transfusion of HS/PC in marrow cavity, and the hematopoietic recovery declined along with time. Histopathologic analysis demonstrated that the sensitized recipients died of bone marrow failure. The results of CDC tests showed that the percentage of dead cells in non-sensitized and sensitized group was 7.80 ± 1.93% and 50.80 ± 3.12%, respectively, and the differences were statistically significant (p < 0.05), indicating sensitized sera were capable of impairing allogeneic HS/PC. It is concluded that the strategy of the marrow cavity transfusion of HS/PC can not enhance engraftment of allogeneic donor cells in sensitized recipients.
Animals ; Bone Marrow ; Hematopoietic Stem Cell Transplantation ; methods ; Hematopoietic Stem Cells ; cytology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Transplantation, Homologous

Aged ; Endoscopy ; methods ; Female ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Video-Assisted Surgery ; methods ; Vulvar Neoplasms ; surgery

The principle and technical background of EOS imaging system are introduced. Combining with the publicity of this technology and the existing literature reports, it is known that low dose EOS technology can reduce radiation dose by 5 to 10 times in the course of examination, and micro dose EOS can even reduce radiation dose by 45 times. The image quality is only high or low; the system has EOS 2D and 3D workstations, which can help clinicians to measure and evaluate coronal and sagittal force lines of lower limbs easily. The tilt and torsion of limbs can be measured three-dimensional after three-dimensional model reconstruction in the three-dimensional workstation. Using these results, preoperative evaluation can be carried out. It is helpful for clinicians to evaluate and improve preoperative planning and post-operative measurement and evaluation of surgical effect. In terms of measurement accuracy, a large number of literatures reported that the accuracy of EOS 2D measurement is comparable to that of general radiology measurement, while the accuracy of EOS 3D reconstruction measurement is comparable to that of CT and MRI. Based on the technical characteristics and advantages of EOS, this paper reviews the literature reports and research progress of EOS in evaluating the accuracy of lower limb alignment.
Imaging, Three-Dimensional ; Lower Extremity ; Mechanical Phenomena ; Tomography, X-Ray Computed

OBJECTIVE: To study the effect of pelvic rotation in three-dimensional direction on the actual placement angle of acetabular prosthesis in total hip arthroplasty. METHODS: Pelvic CT imaging data of normal adults were collected, and three-dimensional reconstruction of pelvic acetabulum was performed with computer software to simulate the rotation of the pelvis around X, Y and Z axes perpendicular to the sagittal, transverse and coronal planes of the human body. Radiographic inclination(RI) and radiographic anteversion (RA) of the acetabular cup were measured when the acetabular prosthesis was implanted at a standard angle. The correlation analysis was used to quantify the relationship between the rotation angle of each axis and the actual angle of acetabulum. RESULTS: The pelvic rotation along the X-axis and Y-axis had little effect on the RA of the acetabulum, but had a great influence on the RI and showed a linear correlation. The regression equations were RA=0.682 4X+10.256(²=0.308 4) and RA=-0.714 1Y+10.424(²=0.999 8). The pelvic rotation along the Z-axis had little effect on the RA, but had a linear correlation with the RI, and the regression equation was RI=1.0Z+46(²=1.0). CONCLUSIONS The anteroposterior rotation of the pelvis or the longitudinal rotation along the body significantly affected the acetabular anteversion, but had little effect on the abduction angle. On the contrary, the left and right deviation of the pelvis on the coronal plane could significantly affect the acetabular anteversion angle, but did not affect its anteversion angle.
Acetabulum ; Adult ; Arthroplasty, Replacement, Hip ; Hip Prosthesis ; Humans ; Pelvis ; Rotation

OBJECTIVE: To study the application value of contrast vision in identifying the malingering decreased vision in the practice of clinical forensic medicine. METHODS: Thirty-one young and middle aged volunteers were selected and divided randomly into group 1 (16 persons with 32 eyes) and group 2 (15 persons with 30 eyes). The optotype contrast was 100%, 25%, 10% and 5%, respectively. The contrast vision of group 1 was tested. The contrast vision of group 2 was tested as follows: (1) the volunteers cooperated without inspector's interference; (2) the volunteers cooperated under inspector's interference; (3) the volunteers disguised decreased vision without inspector's interference; (4) the volunteers disguised decreased vision under inspector's interference. The data was then analyzed by statistics. RESULTS: There was a close correlation between contrast vision and contrast. As the contrast decreased, the vision acuity also decreased. The contrast vision curve of former two methods showed a good reproducibility while the contrast vision curve of latter two methods had a bad reproducibility. CONCLUSION The repetition of contrast curve with or without inspector's interference can be used to discriminate malingering vision. The acquired contrast curves can be provided to the court as direct evidence and can help enhance the verification conclusion.
Adult ; Contrast Sensitivity/physiology* ; Diagnosis, Differential ; Female ; Humans ; Male ; Malingering/psychology* ; Reproducibility of Results ; Sensitivity and Specificity ; Severity of Illness Index ; Vision Tests/statistics & numerical data* ; Vision, Binocular ; Vision, Low/psychology* ; Visual Acuity ; Young Adult

To increase the productivity and yield of recombinant protein in continual perfusion processing, Every amino acid consumption rate in continual perfusion culture of engineering CHO cell line which expressed recombinant TNFRp75: Fc fusion protein were analyzed. Then rational amino acids were accordingly added to improve its comprehensive utilizing. At the same time, glucose supply was controlled to make the concentration of glucose below 0.5 g/L for ameliorating the toxicity of lactate accumulation in order to decrease the perfusion rate. The result showed that the productivity of recombinant protein was 3.1 times (388mg/L) and the total yield was 4. 7 times (244. 4g) that of control cultures after nutrient compensation and metabolism control in 30 liter working volume, and the fermentation period was prolonged one week longer. The sialic acid content and bioactivity in vitro of recombinant TNFRp75: Fc were not changed after nutrient compensation and glucose control supply. Nutrient compensating and metabolic control in continual perfusion fermentation could significantly increase the productivity and yield of recombinant TNFRp75:Fc, and thus reduced relative industrialization costs.

OBJECTIVETo investigate the surgical outcomes after on transumbilical laparoscopic pull-through procedure for pediatric hypoganglionosis(HYP).

METHODSTwelve children with HYP had received transumbilical laparoscopic pull-through procedure from June 2009 to June 2010. Specially designed curved and elongated laparoscopic instruments were used during the procedures. All the patients were followed up over 10 months. Data were collected and analyzed. The diagnosis of hypoganglionsis was pathologically confirmed.

RESULTSNo conversions to laparotomy or traditional laparoscopic surgery were required and there were no damages to the abdominal blood vessels, intestine, ductus deferens, or ureters. The average duration of operation was 140 min. The mean intraoperative blood loss was 45 ml. The mean length of specimen was 40 cm. Postoperatively there were no complications such as anastomotic leak, anastomotic stricture, constipation, seepage, or fecal in continence. The average hospital stay after surgery was 9 days. During 10 to 22 months of follow-up(median 16 months), no postoperative recurrence was noticed. No obvious scar was seen 1 months after surgery.

CONCLUSIONIt is safe and effective for children with hypoganglionosis to undergo transumbilical laparoscopic pull-through procedure.

Anal Canal ; surgery ; Child ; Child, Preschool ; Colon ; surgery ; Female ; Hirschsprung Disease ; surgery ; Humans ; Laparoscopy ; methods ; Male ; Treatment Outcome ; Umbilicus ; surgery

OBJECTIVETo investigate the volume of pulse lavage sufficient for removal of intraoperative bone and polymethyl methacrylate (PMMA) particles.

METHODSFrom 2007.11 to 2008.11, 18 patients with osteoarthritis underwent cemented TKA. Among the patients, 6 patients were male and 12 patients were female, ranging in age from 54 to 77 years, with an average of 61.5 years. The course of disease ranged from 3 to 9 years, mean 6.7 years. Pulse lavage with 1 L of sterile saline was performed for 8 times using a pulsatile irrigator after prothesis fixed. During pulse lavage, aspirated fluid was collected in a 1 L aliquot, and the weight of bone and PMMA particles in each fluid were measured.

RESULTSThe weight of particles peaked in the first 1 L lavage fluid and gradually decreased until the 8th lavage fluid. Significant differences were found between the first vs second, second vs third, and third vs fourth lavage. However, no significant differences were found beyond the fourth lavage.

CONCLUSIONThe results of this study indicates that 4 L of pulse lavage is effective for removing the bone and PMMA particles during cemented TKA.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Male ; Middle Aged ; Polymethyl Methacrylate ; Sodium Chloride ; administration & dosage ; Therapeutic Irrigation