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 study the relationship between the dynamic changes of caveolin-1 with the degrees of liver fibrosis and portal venous pressure (PVP) in the process of rat liver cirrhosis formation induced by dimethylnitrosamine (DMN); also to investigate the mechanisms of caveolin-1 in the regulation of endothelial nitric oxide synthase (eNOS).

METHODSLiver cirrhosis was induced in rats by DMN. The degrees of liver fibrosis and PVP were measured. NOS activity was assessed by citrulline generation. Protein expressions of caveolin-1, eNOS and caveolin-1-eNOS interactions were examined by Western blot and immunoprecipitation, respectively.

RESULTSFour weeks after DMN administration, liver fibrosis was at its peak and then decreased gradually. Immunoprecipitation and Western blot demonstrated that there was enhanced binding of caveolin-1 with eNOS in the process of rat liver cirrhosis. An increase in caveolin-1 expression was detected but the expression of eNOS was lower in cirrhotic tissues than in normal liver tissues. Caveolin-1 protein levels were positively correlated with the degrees of liver fibrosis and the levels of PVP (r=0.967, P < 0.01; r=0.922, P < 0.01, respectively), while NOS catalytic activity was negatively correlated with the degrees of liver fibrosis and levels of PVP (r= 0.973, P < 0.01; r=-0.947, P < 0.01) respectively.

CONCLUSIONSCaveolin-1 upregulation is associated with the development of portal hypertension in liver cirrhosis. Over-expression of caveolin-1 in perisinusoidal cells may promote caveolin-1-eNOS binding and reduce the activity of eNOS.

Animals ; Caveolin 1 ; metabolism ; Hypertension, Portal ; metabolism ; Liver Cirrhosis, Experimental ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo analyze the metaphase outcome of total hip arthroplasty with Zweymuller system and deepening acetabulum technique in treating DDH.

METHODSFrom Jan.1998 to Dec. 2004,56 patients (62 hips) with DDH (secondary osteoarthritis) were treated with total hip arthroplasty with Zweymuller system. There were 14 males (15 hips) and 42 females (47 hips) with an average age of 48.6 years,ranged from 30 to 67 years. All patients had pain of hip joint and functional disturbance before operation. Observation items included postoperative complications,imaging and function of hip joint. The function of hip joint was analyzed according to Harris scoring.

RESULTSAll patients were followed up from 5 to 11 years with an average of 6.5 years. X-rays showed that the acetabular cup was in the position of true acetabulum, which combined tightly with the peripheral bone, the abduction angle of the acetabular cup was from 35 degrees to 45 degrees, introversion and extroversion of the femoral prosthesis was within 3 degrees, operated legs were shorter with a mean of (0.5 +/- 0.2) cm. The complications were as following:deep vein thrombosis in 20 cases,which were improved after thrombolysis;hip dislocation in 1 case,which was treated with reduction and immobilization for 3 weeks; ectopic ossification in 4 patients,all were Brook II type; no found infection or nerve injury. The Harris scoring was 87.4 +/- 3.5 postoperative,which was significant higher than that preoperative (43.2 +/- 6.7).

CONCLUSIONThe metaphase outcome of total hip arthroplasty with Zweymuller system and deepening acetabulum technique in treating DDH can obtain good result.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Bone Diseases, Developmental ; diagnostic imaging ; surgery ; Female ; Follow-Up Studies ; Hip ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome