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

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

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

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 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

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 explore the association between the leg length discrepancy and postoperative function after total hip arthroplasty.

METHODSFrom June 2004 to June 2007, the Leg length in 80 consecutive patients (38 males and 42 females, ranging in age from 56 to 86 years, with an average of 72.3 years) who underwent primary unilateral total hip arthroplasty was measured radiologically. Postoperative hip function and patients' satisfaction was assessed using the Oxford Hip Score (OHS) at three months and one year after surgery.

RESULTS(1) Leg length: 52 operated legs were longer than the other side by a mean of (9.2+/-3.2) mm (1 to 22 mm), in which 29 legs were longer for 1 to 10 mm (mean value 4.9 mm) and 23 legs were longer for 11 to 22 mm (mean value 14.6 mm); 13 operated legs were shorter by a mean of (6.4+/-2.1) mm (3 to 19 mm); 15 operated legs were of the same length as the other side. (2) Oxford hip scores: At three months after operation, the mean Oxford hip scores in patients with lengthened legs (two groups) were significantly higher (i.e., worse) than in the patients with shortened legs or in patients with legs of the same length. Significant difference in Oxford Hip Score was not found between the two groups of lengthened legs (1 to 10 mm vs 11 to 22 mm). Significant difference in Oxford Hip Score was also not found between the patients with shortened leg and the patients with legs of the same length. At one year after operation, the Oxford hip scores were significantly higher (i.e. worse) in the patients with lengthened limbs (11 to 22 mm) than in those of shortened limbs, or with limbs of equal length, or patients with lengthened legs (1 to 10 mm). No significantly differences of the Oxford hip scores were found within the patients with shortened limbs, the patients with limbs of equal length and the patients of lengthened limbs (1 to 10 mm). There was no significant difference between the Oxford hip scores at three months' follow-up and that at one year's follow-up in the lengthened group (11 to 22 mm), shortened group or same length group. The Oxford hip score was improved significantly one year after surgery when compared with that of three months after surgery in the lengthened group (1 to 10 mm).

CONCLUSIONLeg length discrepancy, especially for that 11 to 20 mm longer than the healthy side, affects the functional outcome after total hip arthroplasty, and it does not relieve over time. Well planned measures should be taken to minimize leg length discrepancy.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Female ; Humans ; Leg Length Inequality ; diagnosis ; etiology ; physiopathology ; Male ; Middle Aged ; Postoperative Complications ; etiology ; psychology

OBJECTIVETo study the efficacy of periarticular multimodal analgesic drugs injection in total hip arthroplasty.

METHODSSeventy-six patients undergoing total hip arthroplasty were randomly divided into two groups, 38 patients received periarticular intraoperative injection of multimodal analgesic drugs, and others not do. Pain of patients were evaluated with a visual analog scale postoperatively, and all patients received patient-controlled analgesia for 24 hours after surgery. The consumption of patient-controlled analgesia was recorded at different time-points.

RESULTSCompared to the control group, visual analog scores for pain of the patients of injected group had significantly lower in the post-anesthetic-care unit and four hours after surgery. Patients of the injected group used significantly less patient-controlled analgesia at 6, 12 hours, and over the first 24 hours after surgery than the control group. No adverse effects resulted from the multimodal analgesic drugs were noted in the injected group.

CONCLUSIONPeriarticular injection of multimodal analgesic drugs in total hip arthroplasty can significantly reduce the postoperative pain of patients and the consumption of patient-controlled analgesia.

Aged ; Aged, 80 and over ; Analgesia, Patient-Controlled ; Analgesics ; therapeutic use ; Arthroplasty, Replacement, Hip ; Female ; Humans ; Male ; Pain Measurement ; Pain, Postoperative ; drug therapy ; Treatment Outcome