Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Objective To observe the analgesic effect of COX-2 inhibitors combined with PCA in treatment of the pain after total knee arthroplasty(TKA)and explore novai method for pain control after TKA. Methods This study was,a double blind,controlled,randomized,placebo-controlled,parallelgroup and single center study and obtained the consent of the Medical Ethics Committee of Chongqing Medical University.Inclusion criteria:the patients with severe trauma or degenerative knee,at age of 58-75 vears.ASA Ⅰ or Ⅱ, tolerance of the intravenous anesthesia.The same solvent formula of PCA was routinely prepared based on body weight after TKA.Intravenous injection of 40 mg Parecoxib plus 2 ml normal saline or injection of only 2 ml normal saline was done when closing the incision.which was recorded and prescribed by the researcher A.The same reagent waft,used continually every other 12 hours till48 hours.Celecoxib or placebo capsules was not usod orally at 72 hours until two weeks later.The knee ioint function was observed preoperatively and at days 3,7 and 15 after TKA. Results The study was completed in 60 patients including 30 patients in the group treated with Parecoxib and Celecoxib sequential therapy and 30 patients in placebo-control group.There was no statistical difference in aspects of general condition in both groups(P>0.05).There was no statistical difference in aspect of preoperative knee score between two groups(P>0.05).The analysis showed statistical difference in the knee function score at days 3.7 and 15 after operation(P<0.05 or0.01).Conclusions The COX2 inhibitors combined with PCA has definite analgesic effect on the pain after TKA,which positively correlates with early modified HSS evaluation of TKA.

Objective To observe clinical results and indications of open reduction and internal fixation by bold canal titanium screws for treatment of radial head fractures. Methods From May 2003to February 2007,18 cases of radial head fractures were treated by open reduction and intemal fixation with bold canal titanium screws.There were 12 males and 6 females at age range of 15-53 years(mean 28.6 years).Of all,13 cases had Mason typeⅡ fractures,3 Mason typeⅣ and 2 Mason typeⅣ.Rehabilitation began as early as possible after operation if the internal fixation was secure;otherwise,rehabilitation began 2 weeks after operation.Postoperative plain radiography was made to observe fracture healing and complications. Results After operation,the rehabilitation was done at the first day in 15 cases and at 2 weeks in 3,with mean fracture healing time of 3 months.Function of elbows and rotation of forearnls were excellent except for 2 eases with Mason Ⅳ fractures.No deep branch of radial nerve injury occurred. Conclusion Open reduction and internal fixation with bold titanium canal screws can attain satisfactory clinical results in treatment of Mason type Ⅱ and Mason typeⅢradial head fractures.

Objective To discuss causes and corresponding prevention for groin pain occurred early after total hip arthroplasty(THA).Methods A retrospective study was done on 189 cases(193 hips)treated with THA including unilateral procedures in 185 hips and bilateral procedures in eight hips to analyze common causes for early groin pain.Results Groin pain was found in 9.3% hips(18/ 193)during hospital stay,including 1.6%(3 cases)with deep infection,1.6%(3 cases)with incision infection,1%(2 cases)with posterior dislocation,4.1%(8 cases)with leg lengthening and 1%(2 cases)with hematoma.Conclusions Despite of the numerous diagnostic alternatives available to the orthopedic surgeon,detailed history,careful physical examination,necessary laboratory and imaging stud- ies can contribute to a correct determination of causes for groin pain.Meanwhile,appropriate indication, accurate preoperative radiographic measurement,intraoperative standardized surgical procedures and per- fect rehabilitation are necessary to avoid complications.

ObjectiveTo preliminarily investigate the relationship between the chronic hepatitis C virus (HCV) genotypes, 2a and 1b, and thyroid hormone levels and autoantibodies. MethodsIn patients who were admitted to our hospital and diagnosed with chronic hepatitis C from October 2013 to December 2014, reverse transcription-polymerase chain reaction was performed to determine the HCV genotype. A total of 196 patients with HCV genotype 2a or 1b were enrolled as subjects. The levels of thyroid hormone and thyroid autoantibodies were determined by chemiluminescence immunoassay, and the relationship between the HCV genotype and thyroid function was analyzed. Between-group comparison of continuous data was performed by t test, and the risk factors were evaluated by logistic regression analysis. ResultsIn the 196 patients with hepatitis C, 57.7% (n=113) were infected with HCV-2a, and 42.3% (n=83) were infected with HCV-1b. There were no significant differences in levels of thyroid hormone and thyroid autoantibodies between patients with HCV-2a and HCV-1b (P＞0.05). In the 92 patients who were treated with interferon, there were no significant differences in levels of thyroid hormone and thyroid autoantibodies between patients with HCV-2a and HCV-1b (P＞0.05). Logistic regression analysis showed that the genotype classification was not a risk factor for abnormal thyroid autoantibodies (OR=2.012, P＞0.05). ConclusionThere is no intrinsic link between chronic HCV genotype classification and thyroid function. The genotype classification has no substantial effect on thyroid function.

Objective To compare the effect of continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) on pain relief,rehabilitation efficacy,satisfaction degree following total knee arthroplasty (TKA) in an attempt to find a safe and effective analgesia at the stage of rehabilitation.Methods The records of 116 patients undergone unilateral TKA for osteoarthritis or rheumatoid arthritis of the knee were evaluated.The patients with preoperative American Society of Anesthesiology (ASA) score of 1 to 3 were randomized into CFNB group (58 cases) and PCIA group (58 cases) according to the random number table.Both operations were performed under ultrasound guidance.Postoperative visual analogue score (VAS),knee function,incidence of adverse reaction,and satisfaction degree were compared between the two groups.Results Regardless of the score at postoperative 4 and 12 hours,VAS between CFNB and PCIA groups revealed significant differences at postoperative 24 [(3.2±1.1)pointsvs (4.1 ±1.5)points],48 [(3.4±1.2)pointsvs (4.1 ±1.0) points] and 72 hours [(3.3 ± 1.2) points vs (4.0 ± 1.1) points] (all P ＜ 0.05).Time to achieve knee rehabilitation training objectives like straight leg raise,walking with crutches,and passive bending to 90° were similar between the two groups.Both groups achieved comparable knee function status with respect to Hospital for Special Surgery (HSS) score,Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score,and maximal knee flexion angle at postoperative 3 months.Postoperative nausea and vomit were significantly more frequent in PCIA group (24％) than in CFNB group (14％) (all P ＜O.05),but patients in both groups were satisfactory.Conclusion Ultrasound guided CFNB is an effective analgesic method during the early stage of TKA,for it can control pain,accelerate rehabilitation training and function recovery,reduce adverse reaction as well as improve patients' satisfaction.

The aim of this research was to evaluate the influence of steam sterilization on poly(ethylene glycol-terephthalate) and poly(butylene terephthalate) copolymer (PEGT/PBT) and its vascular cells compatibility, which was used as the scaffolds in vascular tissue engineering. Endothelial cells, smooth muscle cells and fibroblasts were cultured separately on the films after steam sterilization and after ultraviolet sterilization. These cells can grow well on the films after ultraviolet sterilization, while they can hardly adhere on steam sterilized films. Differential scanning calorimetry, static contact angle, X-ray photoelectron spectroscopy, surface carboxyl density quantity, H-nuclear magnetic resonance and scanning electronic microscope were employed to characterize the properties of poly(ether-esters) films before and after sterilization. These results showed that steam sterilization had little effect on the surface morphology and on the constitution of the copolymer, but the copolymer segments were redistributed during steam sterilization. The hydrophilic poly(ethylene glycol) (PEG) and the end carboxyl groups transferred from the bulk and enriched on the surface and the degree of crystallinity of hard segments increased slightly. Both the end carboxyl and PEG enriched on the surface can hinder the protein adhesion on the surface; so, lacking in receptor, the vascular cells cannot adhere on the films surfaces.
Biocompatible Materials ; chemistry ; Cell Adhesion ; Endothelial Cells ; cytology ; Humans ; Polyesters ; chemistry ; Polyethylene Glycols ; chemistry ; Polyethylene Terephthalates ; chemistry ; Steam ; Sterilization ; Surface Properties ; Umbilical Veins ; cytology

Objective To use estimation of physiologic ability and surgical stress (E-PASS) to assay operative risks in patients with hip fracture and to discuss its application value.Methods Sixtyfour patients with hip fractures were subjected to the retrospective review.There were 38 males and 26 females,at mean age of 54.3 years (range,19-84 years).The operative risk was assayed by E-PASS and postoperative complications as well as case fatality were detected and compared.Results Postoperative complications developed in 16 patients (25％).E-PASS score was significantly higher for the patients with postoperative complications than in those without [(0.64 ± 0.31) points vs (0.22 ± 0.31) points,P ＜ 0.05].Incidence of complications was significantly lower for patients with a E-PASS score ＜ 0.6 than for those with a E-PASS score ＞ 0.6 (19％ vs 50％,P ＜ 0.01).There were 2 deaths among 16 patients with a E-PASS score ＞ 0.6.The remaining 48 patients with a E-PASS score ＜ 0.6 obtained satisfactory recovery.Conclusion E-PASS is effective for predicting operative risk and is instructive for surgery decision in treatment of hip fractures.

Objective To explore the agreement of anterior chamber angle examination by slit lamp optical coherence tomography (SL-OCT) and gonioscope.Design Case series.Participants Thirteen patients with primary glaucoma (26 eyes) and 8 normal persons(16 eyes).Methods Anterior chamber angle was measured with SL-OCT and gonioscope in turns for temporal,nasal,superior and inferior quadrant.Results of two methods were analyzed and the data were analyzed with Pearson correlation coefficient and Kappa value.Main Outcome Measures Anterior chamber angle.Results The Pearson correlation coefficient of the two methods was 0.86(P=0.00)and the Kappa value is 0.75 (P=0.00).The specificity and sensitivity of detecting occludable angle were 94.7% and 89.4%.Conclusions Anterior chamber angle examination with SL-OCT and gonioscope are well consistent.The specificity and sensitivity for SL-OCT in detecting occludable angle is satisfying.SL-OCT can be regard as an objective assistant method for the diagnosis of angle closure glaucoma.

Objective To investigate the curative effect of modified tracheal catheter in acute respiratory failure caused by central airway stenosis.Methods 16 cases inpatient with acute respiratory failure caused by central airway stenosis were involved.Found out the position and range of stenosis of central airway by X-ray and CT of chest and fiberbronchoscope,chose the suitable silicon suction tube and cut it to make a tracheal catheter,then guided the catheter through the stenosis by fiberbronchoscope to construct artificial airway.Results The dyspnea of all 16 cases of acute respiratory failure caused by central airway stenosis could by relieved in short time,the PaO_2 raised from(39?12)mm Hg to(72?10)mm Hg,SaO_2 raised from(75?13)% to(93?3)%,PaCO_2 dropped from(102?21)mm Hg to(62?13)mm Hg after therapy.The effective rate is 100%.There was no other serious complication except for 2 cases of little amount of bleeding in trachea.15 cases survived and one died of serious muhisystem organ failure.Conclusions The use of modified tracheal catheter in treatment of acute respiratory failure caused by central airway stenosis can relieve the acute dyspnea in short time,it also can dilate central airway,save the cost of tracheal balloon dilatation for the follow-up therapy.