Total knee arthroplasty has become one of the effective operation methods on end-stage knee osteoarthritis. However,the postoperative pain has been plaguing the clinicians. The cause of postoperative pain can be divided into iatrogenic, prosthesis and patient. Pain treatment in perioperative period includes preoperative education, analgesia in advance, and the selection and design of reinforcement; during operation mainly includes the appropriate surgical approach, keep the balance of soft tissue around the knee joint, cocktail analgesia pain around the knee joint; after operation mainly includes oral analgesic drugs, femoral nerve tissue and patient controlled analgesia. And the multimodal analgesi.a which is the analgesic methods combined application in perioperative period raised in resent years fully intervene the pain in perioperative period,so that it can effectively reduce the pain of patients after knee replacement, promote the patients do functional exercise more better and get better operation result.
Analgesia, Patient-Controlled ; Arthroplasty, Replacement, Knee ; Humans ; Nerve Block ; Pain Management ; Pain, Postoperative ; drug therapy ; etiology

A simulation experiment was carried out by applying the simulation model to spread of influenza A (H1N1) in communities with different population density. Population at the community-level was divided into susceptible, infected and recovered ones, according to the susceptive-infective-removal (SIR) model, and the age structure of the population was set on the basis of data from the Fifth Population Census. Contact and moving of the individuals were based on the Network Random Contact Model and the mortality and infection mode were established in line with the influenza A (H 1N 1) medical description. The results of an example analysis showed that the infection rate was closely related to the density of the community-based population while the rate on early infection grew rapidly. Influenza A (H1N1) seemed more likely to break out in the community with population density of over 50/hm2. Comparative tests showed that vaccination could effectively restrain the spread of influenza A (H1N1) at the community level. Conclusion Population density,and the coverage of influenza vaccination were risk factors for influenza A (H1N1) epidemics.Results of the experiment showed of value, for prevention and vaccination on this topic.

Objective To investigate the diagnostic accuracy of 13C urea breath test (13C-UBT)in the diagnosis of Helicobacter pylori (Hp) infection in patients with gastric remnant.Methods A total of 94 gastric remnant patients (gastric remnant group) and 100 non-gastric remnant patients (control group) received 13C-UBT.According to the course of the disease,the gastric remnant group were divided into group 1 (29 cases,≤5 years),group 2 (33 cases,6 to 10 years) and group 3 (32cases,＞10 years).Before surgery,the diagnosis of Hp infection was according to 13C-UBT and gastric mucosa tissue staining.After surgery,the diagnosis was according to gastric mucosa tissue staining.The applying value of 13C-UBT in gastric remnant patients was evaluated.The consistency of results between 13C-UBT and gastric mucosa tissue staining were evaluated by the Kappa test.Results In gastric remnant group,the Hp infection rate after surgery (37.2％) was obviously lower than that before operation (79.8％;x2 =35.058,P＜0.01) and that of control group (77.0％).After surgery,the Hp infection rate of patients with Billroth Ⅱ gastrectomy (24.4％) was lower than that of patients with Billroth Ⅰ gastrectomy (47.2％ ; x2 =5.133,P=0.023).Before surgery,the Hp infection rate of gastric remnant subgroups were similar (P＞0.05).With the extension of the postoperative course,the Hp infection rate gradually decreased in gastric remnant subgroups (group 1:58.6％,group 2:36.4％,group 3:18.8％; x2=7.839,P=0.021).Setting the cut-off point at 2.0‰ in the gastric remnant group and 3.5‰ in the control group,the accuracy rate of diagnosis was the highest (92.6％ and 96.0％).There was good consistency between the results of 13C-UBT and gastric mucosa tissue staining (Kappa =0.84,P＜0.01).Conclusion With suitable operation and standard,13C-UBT may be a easy,safe and effective assay applied in the gastric remnant patients.

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

OBJECTIVETo explore the pathogenesis of idiopathic thrombocytopenic purpura (ITP) and improve the differential diagnosis from myelodysplastic syndromes (MDS).

METHODSPolymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was performed to detect the point mutation of codon 12,13 in N-ras gene and codon 301, 969 in fms gene in adult and aged ITP and MDS patients.

RESULTSIn 25 ITP patients, N-ras mutation and fms mutation were detected in one each (4%). Mutations were found in 3 of 8 MDS patients: two (25%) with N-ras mutation and one (12.5%) with fms mutation.

CONCLUSIONSPatients with N-ras or fms gene mutation diagnosed as MDS rather than ITP.

Adult ; Aged ; Female ; Genes, fms ; genetics ; Genes, ras ; genetics ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Purpura, Thrombocytopenic, Idiopathic ; genetics

Animals ; Cromolyn Sodium ; administration & dosage ; Disease Models, Animal ; Intestines ; blood supply ; Mast Cells ; drug effects ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; mortality ; pathology ; p-Methoxy-N-methylphenethylamine ; administration & dosage

OBJECTIVETo compare the curative effects of primary osteoporosis treated with heat-sensitive point moxibustion and Gaitianli (Oyster Shell and Calcium Carbonate Chewable) tablets for oral administration and explore the treatment mechanism.

METHODSSixty cases of primary osteoporosis were randomly divided into a heat-sensitive point moxibustion group (moxibustion group) and a Gaitianli tablets group (medication group), 30 cases in each group. In the moxibustion group, the heat sensitized points were searched around Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4) and treated by heat-sensitive point moxibustion; in medication group, Gaitianli tablets were taken by oral administration, 3 pills for once and 3 times a day. The curative effects, bone mineral density (BMD), alkaline phosphatase (S-AKP) and urinary calcium to creatinine ratio (U-Ca/Cr) in both groups were observed before and after treatment.

RESULTSThe total effective rate was 86.7% (26/30) in moxibustion group, superior to that of 76.7% (23/30) in medication group (P < 0.05). After treatment, the BMD of lumbar vertebrae (L2-L4) mean was improved (P < 0.05), and the S-AKP and U-Ca/Cr were reduced (all P < 0.05); in medi cation group, the indexes above were no obvious changes (all P > 0.05).

CONCLUSIONThe therapeutic effect of primary osteoporosis treated with heat-sensitive point moxibustion is superior to that with Gaitianli tablets for oral administration. The mechanism is restraining bone resorption, increasing bone strength, keeping balance of bone metabolism, in order to increase bone mineral density and improve the clinical symptoms.

Acupuncture Points ; Aged ; Alkaline Phosphatase ; blood ; Bone Density ; Calcium ; urine ; Creatinine ; urine ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Osteoporosis ; metabolism ; therapy

OBJECTIVETo investigate the clinical significance of plasmic L-plastin level in patients with colorectal cancer.

METHODSFrom March 2008 to March 2009, plasma samples were collected from 40 patients and 40 healthy controls. Plasmic L-plastin level was measured by ELISA kit and was compared to TIMP-1.

RESULTSPlasmic L-plastin level in patients with colorectal cancer was higher than that in healthy adults (1.662±0.386 vs. 0.485±0.085 μg/L, P<0.01). The sensitivity of L-plastin in the diagnosis of colorectal cancer was 67.5%, and the specificity was 80.6%. The Youden index was 0.481 and AUC was 0.772 (P<0.01). Plasmic L-plastin levels were associated with the tumor size (P=0.006), serosal penetration (F=4.687, P<0.05) and lymphatic metastasis (P<0.01). Compared to plasmic TIMP-1 level, L-plastin showed the same capability in indicating the depth of tumor. The specificity of L-plastin was better in indicating lymphatic metastasis (86% vs. 58%, χ2=4.2, P<0.05).

CONCLUSIONSPlasmic L-plastin level may serve as a potential marker in colorectal cancer.

Aged ; Case-Control Studies ; Colorectal Neoplasms ; blood ; diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Membrane Glycoproteins ; blood ; Microfilament Proteins ; blood ; Middle Aged ; Sensitivity and Specificity ; Tissue Inhibitor of Metalloproteinase-1 ; blood

The myelodysplastic syndromes (MDS) include a diverse groups of clonal and potentially malignant bone marrow disorders. Evidences exist that microenvironment cells from MDS marrow show functional abnormalities, which may be relevant to the incidence of such a disease. Mesenchymal stem cells (MSCs) are a very important component of hematopoietic microenvironment. This study was supposed to investigate the biological characteristics and functions of MSC derived from patients with MDS in low-risk. MSCs from bone marrow samples of 11 low-risk MDS patients were isolated, cultured and expanded. Morphology, immunophenotype and osteoblasts differentiation were analyzed. Their capacity of proliferation and hematopoietic supporting in vitro were measured. A real-time quantitative reverse transcriptase polymerase chain reaction method (RQ RT-PCR) was used for detecting the expression levels of relative cytokines and chemokines in MSC. MSCs from healthy donors were used as controls. The results showed that the culture-expanded cells from MDS patients displayed a typical fibroblast-like morphology. Cells were positive for SH2 (CD105), SH3 (CD73), Thy-1 (CD90), while negative for CD34 and CD45. After induction, these cells could differentiate into osteoblasts. The proliferative ability of MSCs in MDS patients were not different from those of MSC isolated from normal bone marrow (p > 0.05), however, their capacity of hematopoietic supporting in vitro were significantly weaker (p < 0.05). RQ RT-PCR detection indicated that the SDF-1 gene expression level in MSCs of low-risk MDS patients was significantly higher than that in MSC derived from healthy donors (p < 0.01). It is concluded that the abnormal function of MSC influences the regulation of hemotopoiesis in the bone marrow microenvironment of MDS patients. It is worthy to further investigate the new clue in etiological mechanism and therapeutic strategies for MDS.
Bone Marrow Cells ; pathology ; Chemokine CXCL12 ; genetics ; metabolism ; Hematopoiesis ; Humans ; Mesenchymal Stromal Cells ; pathology ; physiology ; Myelodysplastic Syndromes ; pathology ; physiopathology ; Risk Factors

Communicable Disease Control ; Communicable Diseases ; Forecasting ; Models, Statistical