OBJECTIVETo compare therapeutic effects between patella replacement and patella osteotomy in total knee arthroplasty.

METHODSFrom April 2004 to April 2011, 52 patients (54 knees) were enrolled in the clinical trail of total knee arthroplasty, who received patella replacement (24 knees, including 13 males and 11 females,ranging in age from 53 to 78 years old or patella osteotomy (30 knees,including 16 males and 12 females,ranging in age from 55 to 79 years old. The average follow-up period was 56 months,ranging from 20 to 80 months. The American HSS Score for knee, the Feller score for patella, range of motion (ROM) for knee, patient satisfaction and complications related to the patella were used to evaluate therapeutic effects.

RESULTSIn the patella replacement group,the preoperative and final follow-up HSS scores of patients were 38.4 +/- 8.2 and 91.2 +/- 8.6 respectively; Feller scores were 13.6 +/- 6.2 and 25.2 +/- 4.2; scores of anterior knee pain were 3.9 +/- 3.2 and 11.2 +/- 3.7; ROM were (78 +/- 26) degrees and(108 +/- 18) degrees. In the patella osteotomy group,the preoperative and final follow-up HSS scores of patients were 39.5 +/- 8.4 and 91.0 +/- 8.5 respectively;Feller scores were 13.4 +/- 6.5 and 25.6 +/- 4.0; scores of anterior knee pain were 3.7 +/- 3.1 and 11.3 +/- 3.6; ROM were (76 +/- 27) degrees and (110 +/- 19) degrees. In the patella replacement group,patient's satisfaction was 91%, and complication related to the patella was 16.7%; in the patella osteotomy group, patient's satisfaction was 89%, and complications related to the patella was 10.0%. There were no statistically significant differeneces in final follow-up HSS scores, Feller scores, scores of anterior knee pain and ROM between the two groups. However,there was no significant difference of patient's satisfaction between them. There was statistically significant differenece of patella-related complications between the two groups, and the complication rate in the patella replacement group was higher than that in the patella osteotomy group.

CONCLUSIONTotal knee arthroplasty with patella replacement or patella osteotomy dramatically relieves pain and improves the knee function. Patella-related complications are associated with its treatment methods, but post-operative anterior knee pain and patient's satisfaction are not related to treatment methods of the patella.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Case-Control Studies ; China ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteotomy ; adverse effects ; Pain, Postoperative ; epidemiology ; etiology ; Patella ; surgery ; Treatment Outcome

Oral iron is a commonly used preparation for the treatment of iron deficiency and iron-deficiency anemia in children, but its undesirable taste has become a major factor affecting clinical adherence to the medication. No studies have been conducted to evaluate the palatability of oral iron supplements. Thirteen representative oral iron supplements were selected to evaluate the palatability of oral iron supplements from different perspectives of in vivo and ex vivo by combining the electronic tongue (e-tongue) test, FaceReader facial expression analysis technology and taste interviews. E-tongue test results showed that iron dextran granlues were closest to odorless potassium chloride solution, basically free of bitterness and astringency, which was superior to the other products. FaceReader facial expression results showed that 58.7% of the subjects valued iron dextran granlues for their emotional efficacy higher than that of iron proteinsuccinylate oral solution. Among 43 participants aged ≥ 5 years, the taste preference for iron dextran granlues was 83.7%, and 83.7% of participants chose to take iron dextran granlues again. This study found that iron dextran granlues have a better taste and their flavor is more popular among children, which provides a reference for pediatric clinical use of oral iron supplementation preparations and a new idea for the evaluation of palatability of medications for children. This in vivo palatability evaluation is an investigational clinical trial that was approved by the Institutional Review Board of the Beijing Children's Hospital (No. 2021-149-Y).

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.

AIMTo establish an assay method for the determination of three kinds of biologically active components, five compounds (emodin, chrysophanol, baicalin, wogonin and berberine hydrochloride) simultaneously in Sanhuang tablets.

METHODSHPLC was carried out, using a C18 column (150 mm x4. 6 mm ID, 5 microm) set at 30 degrees C, acetonitrile-0.02 mol x L(-1) acetic ammonium (adjusted pH to 3. 50 with acetic acid glacial) as mobile phase (using gradient) with flowing rate 1. 00 mL x min(-1) and detected at 270 nm.

RESULTSThe calibration curve of emodin was linear from 0.020 7 microg to 0.207 microg with r = 0.999 9, the average recovery was 99.65% with RSD 1.25%. The calibration curve of chrysophanol was linear from 0.052 microg to 0.52 microg with r = 0.999 9, and the average recovery was 100.36% with RSD 0.96%. The calibration curve of baicalin was linear from 0.250 5 microg to 2.505 microg with r =0.999 8, and the average recovery was 100.22% with RSD 1.29%. The calibration curve of wogonin was linear from 0.047 6 microg to 0.476 microg with r = 0.999 9, and the average recovery was 98.97% with RSD 1.20%. The calibration curve of berberine hydrochloride was linear from 0.053 12 microg to 0.531 2 microg with r = 0.999 5, and the average recovery was 96.02% with RSD 2.02%. The established method had also been used in the determination of the 5 compounds in 10 different batches of Sanhuang tablets.

CONCLUSIONThis method was proved to be accurate and quick, and can be used for the quality control of the preparation all-around.

Anthraquinones ; analysis ; Berberine ; analogs & derivatives ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coptis ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; isolation & purification ; Emodin ; analysis ; Flavanones ; analysis ; Flavonoids ; analysis ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results ; Rheum ; chemistry ; Scutellaria baicalensis ; chemistry ; Tablets

Bacterial biodiversities of microbial mat and sediments, which were sampled from thermal springs of Tengchong Rehai in Yunnan, were preliminarily studied with PCR-denaturing gradient gel electrophoresis (PCR-DGGE). Directly extracted total DNA from environmental samples amplified by PCR with two sets of bacteria-specific primers. The PCR products, which include the V 8 and V 9 high-variable regions respectively, were analyzed by using DGGE. The DGGE profiles not only indicated the existence of higher levels of bacterial diversity, but also showed that the microbial mat and sediments have different dominant bacteria. Furthermore, the bacterial PCR-DGGE displayed clear profiles of bacterial structure selected by the key abiotic factors of the extreme environments, such as temperature and concentration of oxygen.

Objective To study the clinical features,diagnosis and treatment of eosinophilic granuloma of bone(EGB).Methods Twelve cases(8 male and 4 female)of EGB and their medical record,imaging examinations,follow-up data were reviewed,and the lesion sites,symptom and clinical features were analyzed with reference to relative literature.Results Nine unifocal cases were found in the cervical spine(3 cases),the thoracic spine(1 case),the lumber spine(1 case),the femur(1 case),the metacarpal bones(1 case),and the ilium(2 cases).Three multifocal cases were found in the thoracic and lumber spine(1 case),in the femur,the multiple ribs,the skull,the scapula(1 case)and in the skull,the femur,the ilium(1 case).The most common presenting symptom was pain at the lesion site and restricted motion was obviously in the cervical lesion.The case of the thoracic lesions was found neurologic deficit.Osteolytic destruction was found in the radiologic examination in EGB and the periosteal reaction was found in the long bone lesions,and vertebra plana was considered as typical cha-racteristics in the spine lesion.The lesions not in the spine were diagnosed by biopsy,exclusive methods and close following-up were performed in the spine lesions.Two unifocal were healed spontaneously and three were performed with curettage with one bone grafting.Multifocal and the lesions in the spine underwent chemotherapy.All cases were followed up and no recurrence was found.Conclusions EGB is commonly solitary and not seldom in the spine.Topical pain may be chief complaint.Osteolytic image was found in the radiologic examination.Biopsy and exclusive methods combining closely follow-up were used for diagnosis.EGB is self-limited observation,so curettage or chemotherapy can be used in treatment,and prognosis is good.

Background The fundus autofluorescence (FAF)can reflect the function of retinal pigment epithelium(RPE) cell.As an invasive examination,it has been extensive used in retina disease,but there has not any report in syphilitic posterior uveitis.Objective This study was to characterize and contrast the FAF and fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) findings in patients with syphilitic posterior uveitis.Methods A retrospective series of cases observational study was designed.The clinical data of 27 eyes from 18 patients with syphilitic posterior uveitis were included in Shanghai First People's Hospital from 2010 May to 2012 October,and all the patients were diagnosed by serologic and ophthalmic tests.The patients were assigned to acute stage group(with the course ＜2 months)and chronic stage group(with the course ≥ 2 months).FFA,ICGA and FAF were performed respectively on all the patients,and the examination results were compared and analyzed.Results In the affected eyes with syphilitic posterior uveitis,the FFA image showed a retinal vasculitis sign and mottle-like fluorescence appearance in posterior pole and equator zone,and some affected eyes exhibited edema of optic disc and macula.Hypoautofluorescence zone was seen in the acute stage group and cystoid macular edema was found in the chronic stage group.ICGA presented with a wider damage of RPE,especially in the later phase of ICGA.A confluent of hyperautofluorescence with hypoautofluorescence in the posterior fundus,punctiform hyperautofluorescence as well as hypoautofluorescence in papillitis and macular edema were found on the FAF image.Conclusions The pathological basis of syphilitic posterior uveitis is retinal vasculitis and papillitis.ICGA indicates the damage of choroid membranes and RPE,and FAF reflects a metabolism disorder of RPE in the acute stage and atrophy and loss of RPE in the chronic stage.FAF is helpful for the diagnosis of syphilitic posterior uveitis as an assistant index.

OBJECTIVETo investigate the feasibility of using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people.

METHODSFrom June 2011 to May 2013, 91 patients with closed and fresh Barton fracture were analyzed retrospectively which information was complete. According to different methods these patients were divided into three groups: 33 patients in group A were treated by simplex fixation of gypsum or splint after manipulative reduction, including 20 males and 13 females with an average age of (63.27 ± 5.83) years old; 35 patients in group B were treated by percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation, including 23 males and 12 females with an average age of (64.25 ± 4.53) years old; 23 patients in group C were treated by open reduction and internal fixation including 15 males and 8 females with an average age of (64.04 ± 4.83) years old.

RESULTSAll the patients were followed up for 10 to 16 months with an average of 12 months by the method of recheckging in outpatient clinic. According Dienst scoring system: in group A, the result was excellent in 15 cases, good in 7 cases, fair in 11 cases; in group B, excellent in 25 cases, good in 6 cases, fair in 4 cases; in group C, excellent in 16 cases, good in 5 cases, fair in 2 cases. The excellent and good rate of group C was better than that of group B and A, further more group B is better than group A. According to X- ray standard, in group A, 26 patients were acceptable, 7 patients were unacceptable; in group B,28 patients were acceptable, 7 patients were uacceptable; in group C, 19 patients were acceptable,4 patients were unacceptable; there were no statistical significant difference (P > 0.05). There were 18 patients with emerging recrispation in group A, 10 patients in group B, 6 patients in group C, the result of group B and C was better than that of group A, and there was no statistically significant between group B and C (P > 0.05).

CONCLUSIONUsing percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people is an effective method, it has advantages of micro-invasived, reliable fixation, less complication, not need to fix wrist joint and early functional exercise.

Aged ; Bone Wires ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Radius Fractures ; therapy ; Retrospective Studies ; Splints

Objective To explore the effect of adenovirus carrying pigment epithelium-derived factor(ADV-PEDF)gene treatment on retinal neovascularization of mice with retinopathy of prematurity (ROP).Methods Sixty 7 d C57BL/6J mice were put into the environment with (750?5)mL/L oxygen for 5 days and returned to normal environment to establish animal models of ROP.The eyes in experimental group received an intravitreal injection of 1 ?L of ADV-PEDF,and the same volume of ADV-LacZ was injected into the eyes of mice in control group.The ADPase histochemical staining was used for retinal flatmount to observe changes of retinal vessels.The inhibitory effects of PEDF on retinal neovascularization were evaluated by counting the endotheliocyte nuclei of new vessels extending from retina to vitreous in the tissue-slice.The expression of PEDF in retina were detected by Western blotting.Results The vessels from optic disc were very thin and distorted in eyes of control group in retinal flatmount.There were avascular area around optic disc and neovascular trufts beside avascular area.Compared with control group,regular distributions and no conspicuous avascular area were found in eyes of experiment group in retinal flatmount.The number of the endotheliocyte nuclei of new vessels extending from retina to vitreous was less in the eyes of the experiment group than that in control group (P

OBJECTIVETo discuss the clinical significance of the reduction and fixation for femoral lesser trochanteric fragment in treating the femoral comminuted intertrochanteric fractures.

METHODSFrom January 2012 to December 2013,32 patients with intertrochanteric fractures were treated by surgery, and self-designed reduction fixators were used in the patients for the fixation of lesser trochanter of femur. There were 11 males and 21 females, ranging in age from 45 to 81 years old with an average of 64 years old. According to the Evans typing, 12 cases were type II, 13 cases were type III and 7 cases were type IV. Simple lag screw fixed in 19 cases and steel wire fixed in 13 cases. Hip joint function was evaluated according Harris score and the complications such as coxa adducta,cutting of femoral head and neck,implants breakage were observed.

RESULTSThirty-two patients were followed up from 9 to 24 months with an average of 13 months. Coxa adducta occurred in 1 case,no cutting of femoral head and neck occurred and implants breakage were found. The mean Harris score was 91.80 ± 3.05 in 32 patients.

CONCLUSIONThe reconstruction and fixation for the posterior medial bone cortex continuity is a key factor on affect the stability of femoral intertrochanteric fracture. Self-designed reduction fixators can effective reduce and fix the lesser trochanter of femur, it has advantage of fast reduction and fixation, and simple operation.

Aged ; Aged, 80 and over ; Equipment Design ; Female ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged