BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

Actins ; metabolism ; Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Hypophosphatemia ; blood ; etiology ; Ilium ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Osteomalacia ; blood ; etiology ; Phosphates ; blood ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tomography, X-Ray Computed

The survey of traditional knowledge related to Chinese materia medica resources is the important component and one of the innovative aspects of the fourth national survey of the Chinese materia medica resources. China has rich traditional knowledge of traditional Chinese medicine (TCM) and the comprehensive investigation of TCM traditional knowledge aims to promote conservation and sustainable use of Chinese materia medica resources. Building upon the field work of pilot investigations, this paper introduces the essential procedures and key methods for conducting the survey of traditional knowledge related to Chinese materia medica resources. The essential procedures are as follows. First is the preparation phrase. It is important to review all relevant literature and provide training to the survey teams so that they have clear understanding of the concept of traditional knowledge and master key survey methods. Second is the field investigation phrase. When conducting field investigations, survey teams should identify the traditional knowledge holders by using the 'snowball method', record the traditional knowledge after obtaining prior informed concerned from the traditional knowledge holders. Researchers should fill out the survey forms provided by the Technical Specification of the Fourth National Survey of Chinese Materia Medica Resources. Researchers should pay particular attention to the scope of traditional knowledge and the method of inheriting the knowledge, which are the key information for traditional knowledge holders and potential users to reach mutual agreed terms to achieve benefit sharing. Third is the data compilation and analysis phrase. Researchers should try to compile and edit the TCM traditional knowledge in accordance with intellectual property rights requirements so that the information collected through the national survey can serve as the basic data for the TCM traditional knowledge database. The key methods of the survey include regional division of Chinese materia medica resources, interview of key information holders and standardization of information.' In particular, using "snowball method" can effectively identify traditional knowledge holder in the targeted regions and ensuring traditional knowledge holders receiving prior informed concerned before sharing the information with researcher to make sure the rights of traditional knowledge holders are protected. Employing right survey methods is not only the key to obtain traditional knowledge related to Chinese materia medica resources, but also the pathway to fulfill the objectives of access and benefit sharing stipulated in Convention on Biological Resources. It will promote the legal protection of TCM traditional knowledge and conservation of TCM intangible, cultural heritage.
China ; Data Collection ; Databases, Pharmaceutical ; Drugs, Chinese Herbal ; Materia Medica ; Medicine, Chinese Traditional

OBJECTIVETo evaluate the clinical effects of single posterior debridement, bone grafting, internal fixation and local chemotherapy in treating thoracolumbar spinal tuberculosis.

METHODSFrom February 2009 to September 2012,11 patients with thoracolumbar spinal tuberculosis were treated by single posterior debridement, bone grafting, internal fixation and local chemotherapy. There were 7 males and 4 females, aged from 27 to 65 years old with an average of 53.7 years. The courses of disease was from 3 months to 2 years with the mean of 9 months. According to ASIA standard of spinal cord injury, 3 cases were grade C and 8 cases D. After treatment, clinical effects were evaluated by ASIA grade, visual analogue score (VAS) and Oswestry Disability Index (ODI); kyphosis Cobb angle change was observed by X-rays.

RESULTSEleven patients were followed up from 12 to 29 months with an average of 18 months. ASIA grade of spinal cord injury, 3 patients with grade C improved to grade D in 2 cases and grade E in 1 case 8 patients with grade D improved to grade E in 7 cases and unchanged in 1 case. VAS decreased from preoperative 6.10 ± 1.30 to 1.70 ± 0.80 at 3 d after operation (P < 0.05). ODI improved from preoperative (68.36 ± 10.41)% to (14.55 ± 8.99)% (P < 0.05) at 3 d after operation. Kyphotic Cobb angle was corrected from preoperative (22.64 ± 4.84)° to (4.27 ± 1.49)° (P < 0.05) on the 3rd day after operation, and angle loss was mild at final follow-up, there was no significant difference between postoperative at 3 d and final follow-up.

CONCLUSIONSingle posterior debridement, bone grafting, internal fixation and local chemotherapy for the treatment of thoracolumbar spinal tuberculosis can effectively remove the lesion, improve nerve function and correct deformity, has advantage of single incision, little trauma, and low recurrence rate. But it still need long-term and systemic treatment with anti-TB drugs.

Adult ; Aged ; Bone Transplantation ; Debridement ; Female ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; therapy

Objective To understand the hypertension prevalence situation and its associated factors among residents in Hu‐bei Province to provide a reference basis for preventing and controlling residents′ hypertension .Methods The residents aged 15 years old or more were sampled from 20 counties (cities and districts) by adopting the multi‐staged stratified cluster sampling .The unified questionnaire was adopted to conduct the face to face interview by entering home .The multivariate Logistic regression was used to analyze the influencing factors of hypertension .Results A total of 28 555 respondents were investigated ,4 135 respondents reported hypertension and the hypertension prevalence rate was 14 .48% .The hypertension prevalence rate in urban residents was 18 .41% ,which was higher than 11 .71% in rural residents(P<0 .01) .The prevalence rates in males and females were 14 .10% and 14 .83% respectively ,showing no statistically significant difference between males and females (P>0 .05) .The multivariate Logistic regression results revealed that the risk of hypertension was increased with age ;compared with job‐hololers ,the retired(OR=1 .44 , 95% CI:1 .25-1 .65)and the unemployed(OR=1 .29 ,95% CI:1 .15-1 .46)had more possibility to suffer from hypertension ;higher income earners had lower risk of hypertension ;obese people(OR=3 .09 ,95% CI:2 .63~3 .63)and diabetes(OR= 3 .87 ,95% CI:3 .30-4 .52)were more likely to suffer from hypertension .Conclusion The prevalence rate of hypertension among residents aged 15 years old or more in Hubei Province presents the increasing trend ,which needs the corresponding departments and institutions to adopt the measures to actively prevent and control hypertension .

Objective To study the prevalence rate and influential factors of diabetes among residents aged over 15 in Hubei province to provide evidences for diabetes control .Methods Through stratified cluster sampling ,20 cities and counties ,including 100 blocks and towns ,200 communities and villages were sampled .Household survey was carried out from October to November , 2013 .Data was analyzed with SPSS18 .0 .Results In total ,28 555 eligible residents were surveyed ,among which 823 (2 .88% ) self‐reported being diagnosed as diabetes .The prevalence rate for urban and rural residents were found as 4 .37% and 1 .83% respective‐ly ,that of male and female as 2 .61% and 3 .13% respectively .Residents aged 65 and above reported highest prevalence rate (6 .61% ) while those from 25 to 34 years old had the lowest (0 .06% ) .Multiple logistic regression analysis yielded results that ru‐ral‐urban residence ,age ,occupational status ,type of medical insurance ,alcohol drinking and obesity were influential factors of diabe‐tes .Conclusion Prevalence rate of diabetes among residents aged over 15 in Hubei province was at a relatively lower level and there were differences between population subgroups .

OBJECTIVETo observe the effect of natural type ginsenoside Rg2 (Rg2) and its stereoisomers [20 (R)-Rg2 and 20 (S)-Rg2] at different concentrations on oxygen-glucose deprivation/ reperfusion (OGD/R) induced cortical neuronal injury model in vitro, and to explore the mechanism, and compare their differences of action.

METHODSCortical neurons after 7-day culture were randomly divided into 5 groups, i.e., the control group, the model group, the Rg2 group, 20 (R) -Rg2 group, and 20 (S) - Rg2 group. Cortical neurons in the Rg2 group, 20 (R)-Rg2 group, and 20(S)-Rg2 group were pretreated with 20, 40, and 80 μmol/L Rg2, 20 (R) -Rg2, and 20 (S) -Rg2 for 24 h to prepare OGD/R model. The cell survival rate, the activity of Caspase-3, the intracellular Ca2+ concentration, contents of superoxide dismutase (SOD) and malondialdehyde (MDA) were detected 24 h later.

RESULTSCompared with the control group, cell survival rates and activities of SOD obviously decreased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly increased with statistical difference (P < 0.05). Compared with the model group, cell survival rates and activities of SOD obviously increased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly decreased in 20 μmol/L Rg2 group, 40 μmol/L 20 (R) -Rg2 group, and 80 μmol/L 20 (S) -Rg2 group (P < 0.05). Compared with 20(S)-Rg2 group, cell survival rates increased and contents of MDA significantly decreased in 20, 40, and 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). The activity of Caspase-3 decreased and contents of SOD increased in 80 μmol/L 20 (R)-Rg2 group, and 40, 80 μmol/L Rg2 groups (P < 0.05). Ca2+ fluorescent optical gray value decreased in 40, 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). Compared with 20 (R)-Rg2 group, Ca2+ fluorescent optical gray value decreased in 80 μmol/L Rg2 group (P < 0.05); contents of SOD increased in 40 and 80 μmol/L Rg2 groups (P < 0.05); contents of MDA decreased in 20, 40, and 80 μmol/L Rg2 groups (P < 0.05).

CONCLUSIONSRg2 and its stereoisomers could improve cell vitality of cortical neurons against OGD/R induced injury. This might be related to improving anti-apoptotic capacities and antioxidant abilities, and reducing Ca2+ inflow. Besides, the neuroprotective effect of 20 (R) -Rg2 was better than that of 20 (S) -Rg2, but inferior to that of Rg2.

Antioxidants ; metabolism ; Apoptosis ; Calcium ; metabolism ; Caspase 3 ; metabolism ; Cell Survival ; Cells, Cultured ; Ginsenosides ; pharmacology ; Glucose ; Humans ; Malondialdehyde ; metabolism ; Neurons ; drug effects ; Neuroprotective Agents ; pharmacology ; Oxygen ; Random Allocation ; Reperfusion Injury ; Stereoisomerism ; Superoxide Dismutase ; metabolism

Objective To compare maternal and neonatal outcomes after induction,elective cesarean section and spontaneous onset of labor in uncomplicated term nulliparous women.Methods A total of 3751 uncomplicated term nullipara who delivered in Peking Union Medical College Hospital from Sept 2002 to April 2007 were retrospectively analyzed.They were divided into three groups:the induction group, the elective cesarean section group,and the spontaneous onset of labor group.Their general conditions (such as age,weeks of pregnancy,hospital days and cost),postpartum complications(such as postpartum hemorrhage,puerperal morbidity,urinary retention,blood transfusion,delayed healing,and trauma),and Apgar score were compared by statistic methods.Results(1)Among 3751 women,501(13.3%)of them underwent induction(the induction group),1634(43.6%)delivered by cesarean section(cesarean section group),the other 1616(43.1%)women underwent spontaneous onset of labor(the spontaneous onset of labor group).(2)Results of general conditions:the spontaneous onset of labor group had the shortest hospital days,which was longer in the induction group,and the longest in the selective cesarean section group(P

Objective To investigate the current status of tobacco control in public places in Jiading District, after the introduction of "Tobacco Control Regulation in Public Places of Shanghai" (amendment), providing basic data for further implementing regulations. Methods The method of field observation was adopted to conduct the monitoring in 14 representative public places, including site staff in 109 places in April and September. Results The display rate of tobacco control propaganda increased(χ²=10.588, P < 0.001), but the posting rate of pictures for smoking control warnings decreased(χ²=6.272, P=0.012);the differences between two monitoring results were both statistically significant; the smoking rate in the staff within the workplaces decreased to 5.17%(χ²=20.973, P < 0.05);the differences between two monitoring results were both statistically significant. Conclusion The situation of tobacco control in Jiading District public places is good, but in some places smoking control should be further strengthened, and the intensity of tobacco control in public places should be maintained.

OBJECTIVETo investigate the antagonistic effects of three species of oral Streptococcus on the growth of oral Saccharomyces albicans in vitro.

METHODSDirect inoculation method, reverse inoculation method and mixed culture methods were respectively chosen to observe the changes of Saccharomyces albicans colony formation on the effects of Streptococcus mutans, Streptococcus sanguis and Streptococcus salivarius.

RESULTS1) No clear inhibition zone was observed in each of the groups by direct inoculation method. 2) Compared with the control groups, Saccharomyces albicans colony formation on soft agar of Streptococcus sanguis decreased significantly (P < 0.05). 3) Mixed culture method results showed that Streptococcus mutans could inhibit the growth of Saccharomyces albicans significantly at different time points (P = 0.001). 4) Under the action of bacteria culture supernatant, the count of Saccharomyces albicans in experiment groups showed statistical significance when compared with the control groups at 24, 48, 72 h (P = 0.001); The differences among the experimental groups were of no statistical significance at majority times (P > 0.05).

CONCLUSIONStreptococcus mutans, Streptococcus sanguis, and Streptococcus salivarius could obviously inhibit the growth of Saccharomyces albicans in vitro. However, it is still unclear that among which the inhibition effects is stronger. The antagonistic effects is weakened gradually.

In Vitro Techniques ; Saccharomyces ; Streptococcus ; Streptococcus mutans ; Streptococcus sanguis