Objective To investigate the arthroscopic presentations of knee joint of rheumatoid arthritis (RA). Methods During December 2005 to February 2008,223 patients with RA in our department underwent knee arthroscopy examination. The arthroscopic presentations of 310 knee joints were analyzed retrospectively. Results Synovial hyperplasia were observed in 305 knees (98.4% ) out of 310 ones. The medial part (88.4%), intercondylar fossa (86.1%) and lateral space (83.2%) were the most frequent localization of synovial hyperplasia, which was less common in the suprapatellar bursa. Hyperplastic synovium of 296 knees had coralloid or cotton-wool like presentation, with central nourishing vessels. Nine knees were lichen-like hyperplasia, without nourishing vessels. Different degrees of pathological changes or defect could be seen in 301 knees, including merely cartilage degeneration in 63 knees, cartilage degeneration plus cartilage damage or defect in femoral medial condyle or lateral condyle in 124, 163 knees, in which 53, 45 with the damage deep to the cancellous bone. Most anterior or posterior cruciate ligament (in 274 knees) were covered with hyperplastic synovium, anterior cruciate ligament of 51 knees were partial ruptured, 5 ones were completely ruptured,while 23 and 1 case had these presentations in the posterior cruciate ligament.. Meniscus damage was commonly seen under arthroscope. 234 and 38 knees had medial meniscus torn or disappeared completely, while 214 and 45 in the lateral meniscus. Conclusion Synovial hyperplasia is commonly seen in knee joints of RA and most commonly seen in the intercondylar fossa, medial space and lateral space, but less common in the suprapatellar bursa. The hyperplastic synovium appears most often in the coralloid or cotton-wool like form, Cartilage damage is commonly seen in knee joints of RA. The most serious damage of the cartilage is seen in the femoral medial condyle or lateral condyle. Partial or complete anterior cruciate ligament rupture can be seen in one proportion of knees. In most knees of RA, meniscus are torn or disappeared mostly or completely.

Objective:To investigate the impact of body mass index (BMI) on delayed extubation of patients with acute Stanford type A aortic dissection (ATAAD).Methods:A total of 400 ATAAD patients who were admitted to our hospital from October 2021 to October 2023 and underwent surgical treatment were selected as the research objects. According to BMI, they were divided into obese group (BMI≥28 kg/m 2, 119 cases) and non-obese group (BMI<28 kg/m 2, 281 cases). The differences of preoperative clinical characteristics, intraoperative and postoperative data between the two groups were compared. Starting from transferring to the ICU and ending with the first successful extubation, The risk factors of postoperative invasive mechanical ventilation time ≥ 48 h in ATAAD patients were analyzed, and the predictive efficacy of related factors for postoperative invasive mechanical ventilation time ≥ 48 h in ATAAD patients was evaluated. Results:Compared with the non-obese group, the proportion of hypertension, diabetes, admission heart rate, admission systolic blood pressure, admission diastolic blood pressure and preoperative white blood cell count in the obese group were significantly increased, and the differences were statistically significant ( P<0.05). The cardiopulmonary bypass time, aortic cross-clamp time, operation time, red blood cell transfusion volume, invasive mechanical ventilation time, secondary operation rate and total hospitalization cost in the obese group were significantly higher than those in the non-obese group, and the differences were statistically significant ( P<0.05). Univariate logistic regression analysis showed that BMI, cardiopulmonary bypass time, ascending aortic cross-clamp time, operation time, age, hypertension, and red blood cell transfusion were related factors for postoperative invasive mechanical ventilation time ≥48 h in ATAAD patients ( P<0.05). Logistic multivariate regression analysis showed that increased BMI ( OR=1.213, P<0.05) and increased age ( OR=1.020, P<0.05) were independent risk predictors of postoperative invasive mechanical ventilation time≥48 h in ATAAD patients. Receiver operating characteristic curve ( ROC) analysis showed that the area under the ROC curve ( AUC) of BMI for predicting the duration of postoperative invasive mechanical ventilation in ATAAD patients≥48 h was 0.682 ( P<0.05), and the best predictive cut-off value was 25.64 kg/m 2. Conclusion:BMI≥28kg/m 2 increases the difficulty of surgery and the duration of invasive mechanical ventilation in ATAAD patients. BMI has a high predictive value for the duration of invasive mechanical ventilation in ATAAD patients after surgery ≥48 h, and effective intervention measures can be formulated to improve the treatment effect of patients.