Objective To evaluate the early clinic effects and anterior knee pain after total knee arthroplasty with or without patellar resurfacing.Methods From June 2010 to June 2011,100 patients who underwent TKA in our department were covered in this study,they were randomly divided two groups:resurfacing of the patellar (42 patients,50 knee) and nonresurfacing of the patellar (57 patients,66 knee).They were followed up at 6th month and 12th month.Comparison was performed with the West Ontario and McMaster Universities score (WOMAC) and Knee Surgery Society (KSS) score system,anterior knee pain visual analogue scale (VAS) score between two groups.Results Anterior knee pain VAS score had significant improvement postoperation in resurfacing groups and nonresurfacing group.But there was no statistical difference between two groups.In two groups,WOMAC scores at 6th month were 28.8±11.2 and 18.6±7.2,20.7±6.2 and 16.0±5.5 at 12th month.KSS scores at 6th month were 87.0±8.3 and 90.9±7.2,84.2±10.6 and 88.8±9.2 at 12th month.And the KSS function scores at 6th month were 86.6±21.6 and 84.9±16.5,85.2±16.4 and 91.0±10.0 at 12th month and had no statistical difference between two groups.In sunrise views (Bending 30 degrees),the curvature tolerance between patella and femoral trochlea was well at two timestamp postoperation without instability and dislocation.No revision of TKA and no re-resurfacing of patella one year after TKA.Conclusion TKA is very effective for relief of knee pain and improvement of joint function for OA and RA.Patella resurfacing and nonresurfacing have not significant difference during one year and two ways,and have the same good result in function and anterior knee pain improvement.

Obesity has been seriously endangering the human health,and it is one of the most serious chronic diseases in the modem society.Losing excess weight can decrease the incidence of obesity-related diseases and mortality.Currently,surgical treatment is the most successful and durable therapy for obesity.Since 1952,when the first metabolic surgery was reported,there has been a variety of metabolic surgeries appearing,which got confirmation and innovation continually worldwide.The metabolic surgery started in China in 1980s,until now closing to the world level gradually from a relative disadvantage.Metabolic surgery transformed from open surgery to laparoscopic surgery,and then it has been changing from the extensive mode to the precision mode.Surgical treatment for obesity and metabolic diseases has great potential and vast development prospects in China.

Objective To discuss the design of arthroscopic reconstruction of posterior cruciate ligament (PCL) with quadriceps tendon fixed by a patellar block and an allograft bone plug, and its clinical outcome. Methods Thirteen patients suffering from PCL injury were treated by the technique mentioned above. The connection between quadriceps tendon and superior patellar pole was preserved in the harvest process of quadriceps tendon. The femoral tunnel was made like a bottle neck, which was clogged with the patellar bone block. The quadriceps tendon strip was fixed by an allograft bone plug pressed into the tibial tunnel. Their functional recovery was evaluated by Lysholm scoring and IKDC(International Knee Documentation Committee) criteria. Results In the average follow-up period of 19 months, there were not any severe nerve or blood vessel lesions, or failures of transplanted ligament None of the patient complained of knee instability after the operation. The pain was relieved in most patients, but three complained of pain after knee movement A little calcification was found in the quadriceps tendon at the superior patellar pole one year after the operation in the X-ray of a patient There was significant difference in Lysholm scale between pre-operation and post-operation (P

[Objective]To study and evaluate the result of the surgical treatment for arthroscopic reconstruction of anterior cruciate ligament(ACL) with double-bundle semitendinosus.[Method]Thirty-one cases who underwent surgical treatment of arthroscopic reconstruction of ACL with double-bundle semitendinosus during 1990～1998 were analyzed retrospectively.The mean follow up time was 127.36 months(98～168 months).Among them,11 case was simplicity ACL injury,15 cases associated with medial meniscus injury,8 cases combined with lateral meniscus injury,6 cases combined with medial collateral ligament injury,2 case combined with lateral collateral ligament injury.All the patients with medial collateral ligament injury were associated with medial meniscus injury.The analysis was performed on the symptom,physical sign,Lysholm score system and IKDC score pre and postoperation recently.[Result]All the patients had good clinical results with no click,locking,"give way",extra-extension pain,and floating patella test were negative.There were no other complications correlated with semitendinosus grafting.But mild pain were seen in 11 cases,Lachman test were positive in 3 cases,anterior drawer test were positive in 8 cases without complications of instability.The Lysholm score:preoperation was 49.62?8.22 and 76.60?7.68 in follow-up time(P

[Objective]To treat stenosing tenosynovitis by a kind of mini-invasion operation with endscopy assisted,and to observe the clinical results,and to discuss the problem of open and percutaneous A1 pulley release.[Method]Eleven cases,suffering from stenosing tenosynovitis,were treated by the technique of mini-invasion operation with endscopy assisted with a kind of special release knife.The clinical results was investigated and the operative methods was investigated.[Result]All of the patients showed relieving of symptoms of disfunction and trigger finger.There was no serious complication,such as injury of nerves,infection,wound ununion and hand disability.None recurrent case in the follow-up period of 6 to 36 months.[Conclusion]The method of miniinvasion surgical treatment of stenosing tenosynovitis by endscopical technique assisted is safe,effective and low-cost with few complications,which fit for treating stenosing tenosynovitis,specially for those patients with cortisone injection,diabetes and thumb stenosing tenosynovitis.

After the digital resources in 8 famous domestic medical academic libraries were investigated, the status quo and characteristics of digital resources development and the use of different social networking tools in these libraries were analyzed, the crowd-sourcing concept was used to guide the users to participate in the development of digital resources using the social networking tools, and a platform for users participating in information organization and integration was constructed by making use of mobile communication/WeChat.

Objective:To analyze the effects of mutiparity on the pelvic floor muscle and the best time of postpartum for pelvic floor rehabilitation intervention.Methods:By questionnaire survey and pelvic floor functional checking on women with 42 days postpartum clinic routine health checking,and following up pelvic floor muscles force exam in postpartum 3 months,6 months and 1 year,426 cases were included in the puerpera group,including primipara 325 cases as primiparous group,two birth multipara 101 cases as multiparous group,the damage of pelvic floor muscles(≤level Ⅱ) was compared between the two groups,the difference between multiparity and primiparity were compared.Results:①In postpartum 42 days,type Ⅰ muscle fiber damage rate was lower in multiparous group than that in primiparous group(P ＜0.05),there was no significant difference on the muscle fiber damage ratio (muscles force below Ⅲ) between the two groups (P ＞ 0.05).②)In postpartum 3 months,6 months,1 year there was no significant difference in proportion of muscle damage between the two groups (P ＞ 0.05).③Multiparous group pelvic floor muscle damage ratio decreased slowly and gradually in the four periods,there was no statistical difference between adjacent period (P ＞ 0.05),the pelvic muscle damage ratio appeared significant statistical difference between postpartum 6 months and postpartum 42 days(P ＜ 0.01).④In primiparous group,pelvic floor muscle damage ratio decreased significantly in postpartum 6 months,postpartum 42 days、3 months,6 months,the differces were statistically significant among the three times(P ＜ 0.05),there was no statistical difference between postpartum 6 months and 1 year(P＞0.05).Conclusions:Type Ⅰ muscle fibers suffer injury more in Primipara than that in multipara,multiparous pelvic floor muscle recovery process is more slowly than primipara's,we should pay attention to pelvic muscle recovery within 6 months after delivery.

Objective To analyze the effect of aspirin combined with clopidogrel in the treatment of patients with cerebral infarction of middle cerebral artery stenosis.Methods 88 patients with cerebral infarction of middle cerebral artery stenosis were selected and divided into group A and B based on the methods of treatment,44 patients in each group.Patients in group A were given aspirin, and patients in group B were given aspirin combined with clopidogrel.The effects of the group A and B were observed and compared.Results The total effective rate of group B was 90.91%,which was higher than 75.00%(33/44) of group A,the difference was statistically significant(χ2 =3.938,P<0.05).The progression rate and relapse rate of group B were 6.82%and 4.55%,which were lower than 27.27%and 20.45%of group A,and the differences were statistically significant(χ2 =7.639,5.091,all P<0.05). The scores of modified Barthel Index and modified Fugl-Meyer in group B were all better than the scores in group A after treatment,and the differences were statistically significant(all P<0.05).Conclusion It is effective for aspirin combined with clopidogrel to treat the patients with cerebral infarction of middle cerebral artery stenosis,which can decrease the rate of progression and relapse,and worthy of clinical application.

Objective To explore the effectiveness and feasibility of microwave Hesetor in resection of soft tissue sarcoma of deep thigh. Methods From January 2009 to August 2014, 33 patients underwent tumor resection of soft tissue sarcoma of deep thigh (10-37 cm in diameter).The high frequency electroscalpel was used in 15 cases before December 2012 (electroscalpel group) whereas the microwave Hesetor was used in 18 cases after January 2013 ( microwave group) .The intraoperative blood loss, operation time, transfusion proportion, length of hospital stay and postoperative drainage volume were compared between the two groups. Results The intraoperative blood loss was significantly decreased in the microwave Hesetor group as compared with that in the electroscalpel group [(175.0 ±129.8) ml vs.(356.7 ±238.2) ml, t=-2.645, P=0.015].Three patients in the electroscalpel group were given blood transfusion of 200 ml, 400 ml and 400 ml, respectively, due to a massive intraoperative hemorrhage, while none in the microwave group required blood transfusion.There was no statistical difference between the two groups regarding to the operation time, length of hospital stay and postoperative drainage volume (P>0.05). Conclusion Microwave Hesetor is of great value in the resection of soft tissue sarcoma of thigh for significantly reducing intraoperative bleeding and obviating blood transfusion.

Objective: To observe the efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for hip involvement in ankylosing spondylitis (AS). Methods: A total of 60 patients with hip involvement in AS were randomly divided into a control group and an observation group, with 30 cases in each group. The patients in the control group were given an intra-articular injection of sodium hyaluronate, once a week. The patients in the observation group were given additional warm needling moxibustion, once a day, with a 2-day interval after five consecutive days of treatment. After 5 weeks, changes in such indicators as visual analog scale (VAS) score, Harris score, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), serum cartilage oligomeric matrix protein (COMP), interleukin (IL)-17 were observed, and the efficacy was evaluated. Six months after treatment, Bath ankylosing spondylitis radiology index-hip (BASRI-hip) was evaluated. Results: After treatment, the total effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, the VAS scores in both groups were lower than those before treatment (P<0.05), and the score of the observation group was lower than that of the control group (P<0.05). After treatment, the Harris scores of both groups were higher than those before treatment (P<0.05), and the score of the observation group was higher than that of the control group (P<0.05). Six months after treatment, the BASRI-hip score of the control group was higher than that before treatment (P<0.05), while the score of the observation group was not significantly different from that before treatment (P>0.05) and was lower than that of the control group (P<0.05). After treatment, the scores of BASDAI and BASFI of both groups were lower than those before treatment (P<0.05), and the scores of the observation group were lower than those of the control group (P<0.05). After treatment, the levels of serum COMP and IL-17 of both groups were lower than those before treatment (P<0.05), and the levels of the observation group were lower than those of the control group (P<0.05). Conclusion: The efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for hip involvement in AS is better than the intra-articular injection of sodium hyaluronate alone. This combined approach can alleviate hip pain, improve hip functions, delay the destruction of the hip, prevent AS development, and reduce the levels of serum COMP and IL-17.