Objective To analyze the curative effects of total knee arthroplasty(TKA)for severe genu varus combined with flexion deformity.Methods The clinical data of 25 patients(36 knees),who had undergone TKA for severe genu varus combined with flexion deformity from January 2005 to October 2010,were retrospectively analyzed.There were 7 males and 18 females,aged from 55 to 80 years(average 70.5 years).The primary diseases were osteoarthritis in 22 cases and rheumatoid arthritis in 3 cases.HSS knee score was used before and after the operation to assess the efficacy of the TKA.Results All of the patients were followed up for 4 to 9 years(average 6 years).The degree of flexion deformity was reduced from (21 ±63)°to(1.1 ±2.3)°;the degree of the varus decreased from(210 ±4.8)°to(175.6 ±2.1)°;range of motion of the knee joint increased from(70.5 ±20.5)°to(115.1 ±5.3)°;knee score augmen-ted from(33.2 ±10.5)to(90.7 ±8.5);function score added from(35.5 ±14.2)to(85.6 ±10.5);there were 21 cases(8 knees)rated as excellent,2(3 knees)as good and 2(3 knees)as fair,and the excel-lent and good rate was 86%.Most of the patients had normal force line of the knee joint,but 2 patients re-mained varus deformity of 5°~10°.Conclusion Satisfying outcome can be achieved by TKA in treating severe genu varus combined with flexion deformity of the knee.

Objective To evaluate the prevalence of the DJ-1 mutation in early-onset Parkinson's disease (EOPD) patients,and analyzed the association between the certain polymorphic marker g.168_185del in intron1 and Parkinson' s disease (PD).Methods We screened all 7 exons and exon-intron boundary regions of DJ-1 by PCR and direct nucleotide sequencing in 90 Chinese patients with EOPD.We also compared the allele and genotype frequencies of the g.168_185del polymorphism between EOPD patients and controls.Results We found no causative DJ-1 mutations in our cohort of Chinese EOPD patients.But we did identified 4 known polymorphic variants,including the g.168_185del in intron 1,g.5027G ＞ A (rs17523802),g.5065T ＞ C (rs226249),and g.5094C ＞ T (rs11121064) within exon 1.Del/Ins frequencies of the g.168_185 del polymorphism were 11.1％ (10/90)and 13.3％ (14/105) in EOPD group and normal group,respectively.Ins/Ins frequencies were 88.9％ (80/90) and 86.7％ (91/105),thex2 and P value of genotype frequency were 0.222 and 0.669 between EOPD patients and controls,respectively.The insert frequencies were 94.4％ (170/180)and 93.3％ (196/210) in EOPD patients and controls,the deletion frequencies were 5.6％ (10/180) and 6.7％ (14/210),thex2 and P value of allele frequency were 0.207 and 0.679 between EOPD patients and normal,respectively.Furthermore,the P value of genotype and allele frequencies were 0.736 and 0.744 between familial EOPD patients and controls,respectively;P values of genotype and allele frequencies were 0.847 and 0.852 between sporadic EOPD patients and control group,respectively.There was no statistical difference between groups.Conclusion Mutations in DJ-1 are uncommon in Chinese EOPD patients,and no association is observed between the DJ-1 intron 1 g.168_185del polymorphism and risk of PD.

The effects of high erucic acid rapeseed oil (HER) on fatty acid oxidation in rat livers compared with low erucic acid rapeseed oil (LER) were studied. Weanling male SD rats were fed on 20% (% by weight, similarly hereinbelow) HER or LER diet for a week or 4 weeks, or 5% HER diet for 4 weeks. The hepatic capacity for oxidation of butyric acid and palmitic acid was determined by titrating the acetone produced by the fatty acid oxidation. The results showed that feeding HER to rats led to an increse in weight of liver and the extent of this increase was positively correlated to the intake of erucic acid (C22:1, n-9 cis). Feeding HER reduced the hepatic oxidation capacity for palmitic acid, notably in 20% HER (1 wk) group. Feeding LER had not shown this effect,indicating that erucic acid plays an important role in the toxicity of rapeseed oil. In the present study it was not found that the hepatic oxidation capacity for butyric acid was influenced by the intake of HER. Therefore, we considered that the inhibitory effect of HER on oxidation of long-chain fatty acids probably resulted from that the incorporation of erucic acid into mitocho-ndrial membranes interfered with the fatty acyl-CoA transfering system on the membranes, leading the fatty acyl-CoA to be unable to enter the mitochondria and to be oxidized there, but not from that the B-oxidation system in mitochondria was directly inhibited.

Objective To evaluate the precision and uncertainty and comparison analysis of 6 items blood lipids index among 5 different Beckman AU biochemical testing systems ,such as triglyceride(TG) ,total cholesterol(TCHO) ,high density lipoprotein cholesterol(HDL‐C) ,low density lipoprotein cholesterol(LDL‐C) ,apolipoproteins A1(APOA1) ,apolipoproteins B(APOB) .Meth‐ods According to the document the EP15‐A2 of national Committee for Clinical Laboratory Standards ,6 items blood lipids index were respectively detected by 5 different Beckman AU biochemical testing systems to obtain precision and comparison .The intra‐and inter‐precision and results of comparability among different system were low than 1/4 or 1/3 or 1/2 CLIA′88 as evaluation standard ,respectively .The measurement uncertainty of these items were evaluated by the calibrator uncertainty and internal quality control and external quality control .Results The intra‐and inter‐or day‐to‐day precision and relative bias were accepted by clinical requirements .The expanded measurement uncertainty for TG was 0 .079 mmol/L and 0 .035mmol/L .The expanded measurement uncertainty for TCHO was 0 .248 mmol/L and 0 .157 mmol/L .The expanded measurement uncertainty for HDL‐C was 0 .144 mmol/L and 0 .018 mmol/L .The expanded measurement uncertainty for LDL‐C was 0 .140 mmol/L and 0 .186 mmol/L .The ex‐panded measurement uncertainty for APOA1 was 0 .148 mmol/L and 0 .090 mmol/L .The expanded measurement uncertainty for APOB was 0 .104 mmol/L and 0 .058 mmol/L .Conclusion The results of 6 items blood lipids index respectively show well preci‐sion and significantly correlation among 5 different Beckman AU biochemical testing systems and the results were comparable ,and the influence factor of detection results were expression directly by evaluating the measurement uncertainty of 6 items blood lipids index .This way of assessment is simple .

Objective To analyze the effect of dexmedetomidine hydrochloride injection on patients with craniocerebral disease who has no artificial airway in the process of bronchoalveolar lavage treatment.Methods Forty-six patients (age 17-28,average age 56.6±9.2,26 men and 20 women) with craniocerebral disease who has no artificial airway were selected,and were treated by bronchoalveolar lavage for lung infection.The patients were randomly divided into two groups,control and test group.The control group (n=23) received midazolam for sedative and the test group (n=23) received dexmedetomidine hydrochloride for sedative while they were in the process of bronchoalveolar lavage treatment.Heart rate,mean arterial pressure and blood oxygen saturation of fingers collected from patients before and during the process of bronchoalveolar lavage were compared.Results In the process of bronchoalveolar lavage treatment,the minimum blood oxygen saturation of finger artery from the control group was lower than that from the test group,the fastest heart rate from the control group was greater than that from the test group,and the lowest mean arterial pressure from the control group was lower than that from the test group (P＜0.05).In two groups,heart rate in the process of bronchoalveolar lavage treatment was faster than that from before the treatment,while both mean arterial pressure and blood oxygen saturation of finger artery were decreased (P＜0.05).Conclusions Continuous intravenous pumping of dexmedetomidine hydrochloride on patients with craniocerebral disease who has no artificial airway during the process of bronchoalveolar lavage treatment is effective and safe,and it has less inhibitory effect on respiratory function and blood pressure.

Objective To evaluate the ability of a synthetic PET/NIRF probe,named 18F-PSVue643,on the apoptosis detection in animal models with the anti-cancer drugs therapy,and compare the advantages and disadvantages between PET and NIRF.Methods Cell apoptosis was detected by MTT and flow cytometry in vitro.Established U87MG glioblastoma xenograft tumors in nude mice were treated with retinol and paclitaxel for nine days (for PET imaging) or eleven days (for NIRF imaging) continuously.The uptake values were recorded by ROI and expressed as ％ID/g.Results The apoptosis ratios in 10 and 100 nmol/L paclitaxel-treated groups were 7.4％ and 7.5％,respectively,and the apoptosis ratio of the control group was 4.3％.The apoptosis could be well detected by both NIRF and PET imaging during the whole process of treatment.However,the amount of probe for PET imaging was only a half of that for optical imaging to get the same apoptosis visualization.Conclusion 18F-PSVue643 is suitable for NIRF and PET imaging in detection of apoptosis,and it may be a promising agent for further clinical studies.

Objective To analyze the pitfalls of 18F fluorodeoxyglucose (FDG) positron emission tomography/computer tomography (PET-CT) scan in the diagnosis of 60 patients of tuberculosis mimicking malignancy.Methods The study included 60 patients with PET-CT diagnosis of probable malignancy.Fifty patients were proved to be tuberculosis by pathological examinations and 10 were diagnosed by clinical followup.The images of whole body were acquired at 60 min after administration of 222-555 MBq 18F-FDG.The PET-CT imaging characteristics and clinical data,including lesion size,distribution,standardized uptake value (SUV) were retrospectively analyzed.After the whole body scan of PET-CT,each patient had a chest spiral CT scan for detailed observation of lung lesions.Contrast enhanced CT (CECT) was performed in 8 patients.Results (1)Thirty patients were misdiagnosed as lung cancer,14 patients as malignant lymphoma,6 patients as malignant mesothelioma,3 as intestine carcinoma,2 as bone malignancy,1 patient as hepatocarcinoma,spleen malignancy,ovarian cancer,laryngocarcinoma and nasopharyngeal carcinoma respectively.(2) 90.9％ (20/22) of patients showed normal level of serum CEA and 100％ (13/13) of patients showed normal level of CA199.Increasing serum CA125 was found in all patients (6/6) with activeTB patients accompanied with ascites,pleural fluid and (or) pericardial effusion.(3) 93.3％ (28/30)active tuberculosis showed accumulated 18F-FDG which was incorrectly interpreted as malignancy.The most common sites of TB lymphadenopathy were bilateral cervical tissues,which was accounted for 85.7％(12/14).CECT revealed characteristics of peripheral enhancement and central necrosis in tubercular lymphadenopathy,which was 87.5％ (7/8).Conclusions The diverse manifestations of TB on imaging and high uptake of 18F-FDG on PET imaging result in misdiagnosis of malignancy.It is important for radiologists and nuclear medicine physicians to identify the common imaging features and patterns of TB to make a correct diagnosis.Integration of reconstruction HR CT,PET-CT and lab examinations may improve the diagnostic accuracy.

Objective To investigate the diagnosis and surgical treatment of intracaval venous tumors. Methods Clinical data of 6 cases were retrospectively analyzed, including signs and symptoms diagnostic means such as type-B ultrasound, CTA, MRA, surgical procedures and prognosis. Results All six cases received type-B ultrasonic examination, final definite diagnosis was achieved by CTA exam in 2 cases and through MRA in 4 cases. Heart involvement was found in 3 cases. All patients underwent a surgery. According to the extent of the tumor,3 cases had thoraco-abdominal incision,3 cases with extracorporeal circulation and right atrium opening. All of the tumors were completely resected. Pathological exam revealed that 4 cases were of leiomyomatosis and 2 cases were of leiomyosarcoma. One case with leiomyosarcoma died of liver disfunction postoperatively.The other 5 cases recovered without major complications. An average 51 months of follow-up found no recurrence. Conclusions CT and MRI are the mainstay for the diagnosis,and MRI can provide clear anatomy image to the surgeons, help choose the surgical procedures. The one-stage operation is effective. During the operation, the main branches of the vena cava system should be detected, and the attachment of the tumor should be found and removed thoroughly to prevent the recurrence of the tumor. When the attachment point is lower than the iliac vein level, ligation of the involved iliac vein should be mandatory.

The general characteristics, outcomes and risk factors of the patients with aortic dissection (AD) were evaluated in a single medical center. From January 2002 to December 2008, 284 patients with AD were treated and followed-up at our institution, including 105 cases of type A AD and 179 cases of type B AD. The patients in each type were divided into three groups according to management: medical treatment group (A or B), open surgery group (A or B), and stent-graft group (A or B). The characteristics and follow-up outcomes were compared between the groups or subgroups. The results showed that there was significant difference in the prognosis for type A AD between medical treatment group and open surgery group, but there was no significant difference in the prognosis for type B AD between medical treatment group and stent-graft group. Independent risk factors of follow-up mortality for patients with type A AD included a history of atherosclerosis (HR, 3.807; 95% confidence interval [CI], 1.489 to 7.611; P=0.003), in-hospital hypotension/shock (HR, 4.687; 95% CI, 1.846 to 11.900; P=0.001), in-hospital myocardial ischemia or infarction (HR, 3.734; 95% CI, 1.613 to 8.643; P=0.002), pleural effusion (HR, 2.210; 95% CI, 1.080 to 4.521; P=0.030), branch vessel involvement (HR, 2.747; 95% CI, 1.202 to 6.278; P=0.016) and surgical treatment (HR, 0.177; 95% CI, 0.063 to 0.502; P=0.001). And there were insignificant independent predictors for mortality of the patients with type B AD. It was concluded that there were significant differences in characteristics and one year mortality between type A AD and type B AD, but after one year, there was no significant difference in the mortality and complications of them. There were several discordant risk factors of AD, such as female gender, age, thrombus, abrupt onset of pain that were considered as the risk factors in some papers. And there was no definite risk factor of mortality in this study in the patients with type B AD.

Objective To analyze the causes for diffuse bone marrow uptake of 18F-FDG on PET/CT scans. Methods Sixty-six patients with diffuse bone marrow uptake on whole-body FDG-PET/CT imaging were enrolled for this study. Seventy-nine healthy subjects ( with no history of tumor or recent fever) were selected as normal control. The SUVmax and SUVmean were measured in bone marrow and mediastinum in both groups. The maximum (bone marrow SUVmax/ mediastinum SUVmax) and mean value ratios (bone marrow SUVmean/ mediastinum SUVmean) were calculated. Statistical analysis was performed by one-factor variance analysis. Results With diffuse bone marrow uptake pattern of 18F-FDG, 27 were caused by injection of hematopoietic growth factor, 21 by hematopathy and 18 due to fever. SUVmeanof those three causes were 3.076±1.955, 3.633±2.405 and 2.546±0.791 respectively, each was significantly different from that of the control group (1.026±0.190; F =34.465, P<0.001). Conclusion Diffuse bone marrow uptake on FDG-PET/CT are caused by both benign and malignant reasons.