Objective To comparatively investigate the effect of local cryotherapy pretreatment of tourniquet position on postoperative pain and short-term function recovery during total knee arthroplasty (TKA).Methods Thirty-one patients (38 knees) who received total knee arthroplasty for the first time from July 2012 to December 2012 were allocated to two groups according to the random number table:17 patients (22 knees) in experimental group received local cryotherapy pretreatment on the position of the tourniquet,while 14 patients (16 knees) in control group did not.Duration of tourniquet use in operation,postoperative swelling of limbs,visual analogue score (VAS) for tourniquet pain,postoperative function recovery,and perioperative complications were compared between the two groups.Results All patients were available to the follow-up.There were no significant differences between the two groups regarding the duration of tourniquet use,postoperative swelling of limbs,and perioperative complications.Lower VAS was observed in experimental group compared with control group at days 1 and 2 postoperatively.Time to meet the standard of short-term function recovery in experimental group was significantly shorter than that in control group[(5.3±1.5)daysvs(7.1±1.3)days,t=-3.77,P＜0.01].Conclusion During TKA,local cryotherapy pretreatment of the tourniquet position can improve local soft tissue' s tolerance to ischemia and anoxia,alleviate local inflammation and ischemia-reperfusion injury,ease tourniquet pain in early period after operation,accelerate short-term function recovery and improve patients' satisfaction.

Objective　To study the relationship between smoking and oxygen free radicals (OFR) , activities of antioxidases.Methods Concentration of serum lipoperoxides(LPO) and activity of superoxide dismutase(SOD) ,glutathioneperoxides(GSH-PX) in 216 healthy smoker and 155 healthy non-smoker were performed.Results The smoker group: the averageLPO concentration was 5.87±1.23, the average SOD activity was 88.24±11.96, the average GSH-PX activity was 176.87±23.31;the non-smoker group:The average LPO concentration was 4.24±0.76, the average SOD activity was 106.18±16.04, the average GSH-PX activity was 206.32±50.25.The average LPO concentration of the smoker group was significantly higher than that in the non-smoker group (P<0.01) ; the average SOD GSH-PX activity of the smoker group were significantly lower than those of the non-smoker group (P<0.01) .The LPO concentration in 50 male smokers(39～45years of age)increased, while SOD and GSH-PX activity decreased as the duration and amount of smoking increased (P<0.01) , showing a linear correlationship.Conclusion The results suggest that smoking is one of the important factors causing, not only OFR and reaction of LPO obviously intensified,but also the imbalance between oxidation and antioxidation in the body.

Objective To investigate the correlation and characteristic of the functional polymorphism of the dopamine D4 receptor gene on the behavioral problems in school-age twins.Method The behavioral problems were assessed among a total of 147 twin pairs aged 6-12 years with the Achenbach Child Behavior Checklist (CBCL).The DRD4 gene polymorphism was applied for different types with polymerase chain reaction.The generalized estimating equations model was used to analyze the effect of DRD4 gene polymorphism and the interaction of DRD4 gene polymorphism with children age,gender,monozygotic/dizygotic on twins' behavioral problems.Results (1) School-age children's anxiety/depression,withdrawn,thought problems,attention problems,social problems,delinquent problems,aggressive behavior and total variance mainly were correlated with DRD4 gene polymorphism (P＜0.05),and physical discomfort might be related with DRD4 gene polymorphism (P=0.067).Except social problems,the detection rate of behavioral problems of the twins with 4/6 genotype (Gene type carrying 5 or more repeated sequences) of DRD4 gene (6.25％-21.25％) was higher than those with other genotypes (0-14.74％).(2) Withdrawal was related to children age (x2=4.348,P＜0.05),and twins aged 6-10 might lead to withdrawal.(3) The interaction of DRD4 gene polymorphism and children age had a significant effect on withdrawal (x2=4.348,P＜0.05) and physical discomfort(x2 =5.189,P＜0.05),and the elder age (11-12 years) children had a certainly protective effect on the withdrawal and physical discomfort with 4/6 genotype in twins.The detection rates were 3.54％ and 2.65％ in the younger-age (6-10 years) twins,while all 0 in the elder-age (11-12 years) for the withdrawal and the physical discomfort respectively.Conclusions The DRD4 gene polymorphism may be correlated with behavioral problems in school-age twins.The interaction of DRD4 polymorphism and children age had a significantly effect on withdrawal and physical discomfort.

Objective To explore the influence of nursing intervention on patients with schizophrenia receiving repetitive transcranial magnetic stimulation (rTMS) treatment.Methods A total of 80 patients with schizophrenia receiving (rTMS) treatment were randomly divided into intervention group 40 cases and control group 40 cases by random digits table method.The control group was given routine care, and the intervention group was given routine nursing and nursing intervention.Before and after treatment, the curative effect was evaluated by the Positive And Negative Symptoms Scale, and the completion of the treatment between two groups was compared.Results The Positive Scale score, Negative Scale score, General Psychopathology Scale, total score in intervention group after treatment were lower than those in control group:(13.1±2.3) points vs.(16.7±2.1) points,(11.5±2.6) points vs.(15.3±2.3) points, (28.3±2.3) points vs.(30.9±2.2) points,(56.9±1.8) points vs.(67.4±1.7) points, and there were significant differences, t=2.398,2.401,2.452,2.191 ,P＜0.05.There was no significant difference in the rTMS completion, x2=5.541, P＜0.05.Conclusions Nursing intervention can effectively improve the patients with schizophrenia completion of rTMS treatment to improve mental symptoms, so as to improve the clinical curative effect, promote patients recovery of disease.

Objective To investigate the expression level and its significance of KLF13 in patients with diffuse large B-cell lymphoma (DLBCL).Methods Fifty-six DLBCL patients treated with CHOP chemotherapy regimen were followed up in 4-6 years.Tissue samples of the 56 DLBCL patients were collected.Then the expression level of KLF13 in tissue samples was detected by immunohistochemistry,the relationship between the expression level of KLF13 and the survival rate,clinical features of the patients were analyzed,respectively.Western blot was used to detect the expression level of KLF13 in DLBCL cell trains Pfeiffer and LY8.Subsequently,the expression of KLF13 in DLBCL cell strains was blocked by siRNA method.The proliferation rates of DLBCL cell strains were assayed by CCK-8.Results The expression of KLF13 was significantly over-increased in 32 patients with DLBCL (57.1％) and slightly increased in 24 patients with DLBCL (42.9 ％).The 5-year survival rate in the significant overexpression group (46.5 ％) was lower than that of slight overexpression group (75.0 ％) (P =0.01).Multivariate analysis demonstrated that KLF13 expression,serum LDH levels and clinical pathological stage were independent prognostic indicators for patients with DLBCL (all P ＜ 0.05).There was statistically significant association between the expression level of KLF13 and the clinical stage,the diameter of lymphoma,respectively.After the expression of KLF13 in DLBCL cells was blocked,the proliferation rate of cells decreased.Conclusion KLF13 might be regarded as a prognostic factor and used as a treatment target.

Objective To assess the left ventricular contraction asynchrony in patients with acute myocardial infarction(AMI) by velocity vector imaging(VVI).Methods Sixty AMI patients and 40 healthy volunteers were included.Using VVI,the time to peak longitudinal systolic velocity (TL-V) was measured in the left ventricular long axis views,the time to peak radial systolic velocity (TR-V) was measured in parasternal short axis views.The deviation of the earliest and the latest TL-V and TR-V (Ts max-min) was measured,and the standard deviation of TL-V and TR-V (TS-SD) was also measured.Results ①TL-V ,TR-V of the infarcted and non-infarcted segments in patients with acute myocardial infarction were longer than those of the normal segments (P ＜0.05).②The longitudinal Tsmax-min,Ts-SD and the radial Tsmax-min,Ts-SD in infarcted patients were increased compared with the healthy volunteers (P ＜0.001).③Ts of the infarcted segments was increased in turn from the class Ⅰ to class Ⅳ of the cardiac function (P ＜0.001).Conclusions VVI could be used to assess the left ventricular contraction asynchrony in patients with AMI.VVI is a new useful method to determine the infarcted segments.

Objective: To investigate the significance of doctor -patient communication courses to medical staff.Methods:Using self-made questionnaire and self -evaluation of anxiety scale (SAS), selection in our u-niversity study of 200 cases of medical personnel , in accordance with the doctor -patient communication before and after the course is divided into classes before and after teaching group , respectively on two groups before and after learning the medical staff on the SAS scores and questionnaire survey .Results:Compared with group before teach-ing, teaching group after medical staff thought through the study of doctor -patient communication course , is con-ducive to cultivating communication consciousness , improve doctor -patient communication skills as well as pre-venting the doctor-patient contradiction (P<0.05).After teaching group SAS score (34.50 ±6.88), signifi-cantly lower than the teaching group SAS score (45.51 ±6.97), difference was statistically significant (t =15 .622 ,P<0 .01 ) .Conclusion:Doctor-patient communication courses are effective way to improve the ability to communicate , to alleviate the anxiety of the medical staff at the same time also has a certain value .

Objective To compare the clinical outcomes and safety of synchronous vs staged bilateral total hip arthroplasty (THA).Methods Fifty-eight cases (116 hip joints) undergone bilateral THA from January 2008 to January 2010 were reviewed retrospectively.Follow-up period was postoperative 2 years,including synchronous bilateral THA in 29 cases (synchronous group) and staged bilateral THA in 29 cases (staged group).The two patient groups were compared in aspects of total operation time,total amount of blood loss,total amount of blood transfusion,duration and cost of hospitalization,postoperative discrepancy in bilateral leg length,preoperative and postoperative function score and perioperative complications.Results During the follow-up,no complications of incision infection,deep vein thrombosis and prothesis dislocation or loosening were noted.And postoperative delirium symptoms occurred only in four cases (three in synchronous group and one in staged group).There were no statistical differences between synchronous group and staged group in aspects of total operating time [(117.9 ± 23.8) minutes vs (124.1 ± 18.8) minutes],total amount of blood loss [338.1 ml (180-720 ml) vs 303.9 ml (200-600 rnl)],total amount of blood transfusion [227.6 ml (0-800 ml) vs 189.7 ml (0-400 ml)],postoperative function score.However,differences of the following data were considered statistical significance between synchronous group and staged group:expense of hospitalization [9.5 ten thousand yuan (7.0-11.3 ten thousand yuan) vs 10.5 ten thousand yuan (8.8-11.0 ten thousand yuan)],length of hospitalization [(12.1 ±3.2) days vs (20.1 ±3.5) days],postoperative discrepancy in bilateral leg length [(0.11 ± 0.22) cm vs (0.42 ± 0.44) cm].Conclusions Synchronous bilateral THA is safe and feasible as far as the patients' physical condition is allowed,perioperative management is rational and physicians have mature surgical techniques.Moreover,it gains advantage over staged bilateral THA considering cost of hospitalization,length of hospitalization and postoperative discrepancy in bilateral leg.

ObjectiveTo explore the clinical features,etiological factors,diagnosis and treatments in children with hemophagocytic syndromes (HPS).MethodsA retrospective study was carried out to analyze etiological factors,clinical symptoms and sighs,laboratory findings and outcomes of 32 children with HPS in our hospital.Results( 1 ) Etiological factors:virus infection cases accounted for 75.0％ (24/32),in which Epstein-Barr virus infection cases were predominant,making up to 68.8％ (22/32) ; (2) Main clinical features:included persistent fever,hepatosplenomegaly,lymphadenopathy; ( 3 ) Characteristic laboratory findings:included decrease of three lines or two lines of peripheral blood cells,hyperferrttinemia,abnormal liver function and coagulation function,hypertriglycerdema and decreased fibrinogen,hemophagocytosis in bone marrow,high soluble interleukin-2 receptor level,decreased natural killer cell activity.(4) Treatments and outcomes:twenty-four(24/32) virus infection cases received antivirus and high dose of immunoglobulin treatment.Twenty-two cases were treated with glucocorticoid and cyclophosphamide,resulting in 11 cases improvement,5 cases with complete remission,2 cases giving up and 4 death.The other 10 cases were treated under the guide of HLH-2004 protocol treatmemt with 4 cases improved and 6 cases with complete remission.Conclusion HPS is mainly triggered by infections,especially Epstein-Barr virus infection.Serum ferrifin,interleukin-2 receptor level and natural killer cell activity are biomarkers of the disease,so that they should be monitored during the progress of chemotherapy.HLH-2004 protocol is a good guide for the treatment of this disease.

Objective To observe the curative effect of paracetamol and indomethacin suppository in cancer- ous febrile. Methods 108 patients of lung cancer with fever were divided into.two groups,the treatment group of 54 cases and the control group of 54 cases, administered with paracetamol and indomethacin suppository respectively. Results After the two groups took medicine, the difference in defervesceing was significant, with statistics signifi- cance( P < 0.05). Conclusion Indomethacin suppository shows better function of defervesceing than paracetamol.