BACKGROUND: It is difficult to revise replacement due to infection-induced osteodeficiency, osteoporosis, soft tissue lost orcicatrization.OBJECTIVE: To establish the standardized clinical prevention and treatment methods by summarizing the new progress to prevent, diagnosis of the infection, and its effective treatment, as well as rehabilitation evaluation after total Knee replacement. METHODS: A computer-based online search of CNKI and PUBMED database between January 1990 and December 2010 was performed to search related articles with the key words of total knee arthroplasty, infection. A total of 2 346 articles were retrieved. Moreover, related works were manually searched. Totally, 30 articles were included.RESULTS AND CONCLUSION: It is better to prevent infection rather than treatment after total knee replacement. Currently, there is lack of a clear diagnosis standard on the infection. In treatment aspect, debridement, revision surgery, and choosing effective antibiotics can effectively control the infection. Meantime, new methods are expected to improve the success rate of infection after total knee replacement. Exercise is a continuation of rehabilitation therapy and an important step in treatment. Therefore, on the basis of total knee replacement, it is important to establish the early prevention of postoperative infection, early diagnosis, effective treatment and rehabilitation evaluation system, in order to minimize the incidence of infection and treat infections timely and effectively.

Aim To investigate the protective effects of breviscapine(Bre) on myocardial hypertrophy and fibrosis induced by isoproterenol (Iso) in rats and its mechanism. Methods Myocardial hypertrophy and fibrosis model of rats were induced by injection of Iso for 7 days(5 mg?kg -1?d -1,sc).From day 2～15,rats were treated with Bre 12.5 and 25 mg?kg -1?d -1 ip,the NS control and Iso model group received saline injection.On day 15,animals were killed by decapitation,monitored in terms of myocardial indexes (heart weight/boday weight, HW/BW and left ventricalar weight/body weight,LVW/BW);the contents of angio- tensin Ⅱ(AngⅡ),nitric oxide(NO) and hydroxyproline and the activity of Na+,K+-ATPase and Ca 2+-ATPase in left ventricle were assayed with radioimmunoassay and spectrophotometry,respectively. Results Compared with the NS control group, the myocardial indexes, the level of AngⅡ and hydroxyproline in left ventricle were markedly increased and NO content, activity of Na+,K+-ATPase and Ca 2+-ATPase in left ventricle were decreased in Iso model group;treatment with Bre 25 mg?kg -1?d -1 significantly reduced the myocardial index and content of AngⅡ and hydroxyproline in left ventricle,increased the NO content ,enhanced the activity of Na+,K+-ATPase and Ca 2+-ATPase.Conclusion Bre can alleviate myocardial hypertrophy and fibrosis induced by Iso in rats.

Myocarditis refers to inflammatory disease of the myocardium caused by variety patho-gens,90%of patients are asymptomatic.A new and effective screening method is badly needed.Lake Louise standard cardiac MRI has become the non-invasive alternative diagnostic methods for myocarditis(instead of myocardial biopsy),as it can not only to show myocardial injury site,but can also reveal the extent of myo-cardial edema,fibrosis repair in late phase.

The efficacy of intravenous captopril on plasma renin activity (PRA ) and angiotensinⅡ (All ) during isoflurane-induced hypotension were investigated. 24 patients (aged 20-50 years,ASA Ⅰ-Ⅱ )scheduled for elective cerebral surgery were randomly divided into two groups: Group I (isoflurane, n = 12 )and Group J (captopril 0. 15mg/kg plus isoflurane n=12 ). MAP was reduced approximately 30% in all of patients. Angiotensin Ⅱ concentration increased 260% during hypotension in group I, but only a slight reduction in Group Ⅱ. The end-expiratory concentration of isoflurane in Group I were higher than Group I during induced and hypotension period. It is concluded that intravenous captopril can inhibit the increase of PRA and All concentration and less isoflurane required for the deliberated hypotension. Induced-hypotension by the combination of isoflurane with captopril may be advantageous.

Legal relationship between doctors and patients is constructed by the three el-ements:the subject,the object and the contents.The subject is the medical side and patient side.The object is a medical act.The content of medical and legal relations is rights and obligations of both sides.

Objective To evaluate effects of minimal invasive plating for treatment of mid-distal humeral shaft fractures.Methods From May 2004 to December 2007, 20 patients with isolated unilat-eral mid-distal third humeral shaft fractures were surgically treated with close reduction and internal fixation using a 4.5 mm dynamic compression plate which was anteriorly inserted through 2 small incisions on the anterior aspects of proximal and distal parts of the arm, away from the fracture site.The postoperative function of the radial nerve and the musculocutaneous nerve, the postoperative alignment of the main fragments on the anteroposterior radiographs, the bone healing time and muscle strength of biceps muscles were measured and recorded, Results Four patients complained of numbness at the area innervated by the lateral ante-braehial cutaneous nerve in the affected forearm after the surgery.No signs of iatrogenic radial nerve palsies occurred after the surgery.A completely normal alignment was achieved in 7 patients, but varus of 11° was found in 2 cases and varus of 2°, 3°, 4°, 5°, 6°, 7° and 10° in one each.Valgus deformity was noticed in 4 cases, and valgus of 3°, 4°, 6° and 7° in one each.The mean follow-up of 10.4 months for 19 patients re-vealed bony union of all the fractures.The average bone healing time was 13.4 weeks.At the latest follow-up, the biceps muscle strength of all the patients was 5 degrees.Hardwires were removed in 5 patients without any complications.Conclusions Minimally invasive anterior plating is a safe alternative osteosynthesis for mid-distal third humeral shaft fractures.However, this technique may interfere with the function of the lateral antebrachial cutaneous nerve.

AIM: To investigate the anti-HIV-1 activity of five anthraquinone derivatives (emodin,rhein,chrysophanol,physcion and aloe-emodin) in vitro.METHODS: Viral replication was estimated by observation of cytopathogenesis and measurement of HIV-1 p24 antigen production in HIV-1ⅢB acutely infected C8166 cells. The anti-HIV-1 activity was evaluated by the 50% effective concentrations (EC50) and selective indexes (SI) of these derivatives.RESULTS: These anthraquinone derivatives inhibited HIV-1ⅢB replication on syncytia formation induced by HIV-1ⅢB infection with EC50 mean values of (11.44±0.93)μmol/L (emodin),(51.28±2.86)μmol/L (rhein),(90.58±2.30)μmol/L (chrysophanol),(8.59±0.38)μmol/L (physcion) and (0.89±0.08)μmol/L (aloe-emodin),respectively. The p24 antigen production with EC50 mean values were (11.61±0.56)μmol/L (emodin),(12.35±4.73)μmol/L (rhein),(39.63±2.87)μmol/L (chrysophanol),>250 μmol/L (physcion) and (2.75±0.20)μmol/L (aloe-emodin) respectively. CONCLUSION: These structurally-related chemicals show different anti-HIV-1 activity in vitro. Among them,aloe-emodin is the most potent inhibitor to HIV-1 replication.

Aged ; Aged, 80 and over ; Female ; Humans ; Hyponatremia ; chemically induced ; Iodipamide ; adverse effects

Objective To investigate the ability of auto-dermis grafts in the prevention of epidural fibrosis and adhesions, and provide reference for clinical application. Methods Five Tibet mini-pigs were used and laminectomy was performed in lumbar 2 and 4 segment. Dura was exposed and covered with auto-genous dermis grafts in lumbar 2 (the experimental group), without grafts in lumbar 4 (the autogeoous blank group). The specimens were observed grossly and histologically at 2, 4, 6, 8 and 10 weeks postoperatively. Epidural scar amount and adhere range was evaluated by modified Robertson scoring method and analyzed by SPSS 13.0. No sear and adhesion, 0 point; small amount scar and light-range adhesion, 1 point; medium sear and midrange adhesion, 2 pionts; bulk scar ang high-range adhesion, 3 pionts. Results All grafted dermis survived and thicken obviously than dermis in body surface (P< 0.05). Hair growth, sebaceous gland cyst and sweat cystogenesis were not observed. A larvaceous dissection abruption plane, little cicatricial tis-sue and adhesions rarefaction between dermis and dura were observed in the experimental group. Massive ei-catricial tissue from erector spinae filled in cavitas epiduralis was observed and dura was separated difficult-ly from cicatricial tissue in the autogeous blank group. Epidural scar amount and adhesion range in the ex-perimental group was significantly lower than the blank group (P< 0.05). Conclusion Dermis is a kind of favourable biomaterial with restraining cicatrisation and isolation barrier. Autogenous dermis grafts has the best effect on preventing peridural cicatrisation and adhesion after laminectomy.

Objective To establish a two-way evaluation system and to explore the application effect of two-way evaluation method in clinical nursing teaching.Methods We carried out two-way evaluation and individual evaluation test to 40 nursing students practicing in the Department of Inter nal Medicine of our hospital in 2012 and 20 teachers responsible for teaching.By using the envelope method,nursing students and teachers were randomly divided into two groups,with 20 nursing students and 10 teachers in the experimental group and the control group respectively.Students' assessment form and the teachers teaching level evaluation table were made,and teachers of both group gave scores every two weeks to the nursing students by nursing students' evaluation sheet,and the score of feedback were given to the nursing students in experimental group.At the same time,the nursing students in experimental group gave scores every two weeks to the teachers of the same group by the teachers' teaching evaluation sheet,and feedback the results.SPSS 13.0 was used to make statistical analysis and the scores of nursing students and teachers of both groups and the last scores were compared with paired sample T test of mean.The results of the experimental group and the control group in the same period were compared with two independent samples T test of mean.Results Comparing the nursing students'scores of both groups with the scores they themselves got last time,the scores of the fourth,sixth,and the eighth week were statistically significant(P＜0.05)and comparing the experimental group teachers' score with and the scores they themselves got last time,the scores of the fourth,sixth,and the eighth week were also statistically significant(P＜0.05); from the fourth week on,nursing students' scores in experimental group compared with those in control group in the same period,show the differences statistically significant(P＜0.05).Conclusion Two-way evaluation system is beneficial to improving the enthusiasm and initiative of the teachers and students.Two-way evaluation and bidirectional interaction are helpful to timely detection of problems and improvement and can effectively improve the quality of clinical nursing teaching in internal neurological medicine.