Objective To investigate technical points,risks and advantages of primary total knee arthroplasty (TKA) through subvastus approach.Methods The study involved 68 patients of similar basic conditions who were treated by TKA between September 2008 and August 2010,including 34 patients treated through subvastus approach (Group A) and 34 patients treated through traditional medial parapatella approach (Group B).Clinical parameters between groups were comparatively studied after operation.Results All patients were followed up for 6-25 months (mean 8.7 months).Alignment of lower extremities in both groups was restored.Group A showed significant differences from Group B in aspects of postoperative drainage volume [(124 ± 32.4) ml vs (182 ± 41.3) ml,P ＜ 0.05],requirement of lateral retinacular release (7％ vs 23％,P ＜0.01),time before patients being capable of having active straight-leg-raising movement [(1.3 ± 0.7) d vs (3.2 ± 0.6) d,P ＜ 0.05],and time away from patients being able to bend their leg up to 90° [(3.1 ± 0.6) d vs (5.3 ± 0.5) d,P ＜ 0.05].Conclusion Primary total knee arthroplasty through subvastus approach can hardly intervene in extension knee apparatus and in blood circulation around patellas,promote rapid recovery of knee function and achieve satisfactory early outcomes.

Aiming at different Oracle database editions, this paper puts forwards several recovery solutions, including the technology of point-in-time recovery, redo logminer, and database flashback.

Objective To investigate the clinical characteristics of hospital infection and the pathogen type,distribution and drug resistance,in the intensive care unit of our hospital,to direct proper antibiotics use and supply the scientific basis for hospital infection control. Methods The clinical data of 392 inpatients in our intensive care unit from April 2008 to March 2010 were monitored prospectively and analyzed retrospectively. Results Of the 392 impatients,78 cases had hospital infection (19.89% 78/392),112 time-case infection (28.57% 112/392). The most common infection was the main respiratory tract infections accounted for 54.46% (61/112) ,followed by urinary tract infections accounted for 15. 19% ( 17/112 ), blood infection accounted for 11.61% (13/112). 152strains pathogens were identified in the study,in which G- bacilli accounted for 69.7%, G+ bacteria accounted for 17. 8% and fungi accounted for 12.5%. Main pathogens such as acinetobacter baumannii ,pseudomonas aeruginosa,klebsiella pneumoniae, staphylococcus aureus showed multiple drug resistance in different degrees. Conclusions Intensive care unit has a high nosocomial infection rate,lower respiratory tract infection is the most frequent type and the main pathogens have different degrees of multi-drug resistance. Standardized, rational use of antibiotics,prevention of the multi-drug resistant bacteria spread may help to reduce the occurrence of hospital infection in intensive care unit.

AIM: To study the effects of IL-6 and IL-1? on the blood polymorphonuclear-neutrophils(PMN) apoptosis postburn. METHODS: Wistar rats inflicted by 30% total body surface area (TBSA) Ⅲ degree scalding were employed as the model. PMN were isolated by density gradient centrifugation using Percoll-hypaque and labeled with TdT-mediated and dUTP nick end labeling (TUNEL) and analyzed by flow cytometric analysis. The intracellular caspase-3 activation and the serum levels of IL-6 and IL-1? were analyzed by fluorometric immunosorbent enzyme assay and enzyme-linked immunosorbent assay, respectively. RESULTS: The serum IL-6 levels (?g/L) in groups of 3, 6, 12, 24 and 48 h postburn (9 14?1 16, 12 49?1 14, 3 01?0 75, 1 41?0 28 and 1 56?0 43 in turn) and IL-1? (ng/L) in groups of 3, 6, 12 h postburn (90 08?8 39, 320 93?14 48 and 47 84?5 19) were much higher than IL-6 (0 24?0 07) and IL-1? (27 65?4 86) in control group ( P

In order to study the analgesic effect of Shaoyao Gancao Decoction, this paper discussed material basis and mechanism from the perspective of macromolecules in traditional Chinese medicine. Inspired by the phenomenon of turbidity after boiling Chinese medicine, this experiment took Shaoyao Gancao Decoction as the research object to study the formation process of precipitation during boiling. The results showed that aggregates with a certain shape were formed in the solvent during the boiling process, and the precipitate was obtained by standing and centrifuging. Analysis found that the precipitation was mainly composed of small molecules such as paeoniflorin, albiflorin, liquiritin, glycyrrhizic acid, isoliquiritin and gallic acid, and macromolecules such as protein and polysaccharide. The composition of precipitate was consistent with that of Shaoyao Gancao Decoction, but the analgesic effect of Shaoyao Gancao Decoction after removing the precipitate was significantly reduced. Based on these results, we isolated small molecular compounds, polysaccharides and protein from Shaoyao Gancao Decoction and their contents are 60.4, 700.7 and 207.2 mg·g^-1 respectively. We get the ratio, polysaccharide: small molecule = 11.6∶1, protein: small molecule = 3.4∶1, the precipitate is prepared in the state of boiling. The characterization results showed that the particle size of the precipitate will change significantly after co-heating, and the content determination results showed that the content of the six small molecular compounds which was free in solvent was significantly reduced after the formation of the precipitate. The acetic acid writhing experiment proved that the precipitate has a good analgesic effect, and effectively reduced the levels of inflammatory factors prostaglandin E2 and nitric oxide, and increased the level of anti-inflammatory factor interleukin-10. These results proved that the precipitate in Shaoyao Gancao Decoction is an important material basis for analgesic effect, and macromolecules such as protein and polysaccharide are the main components of the precipitate. The study of macromolecules in the precipitate of Shaoyao Gancao Decoction not only provides new ideas and methods for elucidating the pharmacodynamic material basis of Shaoyao Gancao Decoction, but also provides a reference for analyzing the scientificity of traditional decoction.

Objective To investigate the expressions of insulin receptor substrate-1 (IRS-1) and insulin receptor sub-strate-2 (IRS-2) in adipocytes during catch-up growth in neonatal rats with intrauterine growth restriction (IUGR) and their correlations with the insulin resistance. Methods Sprague-Dawley rats (clean grade) were randomly divided into control group and food-restricted group after fertilization. Food-restricted group were received about 30%of food amount consumed in control group every day through the whole pregnant period to establish IUGR animal model, and were fed increased amount of breast-milk from postnatal day 1 to 21 to establish the period of catch-up growth in IUGR animal model (IUGR-CG). Fasting serum glu-cose, insulin and triglyceride were measured in blood from heart ventricles of 4-week old SD rats and insulin resistance index was calculated. Pre-adipocytes and mature adipocytes were obtained from SD rats at different age (1-week, 3-week, 5-week and 7-week old) and the former were induced to differentiate toward mature adipocytes. The levels of IRS-1, IRS-2 in the two kinds of mature adipocytes were detected by Real-Time PCR and Western blot. Results The expression levels of IRS-1, IRS-2 mRNA in mature adipocytes of IUGR-CG rats were signiifcantly lower than those of IUGR rats at 5-weeks and 7-weeks old (P<0.05) while the ex-pression levels of IRS-1, IRS-2 mRNA in differentiated adipocytes of IUGR-CG rats were signiifcantly lower than those of IUGR rats at 5-weeks old (P<0.05). The expression levels of IRS-1, IRS-2 protein in two kinds of adipocytes (mature and differentiated adipocytes) of IUGR-CG rats were signiifcantly lower than those of IUGR rats from postpartum week 1 through 7 (P<0.05). Conclusions IRS-1 and IRS-2 expression levels are downregulated in adipocytes during catch-up growth of IUGR rats, which may be closely related with insulin resistance.

Objective To compare blood pressure control in community hypertensive patients with different management methods.Methods Two neighborhood committees in a community of Pudong were selected as study area using cluster sampling method.A total of 5 166 residents aged ≥35 y were screened for blood pressure; the subjects with high blood pressure and had antihypertensive medication in last 6 months were included,and patients with secondary hypertension was excluded.The patients who entered community hypertension management program and got medication from community were included in community group; those who did not enter in community management program and/or not get medication from community were included in non-community group.Self-designed questionnaire was used for investigation.The medication compliance,awareness of hypertension risk factors and high blood pressure control were compared between two groups.Results Among 5 166 residents 4 763 were surveyed for hypertension with a response rate of 92.2％ and hypertension prevalence rate of 23.2％ (1 105/4 763).Among 1 012 patients with drug treatment for more than 6 months,there were 878 cases in community (86.8％) and 134 cases (13.2％) in non-community group.There were no significant differences in gender,age,education,working condition between community group and non-community group (P ＞ 0.05).44.3％ (389/878) patients in community group had a history of high blood pressure ＞ 10 y and that was 56.7％ (76/134) in non-community group (P =0.011) ; 28.6％ (251/878) patients in community group were at high risk for risk stratification and that in non-community group was 47.8％ (64/134) (P ＜0.001).The awareness of hypertension risk factors in community group and non-community group was 83.9％ and 95.5％,respectively (P ＜ 0.001).The medication compliance and blood pressure control rates in two groups were 93.2 ％ and 84.3 ％ (P ＜ 0.001),68.6％ and 51.5 ％,respectively (P ＜ 0.001).Conclusion The outcomes of hypertension management in terms of medication compliance and blood pressure control in community group are better than those in non-community group.

Objective To investigate the influence of esmolol infusion on QT dispersity(QTd)in elderly patients with coronary heart disease during perioperafive period.Methods Fifty ASA Ⅱ or Ⅲ patients with coronary heart disease aged 65-80 yr undegoing non-cardiac surgery under general anesthesia were randomly divided into 2 groups(n=25 each):control group(group C)and esmolol group(group E).Anesthesia was induced with midazolam,fentanyl and vecuronium and maintained with continuous iv infusion of propofol andvecuronium and intermittent iv boluses of fentanyl.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 25-35 mm Hg.In group E a loading dose of esmolol 0.5 mg/kg was given iv over 1 min at 2 min before skin incision and was followed by esmolol infusion at 25 μg·kg-1·min-1 maintained until the end of operation.Radial artery was caunulated.MAP,HR,SpO2 and PETCO2 were continuously momtored.ECG composed of 12 leads was momtored before operation,at 30 min after skin incision,immediately after operation,and at postsurgery days 1 and 2.The longest and shortest QT intervals were measured and detected by a cardiologist not involved in the study.The QTd was calculated.The ventricular arrhythmia was also recorded.Results QTd,the incidences of QTd abnormality and ventricular arrbythmia were significantly lower in group E than in group C.Conclusion The use ofesmolol during operation may decrease QTd and prevent the occurrence ofventricular arrhythmia.

Objective To develop a TaqMan MGB probe-based,sensitive and specific fluorescence quantitative PCR assay method for rapid detection of Clostridium piliforme.Methods Primers and probes specific to 16S rRNA gene of Clostridium piliforme were designed.A TaqMan MGB probe-based,fluorescence quantitative PCR method was established.Specificity,sensitivity and stability of the method were assessed,followed by real-time quantitative PCR assay to detect Clostridium piliforme on 1156 clinical specimens during 2008-2011 and compared with conventional PCR assay.Results The specificity of TaqMan MGB probe-based fluorescence quantitative PCR was high and did not show cross-reactivity with Helicobacter hepaticus,Helicobacter pylori,Campylobacter jejuni,Pasteurella pneumotropica,Escherichia coli or Pseudomonas aeruginosa.The detection limit was 2.2 copies/μl.The correlation coefficient and slope value of standard curve were 0.999 and -3.204,respectively and the efficiency of TaqMan MGB-based probe fluorescence quantitative PCR assay was 100％.When the TaqMan MGB-based probe fluorescence quantitative PCR assay was preformed to detect Clostridium piliforme on 1156 clinical specimens,a total of 101 specimens showed positive on Clostridium piliforme.However,only 44 specimens showed positive when conventional PCR was used.The real-time quantitative PCR for Clostridium piliforme could be completed within 2 hours.Conclusion The TaqMan MGB-based probe fluorescence quantitative PCR assay method was a reliable,specific,sensitive and useful tool for rapid detection of Clostridium piliforme.