[Objective]To analyze the dynamic changing of inflammatory markers in second stage revision for infected TKA and to explore the sensitive indicators. [Methods]From June 2004 to April 2008,20 cases of infected TKA were admitted and treated by the two stages knee revision.The inflammatory markers included full blood count,erythrocyte sedimentation rate(ESR).C-reactive protein(CRP) were examined weekly,and to evaluate the dynamic changes and the most sensitive indicators.[Results]CRP was the most sensitive index for infection control,and its maximum presented in the first week post antibiotic bone cement implantation,followed by rapid reduction in the second week and there was statistical difference compared to the CRP level before surgery(t=105.84,P

Objective To study the relationship between promyelocytic leukemia(PML) protein and apoptosis and their roles in the pathogenesis of psoriasis. Methods Immunohistochemical techniques were employed to study the expression of PML protein in the uninvolved skin, progressive plaque lesions and regressive lesions. Apoptosis was detected with terminal deoxynucleotidyl transferase-mediated dUTP-DIG nick end labeling(TUNEL). Results There was a significantly upregulated expression of PML protein in progressive plaque lesions, compared with that in uninvolved skin adjacent to the lesions and regressive lesions, and there was nearly no expression in normal skin; there was obvious apoptosis of keratinocytes in the epidermis with intensive PML protein staining. Conclusion The increased apoptosis of keratinocytes in the lesions of psoriasis induced by PML protein might be a homeostatic mechanism to the hyperplasia of keratinocytes.

Objective To compare hip arthroplasty versus internal fixation for treatment of displaced femoral neck fractures in the elderly patients in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.Methods All the randomized controlled trials (RCTs) up to May 2013 on hip arthroplasty versus internal fixation for displaced femoral neck fractures in the elderly were electronically searched for in Pubmed/Medline,EMBASE,Cochrane CENTRAL,CNKI,WanFang and VIP databases.The 2 treatments were compared in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.The Meta analysis was performed with RevMan 5.2.5 software.Results Five eligible RCTs involving 1 288 cases were included for this review.The rate of reoperation (including implant removal and other operations),either within 2 years or over 2 years,in the internal fixation group was significantly higher than that in the arthroplasty group (P ＜ 0.05).The surgery-related complications in the internal fixation group was significantly higher than that in the hip arthroplasty group [OR =8.82,95％ CI (6.45,12.07),P ＜0.001].No significant difference was found in the postoperative 1-2-year mortality between the 2 groups (P ＞0.05).Conclusion In the treatment of displaced femoral neck fractures in the elderly,compared with internal fixation,arthroplasty should be recommended as the first choice,because it can significantly reduce surgery-related complications and reoperations though it cannot decrease the postoperative 1-2-year mortality.

Objective To summarize the effect of bronchoscopy for sputum suction on aspiration pneumonia in elderly patients. Methods 45 elderly patients with aspiration pneumonia treated with bronchoscopy for early sputum suction on the basis of comprehensive treatment were assigned into group A ,and another 44 elderly patients with the same disease receiving the only comprehensive treatment as the control group (group B). After treatment,the two groups were compared in terms of temperature,WBC,arterial blood partial pressure of oxygen and lung shadow resolution. The key links in the operative manipulation were summarized. Results In group A, the temperature and WBC both resumed to the normal level, the time for increased arterial partial pressure of oxygen (PaO2) in group A was significantly shorter than in group B and lung shadow resolution significantly more evident than in group B (P < 0.01). In group A, the sputum suction was completed and there were no cases of death and serious complications. Conclusions Early bronchoscopy for sputum suction in the treatment of aspiration pneumonia in elderly people is effective. Skilled operation and accurate grasping of the key points of the suction process make sure that this technology can be more applicable in clinical practice.

[Objective]To investigate the advantages, risks and kye points of minimally invasive total knee arthroplasty with subvastus approach. [Method] From April 2005 to December 2006, 204 primary total knee arthroplasties were performed, among them 146 cases with convention incision (CI), 58 cases with minimally invasive subvastus approach(MIS). All knees were implanted with the same prosthesis (NEXGEN-LPS, Zimmer).The anesthesia time,operation time, hospitalization time were recorded.The first walking time, walking distance, active knee range of motion, preoperative and postoperative HSS Score and the complications were compared. [Result] Totally 204 cases were followed up and the mean follow-up time was 22 months (range, 13-36 months). The difference of anesthesia time, length of incision, operation time, hospitalization time, walking time had significance between the CI and MIS groups ( u test, P0.05). The difference of active range of motion in 24 hours, 1 week, 2 weeks postoperation had significance between the two groups ( u test, P0.05).The difference of HSS score in 24 hours, 1 week, 2 weeks after operation had significance between the two groups ( u test, P0.05). [Conclusion] The minimally invasive total knee arthroplasty with subvastus approach reduces the quadriceps injury, offers early active knee motion and quickly recovery of knee function. However there is no significant difference in long-term walking distance, range of motion and HSS score.

Objective The beam data is compared with those obtained from Monte Carlo (MC)simulation and measurement to investigate their feasibility and reliability for X-ray small fields.MethodsThe beam data,including the total scatter factor (Scp),percentage depth dose (PDD) was acquired byneasurement and calculation with the field size ranging from 0.5 cm × 0.5 cm to 10 cm x 10 cm.The resultswere compared and analyzed.Results All the data is most consistent for the fields size of ≥3.5 cmx 3.5cm,but they are obvious different for the fields size of ≤ 3.0 cm × 3.0 cm.The measurements seem toreliable using the chambers of CC04 and CC13 for the fields size of ≥2.0 cm x 2.0 cm.Conclusions It isdemonstrated that the accurate measurements and calculations of Scp and PDD can be obtained for the fieldssize of ≥2.0 cm ×2.0 cm,but they needed morc rcscarchcs for thc smaller fields.

Objective To compare the efficiency of compressive bandage dressing and drainage on the blood loss after total knee arthroplasty (TKA). Methods Patients (n=120) who visited Tianjin General Hospital Bin Hai Branch and Tianjin People's Hospital due to varus knee osteoarthritis and underwent TKA were retrospectively analyzed.There are 20 males and 100 females with, mean age was 65.18±6.88 years. Depending on whether placement of drainage, patients were divided into drainage group (60 cases) and pressure bandage dressing group (60 cases). Blood loss, blood transfusion and full blood count (FBC) were all analyzed after TKA in both groups. Results Blood loss after TKA in drainage and pressure dressing group were (1 026.85±274.44),(789.52±251.58) mL respectively. Blood loss was less severe in pressure dressing group than that in drainage group (t=4.938, P<0.01). Allogeneic transfusions were needed in 14 cases of drainage group and five cases of pres?sure bandage dressing group. The circumstances that requires blood transfusion was significantly lower in pressure bandage group than that in drainage group (χ2=5.065, P<0.05). The postoperative limb swelling and postoperative joint mobility did not show statistical significance (P>0.05). Conclusion Application of compressive bandage dressing in TKA surgery is easy to be operate and can reduce perioperative blood loss and allogeneic transfusion incidence.

Objective To assess the accuracy of three-dimensional color Doppler echocardiography (3DCDE) for measuring left ventricular stroke volume (LVSV). Methods A total of 45 patients were studied to measure LVSV by 3DCDE and two-dimensional Doppler echocardiograph(2DDE). Full-volume three-dimensional echocardiography (3DE) was also performed to measure left ventricular end systolic (LVESV) ,end diastolic(LVEDV) ,and LVSV (LVEDV-LVESV), which served as a reference standard for comparison. Results Mean values of LVSV by 3DE,2DDE,3DCDE were (79. 3 ± 22. 6)ml, (74. 0 ± 20. 6) ml,(78. 7 ±22. 6)ml. respectively. Compared with LVSV by 3DE,the correlation was excellent for 3DCDE (r = 0.96), good for 2DDE ( r =0.89). Conclusions LVSV measurement by 3DCDE is reasonably accurate. This new technology may be a valuable clinical tool for assessing cardiac function.

Objective To investigate the effects of tazarotene on the proliferation of cultured human keratinocytes and IFN-?-induced expression of HLA-DR in those cells.Methods Keratinocytes were cul-tured from normal human skin in vitro,and were treated with various concentrations of tazarotene(10 -5 ,10 -6 ,10 -7 mol/L).At24h,48h after treatment,the effects on cell proliferation were assessed by MTT method.The expression of HLA-DR was determined using immunocytochemistry techniques in cultured human ker-atinocytes incubated with tazarotene,IFN-?or both for24h.Results①The proliferation of keratinocytes was decreased when exposed to10 -7 -10 -5 of tazarotene as compared to non-exposed keratinocytes after24h and48h.Moreover,the effects on cell proliferation by tazarotene were dose-dependent;②There was rare expression of HLA-DR in normal human keratinocytes.③HLA-DR expression was inducible significantly with500u/mL of IFN-?,but failed to be induced with10 -6 mol/L of tazarotene,in keratinocytes at24h af-ter treatment.④After24h combined treatment of10 -7 -10 -5 mol/L of tazarotene and IFN-?,the induction of HLA-DR expression was significantly stronger,in a dose-dependent manner,than IFN-?alone(P

Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.