[Objective]To evaluate the effect of integrated management of blood loss in total knee arthroplasty (TKA ) between gypsum fixed up, ice compress,elastic bandage and only with elastic bandage. [Methods]From January 2006 to August 2008,107 patients undergoing TKA were randomized divided into integrated management group( 54 cases) and control group( 53 cases).Sex,age and deseases in two groups were comparative.The patients in integrated management were treated with elastic bandage,gypsum fixed up,leg elevated by 35 degrees at the hip with knee extended, continuous cold therapy.The patient in control group were only treated with single elastic bandage.The loss of blood during 2 h, 12 h, 24 h postoperative were analyzed.[Results]The blood loss was 170 ml(85~505 ml),210 ml(105~560 ml), 260 ml(110~580 ml)at 2 h、12 h、 24 h postoperative in integrated management group,and 180 ml(110~900 ml), 320 ml(115~930 ml),390 ml(170~970 ml) in control group.The blood loss in integrated group was obviously and a statistically significant difference was found between the two groups (P

Objective:To analyze the therapeutic effect and safety of finasteride on aged patients with isolated systolic hypertension (ISH)complicated benign prostatic hyperplasia (BPH).Methods:A total of 84 aged ISH + BPH pa-tients admitted from Jun 2011 to May 2013 were selected.According to medication plan,they were divided into fin-asteride group (n=44)and routine treatment group (n=40,only received routine treatment because they cannot use finasteride).Course of treatment was all six months.International prostate symptom score (IPSS),quality of life (QOL) questionnaire score,prostate-specific antigen (PSA),incidence rate of acute urinary retention,maximum u-rinary flow rate (Qmax),postvoid residual urine (PRV),prostate volume (PV)and incidence rate of adverse reac-tions were compared between two groups.Results:Compared with routine treatment group,there were significant reductions in IPSS [(13.2±2.4)scores vs.(9.4±1.1)scores],PRV [(21.4±4.6)ml vs.(9.0±2.3)ml],PV [(36.8±3.8)ml vs.(29.5±3.0)ml],PSA [(2.45±0.74)μg/L vs.(1.26±0.48)μg/L]and incidence rate of acute urinary retention (17.50% vs.9.09%),P<0.05 or <0.01,and significant increase in Qmax [(10.2±2.4) ml vs.(13.7±3.8)ml]and QOL score [(3.1±1.0)scores vs.(4.7±1.5)scores]in finasteride group (P<0.05). There were no significant difference in incidence rates of adverse reactions between two groups,P>0.05 all.Con-clusion:Therapeutic effect of finasteride is significant and adverse reactions don’ t increase significantly in aged pa-tients with isolated systolic hypertension complicated benign prostatic hyperplasia.

Objective Study the relationship between HLA antibodies production and the number of Gravidity.Methods A total of 856 pregnant women of first pretanal in Xiasha Hospital of Sir Run Run Shaw Hospital of Zhejiang University from Nov 2016 to Mar 2017 were recruited.The blood samples were collected during 24-28 weeks of pregnancy,and the expression of platelet-specific alloantibody was detected by solid-phase red cell adherence assay.Results There were 67 positive HLA antibody in pregnant women,and the antibody positive rate was 7.8％.There were 15 positive HLA antibody in 334 first pregnant women,14 in 214 two or more pregnancy pregnant women without abortion,10 in 107 pregnant women with once abortion,28 in 223 pregnant women with two or more abortion.The antibody positive rate respectively is 4.5％,6.5％,9.3％ and 12.6％.The production of HLA antibody was significantly associated with the numberof gravidity.Conclusion The antibody positive rate of two or more pregnancy is significantly higher than the fisrt pregnancy.

Objective To explore the effect of neural cell adhesion molecule (NCAM) on adhesion,migration and morphology of mouse bone marrow-derived mesenchymal stem cells (BMSCs).Methods We isolated and cultured BMSCs from wild-type and NCAM gene knockout mice.The expression of NCAM was detected by Western blot and immunofluorescence.Wound healing and adhesion assays were used to detect cell migration and adhesion ability respectively.The morphological changes were observed and the expressings of protein β1 integrin,E-cadherin,β-catenin and N-cadherin were analysed by Western blot.Results The migration and adhesion of BMSCs were significantly reduced after NCAM gene knockout.Meanwhile,the expression of β1 integrin was lower than those in wild-type BMSCs (P<0.01).The morphology of NCAM gene knockout BMSCs changed from irregular to flattened,and expressed epithelial identification marker E-cadherin and β-catenin (P<0.05).However,the expression level of mesenchymal identification marker N-cadherin was decreased (P<0.01).Conclusions NCAM is involved in adhesion and migration of BMSCs via regulating the expression of β1 integrin.Furthermore,NCAMmay negatively regulate the mesenchymal-epithelial transitions of BMSCs.

Objective To observe the effects of ginsenoside Rg1 group on the structure and function of rat skeletal muscle with exercise-induced fatigue.Methods SD rats were randomized into blank control group,model group and ginsenoside Rg1 group.The rats in the model group and ginsenoside Rg1 group received medium-intensity treadmill running to induce exercise-induced fatigue.Ginsenoside Rg1 group was given ginsenoside Rg1 50 mg?kg-1?d-1 for 2 continuous weeks during the modeling.After treatment,malondialdehyde(MDA)content,superoxide dismustase(SOD) activity,mitochondrial membrane potential and free calcium content in the rat skeletal muscle were measured.Meanwhile,ultrastructure of the skeletal muscle was observed under the electron microscope.Results In the model group,SOD activity,mitochondrial membrane potential,and free calcium content were decreased,MDA content was increased,and the difference was significant as compared with the blank control group(P

Background and purpose:miR-124 is considered to be a tumor suppressor in multiple tumors, including lung cancer, prostate cancer, bladder cancer, and breast cancer. However, its function is unclear in gastric cancer. This study aimed to explore the expression of miR-124 in human gastric mucosal epithelium cells and different gastric cancer cells, as well as gastric cancer tissues and matched para-cancerous tissues. The correlations of miR-124 expression with gender, age, histological grade, T stage, TNM stage, lymph node metastasis and prognosis of gastric cancer patients were analyzed.Methods:A real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) was employed for detecting the expression of miR-124 in human gastric mucosal epithelium cells and gastric cancer cells. The expression of miR-124 in gastric cancer tissues and matched para-cancerous tissues was detected by in situ hybridization.Results:The RTFQ-PCR results indicated that the expression of miR-124 was down-regulated in MKN-74, MKN-28, MKN-45, MGC-803, SGC-7901 and AGS cells compared to GES-1 cells.In situ hybridization showed that miR-124 was strongly expressed in normal gastric mucosa. However, low expression, focal positive expression or lack of miR-124 expression were observed in gastric cancer tissues. Statistical analysis showed that miR-124 was close-ly correlated to histological stage, TNM stage and node metastasis of gastric cancer patients, but not the age, gender and tumor size. The OS and DFS of the patients with low expression of miR-124 were shorter than that of the patients with high expression of miR-124. Multivariate analysis suggested that miR-124 down-regulation was an independent prog-nostic factor for survival in patients with gastric cancer.Conclusion:miR-124 is down-regulated in gastric cancer cells and tissues. The expression of miR-124 is correlated to histological stage, TNM stage, node metastasis and prognosis.

Objective To explore the therapeutic effect of Han-uvulopalatopharyngoplasty (H-UPPP) combined with coblation on treatment of type Ⅱ mild and moderate obstructive sleep apnea hypopnea syndrome (OSAHS).Methods According to the measuring parameters analyzed and clinical characteristics of velopharyngeal,68 patients were divided into 3 groups:group A (28 patients,treated by H-UPPP combined with coblation of tonsillectomy),group B (22 patients,treated by H-UPPP combined with drilling of tonsil) and group C (18 patients,treated by velopharyngeal multi-points drilling).After operation for 6 months,the pafor tients in 3 groups were detected by the polysomnography (PSG),Epworth sleepiness scale,and the parameters of velopharyngeal were compared.Results After operation for 6 months,the heal,excellence,efficiency and inefficiency patients in group A were 6,10,7,5 cases,in group B were 3,8,7,4 cases,in group C were 2,7,5,4 cases,there was no significant difference (P ＞0.05).After operation for 6 months,the apnea hyponea index (AHI) and the scores of ESS in group A,B,C were significantly lower than those before operation [(10.1 ± 2.3) times/h vs.(21.2 ± 2.5) times/h,(6.4 ± 1.0)scores vs.(16.2 ± 1.0) scores,(6.9 ± 1.3) times/h vs.(16.0 ± 1.4) times/h,(5.4 ± 1.3) scores vs.(14.5 ±1.5) scores,(7.7 ± 1.8) times/h vs.(16.0 ± 2.1) times/h,(4.1 ± 1.0) scores vs.(12.3 ± 1.9) scores],thelevel of LSaO2 was significantly higher (0.885 ±0.035 vs.0.737 ±0.030,0.871 ±0.046 vs.0.763 ±0.033,0.901 ±0.029 vs.0.820 ±0.034),there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).After operation for 6 months,the pharyngomaxillary space,distance between uvula and posterior wall of pharynx,distance between anterior pillars in group A,B,C were significantly increased compared with those before operation [(24.6 ± 0.9) mm vs.(12.3 ± 1.2)mm,(11.6 ±1.2) mm vs.(5.4 ± 0.6) mm,(34.9 ± 1.2) mm vs.(28.3 ± 1.0) mm,(24.0 ± 0.8) mm vs.(14.3 ± 1.0) mm,(11.8 ± 0.8) mm vs.(6.3 ± 0.4) mm,(38.3 ± 0.8) mm vs.(31.9 ± 1.9) mm,(23.6 ± 1.4) mm vs.(19.9 ±1.1) mm,(7.3 ± 0.5) mm vs.(6.8 ± 0.6) mm,(38.5 ± 0.8) mm vs.(35.2 ± 1.0) mm],the length of soft palate was decreased [(31.9±0.9) mm vs.(38.3 ±0.9) mm,(25.6 ± 1.0) mm vs.(35.6 ± 1.2) mm,(29.9 ± 1.3) mm vs.(34.9 ±0.9) mtm],there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).Conclusions H-UPPP combined with coblation on treatment of type Ⅱ mild and moderate OSAHS is effective and safe.According to the clinical characteristics of the patients to select suitable method is the key to get a satisfactory curative effect.

OBJECTIVE To study the best surgical technique for treatment of chronic hypertrophic rhinitis(HR).METHODS Eighty six cases with HR were divided randomly into 3 groups.Thirty cases were treated by transnasal endoscopic submucous inferior turbinate resection(group A),26 cases by partial inferior turbinectomy(group B)and 30 cases by bipolar radiofrequency ablation(group C).The epithelium of the inferior turbinate of the every case in 3 groups was examined with histomorphology and ultrastructure techniques at 6 months after operation. The efficacy and the features of in the 3 groups were compared.The MTR was determined in the patients of the 3 groups.The histomorphology and ultrastructure of the inferior turbinate were observed at 6 months after operation.RESULTS All the cases with HR in 3 groups were followed up for 3 to 6 months after operation.Effective rates of group A,group B and group C were 100 %,100 % and 96.3 % respectively, while there was no significant difference among the three groups.Compared to the group B,surgical techniques applied in Group A and group C have more advantages because ultrastructure of inferior turbinate mucosal cilia and nasal mucociliary transport function were nearly normal at 3 to 6 months after operation. The advantages include operating easily,wound healing up fast.MTR between pre-and post-operation was significant difference in group B.Epithelial tissue remained intact in group A and group C,while epithelial tissue in group B was instead of fiber tissue at 6 months after operation.The ultrastructure of inferior turbinate mucosal cilia in group A and group C remained intact at 6 months after operation.CONCLUSION The transnasal endoscopic submucous inferior turbinate resection and bipolar radiofrequency ablation for treatment of chronic hypertrophy rhinitis are effective. Submucous minimally invasive surgery of the inferior turbinate deserves to be recommended.

Purpose The diagnosis of adult onset Still's disease (AOSD) is usually difficult due to the lack of specific clinical manifestation.This paper summarizes the manifestations of 18F-FDG PET/CT in adult onset Still's disease and investigates the value of PET/CT in diagnosis and differential diagnosis of AOSD.Materials and Methods Fiftyfour patients who was diagnosed as AOSD were selected and underwent 1 8F-fluorodeoxyglueosepositron emission tomography/computed tomography (18F-FDG PET/CT).The clinical features,laboratory examination and the maximum standard uptake value (SUVmax) of liver,spleen,bone marrow,lymph node were collected.Then the main PET/CT manifestations of patients with AOSD,the influence factor of SUVmax and correlation between SUVmax and laboratory indexes were analyzed.Results FDG accumulation occurred mainly in bone marrow (88.89％;SUVmax:3.91 ± 1.16),spleen (79.63％,SUVmax:3.24±0.89) and lymph node (77.78％;SUVmax:3.83± 1.97).FDG accumulation can also occurred in joints,parotid gland,submandibular gland,pleural and other organs.Compared with the nonglucocorticoid group,SUVmax of the spleen,bone marrow and lymph node were significantly decreased in the glucocorticoid group with or without fever (P＜0.05),whereas the SUVmax of liver,spleen,bone marrow and lymph node between the two glucocorticoid groups were not statistically different (P＞0.05).The SUVmax of liver,spleen,bone marrow and lymph node between two groups with or without disease-modifying anti-rheumatic drugs were not statistically different (P＞0.05).Correlation analysis showed that spleen SUVmax and lactate dehydrogenase,bone marrow SUVmax and C reactive protein were weakly correlated (r=0.33 and 0.30,P＜0.05).Conclusion The main manifestations of 18F-FDG PET/CT of AOSD are FDG accumulation in spleen,bone marrow and lymph nodes.Glucocorticoid can reduce the SUVmax.18F-FDG PET/CT can help to rule out malignancy,guide biopsy and assist in definite diagnosis of AOSD.

Objective·To construct C-shaped cartilage rings by rabbit auricular cartilage-derived chondrocytes combing with both electrospun gelatin/ polycaprolactone(GT/PCL) nanofibrous membranes and 3D printed supporters for repairing tracheal cartilage defects.Methods·Primary chondrocytes were isolated from rabbit auricular cartilage with methods of trypsin enzyme digestion and collagenase enzyme digestion.After proliferation in vitro,the chondrocytes of passage 2 were harvested for further experiments.Ultrafine composite fibers of GT/PCL were fabricated via electrospinning.The electrospun GT/PCL membranes were tailored into rectangle shape,the length of which is 12 cm and the width is 2.5 cm.Chondrocytes were seeded on membrane at a density of 1 × 108 cells/mL.Then the membrane were rolled onto a 3D printed supporter of poly(DL-lactide-ε-caprolactone) (PLCL) material to construct a C-shaped cartilage-like complex.After 8 weeks of subcutaneous incubation in vivo,gross inspection and paraffin section staining were applied for evaluation.Results·After 8 weeks of culture in vivo,mature cartilage-like tissue were formed with open-cylindrical bellow appearance and pecific mechanical property.C-shaped rings arranged at regular intervals on the inner surface of tissue,which were similar to the normal structure of tracheal cartilages.Histological and immunohistological staining showed a large number of typical lacunar structures and extracellular matrix secretions.Conclusion·It is feasible to construct tissue engineered C-shaped cartilage tissue by combing chondrocytes with GT/PCL membrane and 3D printed PLCL supporter for tracheal cartilage repair.