BACKGROUND: Although mobile bearing knee prosthesis exhibits good movement and low wear rate in vitro studies,its clinical effect in vivo is still contraversial. OBJECTIVE: To compare and observe the range of motion and clinical outcomes of mobile bearing knee prosthesis and fixed bearing knee prothesis at least 1 year after operation. DESIGN,TIME AND SETTING: A randomized controlled observation. The experiment was performed at the Joint Reconstruction Center,Seoul National University Bundang Hospital,Seoul,Korea between November 2003 and July 2006. PARTICIPANTS: Four hundrend and eighty-eight patients (669 knees) with knee osteoarthritis undergoing total knee arthroplasty (TKA) were selected,of them 244 (341 knees) were treated with fixed bearing knee prothesis and 244 (328knees) with mobile bearing knee prosthesis.METHODS: The surgery was performed by the same physician (TK Kim). With patellar medial approach,the patella was not turned over,but dislocated laterally to expose the bone. Space measurer was used to expand and measure the Space. According to the measurements,soft tissues were released and balanced until the flexion gap was within 3-4 mm more than extension gap or 1-2 mm extension gap more than flexion gap. For varus knees,2-3 mm larger lateral gap was accepted. In all cases,the patella was resuffaced,and implant fixation was carried out with cement.MAIN OUTCOME MEASURES: Degrees of flexion contracture and maximum flexion angle were measured with a goniometer. The knee pain and functional status were evaluated by American Knee Society (AKS) scores,Patellofemoral scores,Western Ontario McMaster Universities Osteoarthritis Index scales (WOMAC) and SF-36 systems.RESULTS: There was no significant difference between two groups in terms of sex,age,body height,body mass and body mass index. No differences wre found in postoperative socres of Patellofemoral scores,WOMAC and SF-36systems (P>0.05). The mean AKS scores of fixed bearing knee prothesis group were higher than mobile group (48.5±3.2,47.5±4.8,P=0.010). The flexion defomity of two groups was significantly corrected following surgery (P=0.341). No differences were found in terms of range of motion (P=0.412) and knee function (P>0.05).CONCLUSION: The mobile bearing design has no advantages in postoperative range of motion,pain relief and knee function relative to fixed bearing design. Surgical technique is critical to achieve good clinical outcomes.

Objective To compare the safety and immunogenicity between domestic and imported,imported and imported split influenza virus vaccine in Chinese population. Methods The published studies during January 1996 and June 2008 on the comparison between split influenza virus vaccine were screened and evaluated.The meta analysis was performed on safety and immunogenicity using fixed model or random model according the heterogeneity of the studies. Results 12 studies which were all random controlled trials between split vaccine were included.10 trials were between domestic and imported vaccine,and 2 trials were between imported and imported vaccine.For 10 domestic and imported vaccine trials,the local reaction pooled OR=0.81,95% CI (0.59,1.11);the systemic reaction the pooled OR=0.78,95% CI (0.50,1.03);the H1N1 subtype seroconversion pooled OR= 0.94,95% CI (0.78,1.14);the H3N2 subtype seroconversion pooled OR =1.01,95% CI (0.87,1.17);the B type seroconversion total OR= 1.35,95% CI (0.98,1.85).For 2 imported and imported vaccine trials,the local reaction pooled OR = 1.19,95% CI (0.60,2.37);the systemic reaction the pooled OR =1.15,95% CI (0.71,1.87);the H1N1 subtype seroconversion pooled OR= 1.27,95% CI (0.37,4.37);the H3N2 subtype seroconversion pooled OR= 1.29,95% CI (0.39,4.33);the B type seroconversion pooled OR= 0.95,95% CI (0.46,1.37). Conclusions There were no statistical difference on the safety and immunogenicity between domestic and imported,imported and imported split influenza vaccine in Chinese population.

Objective To explore the regulating mechanism of the astrocytes on the expression of ?-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors(AMPARs) subunit in epileptogenesis. Methods The astrocytic conditional medium(ACM) was collected after being stimulated by glutamate,and then ACM was added to the cultured hippocampal neurons.The expression changes of neuronal GluR2 and protein interacting with C-kinase-1(PICK1) mRNA were detected by RT-PCR. Results In the cultured hippocampal neurons,the GluR2 mRNA expression was significantly decreased at the 2nd,8(th),and 12(th) hours after the administration of ACM compared with that in the control group(P

[Summary] Nowadays ,obesity and diabetes mellitus have become an important worldwide public health problem. Bariatric surgery is an effective treatment method of morbid obesity and type 2 diabetes mellitus (T2DM ). Although nutrition‐related complications after surgery is relatively common ,these complications can be detected and prevented. The key is to establish a routine perioperative prophylaxis and postoperative long‐term monitoring system. Routine metabolic and nutritional monitoring is recommended after all bariatric surgical procedures ,which can help patients maintain long‐term weight loss ,timely detect and treat surgery‐related complications and improve clinical outcomes. In the present mini review ,the perioperative and postoperative nutrition management was introduced.

Objective To explore the characteristics and rehabilitation of Chinese dysarthria. Methods 31 patients and 63 normal controls were measured with maximum phonation time (MPT), pitch, intensity and mean airflow rate (MAR), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR); Nasalance was tested with Nasalance Acquisition System (NasalView); Speech intelligibility was tested with mandarin words card. And alternative movement rate (AMR) were also tested. All the patients were rehabilitated with physiologic approach, 16 patients who finished the course were tested again after rehabilitation. Results MPT, MAR, aspiratory function, AMR of the patients was remarkable lower than those of the control; the nasalance scores of vowel and nonnasal sounds, words, and sentence were remarkable higher than those of the control; the speech intelligibility was also lower. After intervention, MPT, aspiratory function, AMR, and speech intelligibility improved. In the index, only MPT and AMR were correlated with the speech intelligibility. The nasalance of /i/ and nonnasal sentence related with the listener perceptions of hypernasality. Conclusion The aspiratory and phonation function of the patients with dysarthria are impaired. The patients show hypernasality which is a type of resonance abnormity. AMR is declined. Speech intelligibility is much lower. Physiologic approach can improve their phonation, aspiration, articulation and communication ability, but can't for resonance. The longer the MPT, the more /pa、ta、ka/ in specific time, the higher the speech intelligibility. Nasalance could be used for evaluating the hypernasality.

Dysarthrias are speech disorders that result from neurological impairments associated with weakness,slowness,or incoordination of the musculature used to produce speech.According to the lesion sites and the severity of the speech impairments,it is identified 6 types of dysarthria:spastic,flaccid,mixed spastic-flaccid,ataxic,hypokinetic,and hyperkinetic.And spastic is the most common.The incidence of dysarthria in cerebrovascular disease is 30%～40%.There are many researches and data on this speech disorder abroad.But because of different language,most of the data is not appropriate to Chinese.

Cohesion between sister chromatids occurs during DNA replication, is regulated by cohesin, and depends on acetylation of cell division cycle associated 5 (CDCA5) and cohesin. WAPL can promote dissociation of cohesin from DNA, and CDCA5 can antagonize the effect of WAPL and stabilize sister chromatids cohesion by stabilizing the binding of cohesin to DNA. CDCA5 mRNA has a high transcription level in a variety of tumor cell lines, suggesting that CDCA5 may be related to the higher malignant proliferation activity of tumor cells, and has been confirmed in various tumors such as liver cancer and lung cancer, and CDCA5 may be a potential targeted molecule for the treatment of malignant tumors.

Evidence-based medicine (EBM) has been widely applied in clinical study of acupuncture and moxibustion, and the real-world study (RWS) has gradually become an important way of clinical research in the world in recent years. It is worthy of our in-depth study and discussion that how to evaluate the advantages and limitations of EBM and RWS as well as their reasonable application in clinical study of acupuncture and moxibustion. The characteristics and difference between RWS and EBM, and the situation of acupuncture clinical research methods are discussed in this paper. It is proposed that we should understand the advantages of RWS in acupuncture clinical research, fully realize the limitations of EBM and RWS, recognize the complexity and particularity of RWS, and apply EBM and RWS into acupuncture clinical research. Meanwhile acupuncture clinical manipulation standardization should be further promoted, which is benefit to develop clinical study, improve clinical efficacy and promote the popularization of acupuncture and moxibustion.
Acupuncture Therapy ; standards ; Biomedical Research ; standards ; Evidence-Based Medicine ; standards ; Humans ; Medicine, Chinese Traditional ; Moxibustion ; standards

Objective To investigate the relationship between early brain menifestation such as white matter damage and ventriculomegaly detected by magnetic resonance imaging(MRI) and adverse neurodevelopmental outcome in preterm infants.Methods From March 15,2007 to April 12,2011,122 preterm infants accepted MRI examination 8-14 days after birth in Chinese People's Liberation Army 202 Hospital.Totally,115 preterm infants were followed up at 12 months old and mental development index(MDI) and psychomotor development index (PDI) score were measured.MDI＜70 was as mental dysfunction,-84 as borderline dysfunction and-114 as normal; PDI＜70 was as psychomotor dysfunction,-84 as borderline dysfunction and-114 as normal.The relationship between clinical characteristics of preterm infants,MRI abnormalities and neurodevelopmental outcome were analyzed by analysis of variance,LSD and Kruskal-Wallis H test.Results The 122 premature infants included 69 males and 53 females with the median gestational age of 32 weeks(28-36 weeks)and the median birth weight of 2050 g (1270-3110 g).In 24 premature infants with mentaldysfunction,the average gestational age [(28.7 ± 1.7) weeks],birth weight[(1520.1-44.8) g] and 1 min Apgar score (5.5 ± 0.8) were all lower than those in normal infants [n =59,(33.5 ± 2.2)weeks,(2240.4 ± 47.1) g and 7.1 ± 0.8],while the average mechanical ventilation time was longer [(20.4±5.8) dvs (5.6±2.7) d](t=2.37,2.49,2.13 and 2.44,P＜0.05).In 20 premature infants with psychomotor dysfunction,the average gestational age [(27.9 ±± 1.4) weeks],birth weight [(1515.6±43.7) g],1 min Apgar score (5.6t0.5) were lower than those in normal infants [n=62,(33.2±2.4) weeks,(2264.3±42.5) g and 7.2±0.6],while the mechanical ventilation time was longer [(18.2±4.7) dvs (5.3±2.2) d](t=2.28,2.52,2.09 and 2.38,P＜0.05).Among thirteen preterm infants with severe white matter damage,eleven and nine developed mental or psychomotor dysfunction respectively.Among eleven preterm infants with moderate and severe ventriculomegaly,seven and six developed mental or psychomotor dysfunction respectively.The more severe the white matter damage and ventriculomegaly,the higher the incidence of mental (H=16.23 and 14.33,P＜0.05) and psychomotor dysfuction (H =18.63 and 12.69,P ＜ 0.05).Conclusions White matter damage is common in preterm infants.Prognosis of preterm infants with mental and psychomotor dysfunction is related with the degree of white matter damage and ventriculomegaly.

Objective To study the arthroscopic operative procedure and the result for knee osteoarthritis. Methods 49 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to September 1999 were reviewved.Arthroscopic lavage,debridement or debridement Combined with drilling was performed on different patients. Results The average follow-up period was 5 years.The scale improved 36.0 after operation.No serious complication was found. Conclusions Arthroscopic debridement for osteoarthritis is satisfactory in the long-term efficacy and drilling of grade Ⅳ subchondral bone does not improve long-term outcome.