PURPOSE: End-stage knee osteoarthritis (OA) patients are the primary candidates for total knee arthroplasty (TKA). However, most morphological refinements of TKA prosthesis are based on anatomical data from the knees of healthy individuals. This study aimed to determine whether differences exist in key bony morphological characteristics of the distal femur and proximal tibia between osteoarthritic knees and healthy knees. METHODS: This was a retrospective cross-sectional observational study with a case-control design. Patients who were aged ≥ 50 years, had no history of trauma, fracture, or surgery in the studied knee, and had no obvious knee flexion contracture were included in this study by CT scans. Patients who met the American College of Rheumatology clinical criteria for knee OA were included in the study group. Kellgren-Lawrence grade III or IV knees were studied (for bilateral cases, the more severely affected knee was chosen). Patients who presented with unilateral knee pain or trauma were included in the control group, with CT scans from the opposite (asymptomatic) knee used for analyzing. The studied knee had a Kellgren-Lawrence grade of 0 or I and showed no abnormalities upon physical examination. Archived knee CT scans from 160 patients were divided into 2 groups: the study group (80 moderate-to-severe OA knees) and the control group (80 healthy knees). After 3-dimensional reconstruction and virtual cutting using a CT workstation, 13 morphological parameters of the distal femur and proximal tibia were compared between the 2 groups using independent-samples t-tests. RESULTS: No significant group differences in the femoral anteroposterior dimension (p = 0.797), height of the lateral femoral condyle (p = 0.268), posterior condylar angle (p = 0.240), tibial anteroposterior dimension (p = 0.536), or tibial lateral anteroposterior dimension (p = 0.702) were observed. However, the femoral mediolateral dimension (p = 0.002), distal femoral aspect ratio (femoral mediolateral dimension/femoral anteroposterior dimension) (p < 0.001), height of the femoral trochlear groove (p < 0.001), height of the medial femoral condyle (p < 0.001), tibial mediolateral dimension (p = 0.001), proximal tibial aspect ratio (tibial mediolateral dimension/tibial anteroposterior dimension) (p = 0.004), tibial medial anteroposterior dimension (p = 0.005), and tibial asymmetry ratio (tibial medial anteroposterior dimension/tibial lateral anteroposterior dimension) (p = 0.006) were all significantly greater in the study group. CONCLUSION Knees with moderate-to-severe OA are significantly wider than healthy knees, and OA is a risk factor for increased tibial platform asymmetry. When refining the morphological parameters of TKA prostheses, the specific bony morphological characteristics of OA knees should be taken into account to reduce the potential risk of femoral or tibial component underhang and facilitate optimal balance between tibial component fit and rotational alignment.
Humans ; Osteoarthritis, Knee/pathology* ; Male ; Female ; Cross-Sectional Studies ; Retrospective Studies ; Arthroplasty, Replacement, Knee ; Middle Aged ; Aged ; Case-Control Studies ; Prosthesis Design ; Knee Prosthesis ; Femur/anatomy & histology* ; Tibia/anatomy & histology* ; Tomography, X-Ray Computed ; Knee Joint/diagnostic imaging*

Objective To explore the effects of multidisciplinary teamwork continuity of care for community-dwelling patients with advanced renal cell carcinoma treated with targeted drugs.Methods A total of 80 patients with stage IV renal cell carcinoma treated in our hospital from February 2014 to February 2017 were enrolled using convenience sampling method,and were randomly divided into the experimental group and the control group using random number table,with 40 cases in each group.Both groups were given routine nursing care,and multidisciplinary teamwork continuity of care was adopted in the experimental group additionally.Results One month after intervention,the patients' score of medication compliance questionnaire in the experimental group was significantly higher than that in the control group(P＜0.05);three months after intervention,the quality of life(QLQ-C30) score of the experimental group was significantly improved than that of the control group(P＜0.05),and the number of rehospitalization was significantly less than that in the control group(P＜0.05).The number and severity of adverse effects in the experimental group were lower than those in the control group,and no case of stopping medication or decreasing doses occurred.Conclusion The multidisciplinary teamwork continuity of care model can enhance health status of community-dwelling patients,improve medication compliance and quality of life,and reduce readmission.

Objective To investigate clinical efficacy of empathy nursing combined with venlafaxine slow release tablets for the treatment of depression.Methods A total of 64 depression patients were randomly divided into study group (n =32) and control group (n =32).Two groups were all given venlafaxine slow release tablets,and the specific empathy nursing were additionally carried out in the study group at the same time.The treatment course lasted for four weeks.All patients were measured by the World Health Organization Quality of Life Scale brief version (WHOQOL-BREF),Hamilton depression scale (HAMD),Hamilton anxiety scale (HAMA) before treatment and 4 weeks after treatment.Results After 4-week empathy nursing intervention and drugs treatment,the total scores of HAMD and HAMA in the study group and the control group were decreased,and the study group decreased more significantly than the control group,and the study group was higher than the control group(P ＜0.05).The each item scores of WHOQOL-BREF were increased in both groups,and the study group was significantly higher than the control group (P ＜ 0.05).Conclusion Empathy nursing combined with venlafaxine slow release tablets can improve depression,anxiety and other symptoms,and can improve life function,promote the patient's recovery and treatment efficacy,thereby to improve quality of life of patients.

Objective To investigate clinical efficacy of empathy nursing combined with venlafaxine slow release tablets for the treatment of depression.Methods A total of 64 depression patients were randomly divided into study group (n =32) and control group (n =32).Two groups were all given venlafaxine slow release tablets,and the specific empathy nursing were additionally carried out in the study group at the same time.The treatment course lasted for four weeks.All patients were measured by the World Health Organization Quality of Life Scale brief version (WHOQOL-BREF),Hamilton depression scale (HAMD),Hamilton anxiety scale (HAMA) before treatment and 4 weeks after treatment.Results After 4-week empathy nursing intervention and drugs treatment,the total scores of HAMD and HAMA in the study group and the control group were decreased,and the study group decreased more significantly than the control group,and the study group was higher than the control group(P ＜0.05).The each item scores of WHOQOL-BREF were increased in both groups,and the study group was significantly higher than the control group (P ＜ 0.05).Conclusion Empathy nursing combined with venlafaxine slow release tablets can improve depression,anxiety and other symptoms,and can improve life function,promote the patient's recovery and treatment efficacy,thereby to improve quality of life of patients.

OBJECTIVE:To investigate the use of prophylactic use of antibiotics for special diagnosis and treatment in our hos-pital,and to provide reference for rational use of antibiotics. METHODS:The patients receiving special diagnosis and treatment were collected from our hospital during Jan.-Aug. 2016. The prophylactic application of antibiotics was analyzed statistically. RE-SULTS:Among 149 included patients,there were 62 cases of prophylactic use of antibiotics with utilization rate of 41.61％. Among 62 patients receiving antibiotics,5 cases were given medicine orally and others were via injection. Nine categories 18 types of antibiotics were used,involving 69 times;cephalosporin were used in 49 times(71.01％),among which top 3 types in the list of use sequence were cefodizime,cefotetan and cefazolin;prophylactic use of antibiotics was not found in angiography(including coronary artery) and stent implantation. Utilization rate of antibiotics for other diagnosis and treatment was more than 50％. The prophylactic use of antibiotics was complex in ureteroscopy and cystoscopy,shock wave lithotripsy;the selection of drug types started from the high level. There were 59 cases of single drug(95.16％)and 3 cases of two-drug(4.84％). Total of 41 cases were given medicine 0.5-2 h before surgery or at the beginning of anaesthesia (66.13％). Medication time of 18 cases was ≤24 h (29.03％);that of 11 cases was >24-48 h(17.74％). CONCLUSIONS:The prophylactic use of antibiotics is relatively standard in angiography(including coronary artery),stent implantation and implantation of peritoneal dialysis tube in our hospital. There are some problems during special diagnosis and treatment,such as the indication of drug delivery is not strict;the selection of drug types starts from the high level;medication timing is not suitable;medication course is excessively long.

Objective To investigate the effect of acupoint massage combined with foot bathing in hot water on sleep quality of patients after gynecological operation. Methods Ninety-nine gynecological patients were divided into the control group (n=49) and the observation group (n = 50) after gynecological operation according to time of admission. The control group received the routine nursing and the observation group was treated with acupoint massage and foot bathing in hot water besides routine nursing. Pittsburgh sleep quality index was used to investigate the sleep quality at the day before operation 1 and 8 days after operation. Result The sleep quality of postoperative patients in the observation group was significantly better than that of the control group (P < 0.05). Conclusions The acupoint massage with hot bathing in hot water can improve the quality of sleep of the patients after gynecological operations. For its convenience in manipulation, it is popular among patients and their families.

Objective:To observe the efficacy of polyene phosphatidyl choline combined with Hugan tablets in the treatment of drug-induced liver injury. Methods:Totally 80 cases of drug-induced liver injury were randomly divided into the observation group (40 cases )and the control group(40 cases). The observation group was given polyene phosphatidyl choline injections 697. 5mg+5%glucose injections 250ml,ivd,qd,combined with Hugan tablets 1. 44g,po,tid,the control group was given polyene phosphatidyl choline injections 697. 5mg+5%glucose injections 250ml,ivd,qd,and the symptomatic treatment in the two groups was the same. The two groups were treated for 20d. Alanine aminotransferase ( ALT), aspartate aminotransferase ( AST), total bilirubin ( TBIL), glutamyl transpeptidase(GGT) and alkaline phosphatase(ALP)were detected respectively before and after the treatment, and the therapeutic effects were compared between the two groups. Results: After the treatment,the total effective rate in the observation group was 97. 5%,which was significantly higher than that in the control group(P <0. 01),Symptoms,signs and biochemical indices in the two groups were improved obviously. The decrease of ALT,AST and GGT in the observation group after the treatment was obviously lower than that in the control group(P<0. 05). Conclusion: Polyene phosphatidylcholine injections combined with Hugan tablets in the treatment of liver injury is better than polyene phosphatidyl choline, which is worthy of clinical application.

Objective:To observe the effect of 5-aza-2'-deoxycytidine on proliferation and apoptosis of ovarian cancer cell lines(SKOV3 and 3AO)and on expression of mismatch repair(MMR)genes(hMLH1 and hMSH2)in SKOV3 and 3AO cells.Methods:Human ovarian cancer cell lines SKOV3 and 3AO were treated for 3 d with 5-aza-CdR(0.5,5,50 ?mol/L),a specific demethylation agent,and then cultured in RPMI 1640 medium for another 7 d.The cells growth was observed by MTT assay before and after 5-aza-CdR treatment and the cell apoptosis was analyzed by flow cytometry.The expression of hMLH1 and hMSH2 mRNA was examined by semi-quantitative reverse transcription polymerase chain reaction(RT-PCR).Results:5-aza-CdR(0.5,5,50 ?mol/L)obviously inhibited the growth of SKOV3 and 3AO cells compared in a concentration dependent manner.The apoptosis rates of SKOV3 cells were(10.59?1.57)%,(17.52?1.72)%,(34.10?1.45)% after treated with 0.5,5,50 ?mol/L 5-aza-CdR,respectively;and the apoptosis rates of 3AO cells were(11.11?2.21)%,(17.24?1.11)%,and(26.53?2.00)%,respectively,which were all markedly higher than those of control group(P