Spatial-temporal distribution of human brucellosis in mainland China from 2004 to 2017 and an analysis of social and environmental factors

BACKGROUND@#This study aimed to describe the changing distribution of human brucellosis between 2004 and 2017 in mainland China and seek scientific evidence of the relationship between socio-economic, environmental, and ecological factors and human brucellosis incidence.@*METHODS@#The annual numbers of brucellosis cases and incidence rates from 31 provinces in mainland China between 2004 and 2017 were obtained from the Data-Center for China Public Health Science. The number of monthly brucellosis cases in 2018 was obtained from the Chinese Center for Disease Control and Prevention. The electronic map of the People's Republic of China was downloaded from the National Earth System Science Data Sharing Platform. Human population density, gross domestic product (GDP), and an inventory of cattle and sheep at the end of each year from 2004 to 2017 were obtained from the National Bureau of Statistics of China. Annual rainfall data from 31 provinces in the People's Republic of China from 2004 to 2017 were collected from the China Meteorological Data Service Center. The risk distribution and changing trends of human brucellosis were mapped with ArcGIS. A cluster analysis was employed to identify geographical areas and periods with statistically significant incidence rates. Multivariate linear regression was used to determine possible factors that were significantly correlated with the presence of human brucellosis cases.@*RESULTS@#Human brucellosis cases have spread throughout the whole country. Human brucellosis cases occurred mostly from March to August and were concentrated from April to July. The inventory of sheep, GDP, and climate were significantly correlated with the presence of brucellosis cases in mainland China.@*CONCLUSIONS@#The geographical expansion of human brucellosis in mainland China was observed, so did the high-incidence clusters between 2004 and 2017. Most of the cases were reported during the early spring to early summer (February-August). Results from the multivariate linear regression suggested that the inventory of sheep, GDP, and climate were significantly associated with the incidence of human brucellosis in mainland China.

Plant homeodomain finger protein 23 inhibits autophagy and promotes apoptosis of chondrocytes in osteoarthritis / 中华医学杂志(英文版)

Background@#Plant homeodomain finger protein 23 (PHF23) is a novel autophagy inhibitor gene that has been few studied with respect to orthopedics. This study was to investigate the expression of PHF23 in articular cartilage and synovial tissue, and analyze the relationship between PHF23 and chondrocyte autophagy in osteoarthritis (OA).@*Methods@#Immunohistochemical staining and western blot were applied to show the expression of PHF23 in cartilage of different outbridge grades and synovial tissue of patient with OA and healthy control. The normal human chondrocyte pre-treated with rapamycin or 3-methyladenine, treated with interleukin-1β (IL-1β). IL-1β induced expression level of PHF23 and autophagyrelated proteins light chain 3B-I (LC3B-I), LC3B-II, and P62, were examined by Western blot. A PHF23 gene knock-down model was constructed with small interfering RNA. Western blot was performed to detect the efficiency of PHF23 and the impact of PHF23 knockout on IL-1β-induced expression of autophagy-related and apoptotic-related proteins in chondrocyte.@*Results@#The expression of PHF23 was significantly increased in the high-grade cartilage and synovial tissue of patients with OA. The IL-1β-induced expression of PHF23 was gradually enhanced with time. The level of LC3B-II, P62 changed with time. After knockdown of PHF23, the level of autophagy-related proteins increased and apoptotic-related proteins decreased in IL-1β-induced OA-like chondrocytes.@*Conclusions@#The expression of PHF23 increased in human OA cartilage and synovium, and was induced by IL-1β through inflammatory stress. PHF23 can suppress autophagy of chondrocytes, and accelerate apoptosis.

Plant homeodomain finger protein 23 inhibits autophagy and promotes apoptosis of chondrocytes in osteoarthritis / 中华医学杂志(英文版)

BACKGROUND@#Plant homeodomain finger protein 23 (PHF23) is a novel autophagy inhibitor gene that has been few studied with respect to orthopedics. This study was to investigate the expression of PHF23 in articular cartilage and synovial tissue, and analyze the relationship between PHF23 and chondrocyte autophagy in osteoarthritis (OA).@*METHODS@#Immunohistochemical staining and western blot were applied to show the expression of PHF23 in cartilage of different outbridge grades and synovial tissue of patient with OA and healthy control. The normal human chondrocyte pre-treated with rapamycin or 3-methyladenine, treated with interleukin-1β (IL-1β). IL-1β induced expression level of PHF23 and autophagy-related proteins light chain 3B-I (LC3B-I), LC3B-II, and P62, were examined by Western blot. A PHF23 gene knock-down model was constructed with small interfering RNA. Western blot was performed to detect the efficiency of PHF23 and the impact of PHF23 knockout on IL-1β-induced expression of autophagy-related and apoptotic-related proteins in chondrocyte.@*RESULTS@#The expression of PHF23 was significantly increased in the high-grade cartilage and synovial tissue of patients with OA. The IL-1β-induced expression of PHF23 was gradually enhanced with time. The level of LC3B-II, P62 changed with time. After knockdown of PHF23, the level of autophagy-related proteins increased and apoptotic-related proteins decreased in IL-1β-induced OA-like chondrocytes.@*CONCLUSIONS@#The expression of PHF23 increased in human OA cartilage and synovium, and was induced by IL-1β through inflammatory stress. PHF23 can suppress autophagy of chondrocytes, and accelerate apoptosis.

Trends of reported human brucellosis cases in mainland China from 2007 to 2017: an exponential smoothing time series analysis

BACKGROUND@#The main objective of this study was to describe the temporal distribution of monthly reported human brucellosis cases in mainland China and develop an appropriate time series model for short-term extrapolation forecast.@*METHODS@#Surveillance data of the monthly reported human brucellosis cases occurring from April 1, 2007, to March 31, 2017, in mainland China were obtained. The spectrum analysis was first adopted to find the cyclic and seasonal features, the existence of the seasonality and trend was determined by exponential smoothing method and the seasonal-trend decomposition. The candidate models of exponential smoothing included the additive model and multiplicative model; R was selected as the indicator for the selection of candidate model, and the stability of the model was verified by adjusting the training data and test data set. Finally, the extrapolations of monthly incident human brucellosis cases in 2017 were made.@*RESULTS@#From April 1, 2007, to March 31, 2017, a total of 435,108 cases of Brucellosis occurred in mainland China were reported, with an average of 3626 cases per month and a standard deviation of 1834 cases. The R of the exponential smoothing method that based on additive model increased steadily from 0.927 to 0.949 with the increase of the data volume. Ten of 12 actual values fell in the confidence interval of predicted value.@*CONCLUSIONS@#Human brucellosis cases peaked during the months from March to August in mainland China, with clear seasonality. The exponential smoothing based on the additive model method could be effectively used in the time series analysis of human brucellosis in China. Control methods, such as vaccination, quarantine, elimination of infected animals, and good hygiene within the production cycle, should be strengthened with paying more attention to the seasonality. Further research is warranted to explore the drivers behind the seasonality.

Principles and skills of designing opening speech in epidemiological courses in the vision of internet / 中华医学教育探索杂志

Internct has provided abundant resources for teaching,but it also brings two challenges,information overload and knowledge fragmentation.Under the environment of Internct,only by efficient course designs,can teachers deal with these two new challenges,and attract students' attentions and motivate their learning interests.Among teaching designs,the design of teaching ‘opening speech’ is quite important.During the course construction of Epidemiology in China Medical University,design strategies on opening speech were explored;the principles of opening speech design were determined.And the opening speeches were designed and cumulated for the teaching modules of Epidemiology.Furthermore,the skills of opening speech design were summarized.

The exploration and exam quality analysis of ‘Probability’ course for foreign medical students / 中华医学教育探索杂志

Objective The exam quality of ‘Probability’ course for foreign medical undergraduates was analyzed,aiming at providing some reference for the improvement of the student evalua-tion system and course quality.Methods The ‘Probability’ course exam scores of 167 foreign un-dergraduates of 2014 batch were collected,the students were divided into two classes according to their entrance date,the former part class A consisted of 90 students,the latter part class B consisted of 77 students.The reliability of the test paper was judged according to Cronbach's α,Hotelling's T2 and Pearson correlation coefficient.The Spearman correlation analysis was adopted to evaluate the cor-relation between the question items.For the two classes,the impact of the entrance time on the test scores was explored on the basis of Student's t-test of question item scores and the total scores.Results The average score of the course exam was 82.587 points with the standard deviation of 13.520,Kol-mogorov-Smimov statistic was 1.627 (P=0.010),the exam scores could not follow normal distribution.The Cronbach's α for the exam paper was 0.808,the standardized Cronbach's α was 0.815.The Spearman correlation coefficients between the five question items were all with statistical significance and varied from 0.315 to 0.657.As the students were divided into two classes according to their entrance date,for the ‘Probability’ section scores of the latter batch students were less than the scores of the former batch,with the difference 4.017 points,the same situation was also found that all the five items in the ‘Probability’ section.Conclusions The entrance time for the foreign medical freshman has an impact on their exam scores,suggesting that more attention should be paid to those students.

Simulation of the epidemic of influenza A(H1N1)in a university using cel-lular automata model / 中国感染控制杂志

Objective To explore the application value of cellular automata(CA)in simulating the epidemic spread of out-break of influenza A(H1N1).Methods The publications regarding influenza A(H1N1)from January 2009 to March 2015 were collected from the China National Knowledge Infrastructure(CNKI),epidemiological data of H1N1 were retrieved ac-cording to inclusion criteria,the Matlab 7.0 software was adopted to construct CA model for simulating and analyzing the epidemic of H1N1 occurred in a university in Chongqing between October 12 and November 20,2009.Results There were a total of 17 820 students in this university,the epidemic of influenza lasted 40 days in 2009;When the parameter,the ef-fective infection rate was 0.04,the model of CA fit well,and gave estimate for basic reproduction number (R0 )1.202. Conclusion CA has certain reliability in simulating epidemics of airborne infectious diseases,it can provide reference for the prevention and control of disease.

Hot spots in studies on international radiotherapy for uterine cervical cancer / 中华医学图书情报杂志

Radiotherapy is an important therapy for uterine cervical cancer and plays a great role in improving the outcome in uterine cervical cancer patients. The high frequency subject headings/subheadings in papers on radio-therapy for uterine cervical cancer in the past 10 years were analyzed by co-occurrence clustering analysis to dis-play the hot spots and a strategic coordinate figure was plotted to show the developing tendency of its hot spots in studies on radiotherapy for uterine cervical cancer in order to provide reference for its-related studies.

Paracrine effect of chondrocytes on gene expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in osteoblasts / 中国组织工程研究

BACKGROUND:Cel co-culture can maximize the simulation ofin vivomicroenvironment. Cel scratch test and interleukin-1β can destroy the balance between matrix metaloproteinases (MMPs) and matrix metaloproteinase inhibitors (TIMPs), resulting in extracelular matrix degradation of the articular cartilage, functional disorders of chondrocytes and articular cartilage degeneration. OBJECTIVE:To study the effect of interleukin-1β on migration, MMP and TIMP expression of chondrocytes co-cultured with osteoblast supernatantin vitro. METHODS:There were three groups: chondrocyte monoculture group, osteoblast+chondrocyte group (co-culture group), osteoblast+chondrocyte+interleukin-1β group (interleukin-1β group). Cel scratch test was conducted to observe the migration of chondrocytes within 24 hours. Semi-quantitative PCR test was used to detect the changes in expressions of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, TIMP-2, TIMP-3, TIMP-9 in chondrocytes within 24 hours. RESULTS AND CONCLUSION:Compared with the monoculture group, cel migration rate of the other two groups were increased significantly (P< 0.01). Compared with the monoculture group, the gene expressions of MMP-1, MMP-2, MMP-3 and MMP-9 were increased significantly in the coculture group (P < 0. 05); the gene expressions of MMP-1, MMP-3, MMP-9 were increased significantly in the interleukin-1β group (P< 0. 01). Compared with monoculture group, the gene expression of TIMP-1 was increased significantly (P < 0. 01), but the gene expressions of TIMP-3 and TIMP-4 were declined significantly (P < 0. 05) in the other two groups. These findings indicate that co-culture of chondrocytes with osteoblasts can promote chondrocytes migration, enhance gene expression of chondrocytes MMP-1, MMP-2, MMP-3, MMP-9 and regulate gene expression of TIMPs family. Interleukin-1β inhibitsthe migration of chondrocytes co-cultured with osteoblasts and gene expression of TIMPs family.

Application of nonlinear autoregressive neural network in predicting incidence tendency of hemorrhagic fever with renal syndrome / 中华流行病学杂志

Objective To explore the prospect of nonlinear autoregressive neural network in fitting and predicting the incidence tendency of hemorrhagic fever with renal syndrome (HFRS),in the mainland of China.Methods Monthly reported case series of HFRS in China from 2004 to 2013 were used to build both ARIMA and NAR neural network models,in order to predict the monthly incidence of HFRS in China in 2014.Fitness and prediction on the effects of these two models were compared.Results For the Fitting dataset,MAE,RMSE and MAPE of the ARIMA model were 148.058,272.077 and 12.678％ respectively,while the MAE,RMSE and MAPE of NAR neural network appeared as 119.436,186.671 and 11.778％ respectively.For the Predicting dataset,MAE,RMSE and MAPE of the ARIMA model appeared as 189.088,221.133 and 21.296％,while the MAE,RMSE and MAPE of the NAR neural network as 119.733,151.329 and 11.431％ respectively.Conclusion The NAR neural network showed better effects in fitting and predicting the incidence tendency of HFRS than using the traditional ARIMA model,in China.NAR neural network seemed to have strong application value in the prevention and control of HFRS.

Programmed cell death 5 correlates with disease activity and interleukin-17 in serum and synovial fluid of rheumatoid arthritis patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Programmed cell death 5 (PDCD5) is a novel apoptotic regulatory gene that promotes apoptosis in various tumor cells. Studies have shown that PDCD5 accelerates the apoptosis of synoviocytes in vitro, implying a potential role in rheumatoid arthritis (RA) pathogenesis. This study examined the expression of PDCD5 in serum and synovial fluid of RA patients, its effect on the expression of inflammatory cytokine, interleukin-17 (IL-17), and the assessment of disease activity in RA.</p><p><b>METHODS</b>PDCD5 and IL-17 levels in serum and synovial fluid from 18 patients with RA and 22 patients with osteoarthritis (OA) were detected using enzyme-linked immunosorbent assay (ELISA). Concentrations of serum PDCD5 in 40 healthy people were also detected as controls. As disease activity indices, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and X-ray grading scale were also evaluated.</p><p><b>RESULTS</b>Serum and synovial fluid PDCD5 levels in RA patients were significantly higher than those in OA and healthy controls. Serum PDCD5 level was inversely correlated to CRP and ESR, and was significantly higher in the RF negative group than in the positive group. PDCD5 level was also negatively correlated with IL-17 levels both in serum and synovial fluid of RA patients. However, differences in synovial fluid PDCD5 level from RA patients at different Larsen stages were not detectable.</p><p><b>CONCLUSIONS</b>PDCD5 affects RA pathogenesis. Insufficient apoptosis of fibroblast-like synoviocytes and inflammatory cells in RA could increase the expression of PDCD5 protein. As PDCD5 levels correlated negatively with disease activity indices and IL-17 level, PDCD5 could become a target in the diagnosis and treatment of RA.</p>

Estimation and prediction for incidence, mortality and prevalence of common gastrointestinal tract cancers in China, 2008 / 中华流行病学杂志

Objective To estimate the incidence,mortality and prevalence of most common gastrointestinal tract cancers (esophageal,gastric and colorectal cancers) in China in 2008 and to predict the related incidence and mortality in the next 20 years.Methods Data from 36 Chinese cancer registries and the Third National Death Survey in China (2004-2005) were used to estimate the incidence,mortality and 5-year prevalence of esophageal,gastric and colorectal cancers in China in 2008.Mathematical models were used to predict the incidence and mortality of these cancers in the next 20 years.Results In 2008,the incident cases of esophageal,gastric and colorectal cancers were estimated to be 259 235,464 439 and 221 313,respectively,which totally accounted for one third of all the incident cancer cases.Age-standardized incidence rates of esophageal,gastric and colorectal cancers were estimated as 16.7/100 000,29.9/100 000 and 14.2/100 000,respectively,while the mortality rates were 13.4/100 000,22.3/100 000 and 6.9/100 000,respectively.The number of 5-year prevalent cases were estimated as 257 352 for esophageal cancer,680 824 for gastric cancer and 509 140 for colorectal cancer,which correspondingly ranked the seventh,first and third among all the number of cancers,respectively.Till 2030,incident cases of these cancers would reach 484 923,860 022 and 400 086,while deaths reach 412 916,678 670 and 211 714,respectively.Conclusion Esophageal,gastric and colorectal cancers had been the main digestive tract cancers in China,that causing serious health burden.As dramatic increasing burden was predicted in the next two decades for these three cancers,more attention needs to be paid accordingly.

Forensic analysis of 74 tumor related medical malpractice cases / 法医学杂志

OBJECTIVE@#To analyze the causes of medical malpractice in patients with tumor, to determine the medical responsibility, and to recommend the related preventions.@*METHODS@#Seventy four medical malpractice cases, which were involved in tumor and collected from 2000 to 2009 in medicolegal expertise center of west China, were analyzed retrospectively.@*RESULTS@#The medical malpractice cases in the patients with tumor showed an increasing tendency in recent years. The main causes are missed diagnosis, misdiagnosis, improper chemotherapy and neglect of complications. The causes of medical malpractice were different in the different levels of medical services. The occurrence of medical malpractice in surgery and OB-GYN showed more frequent than the others.@*CONCLUSION@#Forensic pathology autopsy is important to resolve medical malpractice of tumor patients by finding out the cause of death and clarifying the medical responsibility. The occurrence of medical malpractice could be reduced by the clinical doctors through improving serve consciousness, obtaining the patients' trust, improving the medical treatment, following related laws and rules, fulfiling duty of medical careness.

Clinical significance of serum levels of endostatin in patients with clear cell renal cell carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To assess serum levels of endogenous endostatin in patients with clear cell renal cell carcinoma (CCRCC) and to determine the relationship of these levels to tumor stage, grade.</p><p><b>METHODS</b>From March 2004 to October 2008, preoperative serum were obtained from 138 consecutive patients with CCRCC (73 patients in T1, 39 patients in T2, 20 patients in T3, and 6 patients in T4) and 40 healthy controls. Serum levels of endostatin were measured by sandwich-ELISA. Associations between circulating endostatin levels and clinicopathologic factors and clinical outcome were determined.</p><p><b>RESULTS</b>Endostatin levels did not differ significantly between the patients with CCRCC (93.1 microg/L) and healthy controls (78.9 microg/L, P > 0.05). Serum levels of endostatin were significantly higher in the T2-4 CCRCC patients (107.2 microg/L) than those of the T1 patients (80.4 microg/L, P < 0.01). No significant difference was found in the endostatin levels among the T2-4 patients, or between healthy controls and the T1 patients. The serum endostatin concentration was significantly higher in the metastasis group (118.4 microg/L) than in the no metastasis group (89.5 microg/L, P < 0.05), but there was no significant difference between patients with distant metastasis group (122.0 microg/L) and lymph nodes metastasis (110.0 microg/L, P > 0.05). Patients with G3-4 tumors had significantly higher endostatin levels (111.8 microg/L) than those of patients with G1 (80.4 microg/L) and G2 tumors (86.2 microg/L, P < 0.01), but endostatin levels did not differ significantly between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Preoperative serum levels of endostatin elevated in patients with CCRCC and associated with higher stage and grade.</p>

Total knee arthroplasty for extension ankylosing deformity / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the outcomes and complications of total knee arthroplasty (TKA) for extension ankylosing deformity of the knee.</p><p><b>METHODS</b>From January 1996 to June 2006, total knee arthroplasty was performed on 8 patients (9 knees) with extension ankylosing deformity. The preoperative ROM of all patients was 0 degrees . Preoperative knee and function score of KSS were 44 points (from 10 to 68) and 17 points (from -10 to 55) respectively.</p><p><b>RESULTS</b>The complications of all TKAs included patellar tendon avulsion in 1 knee, partial fracture of inferior patella in 1 knee, hematoma in 1, superficial infection in 1. All patients were followed up for an average of 40.4 months (from 7.0 to 120.0). The average postoperative ROM was 89 degrees (from 50 degrees to 120 degrees ). Postoperative knee and function score of KSS were 81 points (from 55 to 93) and 79 points (from 50 to 90) respectively. Extension lag occurred in 2 knees, one was 10 degrees and the other was 25 degrees . One knee had undergone re-revision of changing the thicker tibial spacer for the reason of instability of joint 1 year after revision.</p><p><b>CONCLUSIONS</b>TKA performed in extension ankylosing deformity can get less satisfactory clinical results comparing with fixed flexion deformity. Exposure of the knee joint and separation of the fused bones, providing a mobile joint space plays crucial procedure for the next step of surgery. Preservation of sufficient bone stock of patella, protection of patellar tendon and blood supply of the knee and proper soft tissue balance are the key to TKA for extension ankylosing deformity.</p>

Total knee arthroplasty and perioperative management of hemophilic arthritis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical results and perioperative management of primary total knee arthroplasty (TKA) in hemophilic patients.</p><p><b>METHODS</b>From February 1997 to February 2006, the data of 6 total knee arthroplasty performed in 4 hemophilic patients was reviewed retrospectively. The values of coagulation factor were maintained at suitable level by monitoring the activity of the factors and their inhibitors during perioperative period. The mean follow-up time was 4.4 years, knee society score and the last postoperative radiographs were recorded.</p><p><b>RESULTS</b>After TKA, the hemophilic patients felt pain of knee relieved, the knee function was improved, but the range of motion increased limitedly. At the early post-operative stage, 3 knees in 2 patients with hemarthrosis or muscle bleeding, 1 of the 2 patients complicated with formation of inhibitor of factor VIII and healing problem in 1 knee after TKA, 1 patient with transient paralysis of the common peroneal nerve, 1 patient with venous circulation insufficiency crisis, but no compartment syndrome. In the late stage after TKA, 1 patient with hemarthrosis of both elbows, but no late infection, loosening, displacement and fracture of the prosthesis in the 6 knees.</p><p><b>CONCLUSIONS</b>Total knee arthroplasty could alleviate knee pain and improve joint function in advanced severe hemophilic arthritic patients. It is important to monitor the activity and inhibitors of coagulation factor VIII or IX, which could decrease the early and late postoperative complications.</p>

Meta-analysis on relationship between FasL and gastric cancer / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the relationship between Fas ligand (FasL) and gastric cancer extensively.</p><p><b>METHODS</b>The computerized CNKI database, Wangfang database, Weipu database, Springerlink full-text periodical database and ProQuest full-text periodical database were searched. And, the literatures detecting FasL in gastric cancer with immunohistochemical method which have been published during 1990 to 2006 were also reviewed. The research hypothesis and research method of each literature were the same; the diagnosis of case and control were definite; the size of sample was also definite; the primitive data must offer the number of object whose FasL were expressed positively or offered the positive rate. Each study and its quality were also evaluated. A software Review Manager 4.2.10, was used to analyze the data. and to estimate the overall OR and its 95% CI.</p><p><b>RESULTS</b>A total of 49 literatures have been reviewed. According to the selection and washing out criteria, 13 literatures were used in this Meta-analysis. In the research of gastric cancer group and normal gastric mucosa group, 10 literatures were used. Between the two groups the expression of FasL has statistical significance (OR(overall) = 14.88, 95% CI 5.34 - 41.48; P < 0.00001); In the research of different differentiation level, 8 literatures were used. Between the two groups the expression of FasL had no statistical significance (OR(overall) = 1.90, 95% CI 0.68 - 5.28; P = 0.22); In the research of different TNM staging, 5 literatures were used. Between the two groups the expression of FasL had statistical significance (OR(overall) = 2.58, 95% CI 1.05 - 6.32; P = 0.04); In the research of different Lymph node metastasis, 8 literatures were used. Between the two groups the expression of FasL has no statistical significance (OR(overall) = 1.00, 95% CI 0.45 - 2.21; P = 1.00).</p><p><b>CONCLUSION</b>The high expression of FasL is the high risk of gastric cancer, and TNM staging has some associations with gastric cancer.</p>

Relationship between the injury time and DNA fragmentation and its quantity in rat brain / 法医学杂志

OBJECTIVE@#To observe the changes of DNA fragmentation and its quantity along with the time of injury in nerve cells after brain contusion.@*METHODS@#The model of brain contusion caused by free drop hammer was established. TUNEL and Feulgen's DNA staining conjoined with image analysis technique were used for exploration.@*RESULTS@#With the gradually rising of DNA fragmentation, DNA quantity was declining in the brain tissue after contusion.@*CONCLUSION@#TUNEL and Feulgen's DNA staining conjoined with image analysis technique could be utilized in the timing of brain injury and provide a new approach for this issue.

Influence of preoperative range of motion on the early clinical outcome of total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the influence of preoperative range of motion (ROM) and maximal flexion degree on the early clinical outcome of total knee arthroplasty (TKA).</p><p><b>METHODS</b>From January 2000 to December 2003, 97 knees of 65 patients that were underwent total knee arthroplasty with Scorpio posterior-stabilized knee prosthesis were reviewed. There were 55 osteoarthritis patients (81 knees), and 10 rheumatoid arthritis (16 knees). Thirty-three patients were underwent unilateral TKA, 32 patients were underwent bilateral TKA. According to the preoperative ROM of knee, these patients were divided into two groups, one <or= 90 degrees (range, 5 degrees - 90 degrees ) and the other > 90 degrees (range, 95 degrees - 140 degrees ). Finally the clinical outcomes of two groups (include ROM, maximal flexion degree, KSS score and function score) were evaluated. Three days later after operation, continuous passive motion (CPM) and active functional exercise of the knee were begun, and the wound healed well in all patients. All these operations were primary total knee arthroplasty.</p><p><b>RESULTS</b>The patients were followed up for average 2 years 5 months (range, 10 months to 3 years 8 months). The average ROM of knee was improved to 101.6 degrees (range, 40 degrees - 140 degrees ) after operation from 84.2 degrees (range, 5 degrees - 140 degrees ) before operation (P = 0.000); the average maximal flexion degree was decreased from 103.5 degrees (range, 25 degrees - 140 degrees ) before operation to 101.6 degrees (range, 40 degrees - 140 degrees ) after operation (P = 0.439); KSS of knee joint was improved to 78.8 points after operation (range, 50 - 95 points) from 19.5 points (-24 - 62 points) before operation (P = 0.000). There was statistically difference between the clinical outcomes (ROM, maximal flexion degree, KSS score and function score) in the two groups before and after operation. Those knees with good preoperative ROM tend to lose flexion, while those with poor preoperative ROM gain flexion after TKA. No revision and deep infection happened.</p><p><b>CONCLUSIONS</b>TKA is a complex operation, the clinical outcome of TKA is mainly determined by the good operation skill, abundant clinical experience and the familiarity with the prosthesis of the surgeon. At the same conditions such as same surgeon, same prosthesis and same physical therapy, preoperative range of motion of knee influence on the early clinical outcome of total knee arthroplasty, knees that have good preoperative ROM have better clinical outcomes postoperatively than those with poor preoperative ROM.</p>

Revision hip arthroplasty with the cementless prosthesis: 4 years follow-up study / 中华外科杂志

<p><b>OBJECTIVE</b>To examine the two to eight-year results associated with the use of this hip system.</p><p><b>METHODS</b>Between November 1996 and January 2001, 56 revision total hip arthroplasties with insertion of a Zweymüller BICON-PLUS cup and a cementless SLR-PLUS stem were performed in 55 consecutive patients (average age, fifty-nine years old, range, thirty to eighty years old).</p><p><b>RESULTS</b>At the time of the latest follow-up, 23 patients (24 hips) had lost to follow-up, leaving 32 patients for a minimum of 2 years of clinical and radiographical follow-up. The mean follow-up time was 4 years. Only 3 peri-operative complications occurred, including 1 great trochanter fracture during implant removal, 1 dislocation 2 d after operation with successful closed reduction, and 1 deep wound infection which necessitated reentry and debridement. No femoral stems or cups needed re-revision surgery. The average Harris hip score increased from 40.6 points preoperatively to 80.4 points at final follow-up. Radiographic analysis demonstrated that the position of stems and cups was unchanged and all showed radiographic evidence of bone ingrowth.</p><p><b>CONCLUSION</b>The favourable medium-term clinical results with the cementless Zweymüller hip system show that it is suitable as a revision system for total hip failures of both cemented and cementless primary fixation.</p>