ABSTRACT
Objective To study the therapeutic effect of total knee arthroplasty(TKA)in treat-ment of severe osteoarthritis with patella alta.Methods TKA was performed on 13 patients of severe os-teoarthritis with patella alta,to adjust the relative position of the patella by changing the height of the plat-form line in the operation,and measure the length of the perpendicular line from the lowest point of the pa-tella joint surface to the tibial platform line before and after knee replacement,calculate and compare the ratio of the length to the joint surface of the patella(BP index).In addition,the score of the knee joint was evaluated by American special surgery hospital knee joint scoring system(HSS)at preoperative and post-operative three months.Results All the patients'incision got primary healing who were followed up with-out other complications.The BP index and the HSS score was statistically significant before and after sur-gery(P<0.05).Conclusion Total knee arthroplasty can be used to treat severe osteoarthritis with high patella by adjusting the relative height of the patella and correcting the limb alignment,to improve the function of knee joint and the quality of life.
ABSTRACT
Objective To analyze the clinical characteristics and prognostic factors of elderly patients with cytogenetically normal acute myeloid leukemia (CN-AML). Methods A total of 104 initial CN-AML patients were enrolled in this retrospective study. The clinical characteristics were collected and analyzed retrospectively. Factors affecting complete remission (CR) were analyzed by using chi square test. Univariate and multivariate analyses of prognostic factors were performed by using Kaplan-Meier and Cox hazard regression model respectively. Results After the first chemotherapy, 72 of 104 patients were able to be evaluated the efficacy, the CR rate was 38.9%(28/72) and total response rate was 55.6%(40/72). The white cell count<100 × 109/L and NPM1 mutation were related to a higher CR rate [59.4%(38/64) vs. 12.5%(1/8), 83.3%(10/12) vs. 36.4%(8/22), P<0.05]. Among 104 patients, the median overall survival (OS) was 6.9 months. Univariate analysis results demonstrated that age≥70 years, secondary AML, white cell count≥100×109/L, FLT3-ITD mutation, CD7 expression, achieving CR beyond 2 cycles of induction therapy and CCI score≥2 were influence factors on OS. In multivariable analysis, FLT3-ITD mutation (HR=7.61, 95%CI 1.80-32.11, P= 0.006) and achieving CR beyond 2 cycles of induction therapy (HR= 10.11, 95 % CI 2.38-43.03, P=0.002) were independent prognostic factors for OS in elderly patients with CN-AML. Conclusion The prognosis of elderly patients with CN-AML is the result of the combined effect of many factors, FLT3-ITD mutation and achieving CR beyond 2 cycles of induction therapy are independent prognostic factors in elderly patients with CN-AML.