Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients.

There is an unmet need for a prosthesis designed according to the anatomical parameters of the Chinese population. This study aims to compare the use of a medial pivot (MP) implant or posterior cruciate ligament (PCL) substitution (posterior-stabilized [PS]) prosthesis for unilateral total knee arthroplasty (TKA) in a Chinese population. The medical records of patients undergoing unilateral TKA with an MP implant (Group A) or a PS prosthesis (Group B) at our institution between January 2010 and December 2011 were retrospectively reviewed. Patients were followed up for 5 years. Preoperatively and at the December 2016 postoperative follow-up, the Hospital for Special Surgery scoring system (HSS knee score) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were measured to evaluate TKA outcomes. This study included 49 patients in Group A and 51 in Group B. As of December 2016, there were no significant differences in the preoperative/postoperative changes in any category of the HSS knee score or WOMAC score between the groups. There were no postoperative complications in either group during the 5-year follow-up. There were no periprosthetic infections or need for revision surgery. One patient in Group A experienced aching and a small amount of effusion in the articular cavity that was attributed to overexertion. In conclusion, there were no significant differences in midterm outcomes in Chinese patients receiving an MP implant or a PS prosthesis for unilateral TKA. These data suggest that the MP and PCL substitution design are safe and effective for unilateral TKA in China.

A 12-month follow-up study on the preventive effect of oral lansoprazole on acute exacerbation of chronic obstructive pulmonary disease.

The objective of this study was to evaluate the preventive effects of oral administration of lansoprazole on acute exacerbation of chronic obstructive pulmonary disease (COPD). Patients with COPD in groups C and D in the stable phase were stratified into a group with neither gastroesophageal reflux nor lansoprazole therapy (group A) and a group subjected to oral lansoprazole therapy (group B1 ) and a group not subjected to oral lansoprazole therapy (group B2 ). The frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire, COPD assessment test (CAT) questionnaire, pulmonary function test and the 6-minute walk test were applied; in addition, arterial blood gas, white blood cell (WBC), hs-CRP, liver function and the levels of IL-1ß, IL-6, IL-8, TNF-α and GM-CSF in sputum were monitored during follow-up. In the 12-month follow-up period, the frequency of exacerbation in group B2 was statistically higher than that in groups A and B1 (P < 0.05). After a 3-month follow-up, the score of groups A and B1 in the FSSG questionnaire was significantly lower than that of group B2 (P < 0.05). After the 1-year follow-up, the CAT score, FEV1 , 6-min walk test, the total number of WBC, hs-CRP, alanine aminotransferase, aspartate aminotransferase, pH of the arterial blood, PaO2 , PaCO2 and the levels of IL-1ß, IL-6, IL-8, TNF-α and GM-CSF in the sputum were statistically different in group B2 compared with groups A and B1 (P < 0.05). Oral lansoprazole therapy decreased the frequency of acute exacerbation of COPD by alleviating gastroesophageal reflux and lowering the levels of IL-1ß, IL-6, IL-8, TNF-α and GM-CSF in the sputum.