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OBJECTIVE:To study therapeutic efficacy of total hip arthroplasty(THA)combined with Alendronate sodium tablets in the treatment of femoral neck fracture and its effects on bone mineral density(BMD). METHODS:A total of 98 patients with femoral neck fractures in our hospital during 2014-2016 were divided into observation group and control group by random digital table method,with 49 cases in each group. Both groups were treated with THA. 7 days after operation,control group was given routine anti-osteoporosis treatment [Gaierqi D tablets(containing 600 mg calcium/vitamin D3125 IU in each tablet),p.o., one tablet/time,once a day;Calcitriol soft capsules(25 μ g each pill,p.o.,2 pills/time,once a day)]. Observation group was additionally given Alendronate sodium tablets(10 mg/time,once a day)on the basis of control group. Both groups were treated for consecutive 3 months. The hip function excellent rate was evaluated by using Harris scoring system at 7 days,3 months and 6 months after operation. The periprosthetic 7 cases of egion interest(ROI1-7)BMD were detected and compared between 2 groups. RESULTS:The excellent rate of hip joint function in the control group were 16.33%,40.82%,69.39% 7 days,3 months,6 months after operation,respectively;those of observation group were 17.78%,73.33%,88.89% respectively. There was no statistical significance in the excellent rates of hip joint function between 2 groups 7 days after operation(P>0.05). The excellent rate of hip joint function in observation group was higher than control group 3 months and 6 months after operation(P<0.05). There was no significant difference in periprosthetic BMD between 2 groups 7 days after operation(P>0.05). Compared with 7 days after operation,BMD of ROI1,ROI6 and ROI7 in 2 groups were decreased gradually 3 months and 6 months after operation (P<0.05 or P<0.01). BMD of ROI2,ROI3 and ROI5 decreased first and then increased(P<0.05 or P<0.01). There was no significant change in BMD of ROI4(P>0.05). There was no significant difference in BMD of each area between 2 groups 3 months after operation(P>0.05). BMD of ROI1,ROI2,ROI3,ROI5,ROI6 and ROI7 in observation group were significantly higher than control group 6 months after operation(P<0.05 or P<0.01). CONCLUSIONS:THA combined with Alendronate sodium tablets and conventional anti-osteoporosis treatment can improve the excellent rate of hip joint function in patients with femoral neck fracture and the level of periprosthetic BMD.
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Objective To discuss the feasibility and reproducibility of left ventricular volume and function of patients with left atrial remodeling and left ventricular remodeling by 3-dimensional echocardiography HeartModel (3D-HM).Methods Three-dimensional images of 156 subjects were collected under HMACQ imaging mode.They were assigned into three groups:① control group (group A,n =70);② group of left ventricular remodeling after,acute myocardial infarction (group B,n =17);③group of hypertension left atrial remodeling (group C,n =69).3D-HM method was used for quantifying left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left atrial end-systolic volume (LAESV) and left ventricular ejection fraction (LVEF),and the results were compared with conventional 3D-manual results.The reproducibility of the 3D-HM method within one group and among different groups was evaluated.Results There was a significant difference in all the parameters measured with the 3D-HM method in different groups(P ＜0.05).LVEDV,LVESV,and LAESV in group B were higher than those in group A and group C(P ＜0.05),and LVEF was lower than that in group A and group C(P ＜0.05),LAESV of group C was higher than that of group A(P ＜0.05).The difference in the measurements of LVEDV and LVESV between the two methods was greatest in group B compared with group C and group A(P ＜0.05).In group C,the measured value difference of LAESV between two methods was greater than that of group A (P =0.03).There was closer correlation among LVEDV,LVESV,LAESV and LVEF measured values of 3D-HM method as well as measured values of the 3D-manual method (r =0.94,0.97,0.91 and 0.90).The data post-processing time of 3D-HM was significantly shorter than that of 3D-manual (P ＜0.05).The inter-observer and intra-observer difference of measured values of 3D-HM method had no statistical significance (P ＞0.05).Conclusions 3D-HM is a fast and feasible technique with high reproducibility for quantifying the left ventricular volume and function in patients with left atrial remodeling and left ventricular remodeling.
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BACKGROUND:Knee osteoarthritis is a chronic disease characterized as cartilage degeneration and hyperostosis to impact the soft tissues around the joints, thereby resulting in joint pain, and it can be aggravated and lead to joint deformity after weight-bearing. OBJECTIVE:On the basis of imaging parameters of knee osteoarthritis patients and normal controls, a model was established. And then, knee squatting movement was simulated on the model and stress data from the cartilage surface of patients and normal controls were colected and compared, thereby to obtain the stress characteristics of the cartilage surface in knee osteoarthritis patients. METHODS: There were 30 knee osteoarthritis patients and 30 healthy volunteers in the study. CT and MRI data from these participants were colected and analyzed using Mimics software and simpleware software to establish a model. Based on this model, cartilage-related stress data were harvested from knee osteoarthritis patients and healthy volunteers and compared to summarize the stress characteristics of the articular cartilage in patients with knee osteoarthritis. RESULTS AND CONCLUSION:In knee osteoarthritis patients, the stress on the cartilage surface from standing to squatting was increased in a nonlinear manner. During the process of squatting, the mediolateral stress was higher in the knee osteoarthritis patients than healthy controls (P 0.05). These findings indicate that the knee osteoarthritis musculoskeletal model and finite element model are established successfuly, and these models are closer to the real motion characteristics of the knee joints, based on which, quantitative biomechanical data of the knee can be provided for knee osteoarthritis treatment.
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Objective To preliminary investigate fetal left heart function of fetuses in α-thalassemia using spatio-temporal image correlation (STIC).Methods 95 volumes from fetal hearts in singleton pregnancies at 20-28 weeks of gestation were collected.STIC datasets were frozen in end-systole and enddiastole.Ventricular volumes were measured using VOCAL,Inversion and SonoAVC.The stroke volume was calculated from these measurements.Results All data sets could be measured with all three techniques in this study.The intraclass correlation coefficients (ICCs) between techniques were all ＞ 0.90.The time necessary to measure the stroke volume was significantly shorter using SonoAVC than using VOCAL and Inversion.Bland-Altman plots showed no clinically significant mean percent differences between stroke volume measurements obtained from each ventricle using three techniques.The left ventricular end-systole volume(ESV),stroke volume(SV)and ejection fraction(EF)was significantly different than fetuses with normal heart (P ＜ 0.05).Conclusions This study shows the feasibility of measuring left ventricular volumes during either systole or diastole and thereby calculating stroke volumes with all three techniques.And there was a high degree of reliability for all three techniques,as shown by excellent ICCs.There was good accuracy of STIC techniques in measuring fetal left ventricular volumes with cardiomegaly.
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The fine structure of enoxaparin sodium samples with different degree of 1,6-anhydro derivatives were analyzed with polyacrylamide gel electrophoresis, high performance liquid chromatography, ultraviolet spectroscopy, infrared spectroscopy and nuclear magnetic resonance spectroscopy. A further study of anticoagulation activity of enoxaparins was performed, including those on their inhibition activities of coagulation factor Xa (FXa) and thrombin (FIIa). The results showed that the anti-FXa and -FIIa activities of enoxaparins with different degree of 1,6-anhydro derivatives (20.0%-39.7%) with similar structure characteristics, had decreasing tendency when the degree of 1,6-anhydro derivatives increased. Especially, the anti-FXa activity was sensitive to the change of the degree of 1,6-anhydro derivatives.
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Objective To evaluate the value of three-dimensional color power angiography(3D-CPA) in the differential diagnosis of benign and malignant breast tumors.Methods 3D-CPA vascular parameters were collected and analyzed in 121 breast solid lesions (63 malignant,58 benign) in the 114 female patients.The diagnostic performances of each parameter were compared by receiver operating characteristic (ROC)cure.Results The parameters of intra-tumor flow index (FI1),flow index of shells with outside thickness of 3mm surrounding the breast tumors(FI2 ) and the ratio of FI2 and FI1 (G2) in malignant group were significantly higher than those in benign group( P ＜0.05,respectively).Analysis of the areas under ROC curve showed that the areas under FI2 curve was the largest.No significant difference( P ＞0.05) was found between the area under FI2 curve and the area under G2 curve.Comparing the area under FI2 curve to that under FI1,there was significant differences ( P ＜ 0.05).Taking FI2 ≥ 27.385 as the critical value,the sensitivity and specificity for the diagnosis of malignant breast tumors were 88.9％ and 81.0％,and the positive and negative predictive values were 83.6％ and 87.0％ respectively.Conclusions The sensitivity and specificity of 3D-CPA parameter FI2 in the diagnosis of malignant breast tumors were higher than others,FI2 with the optimal critical value of ≥27.385 could help to identify malignant from benign breast tumors.
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Objective To assess the value of tomographic ultrasound imaging (TUI) for prenatal analysis of the relative orientation of fetal heart and great arteries. Methods Volume datasets acquired from 12 patients of transposition of the great arteries (TGA) and 13 normal fetal heart were evaluated offline with TUI. The aortic valves (AV) and pulmonary valves (PV) were respectively showed on the two parallel slices. According to the pivot point in the middle of the PV in one slice, the relative orientation of the AV on another slices were analyzed. Results In the 12 patients of TGA confirmed postnatally, 7 were concomitant with single ventricle anomaly, AV was on the anterior-right orientation of the PV in 5, and was relatively on the anterior and anterior-left orientation in other 2 of them.In the remained 5 with seeming normal 4 chamber view, AV was found on the anterior-right of the PV in 3, and was relatively on the anterior and upright orientation.in other 2 patients. In 13 normal fetuses, TUI showed that all AV located on the posterior-right orientation to the PV. Conclusion TUI can provide detailed spatial information of the great arteries both in normal and abnormal fetal heart. It may be a convenient and veracious tool for prenatal exploring the morphology of the great arteries.
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Hepatic surgery has got fast development during recent years. Hepatic anatomic complexity is not the fence of hepatic surgery development. The limit of liver function reserve controls hepatic operation and makes surgeons confused. The investigation of hepatic function reserve has made great prograsses recently. This article reviewed domestic and overseas documents to explain the contrilmtion of liww functional reselwe examination for hepatic surgery on the basis of hepateetomy quantity, tumor postoperative relapse, liver transplantation , liver function failure and liver function reserve detection.
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Seventeen patients with femoral intertrochanteric fracture admitted to Department of Orthopedics, First Hospital of Tianjin University of Traditional Chinese Medicine between December 2005 and October 2008, including 6 males, 11 females, aged 81 to 97 years, were retrospectively analyzed. All fractures were caused by acute falling, including left side in 8 patients, right side in 9. According to Evans-Jensen classification, there were 2 cases of ⅡA, 10 of Ⅱ B, and 5 of Ⅲ. All patients underwent artificial femoral head replacement using S-ROM hip joint system (Depuy). The time of the operations, bleeding volumes and the days of hospitalization were recorded, and the complications and the motion of the hip joint were observed. All the operations were accomplished successfully, with the average surgery time of 61 minutes and the bleeding volume 435 mL. Two of them were away from bed in 3 days, 13 in 7 days and others were in 2 weeks. The average hospitalization was 19 days. The patients were followed-up for 13.7 months (ranging 4.5-36.0 months), postoperatively. No death or severe complications were found during hospitalization; 15 patients were recovered basically in doing daily as before injury; 1 patient had tow-grade fever for long period of time and been considered to get urinary system infection, but no severe complication developed. However, 1 patient died of myocardial infarction at 4.5 months post-replacement. The range of motion of the hip joints was 90°-110°. All patients became life-independent postoperatively except 3 patients hospitalized because of cerebral infarction and 2 moved assisted by the walker. The prosthetic appliance significantly reduced operation time and decreased bleeding; it is of clinical significance for elderly patients.
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BACKGROUND:It has been demonstrated that shortening of femoral eccentricity would lead to decreased abductor muscle strength,and overlengthening eccentricity would increase the risk of femoral neck prosthesis fracture and the compressive stress of cemented femoral stem prosthesis after artificial hip replacement,which easily causes prosthetic loosening and subsidence.OBJECTIVE:To investigate the importance of eccentricity adjustment in the artificial hip replacement for treatment of femoral neck fracture in elderly patients.DESIGN,TIME AND SETTING:An observational study was performed at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2004 and December 2005.PARTICIPANTS:A total of 30 patients with femoral neck fracture,12 males and 18 females,averaging 73.8 years of age (range 62-90 years old),received treatment at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and were recruited into this study.METHODS:All patients underwent artificial hip replacement operated by the same team of surgeons.Prior to surgery,some indices on the uninjured side were determined through the anteroposterior radiographs of pelvis using X-Caliper measurement tool,including rotation center of femoral head,rotation center of hip joint,collodiaphyseal angle,femoral transverse eccentricity,abduction moment arm,and moment arm of gravity.These indices were precisely calculated using trigonometric function.The angle of osteotomy plane was determined.Proper prosthesis was selected and eccentricity was adjusted.Following artificial hip placement,a comparison was made between uninjured and injured sides.MAIN OUTCOME MEASURES:Eccentricity and hip joint function.RESULTS:The eccentricity on uninjured side of 30 patients averaged 38.7 mm (range 22-57 mm) prior to surgery and that on the injured side averaged 39.2 mm (range 21-59 mm) after surgery.Limb discrepancy ranged 1.8-8.7 mm,with a mean of 3.4 mm,after surgery.There were 26 patients (86.7%) presenting long limbs and 4 patients (13.3%) showing short limbs after surgery.All patients were followed-up 0.5-2.5 years old.Harris hip score results were excellent in 10 patients,good in 19 patients,and fair in 1 patient,with an excellent and good rate of 97%.CONCLUSION:In treatment of femoral neck fracture,eccentricity adjustment during artificial hip replacement is closely associated with hip joint function after surgery.
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Tissue engineering may allow obtaining patient’s own cells, seeding them on biodegradable scaffolds, thus achieving formation of a particular tissue or organs, such as bone, cartilage, muscle, or heart. These tissues or organs can be used to repair tissue or organs defects caused by disease or trauma. Many animal studies have demonstrated the efficacy of using bone marrow mesenchymal stem cells in treatment of diseases such as nervous system diseases, liver disease, respiratory diseases and kidney disease. The main ways of the stem cells therapy are local implantation and systemic transplantation of bone marrow mesenchymal stem cells, and the effect of such treatments is notable. The use of gene-modified stem cells in gene therapy is an fantastic option due to theoretical advantage of stem cells compared to somatic cells with respect to higher proliferative capacity. Bone marrow mesenchymal stem cells can deliver genes and proteins into organs or tissues with specific need for gene therapy.