ABSTRACT
<p><b>OBJECTIVE</b>To retrospectively study the clinical results of total hip arthroplasty(THA) using Wagner SL revision stem for patients with femoral intertrochanteric fracture.</p><p><b>METHODS</b>From 2006 January to 2009 December, 29 consecutive patients with femoral intertrochanteric fractures were performed THA using Wagner SL revision stem and intertrochanteric reconstruction, including 18 males and 11 females with an average age of 49 years old ranging from 43 to 58. Among them, 8 cases were oboslete femoral intertrochanteric fractures and 21 cases were the intertrochanteric fractures with painful arthritis before injuries. After the operation, the follow-up results were evaluated with clinical and radiographic criteria. The clinical follow-up results were evaluated by Harris score, limb length discrepancy, ROM of hips and the strength of the hip abductor. The X-ray imaging follow-up results were evaluated by periprosthetic osteolysis, prosthesis loosening and radiolucent.</p><p><b>RESULTS</b>All the operations were successfully completed without serious complications associated with THA. Twenty-nine cases were followed up for a mean duration of 8.2 years (ranged, 6 to 10). There was no acceptable thigh pain. The first time walk after operation, 8 patients with oboslete intertrochanteric fracture complained the surgical sides were longer, with the passage of time, the complaint significantly reduced. At 3 months after operation, X-ray films of 21 cases showed intertrochanteric fractures healed well who had painful arthritis before injuries. An average of 6 months after operation (ranged, 3 to 8), X-ray films of 8 cases of oboslete intertrochanteric fracture showed that the bone graft and trochanter with obvious callus connection. There were no obvious prosthesis subsidence on X-ray film at the final follow-up. The recovery of hip movement range was satisfactory, no hip abduction strength was weak. More than 6 years after the operation, according to the Harris scoring evaluation of hip joint, the result was excellent in 18 cases, good in 9 cases, general in 2 cases.</p><p><b>CONCLUSIONS</b>The clinical results of total hip arthroplasty using Wagner SL revision stem for patient with femoral intertrochanteric fracture is a reliable method, intertrochanteric reconstruction not only makes for prosthesis and joint stability, but also increases bone reserve.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To study the contribution of medial or lateral stabilizer to the stability of the patella, to explore the function and effect of releasing the LPR clinically and to provide a biomechanical basis for the clinical treatment of patellar instability(PI).</p><p><b>METHODS</b>The quadriceps femoris of 6 fresh human cadaver knees were loaded to simulate a normal condition of muscle strength. First the loading force was measured and recorded, which subluxated the patella with the different degrees of knee flexion. Intervention 1:released the medial patellar retinaculum(MPR) to simulate pathologic conditions, then repeated the above manipulates and recorded the loading force. Intervention 2:released the LPR furthermore to simulate clinical surgical treatment, then repeated the above manipulates and recorded the loading force.</p><p><b>RESULTS</b>After releasing the MPR, the loading force which subluxated the patella were decreased obviously, and there were significant differences between the two groups(<0.05). The above loading force was further decreased after the further release of LPR, but the difference was not significant(>0.05).</p><p><b>CONCLUSIONS</b>MPR plays an important role in maintaining the stability of the patella and in the normal trajectory of the patellofemoral joint. The attention should be paid to the repair or reconstruction of the MPR in the treatment for patella recurrent lateral dislocation subluxation. Releasing the LPR is not a best choice.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects and mechanisms of diethylhexylphthalate (DEHP) on morphology and function of progenitor Leydig cells (PLC) in rats.</p><p><b>METHODS</b>Twenty pregnant SD rats were randomly divided into 4 groups ( n = 5): normal control group, DEHP low dose group , middle dose group, and high dose group, which were treated from postnatal day (PND) 1 to PND 21 of the pubs with DEHP at the doses of 0, 10, 100, 750 mg/(kg · d) in 0.5 ml of corn oil by gavage respectively. At the end of the treatment, the male pups were killed and blood samples were collected for determination of serum testosterone concentration by chemiluminescence method. The body weight, testis weight and anogenital distance (AGD) were measured. The morphology of PLC was observed by light and transmission electron microscopy. The protein expression of steroidogenic acute regulatory protein(StAR) in PLC was determined by immunohistochemistry. The mRNA expression of insulin-like growth factor-I (IGF-I) in the testis was assayed by real-time PCR.</p><p><b>RESULTS</b>Compared with normal control group, the serum testosterone and AGD of male pubs from the middle and high dose groups were declined significantly (P < 0.01), the testis weight and body weight from high dose group were decreased significantly (P < 0.01), while the testis weight increased in the low dose group (P < 0.05). Under light microscope, PLC showed hyperplasia and cluster aggregation in the low dose group and focal hyperplasia in the middle and high dose group. The spermatogenic cells in seminiferous tubules showed decrease, apoptosis and unfix in the high dose group. Under transmission electron microscope, the PLC showed decreased lipid droplets, smooth endoplasmic reticulum and mitochondriae in the treated group. The mRNA expression of IGF-I increased in the low dose group, and the protein expression of StAR decreased in the middle and high dose group.</p><p><b>CONCLUSION</b>Lactating exposure to DEHP may interfere with the synthesis of testosterone of PLC in male pubs, the decrease of StAR and the damage of PLC may be involved in it.</p>