Bis (2-butoxyethyl) Phthalate Delays Puberty Onset by Increasing Oxidative Stress and Apoptosis in Leydig Cells in Rats / 生物医学与环境科学（英文）

OBJECTIVE@#This study investigated the effects of bis (2-butoxyethyl) phthalate (BBOP) on the onset of male puberty by affecting Leydig cell development in rats.@*METHODS@#Thirty 35-day-old male Sprague-Dawley rats were randomly allocated to five groups mg/kg bw per day that were gavaged for 21 days with BBOP at 0, 10, 100, 250, or 500 mg/kg bw per day. The hormone profiles; Leydig cell morphological metrics; mRNA and protein levels; oxidative stress; and AKT, mTOR, ERK1/2, and GSK3β pathways were assessed.@*RESULTS@#BBOP at 250 and/or 500 mg/kg bw per day decreased serum testosterone, luteinizing hormone, and follicle-stimulating hormone levels mg/kg bw per day (P < 0.05). BBOP at 500 mg/kg bw per day decreased Leydig cell number mg/kg bw per day and downregulated Cyp11a1, Insl3, Hsd11b1, and Dhh in the testes, and Lhb and Fshb mRNAs in the pituitary gland (P < 0.05). The malondialdehyde content in the testis significantly increased, while Sod1 and Sod2 mRNAs were markedly down-regulated, by BBOP treatment at 250-500 mg/kg bw per day (P < 0.05). Furthermore, BBOP at 500 mg/kg bw per day decreased AKT1/AKT2, mTOR, and ERK1/2 phosphorylation, and GSK3β and SIRT1 levels mg/kg bw per day (P < 0.05). Finally, BBOP at 100 or 500 μmol/L induced ROS and apoptosis in Leydig cells after 24 h of treatment in vitro (P < 0.05).@*CONCLUSION@#BBOP delays puberty onset by increasing oxidative stress and apoptosis in Leydig cells in rats.@*UNLABELLED@#The graphical abstract is available on the website www.besjournal.com.

Epidemiological investigation on the local epidemic situation in Zhengzhou High-Tech Zone caused by SARS-CoV-2 Delta variant / 中华预防医学杂志

This study collected epidemic data of COVID-19 in Zhengzhou from January 1 to January 20 in 2022. The epidemiological characteristics of the local epidemic in Zhengzhou High-tech Zone caused by the SARS-CoV-2 Delta variant were analyzed through epidemiological survey and big data analysis, which could provide a scientific basis for the prevention and control of the Delta variant. In detail, a total of 276 close contacts and 599 secondary close contacts were found in this study. The attack rate of close contacts and secondary close contacts was 5.43% (15/276) and 0.17% (1/599), respectively. There were 10 confirmed cases associated with the chain of transmission. Among them, the attack rates in close contacts of the first, second, third, fourth and fifth generation cases were 20.00% (5/25), 17.86% (5/28), 0.72% (1/139) and 14.81% (4/27), 0 (0/57), respectively. The attack rates in close contacts after sharing rooms/beds, having meals, having neighbor contacts, sharing vehicles with the patients, having same space contacts, and having work contacts were 26.67%, 9.10%, 8.33%, 4.55%, 1.43%, and 0 respectively. Collectively, the local epidemic situation in Zhengzhou High-tech Zone has an obvious family cluster. Prevention and control work should focus on decreasing family clusters of cases and community transmission.

Data Mining and Systems Pharmacology to Elucidate Effectiveness and Mechanisms of Chinese Medicine in Treating Primary Liver Cancer / 中国结合医学杂志

OBJECTIVE@#To identify specific Chinese medicines (CM) that may benefit patients with primary liver cancer (PLC), and to explore the mechanism of action of these medicines.@*METHODS@#In this retrospective, singlecenter study, prescription information from PLC patients was used in combination with Traditional Chinese Medicine Inheritance Supports System to identify the specific core drugs. A system pharmacology approach was employed to explore the mechanism of action of these medicines.@*RESULTS@#Taking CM more than 6 months was significantly associated with improved survival outcomes. In total, 77 putative targets and 116 bioactive ingredients of the core drugs were identified and included in the analysis (P<0.05). A total of 1,036 gene ontology terms were found to be enriched in PLC. A total of 75 pathways identified from Kyoto Encyclopedia of Genes and Genomes were also enriched in this disease, including fluid shear stress, interleukin-17 signaling, signaling between advanced glycan end products and their receptors, cellular senescence, tumor necrosis factor signaling, p53 signaling, cell cycle signaling, steroid hormone biosynthesis, T-helper 17 cell differentiation, and metabolism of xenobiotics by cytochrome. Docking studies suggested that the ingredients in the core drugs exert therapeutic effects in PLC by modulating c-Jun and interleukin-6.@*CONCLUSIONS@#Receiving CM for 6 months or more improves survival for the patients with PLC. The core drugs that really benefit for PLC patients likely regulates the tumor microenvironment and tumor itself.

Medial parapatellar soft tissue overlapping suture in total knee arthroplasty for severe osteoarthritis with permanent patellar dislocation: early and mid-term results / 南方医科大学学报

OBJECTIVE@#To evaluate the early and mid-term clinical results of medial parapatellar soft tissue overlapping suture in total knee arthroplasty for treatment of severe osteoarthritis combined with permanent patellar dislocation.@*METHODS@#We retrospectively analyzed the data of 12 patients (12 knees) diagnosed with severe knee osteoarthritis combined with permanent patellar dislocation undergoing total knee arthroplasty with medial parapatellar soft tissue overlapping suture. Knee Society Score (KSS), University of California Los Angeles (UCLA) activity-level rating, Visual Analog Scale (VAS) pain score, and knee range of motion of the patients were assessed before and 2 years after the surgery. Anteroposterior and lateral radiographs of the knee joint, full-length standing radiographs of the lower limbs and patellar axial radiographs were evaluated.@*RESULTS@#The mean Knee Society Score of the patients increased from 34.2±11.1 before surgery to 73.5±6.3 at two years after the surgery (P < 0.001). The UCLA activity-level rating increased from an average of 3.8 ± 0.8 before surgery to 5.8 ± 0.6 at two years postoperatively (P=0.003). The mean VAS pain score decreased from 42.8±6.0 before surgery to 20.1±3.7 (P < 0.001) and the range of motion of the knee joint increased from 74.6±8.9 degrees to 97.5±4.5 degrees at two years (P < 0.001). The radiographs showed no signs of subluxation or dislocation of the patella in all the patients.@*CONCLUSIONS@#Medial parapatellar soft tissue overlapping suture in total knee arthroplasty can achieve good early and mid-term clinical results for treatment of severe osteoarthritis combined with permanent patellar dislocation.

Effect of follower load on facet joint contact force of lumbar spine / 医用生物力学

Objective To study the influence of follower load on contact force of facet joints under various postures of lumbar spine. Methods A 3D nonlinear finite element model of lumbar spine (L1-S1) was developed, with consideration of the non-uniform thickness and nonlinear material properties of the cartilage layer in facet joints. The model was then applied with different follower preload (0, 0.5, 0.8, 1.2 kN), under pure moment of 7.5 N•m in different directions (flexion, extension, lateral bending, extension and torsion). The contact forces of facet joints on the two sides of each segment under different loading conditions were compared. The asymmetry influence of follower load on contact force of facet joints was also quantitatively studied. Results The follower preload increased the facet force under flexion-extension and bending (ipsilateral), while decreased the force on the contralateral facet under lateral bending. All the effects of follower load on facet force became weaker with the increase of preload. For torsion loading, the preload had almost no effect on facet force. The greatest asymmetry influence of follower load on facet force was under bending (the ipsilateral side), followed by flexion, bending (contralateral side), extension and torsion. Conclusions The follower load shows obviously different effects on contact force of facet joints with different postures. The asymmetry of facet joints should be fully considered in biomechanical studies of lumbar spine, especially in studies on post-structures of lumbar spine under physiological loads.

Evaluation on the implementation of malaria elimination measures in Huzhou City / 预防医学

Objective To analyze the situation of malaria epidemic and the course of prevention and control,and to summarize and promote the experience of malaria elimination. Methods The data of malaria prevention measures of different stages in Huzhou City from 1950 to 2015 were analyzed retrospectively. Results Huzhou City went through three serious malaria epidemics during the past 60 years:1954 to 1955,1962 to 1963 and early 1970. The highest incidence rate was 13 981. 76 / 1 00,000 in 1963. Since standard treatments(including anti - relapse treatment)were carried out and anti - mosquito facilities had improved,the average annual incidence rate in the 70 s declined gradually. From 1980 to 1989,Huzhou City set up 15 - 30 longitudinal monitoring stations which covered 70% villages and towns. In 1989,the City passed the fundamental evaluation of malaria eradication. The average annual incidence rate from 1990 to 2009 was 0. 37 / 1 000,000,and 48. 95% were imported cases. After 2010,Huzhou City had no local malaria case,and all cases reported were imported from 2010 to 2015. Conclusion A remarkable effects of the targeted control measures have been made at different stages in Huzhou City. In order to consolidate the achievements,we should strengthen the monitoring of floating population,timely and effective treatment of imported cases.

Total knee arthroplasty with 3D printing technique versus conventional surgery: comparison of the outcomes / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the clinical outcomes of patients receiving total knee arthroplasty (TKA) using 3D printing technique and conventional surgical methods.</p><p><b>METHODS</b>From October, 2015 to February, 2017, 17 patients (20 knees) underwent TKA with the assistance of individualized navigation template and 16 concurrent patients (18 knees) matched for age, gender and knee society score received conventional TKA. The operation time, blood loss, and osteotomy data of the femoral condyle and tibia plateau were recorded. The mean femorotibial angle (MFTA) and sagittal tibial component angle (STCA) after the operation and the KSS at the last follow-up were compared between the two groups.</p><p><b>RESULTS</b>All the patients were followed up for 7-23 months, during which no infection or prosthesis loosening or motion was found. In patients receiving surgery with 3D printing technique, the osteotomy data of the femoral condyle and tibia plateau in the actual surgeries were consistent with those in surgical plans (P>0.05). The patients in the 3D group had a significantly shorter operation time and a higher KSS score than those in the conventional group (P<0.05). Significant differences were found between the two groups in postoperative MFTA and STCA (P<0.05).</p><p><b>CONCLUSION</b>The application of 3D printing technique can simplify the surgical procedure and improve the surgical precision and efficacy of TKA.</p>

Flavonoid glycosides from callus cultures of Dysosma versipellis / 中国中药杂志

Various chromatographic techniques, including silica gel column chromatography, Sephadex LH-20, preparative thin-layer chromatography, and preparative HPLC, were employed to isolate the chemical constituents from callus cultures of Dysosma versipellis. Structures of the compounds were elucidated based on UV, IR, MS and NMR spectroscopic data analysis. Totally, seven flavonoid glycosides were isolated from the 95% ethanol extract of the callus cultures and identified as kaempferol-3-O-[6″-(3″'-methoxy)-malonyl]-β-D-glucopyranoside(1), kaempferol-3-O-(6″-O-acetyl)-β-D-glucopyranoside(2), kaempferide-3-O-β-D-glucopyranoside(3), kaempferol-3-O-β-D-glucopyranoside(4), isoquercitrin(5), quercetin-4'-O-β-D-glucopyranoside(6) and kaempferol-3-(6″-malonyl)-β-D-glucopyranoside(7), respectively.All these compounds were isolated from callus cultures of D. versipellis for the first time.Compounds 1, 2, 3, 6 and 7 were firstly obtained from plant materials of D. versipellis, and compound 1 was a new compound.

Meroterpenoids and isoberkedienolactone from endophytic fungus Penicillium sp. associated with Dysosma versipellis / 药学学报

Seven meroterpenoids and five small-molecular precursors were isolated from Penicillium sp., an endophytic fungus from Dysosma versipellis. The structures of new compounds, 11beta-acetoxyisoaustinone (1) and isoberkedienolactone (2) were elucidated based on analysis of the spectral data, and the absolute configuration of 2 was established by TDDFT ECD calculation with satisfactory match to its experimental ECD data. Meroterpenoids originated tetraketide and pentaketide precursors, resepectively, were found to be simultaneously produced in specific fungus of Penicillium species. These compounds showed weak cytotoxicity in vitro against HCT-116, HepG2, BGC-823, NCI-H1650, and A2780 cell lines with IC 50 > 10 micromol x L(-1).

Zinc supplementation effects on alcoholic liver disease and the molecular mechanism / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To examine dietary zinc supplementation could alleviate the damage of alcoholic liver disease and the relationship with the expression of hepatocyte nuclear factor 4alpha (HNF-4alpha).</p><p><b>METHODS</b>40 adult C57 BL/6 mice were randomly divided into four groups (n = 10): control, zinc, ethanol and zinc plus ethanol, which were sacrificed after fed four different diets for 6 months. Zinc sulfate was added in the drinking water of the Zinc and Zinc Plus Ethanol group and the content was 75 mg/L. Liver regeneration was assessed by immunohistochemical staining of proliferating cell nuclear antigen (PCNA), and the expression of HNF-4alpha was determined by RT-PCR and Western blot. And as to assess the status of oxidative stress of the mice, malondialdehyde (MDA) and superoxide dismutase (SOD) were detected.</p><p><b>RESULTS</b>Compared with the control group, the expression level of HNF-4alpha decreased significantly in the ethanol group (P < 0.05), and the content of MDA increased significantly in this group, while the content of SOD declined significantly (P < 0.05). Compared with the ethanol group, the number of PCNA-positive hepatocytes increased significantly, and the expression level of HNF-4alpha also increased in the zinc plus ethanol group (P < 0.05), and the content of SOD increased in this group, while MDA decreased significantly (P < 0.05).</p><p><b>CONCLUSION</b>Long term ethanol exposure can lead to oxidoreduction imbalances which can be reversed by zinc supplementation. We suppose that zinc-enhanced liver regeneration is associated with an increase in HNF-4alpha, suggesting that dietary zinc supplementation may have beneficial effects in alcoholic liver disease.</p>

The study of effects of pirfenidone on the pulmonary fibrosis induced by paraquat in mice / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the curative effects of pirfenidone (PF) on pulmonary fibrosis induced by paraquat (PQ) in mice and to provide the theoretical basis for clinical treatment.</p><p><b>METHODS</b>Ninety adult healthy male ICR mice were randomly divided into six groups: control group, PQ group, 2 mg/kg Dexamethasone group, 25 mg/kg PF group, 50 mg/kg PF group and 100 mg/kg PF group, there were 15 mice in each group. The corresponding volume of normal saline was given to the each mouse in control group according to the weight, after 2 h 0.1% CMC was given to the each mouse of control group one time by intragastric administration, then the CMC was administrated at regular time until sacrifice. All mice for other 5 groups were exposed to 100 mg/kg PQ by intragastric administration. At 2 h after exposure to PQ, 0.02 ml/10 g dexamethasone and 25, 50, 100 mg/kg PF were given to mice for dexamethasone group and for 3 PF groups by intragastric administration each day for 49 days, respectively. The lung coefficient was calculated and pathological changes of lung tissue were observed by HE staining for each mouse. The hydroxyproline (HYP) level in lung tissue was measured for each mouse. The mRNA level of and the protein level of TGF-β(1) in lung tissue for each mouse were determined, and the protein level of TGF-β(1) in the bronchus-alveolus lavage fluid (BALF) of each mouse was detected.</p><p><b>RESULTS</b>The survival rates on the 3rd day in PQ group, 3 PF groups and dexamethasone group were 53.33%, 46.67%, 73.33%, 86.67% and 80%, respectively. The survival rates on the 3rd day in dexamethasone group, 50 mg/kg and 100 mg/kg PF groups were significantly higher than those of PQ group and 25 mg/kg PF group (P < 0.05). The lung coefficients of 3 PF groups were significantly lower than that of the PQ group (P < 0.05). The lung tissue HYP levels of dexamethasone group and 3 PF groups were 50.95 ± 11.65, 44.52 ± 9.48, 43.27 ± 6.01 and 40.82 ± 5.90 mg/g respectively, which were significantly lower than that (74.27 ± 3.68) of PQ group (P < 0.01). The TGF-β(1) protein levels of BALF in dexamethasone group, 50 and 100 mg/kg PF groups were 22.03 ± 7.27, 27.75 ± 5.84 and 21.31 ± 6.82 ng/ml respectively, which were significantly lower than that (52.52 ± 15.51) ng/ml of PQ group (P < 0.01) The expression level of TGF-β(1) mRNA in 100 mg/kg PF group decreased significantly, as compared with PQ group (P < 0.01).</p><p><b>CONCLUSION</b>PF could reduce the collagen deposition and pulmonary fibrosis induced by PQ in mice lungs.</p>

A modified technique of bone grafting pedicled with femoral quadratus for alcohol-induced osteonecrosis of the femoral head / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Quadratus femoris pedicled bone grafting has yielded satisfactory long-term clinical outcome for osteonecrosis of the femoral head (ONFH) in pre-collapse ONFH without extensive lesion. However, for pre-collapse ONFH with extensive necrotic area, it is still challenging to preserve the femoral head. The current study aimed to introduce a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus and to evaluate its short-term outcomes.</p><p><b>METHODS</b>From January 2008 to December 2008, 10 ONFH patients (12 hips) underwent operations by a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus (group A). According to the ARCO classification system, there were two hips in stage II B and 10 hips in stage II C. Also in the same period, 12 ONFH patients (16 hips) underwent operations by the conventional procedure of quadratus femoris pedicled bone grafting (group B). There were 6 hips in stage II B and 10 hips in stage II C. All patients were males and suffered from alcohol induced ONFH. For the new technique, the necrotic area was evaluated, and a titanium mesh piece of the same size (range from 2.5 cm × 2.8 cm to 2.8 cm × 3.4 cm) was obtained and shaped to match the contour of the head. The cancellous bone was first placed underneath the subchondral bone and was densely impacted (about 1 to 2 mm thick). Then the titanium mesh piece was inserted. The length of the decompressive trough was measured. A titanium cylinder mesh cage with a diameter of 1.6 cm of the same length was obtained, with a "U" shaped window in the wall being created to make room for the muscle pedicle. The muscle pedicle bone was inserted into the titanium mesh cage to form a bone graft-titanium cage complex and, then the complex was inserted. The hundred percent score method was used for outcome evaluation. Clinical and radiographic outcomes were compared between group A and group B.</p><p><b>RESULTS</b>The average operative time was 150 minutes (130 to 185 minutes) in group A, with an average of 130 minutes (120 to 180 minutes) in group B. The mean blood loss was 400 ml (300 to 500 ml) in group A and 350 ml (250 to 500 ml) in group B. Group A patients were followed up for an average of 19.2 months (14 to 24 months), with an average of 18.5 months (12 to 24 months) for Group B. Full weight bearing was allowed 5 to 7 months postoperatively. Pain and function were obviously improved. For group A, pain score improved from a mean of 9.8 points preoperatively to an average of 24.6 points postoperatively, and function score improved from a mean of 9.0 points preoperatively to an average of 17.4 points postoperatively. In group B, pain score improved from a mean of 9.5 points preoperatively to an average of 24.2 points postoperatively and function score improved from a mean of 9.2 points preoperatively to an average of 17.2 points postoperatively. The range of motion changed the least, with score improvement from a preoperative mean of 13.9 points to postoperative 16.8 points for group A and from a preoperative mean of 13.7 points to postoperative 16.5 points for group B. Radiographic score improved from preoperative 31 points to postoperative 38 points for group A, in comparison with an improvement from preoperative 31 points to postoperative 37 points for group B. At the latest follow up, 11 hips were rated as excellent and 1 hip was better for group A, with 14 hips being rated as excellent and 2 hips being better in group B. There was no statistically significant difference between groups A and B in clinical and radiographic outcomes.</p><p><b>CONCLUSION</b>For ONFH in stage ARCO IIC, satisfactory clinical outcome can be achieved by the new technique in the short-term period while the long-term clinical outcome has yet to be determined.</p>

Gene expression of transforming growth factor-beta1 in osteophyte development / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the gene expression and potential functions of transforming growth factor-beta1 in osteophyte development.</p><p><b>METHODS</b>A total of 25 specimens were obtained from individuals undergoing total knee arthroplasty due to severe primary osteoarthritis. Tissue samples were embedded in paraffin wax and made into sections. Hematoxylin and eosin and toluidine blue stainings were performed. The expressions of collagen I, IIa, IIb, and X were detected by immunohistochemistry. Based on the histomorphology of cellularity and matrix abundance, the glycosaminoglycans content, and the differential expressions of collagen I, IIa, IIb, and X, the osteophytic tissues were classified. For each different type of osteophyte, expressions of transforming growth factor-beta1 were detected by immunohistochemistry and in situ hybridization, and results were analyzed using the image analysis system.</p><p><b>RESULTS</b>Five different types of osteophytes were identified as type I, type II, type III, type IV, and type V. Transforming growth factor-beta1 mRNA was more and intensely expressed in chondrocytes of type II and III osteophytes, and was less in other types of osteophytes. The difference was significant (P<0.05, P<0.01).</p><p><b>CONCLUSION</b>Transforming growth factor-beta1 mRNA is mainly expressed in early-mid stages of osteophytes and may play an important role in promoting the proliferation and differentiation of chondrocytes in the early stages of osteophyte development.</p>

Cloning of M and NP Gene of H5N1 Avian Influenza Virus and Immune Efficacy of their DNA Vaccines / 中国病毒学

The M and NP genes of H5N1 avian influenza virus (A/chicken/Hubei/489/2004) were amplified by RT-PCR from viral RNA,and cloned into pMD 18-T vector respectively.The expression plasmid containing the M gene (pHM6-m) or the NP gene (pHM6-np) was then constructed by inserting the M or NP gene into the pHM6 eukaryote expression vector; the constructed plasmid was then sequenced.32 BALB/c mice (6-week-old) were divided into four groups at random.Three groups of BALB/c mice were inoculated one time the intramuscular route with either 30 μg of plasmid pHM6-m,30 μg of plasmid pHM6-np or the mixture of plasmid pHM6-m (15 μg ) and pHM6-np(15 μg) respectively.A additional group of mice were injected with 100 μ1 PBS as controls.Two weeks later,all mice were challenged with homologous H5N1 avian influenza virus,and observed in the following 12 days.The survival rates of mice in the pHM6-m group,the pHM6-np group and mixed plasmids group were 62.5% ,25.0% and 50.0%,respectively.Results showed that effective protection could be provided by either pHM6-m or pHM6-np,but pHM6-m provided a better protective effect than pHM6-np.

A comparative study on maintenance of disc height by different anterior cervical fusion methods / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the effect of autograft, cage and autograft plus internal fixation with plate on maintenance of disc height and recovery of spinal cord function.</p><p><b>METHODS</b>From March 1998 to June 2004, 117 cervical spondylotic patients who received anterior fusion surgery were reviewed. There were 65 males and 52 females with an average age of 57 years (range from 31 to 72 years). One level was involved in 91 patients, and two levels in 26. Fusion methods included autogenous tri-cortical iliac bone grafting alone in 31 patients, cage with autograft bone in 38 and autogenous tri-cortical iliac bone grafting combined with self-locking plate in 49. The measured fusion length was determined as the distance from the midpoint between the anterior and posterior aspects of the superior endplate of the top level of the fusion to the midpoint of the inferior endplate of the bottom level of the bottom level of the fusion. JOA rating criteria was used for cord function evaluation. One-way variation analysis was used to compare the disc height loss and cord function among the 3 groups.</p><p><b>RESULTS</b>All patients were followed-up for an average period of 23 months (range, 13 to 59 months). At final follow- up, disc height loss averaged 1.94 mm in autogenous tri-cortical iliac bone grafting group, greater than that in the other two groups (1.48 mm in cage group and 1.25 mm in instrumented group) with statistical significance. Recovery of spinal cord function was satisfactory in all groups at one year postoperatively with no statistical difference. Three implants failure occurred in self-locking plate group and was salvaged with uneventful recovery.</p><p><b>CONCLUSIONS</b>In anterior cervical fusion surgery, maintenance of disc height could be achieved by proper application of cage or internal fixation with plate.</p>

Anterior fusion for unstable lower cervical spine / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the clinical outcome of anterior fusion for unstable lower cervical spine.</p><p><b>METHODS</b>From October 2000 to October 2004, anterior fusion were performed for 67 cases with unstable lower cervical spine with corresponding clinical manifestations. There were 38 males and 29 females with an average age of 33 years. Instability of lower cervical spine was radiographically determined by sagittal plane displacement between 2 cervical vertebrae of more than 3.5 mm or relative sagittal plane angulation greater than 11 degrees on maximal lateral flexion and extension films. Anterior interbody fusion methods included bone grafting with plate fixation or cage. JOA rating system was used for spine cord function assessment.</p><p><b>RESULTS</b>All patients were followed up for an average period of 14 months. Solid fusion was achieved for all operated levels. The majority of the patients got a satisfactory relief of preoperative symptoms. JOA scores for cord function improved from preoperative 10.15 to postoperative 14.95 with statistical difference (P < 0.05). Complications included screws loosing and backout in 2 cases. Revision surgery were performed with uneventful recovery.</p><p><b>CONCLUSION</b>Satisfactory clinical outcome can be achieved by proper selection of anterior fusion methods for patients with unstable lower cervical spine.</p>

Total hip arthroplasty for patients with osteoarthritis secondary to hip developmental dysplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the methods of restoring normal level of rotation center of the hip and limb length in patients with osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) using total hip arthroplasty (THA).</p><p><b>METHODS</b>From January 2000 to January 2003, total hip arthroplasties were performed for 21 patients (26 hips) with OA secondary to DDH. There were 19 females and 2 males with an average age of 51 years (range from 40 to 66 years). Based on radiographic classification of Crowe, there were 12 in type I, 5 in type II, 2 in type III and IV respectively. In addition to the standard procedure of THA, the methods of restoring normal level of rotating center of the hip included structural bone autografting and medialization of the cup. The methods of limb length restoration included carefully preoperative planning and intraoperative soft tissue release. During the follow-up period at 3, 6, 12 months postoperatively and then annually thereafter, rotation center of the hip and limb length were assessed radiographically. Harris score system (HSS) was used for clinical evaluation.</p><p><b>RESULTS</b>All the patients were followed up for a mean time of 26.4 months (range from 12 to 48 months). All the patients had restoration of the normal level of rotation center of the hip. At the latest follow-up, Harris score was improved from preoperative 35 points (range from 12 to 68 points) to postoperative 94 points (range from 74 to 100 points).</p><p><b>CONCLUSION</b>In addition to standard procedure, the restoration of normal level of rotation center of the hip could be achieved by structural bone autografting and medialization of the cup in THA for patients with DDH. Careful preoperative planning and intraoperative soft tissue release could restore limb length.</p>

Short-term results of modular extensively porous-coated revision stem in revision total hip arthroplasty / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the short-term clinical and radiographic results of modular fully porous-coated stem in revision operation of total hip arthroplasty.</p><p><b>METHODS</b>From May 2001 to November 2002, ten cases with twelve hips received revision total hip arthroplasty using modular Profemur R with fully porous-coated stem. There were three males and seven females and the average age was 54.2 years (35 to approximately 71 years). The reasons for revision operation included aseptic loosing in eleven hips and septic loosing in one hip. All the patients were evaluated radiographically and clinically. Radiographic evaluation included the classification of bone loss, leg discrepancy, offset and antiversion before and after revision and bone in-growth postoperatively. Clinical evaluation were based on Harris score system.</p><p><b>RESULTS</b>The average follow-up period is 13.5 months (range: 6 to approximately 24 months). Leg discrepancy from more than 2 cm in six cases were restored to less than 1 cm postoperatively. Femoral offset, antiversion angle and neck-shaft angle were also restored to normal limitation. All the patients were allowed to full weight-bearing 3 to approximately 5 months later and pain relief occurred in all involved hips. At the last follow-up, bone in-growth occurred in eleven hips and solid fibrous fixation only in one case. Harris score was improved from a mean of 25 to 72. Complications mainly consisted of femoral shaft fracture in three cases but no infection or dislocation was found postoperatively.</p><p><b>CONCLUSIONS</b>Satisfactory results of short-term radiographic and clinical follow-up can be achieved using modular fully porous-coated stem for revision total hip arthroplasty.</p>