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BACKGROUND:Total knee arthroplasty for knee osteoarthritis accompanied with extra-articular deformity is stil chal enging. An individual replacement plan should be designed to obtain good mechanical axis and to recover suitable soft-tissue balance. OBJECTIVE:To observe the safety and feasibility of individual y designed one-stage total knee arthroplasty for knee osteoarthritis combined with ipsilateral femoral extra-articular deformity. METHODS:A total of eight patients with knee osteoarthritis combined with ipsilateral femoral extra-articular deformity were enrol ed in this study. According to preoperative plan, five patients underwent intra-articular compensatory osteotomy, and the remaining three received extra-articular corrective osteotomy. Multi-planar deformities as wel as soft-tissue conditions were recorded. Main outcome measures included the hospital for special surgery score, Western Ontario and McMaster Universities Arthritis Index score and alignments deviation. RESULTS AND CONCLUSION:The patients were averagely fol owed up for 29 months. The hospital for special surgery score changed from preoperative 32.5 points to postoperative 87.5 points. The Western Ontario and McMaster Universities Arthritis Index score was increased from preoperative 37.1 points to postoperative 88.8 points (P<0.05). Mean mechanical axis deviation (either varus or valgus) changed from preoperative 17.1° to postoperative 1.4° (P<0.05). Al cases with extra-articular corrective osteotomy healed within 3 months, and none had postoperative infection, loosening or venous thromboembolic events. One patient was with 5° residual knee anti-sheets. Results verified that one-stage total knee arthroplasty procedures are effective in the treatment of knee osteoarthritis accompanied with ipsilateral femoral extra-articular deformity in accordance with individual preoperative plan.
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BACKGROUND:Clinical work shows that there are a large proportion of patients suffering from osteoerthritis(OA)and osteoporosis(OP),therefore establishing OA+OP models to simulate the clinical disease in postmenopausal women addreasing the basic characteristics of lesions,will offer better prevention and treatment of OA+OP in clinical practice.OBJECTIVE:To attempt to create OA+OP animal model.DESlGN,TIME AND SETTING:Randomized controlled animal expedment in terms of call pathology was perforrned between August 2008 and January 2009 in the Scientific Research Center and Traditional Chinese MediciRe Hospital of Xinjiang Medical University.MATERIALS:Forty 4-month-old female SD rats,weighing(210±10)g,were randomly divided into normal control group,OA group,OP group,OA+OP group.METHODS:In the OA+OP group,rats underwent abdominal incision 1.5 cm longitudinal on both sides of lumbar spine on back,followed by bilateral ovarian resection and ovarian artery ligation,to establish OP models.One month after the skin incision,left knee skin,subcutaneous tissue and fascia were cut,then joint capsule was given a vertical incision.Anterior cruciata ligament was cut off in orthophoria,meniscus was removed,followed by subcutaneous tissue and skin suture,OA model was prepared and placed under warm environment.antibiotic subcutaneous injection for 3 days,and the displacement of one month.OA group and OP group were produced in accordance with the above method of OA.OP model.Normal control rats received no treatment.MAIN OUTCOME MEASURES:When the rats were 6 months old,the left knee femoral condyle articular cartilage were examined by light microscopy and electron microscopy,left femur was used to measure proximal femoral bone mineral density.RESULTS:In three groups of model rats,articular cartilage become thinning and degeneration.In the OP model group and OA+OP model group,trabecular was sparse and arranged in disorder.In the OA model group and OA+OP model group,the incision layer was chiefly deleted,transferring layer was greatly injured,call hypertrophy and colony were observed,a large amount of blood capillary invaded into cartilage and calcification layer,even break through tidal line;in OP model group,incision layer of articular cartilage became thinning and appeared bilateral tidal line.In the OA model group and OA+OP model group,knee condylar number of special-shaped cartilage cells increased,manifested as irregular nuclei,reduced cell organelle,nuclear shnnkage,chromatin uneven distdbution,mitochondrial swelling,rough expansion of endoplasmic raticutum,accumutation of cytoplasmic microfilaments,showing lipid droplets and glycogen granules,gliel fibdllary fracture,disorder arrangement,a large number of cartilage calls were apoptotic.Three groups of model rats exhibited a dramatically decreased bone mineral density compared with control rats(P＜0.05).CONCLUSION:The animal modal of OA+OP was successfully established.
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BACKGROUND: Common complication of traditional joint replacement is hip joint dislocation and large head joint implant can effectively solve this problem. OBJECTIVE: To investigate the preliminary efficacy of large head metal-on-metal implants for patients undergoing total hip arthroplasty. DESIGN, TIME AND SETTING: Prospective cohort study. The patients were selected from Department of Joint Surgery, Xinjiang Hospital of Traditional Chinese Medicine between February 2007 and January 2008. PARTICIPANTS: A total of 65 patients (71 hips) undergoing large head metal-on-metal implantation in Xinjiang Hospital of Traditional Chinese Medicine were selected, including 21 females and 44 males with an average age of 54.6 years (ranging 19 to 77 years). Of them, there were 28 cases of necrosis of the femoral head, 24 of hip osteoarthritis, 9 of femoral neck fracture and 4 of acetabular dysplasia. METHODS: According to age, sex, cause of disease and preoperative joint function, the patients were divided into traditional prosthesis (n=30, 33 hips, metal-on-polyethylene implant) and large head M-O-M group (n=35, 38 hips, ASR/XL prosthesis, DePuy, Motech, Warsaw, IN, USA). MAIN OUTCOME MEASURES: The pre and postoperative Harris scores for the hip, range of motion, periprosthetic radiolucency, leg-length inequality and complications were recorded and compared. RESULTS: All patients were followed-up. The traditional group was followed up for 20 months (ranging 13-28 months), and the large head M-O-M group was followed up for 17 months (ranging 10-26 months). The mean Harris score was 89 points (ranging 59-98) in traditional group, and 94 points (ranging 71-100) in large head M-O-M group (P=0.014). The range of motion of hip was improved, and the large head M-O-M group (34?) was superior to traditional group (26?, P=0.004) at 6 months after surgery; the range of motion was improved 27? in traditional group and 37? in large head M-O-M group (P=0.009) over 1 year of follow up. The leg-length inequality was 4 mm (2-11 mm) in large head M-O-M group and 7 mm (5-16 mm) in traditional group (P=0.005). Both groups exhibited periprosthetic radiolucency (≤1 mm, 2 cases in traditional group and 3 cases in large head M-O-M group). One patient in the traditional group suffered dislocation. CONCLUSION: The large head M-on-M implants in total hip arthroplasty has excellent short-term effects on patients compared with traditional prosthesis. They offer the more stability and better restoration of hip articulation function and biomechanical reconstruction.
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OBJECTIVE:To study the effect of oil phase,emulsifier and drugs on reverse microemulsion.METHODS:Pseudo-ternary phase diagram was adopted to study the effect of Span-80/Tween-80(emulsifier),thymopentin(model drug), long-chain glyceride,medium-chain glyceride,non-glyceride(oil phase).on the preparation of reverse microemulsions.Optimal formula of reverse microemulsions was selected.RESULTS:The largest water-in-oil(W/O)area was obtained in reverse microemulsion which was prepared using medium-chain glyceride as oil phase.Final formula was confirmed and contained distilled water/ Span-80/Tween-80/caprylic/capric triglyceride(2∶3∶6∶9).In addition,thymopentin was incorporated into the aqueous phase.CONCLUSIONS:The preparation of reverse microemulsions will be influenced by emulsifier,constitution of oil phase and drug.The influence factors for the actual preparation of reverse microemulsions should be optimized.
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OBJECTIVE:To develop a method for determining the entrapment efficiency of tetracaine hydrochloride liposome.METHODS:The microcolumn centrifugation was adopted to separate the free tetracaine hydrochloride from liposomes;the content of tetracaine hydrochloride was determined by HPLC and the entrapment efficiency was computed.RESULTS:By microcolumn centrifugation,the liposomes and the free tetracaine hydrochloride were well-separated.The recovery rate of the blank liposomes was 90.4%～100.1%;the absorption rate of free tetracaine hydrochloride was 96.6%～99.2%;and the entrapment efficiencies of tetracaine liposomes stood at about 80%.CONCLUSION:This method established for determining the entrapment efficiency of tetracaine hydrochloride liposome is simple,rapid and reproducible.
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OBJECTIVE: To investigate the effect of poloxamer 188 as co-emulsifier on the pharmaceutical property of emulsion.METHODS: Diclofenac sodium was used as model drug and poloxamer 188 as co-emulsifier,the emulsion was prepared by high pressure homogen-colostrum pH adjusting method,with its entrapment efficiency,particle size,?-electric potential etc determined.RESULTS: The emulsion which was added with poloxamer 188 showed decreased entrapment efficiency and ?-electric potential but increased particle size as comapred with the one without poloxamer 188.CONCLUSION: The pharmaceutical property of emulsion wouldn't necessarily be enhanced by adding poloxamer 188 as co-emulsifier.
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OBJECTIVE:To prepare and characterize lansoprazole(LAP) cationic liposomes. METHODS:Liposomes were prepared by ethanol injection technique.An orthogonal test was utilized to optimize the formulation and preparation of LAP liposomes.The encapsulation efficiency was determined by ultrafiltration.The morphological examination of LAP liposomes was performed using transmission electron microscopy.The particle size and Zeta potential of the liposomes were measured.The release rate of LAP from liposomes was tested. RESULTS:The liposomes with spherical or ellipsoidal shape and better stability featured the encapsulation efficiency of(80?1.23)%,the mean partical size of (184?21)nm,and Zeta potential of (36.1?5)mV.The release kinetics in vitro obeyed first-order equation.The stability of LAP was better. CONCULSION:The selected formulation and preparation technic of lansoprazole liposomes were rational and stable and liposomes featured a sustained release in vitro.
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OBJECTIVE: To establish a method for determining the entrapment efficiency of gemcitabine hydrochloride liposomes(GHL).METHODS: The liposome and the free gemcitabine hydrochloride were separated by ultrafiltration,and the content of free gemcitabine hydrochloride was determined by HPLC.The entrapment efficiency of gemcitabine hydrochloride liposomes was computed as well.RESULTS: The recovery rate in ultrafiltration methods was 97.8%～100.1% for blank substance versus 99.0%～100.1% for sample.The linear range of gemcitabine hydrochloride was 1.0～80.0 mg?L-1(r=0.999 3) and its average recovery rate was 98.7～101.2%,and its inter-day and intra-day RSD were all less than 3% and its average entrapment efficiency was 81.21%.CONCLUSION: The method is simple,accurate and applicable for the determination of the entrapment efficiency of gemcitabine hydrochloride liposomes.
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OBJECTIVE:To prepare bovine serum albumin(BSA)liposomes coated with N-trimethyl chitosan(TMC) and study the factors influencing the quality of the preparation.METHODS:BSA liposomes were prepared by the method of reverse-phase evaporation.TMC polymers for coating liposomes were synthesized by quaternary amination reaction between chitosan and methyl iodide.The TMC-coated BSA liposomes were prepared.The entrapment efficiency of BSA liposomes was determined by high speed centrifugation-Coomassie brilliant blue G-250 dye method.The effects of the composition ratio of soybean lecithin(PC):cholesterol(CH):phospbatidylserine(PS),the mass ratio of TMC to total lipid and the ionic strength on particle size and entrapment efficiency were investigated.RESULTS:All the factors investigated had influences on particle size and entrapment efficiency.The optimal formulation was as follows:PC:CH:PS was 8:9:1,TMC to lipid phase ratio was 0.25:1 and ionic strength was less than 20 mmol?L~(-1).The entrapment efficiency prepared in the above conditions was (46.82?2.07)%.CONCLUSION:The TMC-coated BSA liposomes were obtained successfully and the preparation had uniform particle size and good stability.
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Objective To enhance the oral bioavailability of breviscapine and investigate the feasibility of preparing the proliposome of breviscapine by fluidized bed coating method. Methods The fluidized bed coating method was used to prepare breviscapine proliposome and ultrafiltration-HPLC was applied to determination of the encapsulation efficiency. The influence factors on encapsulation efficiency including carriers, drug-lipid weight ratio, inlet air temperature, spray rate, and spray air volume were investigated. Results When the carrier was sorbitol and the drug-lipid weight ratio was under 1∶3, the encapsulation efficiency could be higher. Inlet air temperature, spray rate, and spray air volume had some effects on the encapsulation efficiency. By the method, the fluidity of the proliposome granules was well and the particle size distribution ratio of them was uniform; the mean particle size of liposomal formulation of breviscapine after rehydration was 98 nm, and the encapsulation efficiency was (63.1?2.8)% (n=3). Conclusion It is feasible to prepare the breviscapine proliposome with fluidized bed coating method.
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Objective To prepare a harmine hydrochloride liposome formulation with high encapsulation efficiency. Methods Preformulation investigation was carried out to obtain the drug physicochemical properties such as solubility and lgD in buffers of different pH value. Harmine hydrochloride was encapsulated into liposomes by active loading method. Encapsulation efficiency of liposomes was determined after the free drug was separated from liposome by ultrafiltration. The influence factors on the encapsulation efficiency including drug-lipid weight ratio, incubation temperature, pH value of external water phase were investigated. Results As the pH value increasing, the solubility of harmine hydrochloride was decreased, while the apparent oil-water distribution coefficient was increased. By active loading method, the encapsulation efficiency could be over 80% when the drug to lipid weight ratio was under 1∶5. The pH gradient between intervesicle and intravesicle obviously influenced the encapsulation efficiency, while incubation temperature had little effect on encapsulation efficiency. Conclusion Active loading is suitable for preparing harmine hydrochloride liposome with high encapsulation efficiency.