Résumé
BACKGROUND:Hemiarthroplasty is a proven method for reconstruction of the hip joint function, especialy for the elderly patients who cannot tolerate the total hip arthroplasty. However, for the patients with osteoporosis, there are stil more controversial in clinical practice about using cemented or cementless femoral prosthesis for hemiarthroplasty. OBJECTIVE: To observe the repair effect of cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis. METHODS:The clinical data from 105 patients treated with hemiarthroplasty were retrospectively analyzed. Osteoporosis was diagnosed in these patients using the dual energy X-ray absorptiometry before surgery.Patients were divided into bone cement group (n=56) and cementless group (n=49) depending on different types of femoral stem prosthesis. The difference of efficacy between cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis was analyzed by comparing the operative time, volume of drainage, post-operative Harris scores of hip joint function and radiographic assessment (prosthesis subsidence, osteolysis, severe stress shielding, heterotopic ossification) during the folow-up after the replacement. RESULTS AND CONCLUSION:In the process of hemiarthroplasty in patients with osteoporosis, the operative time in the cement group was significantly longer than that in the cementless group (P 0.05). At the 1, 3, 6 and 12 of folow-up after replacement, there were no significant differences in the Harris score of hip joint function, total effective rate and radiographic assessment between these two groups (P> 0.05). These results suggest that in the process of hemiarthroplasty in patients with osteoporosis, the clinical efficacy of cementless femoral prosthesis is similar to the cement femoral prosthesis, therefore two prostheses can al be selected; however, the operative time of the cement femoral prosthesis is longer than the cementless femoral prosthesis, so we can give priority to the cementless femoral prosthesis for patients with osteoporosis who can’t tolerate a long operative time because of the poor basic condition.
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BACKGROUND:Cartilage tissue engineering scaffold is a substitution for extracellular matrix, and there is a great significance on the shape and pore structure of the scaffold. OBJECTIVE:To retrospectively focus on the fabrication technology of three-dimensional porous cartilage tissue engineering scaffolds. METHODS:The first author searched PubMed, ELSEVIER SCIENCEDIRECT, Wanfang and CNKI databases (2000/2013) to retrieve relevant articles about the fabrication technology tissue-engineered cartilage scaffolds. The key words were“cartilage tissue engineering;scaffolds;fabrication”in English and Chinese, respectively. RESULTS AND CONCLUSION:The fabrication technologies of three-dimensional porous cartilage tissue engineering scaffolds are as fol ows:Phase separation/freeze-drying, hydrogels, rapid prototyping manufacturing, electrospinning, solvent casting/particulate leaching, gas foaming. The current cartilage studies have demonstrated that the pore size has a significance on the regeneration of the cartilage tissue, the pore size ranging from 100-250μm al ows for the regeneration of bone and cartilage tissue. The scaffold fabricated by the solvent casting/particulate leaching and gas foaming technology at a pore size of 100-250μm is suitable for the bone and cartilage tissue regeneration. To obtain the adequate biological and mechanical properties, researchers usual y combine a variety of methods to fabricate the cartilage tissue engineering scaffolds.
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Objective To study the efficacy of laparoscopic tumor resection combined with iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis. Methods There were 30 patients diagnosed as rectal carcinoma with synchronous hepatic metastasis detected by CT scan. Hepatic metastases were confirmed by needle biopsy under laparoscopy. Laparoscopic radical resection of rectal carcinoma and metastatic hepatic tumors was performed. Those metastatic tumors that could not be resected were managed by RAF. Iodine-125 was planted in the tumors' site. Results Seven new hepatic metastases were found by the laparoscopic ulstrasound during the operation. 8 hepatic metastatic lesions were removed, 25 tumors located in the right liver were managed by RAF. All patients were followed-up from 12 to 25 months(average 22. 3 months), Local recurrence was found in 6 patients, the 1-year survival rate was 73% (22/30). Conclusions Laparoscopic excision, Iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis is safe、effective、minimally invasive.
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Objective:To investigate the changes in protein metabolism after the use of recombinant human growth hormone(rhGH) in gastrointestinal tumor patients after operation.Methods:Thirty-nine patients with gastrointestinal tumor were randomly(double-blind) divided into two groups: ①the control group(n=20),which was treated with hypocaloric parenteral nutrition and placebo,②the rhGH group(n=19),which was treated with hypocaloric parenteral nutrition and rhGH.The levels IGF-1 and protein metabolism were observed.Results:The concentrations of IGF-1,pre-albumin,transferrin and fibronectin were decreased in the two groups on the 3th day after operation.The administration of rhGH resulted to significant increase in serum levels of IGF-1,pre-albumin,transferrin and fibronectin.Conclusion:The administration of recombinant human growth hormone can increase the protein synthesis and improve the nutritional condition.