Effects of bacterial lysates and all trans-retinoic acid on airway inflammation in asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe the effects of bacterial lysates (OM-85BV) and all trans-retinoic acid (ATRA) on airway inflammation in asthmatic mice, and to investigate the immunoregulatory mechanism of OM-85BV and ATRA for airway inflammation in asthmatic mice.</p><p><b>METHODS</b>Forty female BALB/c mice were randomly divided into five groups: normal control, model, OM-85BV, ATRA, and OM-85BV+ATRA. A bronchial asthma model was established by intraperitoneal injection of ovalbumin (OVA) for sensitization and aerosol challenge in all mice except those in the normal control group. On days 25-34, before aerosol challenge, the model, OM-85BV, ATRA, and OM-85BV+ATRA groups were given normal saline, OM-85BV, ATRA, and OM-85BV+ATRA respectively by gavage. Normal saline was used instead for sensitization, challenge, and pretreatment before challenge in the normal control group. These mice were anesthetized and dissected at 24-48 hours after the final challenge. Bronchoalveolar lavage fluid (BALF) was collected from the right lung to measure the levels of interleukin-10 (IL-10) and interleukin-17 (IL-17) by ELISA. The left lung was collected to observe histopathological changes by hematoxylin-eosin staining. The relative expression of ROR-γT mRNA was measured by quantitative real-time PCR.</p><p><b>RESULTS</b>Compared with the normal control group, the model group showed contraction of the bronchial cavity, increased bronchial secretions, and a large number of infiltrating inflammatory cells around the bronchi and alveolar walls, as well as a significantly reduced level of IL-10 (P<0.05) and significantly increased levels of IL-17 and ROR-γT mRNA (P<0.05). Compared with the model group, the OM-85BV, ATRA, and OM-85BV+ATRA groups showed a significant reduction in infiltrating inflammatory cells around the bronchi and alveolar walls; the OM-85BV group showed a significant increase in the level of IL-10 in BALF (P<0.05) and significant reductions in the levels of IL-17 and ROR-γT mRNA (P<0.05); the ATRA group showed significant reductions in the levels of IL-17 and ROR-γT mRNA (P<0.05). Compared with the OM-85BV group, the OM-85BV+ATRA group had significantly increased relative expression of ROR-γT mRNA (P<0.05). Compared with the ATRA group, the OM-85BV+ATRA group had significantly increased levels of IL-10 and IL-17 in BALF (P<0.05).</p><p><b>CONCLUSIONS</b>Both OM-85BV and ATRA can reduce respiratory inflammation in asthmatic mice. However, a combination of the two drugs does not have a better effect than them used alone.</p>

In vitro Anti-tumor Effect of Extracts from Different Parts of Tricholoma Matsutake Sing / 中国药师

Objective:To investigate the anti-tumor effect of different extracts of Tricholoma matsutake Sing. in vitro. Methods:MTT method was employed to study the inhibitory effect of ethanol extracts from different parts of Tricholoma matsutake Sing. and the polysaccharides extracts on HepG-2 cells, MCF-7 cells and Hela cells. FCM assay was used to detect HepG-2 and Hela cell apoptosis induced by the polysaccharides extracts. Results:The polysaccharides extracts of Tricholoma matsutake Sing. could inhibit the prolif-eration of the three tumor cells with IC50 of 53. 77 μg·mL-1(HepG-2), 40. 04 μg·mL-1(Hela) and 100. 65 μg·mL-1(MCF-7), respectively. The inhibitory effect of the polysaccharides extracts showed a time-and dose-dependent manner. The tumor cell apoptosis could be induced by the polysaccharides extracts. Conclusion:The maln anti-tumor effective extracts of Tricholoma matsutake Sing. in vitro is the polysaccharides extracts, which show significant anti-tumor activities in vitro and can induce tumor cell apoptosis.

Association of 5-lipoxygenase expression and clinicopathological factors in colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To examine the association of 5-lipoxygenase (5-LOX) expression with clinicopathological factors in colorectal cancer.</p><p><b>METHODS</b>Immunohistochemical stain was used to detect the 5-LOX expression in 52 resected specimens of colorectal cancer. The association between 5-LOX expression and clinicopathological factors was examined.</p><p><b>RESULTS</b>The positive rate of 5-LOX expression in 52 specimens of colorectal carcinoma was 73.1% (38/52). In 41 colorectal cancer specimens with lymph node metastasis, the positive rate of 5-LOX expression was higher than that in the specimens without metastasis (87.8% vs. 18.2%, P<0.05). The positive rate of 5-LOX expression in the specimens with deep infiltration (T3 and T4) was higher than that in the specimens with superficial infiltration (T1 and T2) (81.1% vs. 53.3%, P<0.05). The positive rate of 5-LOX expression in TNM stage III and IIII cancer was higher than that in stage I and II (79.5% vs. 53.8%, P<0.05). The positive rate of 5-LOX expression in cancers of poor differentiation and non-differentiation adenocarcinoma was higher than that of well and moderately differentiated cancer (100% vs. 50.0%, P<0.05). There were no significant differences of 5-LOX expression with tumor size,vascular invasion and peritoneal dissemination.</p><p><b>CONCLUSION</b>5-LOX expression in colorectal carcinoma is closely associated with lymph node metastasis, infiltration depth, differentiation degree and TNM stage.</p>

Clinical application of Wallis interspinous dynamic stabilization in treating adjacent segment degeneration (ASD) after lumbar spinal fusion / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate therapeutic effects of Wallis interspinous dynamic stabilization in treating ASD after lumbar spinal fusion.</p><p><b>METHODS</b>Totally 40 patients (included 16 males and 24 females, aged 25 to 60 years old) with degenerative disc disease were treated with posterior interbody fusion. Among them, 20 cases (treatment group) were treated with posterior interbody fusion combined with Wallis interspinous dynamic stabilization, while other 20 cases (control group) only treated with posterior interbody fusion. JOA score and VAS score were compared after inserted Wallis interspinous dynamic stabilization at 1 month and 3 years, and changes of intervertebral disc height of adjacent segment and cross-sectional area of the canal were tested and compared.</p><p><b>RESULTS</b>All patients were followed up from 3 to 5 years with an average of 3.6 years. All injuries were healed at stage I and the pain were released after treatment. There were no significant meaning in JOA score and VAS score at 1 month after treatment between two groups (P>0.05), while had meaning at 3 years (P<0.05). There were no statistical significane in intervertebral disc height of adjacent segment and cross-sectional area of the canal at 1 month after treatment (P>0.05), while had statistical meaning at 3 years (P<0.05).</p><p><b>CONCLUSION</b>There is no difference in immediate effects between two groups. Both of them can obtain good results for effective decompression. Medial-term effectiveness of treatment group is obviously better than control group, which depends on Wallis interspinous dynamic stabilization to plays good biology effects and effective accelerate adjacent degeneration caused by lumbar fusion.</p>

Traumatic dislocation of superior tibiofibular joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore the characteristics, diagnosis and treatment on traumatic dislocation.</p><p><b>METHODS</b>From April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment.</p><p><b>RESULTS</b>All patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation.</p><p><b>CONCLUSION</b>The diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.</p>

Influence of nickel sulphate on lens in SD rat / 中华实验眼科杂志

Background Researches showed that the incidence rate of cataract is high in the nickel mining area. Nickel sulphate can apparently inhibit the metabolism and proliferation of human lens epithelium cells. But the study on the injury mechanism of nickel on lens is still seldom. Objective Present study was to investigate the effect of nickel sulphate on the lens of SD rats. Methods Forty-five SPF SD rats aged from 7 to 14 days were grouped randomly into subcutaneous injection group, intraperitoneal injection group and blank group. Nickel sulphate of 2 g/L ( 10 mg/kg) was subcutaneously or intraperitonealy injected for 45 days. The opacity of rat lens was examined under the slit lamp at two-week interval and scored based on the criteria of LOCS II and LOCS III. The rats were sacrificed in 45 days after experiment and the lens were obtained for the pathological examination. Result The mean score of the anterior subcapsule opacity of rat lens was obviously higher in subcutaneous injection group compared with blank control group with a significant difference between them (t= 14. 311, P < 0. 05 ) , but no significant difference in the anterior subcapsule opacity between intraperitoneal injection group and blank control group (t = 4. 355 , P>0. 05 ). The score of posterior subcapsule opacity of lens were evidently higher in both subcutaneous injection group and intraperitoneal injection group than the blank control group (t = 9. 316,P = 0. 004;t = 7. 464, P = 0. 009) ,so was the mean score of the anterior +posterior subcapsule opacities(t = 23. 387,P=0. 000;t= 10. 533,P = 0. 002) and the total score of rat lens opacity ( t = 12. 358 , P = 0. 001; t = 10. 188 , P = 0. 003 ) . No significant differences were found in cortex opacity score and nuclear opacity score among three groups ( P > 0.05 ). Histopathology examination revealed that the degeneration of lens collagen protein was more serious in subcutaneous injection group and intraperitoneal injection group than the blank control group,and the injury degree of lens collagen protein was more dominant in subcutaneous injection group. Conclusion System administration of nickel sulphate induced the injury of anterior and posterior subcapsule of lens in SD rat.

One-hour after-school exercise ameliorates central adiposity and lipids in overweight Chinese adolescents: a randomized controlled trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prevalence of overweight and obesity in Chinese children and adolescents was increasing during the past few decades. The goal of this study was to investigate the effects of after-school exercise with or without diet restriction on total and central obesity, fitness level, and metabolic profile in overweight Chinese adolescents.</p><p><b>METHODS</b>A ten-week weight loss trial was performed using a 2 × 2 block design (exercise × diet). Ninety-three overweight adolescents (average age: (13.6 ± 0.7) years; body mass index (BMI): 22.4 - 34.1 kg/m(2)) were randomly assigned to four groups: 1) diet (D); 2) exercise (EX); 3) diet plus exercise (DEX); and 4) overweight control (C). Caloric intake recipes were enacted based on individual age and corresponding ideal body weight. One-hour after-school exercise was performed once per day, four days per week for ten weeks. Changes of anthropometry, body composition, aerobic fitness, and metabolic biomarkers were determined.</p><p><b>RESULTS</b>Groups D, EX and DEX had a significant decrease in BMI (P < 0.01) after the intervention. The percentage of body and truncal fat, and waist circumference were independently reduced by exercise (P < 0.05 and P < 0.01), but not diet. The decrease in body fat percentage was positively related with the exercise compliance (r = 0.34, P = 0.01). Exercise decreased truncal fat percentage and waist circumference, suggesting a reduction of central adiposity, but did not significantly affect body weight and BMI. Exercise significantly reduced serum low-density lipoprotein cholesterol (P = 0.037), which was positively correlated with decreases of truncal fat percentage (r = 0.222, P = 0.048). No significant effects of interventions on insulin sensitivity, early insulin release index, and aerobic fitness were observed.</p><p><b>CONCLUSION</b>At least twice a week of one-hour after-school exercise significantly attenuated central adiposity and had a significant impact on lipid profiles in overweight Chinese adolescents.</p>

Coracoclavicular ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effects of coracohumeral ligament reconstruction with autologous double-strand of long palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation.</p><p><b>METHODS</b>From April 2006 to June 2009, 31 patients with acromioclavicular joint dislocation were treated with coracohumeral ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament. There were 18 males and 13 females, ranging in age from 18 to 60 years, with an average of 35 years. Twenty-six patients were acute trauma and other 5 patients were chronic trauma. Preoperative symptoms included different degrees of pain, restricted movement, and instability of acromioclaviecular joint. The X-ray showed acromioclavicular joint dislocation.</p><p><b>RESULTS</b>The patients had good incision union without vascular and nerve injuries. All the patients were followed up, and the average duration was 23 months. The JOA scores decreased from preoperative (38.8 +/- 1.5) to (73.2 +/- 1.1) at 1 month after operation,and (93.5 +/- 0.8)at the last follow-up. Twenty-eight patients got an excellent result, 2 good and 1 fair.</p><p><b>CONCLUSION</b>The reconstruction of coracohumeral ligament using autologous double-strand palmaris longus tendon and artificial ligament is an effective method for the treatment of acromioclavicular joint dislocation.</p>

Learning curve of computer-assisted navigation system in spine surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Spine surgery using computer-assisted navigation (CAN) has been proven to result in low screw misplacement rates, low incidence of radiation exposure and excellent operative field viewing versus the conventional intraoperative image intensifier (CIII). However, as we know, few previous studies have described the learning curve of CAN in spine surgery.</p><p><b>METHODS</b>We performed two consecutive case cohort studies on pedicel screw accuracy and operative time of two spine surgeons with different experience backgrounds, A and B, in one institution during the same period. Lumbar pedicel screw cortical perforation rate and operative time of the same kind of operation using CAN were analyzed and compared using CIII for the two surgeons at initial, 6 months and 12 months of CAN usage.</p><p><b>RESULTS</b>CAN spine surgery had an overall lower cortical perforation rate and less mean operative time compared with CIII for both surgeon A and B cohorts when total cases of four years were included. It missed being statistically significant, with 3.3% versus 4.7% (P = 0.191) and 125.7 versus 132.3 minutes (P = 0.428) for surgeon A and 3.6% versus 6.4% (P = 0.058), and 183.2 versus 213.2 minutes (P = 0.070) for surgeon B. In an attempt to demonstrate the learning curve, the cases after 6 months of the CAN system in each surgeon's cohort were compared. The perforation rate decreased by 2.4% (P = 0.039) and 4.3% (P = 0.003) and the operative time was reduced by 31.8 minutes (P = 0.002) and 14.4 minutes (P = 0.026) for the CAN groups of surgeons A and B, respectively. When only the cases performed after 12 months using the CAN system were considered, the perforation rate decreased by 3.9% (P = 0.006) and 5.6% (P < 0.001) and the operative time was reduced by 20.9 minutes (P < 0.001) and 40.3 minutes (P < 0.001) for the CAN groups of surgeon A and B, respectively.</p><p><b>CONCLUSIONS</b>In the long run, CAN spine surgery decreased the lumbar screw cortical perforation rate and operative time. The learning curve showed a sharp drop after 6 months of using CAN that plateaued after 12 months; which was demonstrated by both perforation rate and operative time data. Careful analysis of the data showed CAN is especially useful for less experienced surgeon to reduce perforation rate and intraoperative time, although further comparative studies are anticipated.</p>

Synthesis of 2-hydroxyl-5-butyramidobenzoic acid and its effect on acetic acid-induced colitis in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the method for synthesis of 2-hydroxyl-5- butyramidobenzoic acid and test its effect on acetic acid-induced colitis in rats.</p><p><b>METHODS</b>2-hydroxyl-5-butyramidobenzoic acid was synthesized from 5-aminosalicylic acid and butyric acid by amidation, esterification and hydrolization. The effect of 2-hydroxyl-5-butyramidobenzoic acid on acetic acid enema-induced colitis in rats was investigated.</p><p><b>RESULTS</b>The structure of 2-hydroxyl-5-butyramidobenzoic acid was identified by IR and 1H-NMR. After treatment with acetic acid, the colon mucosal damage index (CMDI), fecal occult blood (OB) test, and activity of myelperoxidase (MPO) increased significantly in the rats as compared to the control levels. 2-hydroxyl-5- butyramidobenzoic acid obviously reduced the CMDI and OB, and reduced the level of MPO in the rats with colitis.</p><p><b>CONCLUSION</b>The synthesis of 2-hydroxyl-5-butyramidobenzoic acid requires only mild conditions with simple procedures, and the synthesized 2-hydroxyl-5-butyramidobenzoic acid shows obvious therapeutic effects on mucosal damage of in rats with acetic acid-induced colitis.</p>

Treatment strategies for the diastasis of the symphysis pubis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate treatment methods and therapeutic effects of the diastasis of the symphysis pubis.</p><p><b>METHODS</b>Thirteen patients with diastasis of the symphysis pubis, including 7 male and 6 female, ranging in age from 20 to 54 years,were treated according to classification based on the pelvic stability. Five patients of type I were treated with conservative methods, five patients of type II were treated with external fixation, and three patients with type III were treated with posterior internal fixation combined with anterior external fixation.</p><p><b>RESULTS</b>All the patients were followed-up and the duration of the follow-up ranged from 4 to 62 months, with an average of 14 months. According to the reduction, pain,gait, limb length and movement of hip,the therapeutic effects were evaluated. There were 7 patients obtaining excellent results, 5 good, 1 fair, the excellent and good rate was 92.3%.</p><p><b>CONCLUSION</b>Treatment methods should be chosen in view of the differences of the patients with diastasis of the symphysis pubis. The external fixation has advantages of simple operation, decreased wound and stable fixation.</p>

Measuring blood flow change of osteonecrosis of femoral head with laser doppler flowmetry / 中华外科杂志

<p><b>OBJECTIVE</b>To detect the blood perfusion of the necrotic area and the femoral head and neck junction in the patients diagnosed as osteonecrosis of femoral head (ONFH) with laser doppler flowmetry (LDF).</p><p><b>METHODS</b>From 2007 to 2008, 50 patients with ONFH 82 hips were performed core decompression and autologous stem cells transplantation. Group A was for ARCO stage II 46 hips (IIA 6 hips, IIB 22 hips, IIC 18 hips), and Group B was for stage III 36 hips (IIIA 20 hips, IIIB 10 hips, IIIC 6 hips). Blood perfusion of necrotic area and femoral head and neck junction with LDP were detected during the operation. Statistical analysis was made.</p><p><b>RESULTS</b>In Group A, the perfusion volume of necrotic area was (30.2 +/- 3.0) PU, and the perfusion volume of femoral head and neck junction was (103.4 +/- 4.4) PU. In Group B, the perfusion volume of necrotic area was (30.6 +/- 2.8) PU, and the perfusion volume of femoral head and neck junction was (103.4 +/- 3.9) PU. In Group A and Group B, the perfusion volume of necrotic area was lower than that of femoral head and neck junction, and the difference was significant (P < 0.01).</p><p><b>CONCLUSIONS</b>LDF can effectively detect that the perfusion volume of ONFH decreased, which provides a theoretical basis in order to further study the pathogenesis of ONFH. Meanwhile, there is application value of LDF on the study of ONFH.</p>

Clinical research of correlation between osteonecrosis and steroid / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the correlation between the dosage of corticosteroid, time of onset and incidence of osteonecrosis (ON) in patients with SARS.</p><p><b>METHODS</b>From July 2003 to January 2004, general survey carried out for ON in 551 patients with SARS. Five hundred and fifty-one patients except 12 were administrated by corticosteroid from 80 mg to 30 000 mg. The age of patients was (33 +/- 9) years old ranging from 19 to 59 years old. One hundred and thirty-one were male, and four hundred and twenty were female. MRI and X-ray film were taken in all patients including both hips, knees, shoulders, ankles and wrists. CT scan was taken in partial patients. Common classification system were used for staging of hip (ARCO), knee (Lotka) and shoulder (Cruess). Independent test, rank-sum test and multiple factor logistic regression analysis were used for statistical analysis.</p><p><b>RESULTS</b>No osteonecrosis was detected in 12 patients without corticosteroid. Osteonecrosis was detected in 176 patients (32.7 percent) among 539 patients. There were ON of femoral head in 130 cases (210 hips), ON of knee in 98 cases (130 knees), ON of humeral head in 21 cases (36 shoulders), ON of talus and calcaneus in 16 cases (26 ankles), ON of scaphoid and lunate in 11 cases (17 wrists), ON of patella in 3 cases (4 patella), ON of ilium in 1 case and bone infarction (femur, tibia) in 18 cases. One hundred and nineteen cases (195 hips) with ONFH were in stage I (IA 45 hips, IB 77 hips, IC 73 hips). Eleven cases (15 hips) were in stage II. All osteonecrosis of the knee and humoral head was stage I. Thirty-four patients with ON had one joint affected, 45 patients had 2 joints, 93 patients had more than 3 joints. The dosage of corticosteroid was (5842 +/- 4988) mg in ON group and (2719 +/- 2571) mg in non-ON group (P < 0.0001). The duration of steroid was (38 +/- 17) d in ON group and (27 +/- 15) d in non-ON group (P < 0.01). The dosage of pulse treatment was (340 +/- 207) mg/d in ON group and (211 +/- 160) mg/d in non-ON group (P < 0.01). The duration of pulse treatment was (28 +/- 13) d in ON group and (18 +/- 11) d in non-ON group (P < 0.01). All patients with ON were detected within 6 months from administration.</p><p><b>CONCLUSION</b>About one-third patients with SARS who were treated with a high dose of corticosteroid occurred osteonecrosis. ON is frequently multiple focuses. The actual time of onset of ON is early of steroid used. MRI is golden standard for early diagnosis of ON. The patients who were treated with a high dose of corticosteroid should be inspected initially by MRI.</p>

Acetabular centralization in total hip arthroplasty for acetabular dysplasia / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the correct localization of the acetabular component, surgical technique and the outcome in total hip arthroplasty (THA) for acetabular dysplasia with secondary osteoarthritis.</p><p><b>METHODS</b>A retrospective review was undertaken of 39 hips (33 patients) that had been performed a total hip arthroplasty for acetabular dysplasia with secondary osteoanthritis from September 1989 to January 2003. These patients were divided into two groups, 16 patients (20 hips) who were performed by regular THA of Harris method were defined as group A and the other 17 patients (19 hips) by acetabular centralization technique as group B. The hip function was evaluated using Harris hip score before and after operation. The horizontal location of the center of the hip (the distance along the intertear drop line extending lateral or medial from the inferior point of the teardrop to the perpendicular line dropped from the center of the femoral head), abduction angle of the cup, and femoral offset was measured.</p><p><b>RESULTS</b>At the most recent follow-up, the mean Harris hip score was 88.9 +/- 5.8, and 82.3 +/- 8.4 for the anatomical position reconstruction and the lateral displacement hips, respectively (P < 0.05). The horizontal distance between the teardrop and the hip center was significantly shorter in B group [(37.3 +/- 3.4) mm] than in A group [(46.1 +/- 5.3) mm] (P < 0.05). Two patients had bone resorption of autograft and malposition of the acetabular component during follow-up, while others had no revision, loosening, or migration of the acetabular component.</p><p><b>CONCLUSION</b>Accurately confirmed acetabular position, stable acetabular component, and appropriate techniques are important to guarantee the clinical efficacy of THA.</p>

Restoration of femoral offset in total hip arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the factors effecting restoring femoral offset and the relation between femoral offset and hip abductor strength during total hip arthroplasty (THA).</p><p><b>METHODS</b>Ninety-nine THA for 81 patients were performed from March 1998 to January 2002. And follow-up was finished. There were 53 women and 28 men and the average age was 57 years (29 to 80). The right hip had been replaced in 28 cases, the left in 35 cases and the bilateral in 18 cases. The mean duration of clinical and roentgenographic follow-up was 36.8 months (range, 19 approximately 66 months). A posterolateral approach was used in all THA. The femoral offset and the abductor lever arm were measured from each radiograph. The measurement of the hip abduction strength was made for some THA by the Cybex machine. Statistical data analysis was performed by SPSS10.0 software.</p><p><b>RESULTS</b>Femoral offset correlated positively with the length of the abductor lever arm (r = 0.613; P < 0.001). Simple regression analysis showed that femoral offset was significantly and positively related to the length of femoral neck and neck-shaft angle (r = 0.451, P = 0.001; r = 0.567, P < 0.001). There was a highly significant and positive correlation between femoral offset (and consequently abductor lever arm) and hip abductor strength (r = 0.500, P = 0.009; r = 0.477, P = 0.014).</p><p><b>CONCLUSIONS</b>It is very important to template both sides of hip preoperatively for restoring femoral offset in THA. Femoral component with more anatomical neck-shaft angle will be used with the increase in the femoral neck length.</p>

Acetabular component centralization in total hip arthroplasty for acetabular dysplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the correct localization of the acetabular component, surgical technique and the outcome in total hip arthroplasty (THA) for acetabular dysplasia with secondary osteoarthritis.</p><p><b>METHODS</b>A retrospective review was undertaken of 44 hips (38 patients) that had had a total hip arthroplasty for acetabular dysplasia with secondary osteoarthritis from September.1989 to April. 2003. 14 were male (one bilateral) and 24 patients were female (5 bilateral). The mean duration of clinical and roentgenographic follow-up was thirty-six months (range, eight to one hundred and sixty-eight months), and the mean age of the patients was fifty-one years (range, twenty-nine to eighty years). Twelve hips were classified as type I; twenty-four as type II; seven as type III; and one as type IV, according to the criteria of Crowe. The horizontal location of the center of the hip (the distance along the interior drop line extending lateral or medial from the inferior point of the teardrop to the perpendicular line dropped from the center of the femoral head) was measured.</p><p><b>RESULTS</b>There were 24 acetabular components that were placed in the centralized position and the other 20 in no deepen placement post-operatively. At the most recent follow-up, the mean Harris hip score was 90.2, 86.3 for the centralized position and the undeepen placement hips respectively, there was a significant difference between these two groups.</p><p><b>CONCLUSIONS</b>In order to obtain the stability of acetabular component, deepen acetabular reaming is necessary for the most acetabular dysplasia in THA. In this way the anatomical rotational center can be obtained medially and lowly. The excellent long-term function will be maintained.</p>

Transtrochateric rotational osteotomy for osteonecrosis of the femoral head / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the indications, operative technique and clinical results of the transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH).</p><p><b>METHODS</b>Nineteen patients (23 hips) with ONFH underwent TRO from October 1992 to May 2001 were reviewed. There were 14 males and 5 females. The age was ranging from 22 to 43 years old with an average age of 33.4 years old. The etiology were as followed: alcoholism 10 cases (12 hips); steroid 6 cases (7 hips); trauma 2 cases (2 hips); caisson disease 1 case (2 hips). Ficat stage: II 8 cases 8 hips; III 11 cases 15 hips. Harris hip score 46 to 74 with mean score 56 preoperatively. In order to determine the location and extent of osteonecrosis, A-P view and accurate lateral view (the film should be placed parallel to the femoral neck with the hip in precisely 90 degrees and flexion 45 degrees of abduction and neutral rotation) were taken in both hips preoperatively. The surgical technique described by Sugioka were used in all patients.</p><p><b>RESULTS</b>Seventeen patients (19 hips) were followed up ranging from 18 to 11 years with mean 54 months. The Harris hip score was from 55 to 94 with mean 80.5. Fourteen hips score more than 80 and good to excellent rate was 73.2%. Harris score were less than 79 in 5 cases and 4 hips of these 5 hips were revised by total hip arthroplasty. The rotation angle was from 55 degrees to 80 degrees with mean 60 degrees .</p><p><b>COMPLICATIONS</b>The circumflex femoral medial artery injury was found in 1 hip; subtrochanteric fracture was found in 2 hips and 1 osteotomy site nonunion occurred.</p><p><b>CONCLUSION</b>TRO can be used to treat ONFH. The indications include: (1) younger patients (less than 45 years old). (2) Ficat stage II and III with more than one third intact articular surface of the femoral head. The better results could be obtained using posterior rotation and lager rotational angle. The Sugioka osteotomy should be used carefully because of its complicated surgical technique.</p>

Study of complications of spinal internal fixation surgery / 第二军医大学学报

Objective: To study the factors and preventive method of post-operative complications of spinal implant operation. Methods: The post-operative complication of 451 cases who had undergone spinal implant operation were analysed retrospectively. The relative factors of complications were analyzed. Results: Infection, thrombosis of deep vein and failed fusion were the most common complications. Among the factors, the age, operation time and blood lose during operation were closely related with the complication. Using antibiotic was effective to reduce the infection. Conclusion: It is effective to reduce the post-operative complication of spinal implant operation by proper pre-operative evaluation. Using antibiotic to control other diseases is also effective.

Experimental study of interbody fusion using CFR/PEEK / 第二军医大学学报

Objective: To study the biocompatibility of CFR/PEEK composite in bone tissue after implanted in lumbar intervertebral space and to evaluate its role in the interbody fusion compared to the allograft bone. Methods: Thirteen beagles were chosen among which 7 were implanted with the disk-like CFR/PEEK composite in the lumbar intervertebral space and the other 6 were implanted with allograft bone. X-ray, QCT and histological examination were employed at 6, 12 and 24 months postoperatively. Results: The X-ray results of fusion segment were in conformity with the QCT's as well as that of histological results. All animals obtained a complete fusion at 24 months. Histological examination revealed that the anterior soft tissue to the implant exhibited a nonspecific foreign body reaction with connective tissue embed the biomaterials. Carbon fragment were seen in the surrounding tissue and some of the debric were phagocytosed by foreign body giant cell. Histological examination of bone and material revealed that new bone grew along the hole of CFR/PEEK implant. Conclusion: CFR/PEEK has an excellent biocompatibility to bone tissue.

Study of complications of spinal internal fixation surgery / 第二军医大学学报

Objective: To study the factors and preventive method of post-operative complications of spinal implant operation. Methods: The post-operative complication of 451 cases who had undergone spinal implant operation were analysed retrospectively. The relative factors of complications were analyzed. Results: Infection, thrombosis of deep vein and failed fusion were the most common complications. Among the factors, the age, operation time and blood lose during operation were closely related with the complication. Using antibiotic was effective to reduce the infection. Conclusion: It is effective to reduce the post-operative complication of spinal implant operation by proper pre-operative evaluation. Using antibiotic to control other diseases is also effective.