Early efficacy of rotational femoral neck osteotomy with preservation of the round ligament in treating subchondral insufficiency fracture of the femoral head in young and middle-aged population / 中华创伤杂志

Objective:To investigate the short-term efficacy of rotational femoral neck osteotomy with preservation of the round ligament in the treatment of subchondral insufficiency fracture of the femoral head (SIFFH) in young and middle-aged people.Methods:A retrospective case series study was used to analyze the clinical data of 13 patients with SIFFH, who were admitted to 920th Hospital of Joint Logistics Support Force from January 2017 to January 2022. The patients included 10 males and 3 females, aged 22-49 years [(33.5±8.3)years]. There were 6 patients with fracture on the left hip and 7 on the right hip. All the patients were treated by rotational femoral neck osteotomy with preservation of the round ligament. Postoperatively, standardized joint functional training was given. The operative time and intraoperative bleeding were recorded. The modified Harris hip score and visual analogue score (VAS) were compared preoperatively, at 3, 6 months postoperatively and at the final follow-up. Radiological examinations were used to observe the occurrence of any collapse of the femoral head, non-union at osteotomy site or other complications.Results:The patients were followed up for 13-24 months [(17.9±3.1)months]. The operative time was (127.3±9.8)minutes, with the intraoperative bleeding of (393.9±21.9)ml. The values of modified Harris hip score were (61.6±3.3)points, (80.2±4.4)points, and (91.9±4.1)points at 3, 6 months postoperatively and at the final follow-up, respectively, being significantly higher than the preoperative (51.4±3.5)points (all P<0.05), and there were significant differences between different postoperative timepoints (all P<0.05). The values of VAS were (4.9±1.1)points, (3.0±0.9)points, and (1.4±0.5)points at 3, 6 months postoperatively and at the final follow-up, respectively, being significantly lower than preoperative (6.7±0.9)points (all P<0.05), and there were significant differences between different postoperative timepoints (all P<0.05). Imaging examination showed no femoral head collapse, with all the bones healed at the osteotomy site. There were no serious complications such as bone non-union, incision infection or peripheral nerve injury. Conclusion:Rotational femoral neck osteotomy with preservation of the round ligament in treating SIFFH in the young and middle-aged population has the advantages of shortened operative time, less intraoperative bleeding, promoted hip function recovery, attenuated pain and decreased complications, showing a satisfactory early effect.

The effects of periacetabular osteotomy in the treatment of borderline developmental dysplasia of the hip / 中华骨科杂志

Objective:To investigate the effects of periacetabular osteotomy (PAO) in treating borderline developmental dysplasia of the hip (DDH).Methods:The patients with borderline DDH [lateral center-edge angle (LCEA): 18°-25°) who received PAO with follow-up duration for more than 2 years from January 2011 to January 2018 in our hospital were retrospectively analyzed. The patients in the control group were matched on a 1∶2 ratio based on gender, age, body mass index (BMI) and follow-up duration. There were 66 patients in the 0°≤LCEA<10° group and 66 patients in the 10°≤LCEA<18° group. The LCEA, anterior center-edge angle (ACEA), T?nnis angle, femoral head extrusion index, femoro-epiphyseal acetabular roof (FEAR) index, femoral anteversion angle, West Ontario and McMaster University (WOMAC) index and International Hip Outcome Tool (iHOT-12) were compared among the three groups before operation and the last follow-up.Results:In the preoperative 18°≤LCEA<25° group, three of 33 patients (9.1%) had LCEA, because the only imaging feature suggested acetabular dysplasia, while other parameters were evaluated within the normal range. There were 17 patients with ACEA <20° (51.5%), 24 patients (72.7%) with T?nnis angle >10°, 12 patients (36.4%) with ACEA <20° and T?nnis angle >10°. The positive rate of posterior wall signs in the 18°≤LCEA<25° group (72.7%) was lower than that in the 10°≤LCEA<18° group (77.3%) and the 0°≤LCEA<10° group (90.9%) with statistically significant difference (χ 2=6.417, P=0.040) at preoperation. The positive rate of cross sign (27.3%) and ischial spine sign (48.5%) in the 18°≤LCEA<25° group were higher than those in the 10°≤LCEA<18° group (10.6% and 18.2%, respectively, χ 2=7.002, P=0.030) and the 0°≤LCEA<10° groups (9.1% and 13.6%, respectively, χ 2=16.497, P<0.001). The FEAR index in the 18°≤LCEA<25° group (3.7±8.0) lower than that in the 10°≤LCEA<18° group (4.3±7.9) and the 0°≤LCEA<10° group (11.0±8.8) with significant difference ( F=12.703, P<0.001). In the 18°≤LCEA<25° group, postoperative LCEA increased from 20.4°±1.8° to 37.8°±7.1°, ACEA increased from 18.3°±7.8° to 36.3°±6.3°. T?nnis angle decreased from 12.7°±6.2° to -5.6°±9.2°, the femoral head extrusion index decreased from 22.9%±6.7% to 10.7%±12.2%, the WOMAC index decreased from 20.1±13.4 to 6.0±6.3, and the iHOT-12 score increased from 50.2±19.9 to 90.0±13.7. The above difference before and after surgery was statistically significant ( P<0.05). At the last follow-up, the WOMAC score in the 18°≤LCEA<25° group was 6.0±6.3, wich was less than 10°≤LCEA<18° group (9.3±9.6) and 0°≤LCEA<10° group (12.0±16.0) ( F=6.515, P=0.002). The iHOT-12 score in the 18°≤LCEA<25° group was 90.0±13.7, which was greater than 10°≤LCEA<18° group (77.7±17.3) and 0°≤LCEA<10° group (78.1±20.5) ( F=15.833, P<0.001). Conclusion:After 2 years follow-up, PAO significantly improved bone coverage of femoral head and hip function in patients with borderline DDH. Before surgery, we should pay attention to the comprehensive evaluation of different radiological parameters of the acetabulum, to make better preoperative planning.

Effects of shooting position on X-ray evaluation index of developmental hip dysplasia / 中华骨科杂志

Objective@#To explore the impacts of the imaging positions on the sagittal tilt of the pelvis and the imaging parameters of the hip joint.@*Methods@#From December 2015 to October 2016, a total of 78 female DDH patients (DDH group) who received Bernese periarticular osteotomy were enrolled, aged 28.41±9.91 years (range 18-49 years) with 135 hips. There were 21 cases on one side and 57 cases on both sides. Another 26 female volunteers without spinal and hip disease were enrolled as the control group, aged 23.54±5.58 years (range 18-49 years) with 52 hips. X-ray films of the anterior and posterior pelvis were performed in both groups. The pelvic sagittal tilt was evaluated by measurement (pubic symphysis to sacrococcygeal distance, PSSC), with lateral center-edge angle of Wiberg (LCEA), Tönnis angle (TA), and Sharp angle (angle of Sharp, SA) assessed the degree of hip dysplasia and assessed the horizontal positional relationship between the femoral head and the acetabulum using tear drop distance (TD). All data were measured twice by two measurers independently. The correlation between hip parameters and X-ray position was analyzed.@*Results@#The average PSSC in the supine and standing positions of the control group were 53.73±16.22 mm and 36.45±14.21 mm, respectively with significant difference-17.28±8.07 mm (t=-10.913, P=0.000). The PSSC of the supine and standing positions of the DDH group were 56.76±13.54 mm and 48.62±15.44 mm, respectively with significant difference-8.13±13.02 mm (t=-5.516, P=0.000). The PSSC of the standing DDH group was larger than that in the control group. There was no significant difference in the PSSC between the two groups in the supine position. Furthermore, there were no significant difference in the supine and standing PSSC between the unilateral and bilateral DDH patients (P>0.05). In the control group, the hip in supine and standing position, LCEA averaged 30.33°±4.69° and 29.70°±3.83° (P>0.05), and TA averaged 4.05°±3.51° and 4.36°±3.07° (P>0.05), respectively. SA averaged 40.53°±4.34° and 41.79°±3.16° (P>0.05), and TD averaged 6.80±0.98 mm and 6.65±1.30 mm (P>0.05), respectively. In the DDH group, the hip in supine and standing positions, LCEA averaged 3.07°±12.07° and 1.69°±12.11° (P<0.05), and TA averaged 22.62°±9.31° and 23.82°±9.45° (P>0.05), respectively. SA averaged 48.01°±4.68° and 48.49°±4.74° (P>0.05), respectively, and TD averaged 10.51±3.51 mm and 10.93±4.23 mm (P>0.05), respectively.@*Conclusion@#From supine to standing, the pelvis backward is the main trend in sagittal plane. In standing, the pelvis of female DDH patients is forward contrast with normal women. There was no difference in pelvic tilt between unilateral and bilateral DDH patients. Female DDH patients from the supine to standing, hip coverage decreased, while the femoral head appeared horizontally outward. The hip joint of DDH patients is unstable.

Effects of shooting position on X?ray evaluation index of developmental hip dysplasia / 中华骨科杂志

Objective To explore the impacts of the imaging positions on the sagittal tilt of the pelvis and the imaging pa?rameters of the hip joint. Methods From December 2015 to October 2016, a total of 78 female DDH patients (DDH group) who received Bernese periarticular osteotomy were enrolled, aged 28.41±9.91 years (range 18-49 years) with 135 hips. There were 21 cases on one side and 57 cases on both sides. Another 26 female volunteers without spinal and hip disease were enrolled as the control group, aged 23.54±5.58 years (range 18-49 years) with 52 hips. X?ray films of the anterior and posterior pelvis were per?formed in both groups. The pelvic sagittal tilt was evaluated by measurement (pubic symphysis to sacrococcygeal distance, PSSC), with lateral center?edge angle of Wiberg (LCEA), T?nnis angle (TA), and Sharp angle (angle of Sharp, SA) assessed the degree of hip dysplasia and assessed the horizontal positional relationship between the femoral head and the acetabulum using tear drop dis?tance (TD). All data were measured twice by two measurers independently. The correlation between hip parameters and X?ray posi?tion was analyzed. Results The average PSSC in the supine and standing positions of the control group were 53.73±16.22 mm and 36.45±14.21 mm, respectively with significant difference-17.28±8.07 mm (t=-10.913, P=0.000). The PSSC of the supine and standing positions of the DDH group were 56.76± 13.54 mm and 48.62± 15.44 mm, respectively with significant difference -8.13±13.02 mm (t=-5.516, P=0.000). The PSSC of the standing DDH group was larger than that in the control group. There was no significant difference in the PSSC between the two groups in the supine position. Furthermore, there were no significant differ?ence in the supine and standing PSSC between the unilateral and bilateral DDH patients (P＞0.05). In the control group, the hip in supine and standing position, LCEA averaged 30.33°±4.69°and 29.70°±3.83°(P＞0.05), and TA averaged 4.05°±3.51°and 4.36°± 3.07°(P＞0.05), respectively. SA averaged 40.53°±4.34°and 41.79°±3.16°(P＞0.05), and TD averaged 6.80±0.98 mm and 6.65± 1.30 mm (P＞0.05), respectively. In the DDH group, the hip in supine and standing positions, LCEA averaged 3.07°±12.07°and 1.69°±12.11°(P<0.05), and TA averaged 22.62°±9.31°and 23.82°±9.45°(P＞0.05), respectively. SA averaged 48.01°±4.68°and 48.49°±4.74°(P＞0.05), respectively, and TD averaged 10.51±3.51 mm and 10.93±4.23 mm (P＞0.05), respectively. Conclusion From supine to standing, the pelvis backward is the main trend in sagittal plane. In standing, the pelvis of female DDH patients is forward contrast with normal women. There was no difference in pelvic tilt between unilateral and bilateral DDH patients. Female DDH patients from the supine to standing, hip coverage decreased, while the femoral head appeared horizontally outward. The hip joint of DDH patients is unstable.

Rotational osteotomy on the base of femoral neck in treating osteonecrosis of the femoral head / 中华骨科杂志

Objective To report the short-term outcomes of the rotational osteotomy on the base of femoral neck in treating osteonecrosis of femoral head.Methods Ten patients (10 hips) with osteonecrosis of femoral head underwent the rotational osteotomy on the base of femoral neck between March 2014 and October 2016.There were 9 males and 1 female.The average age was 29.6 years,ranging from 18 to 42 years.There were 4 patients in right side and 6 in left side.The Association Research Circulation Osseous (ARCO) Stage was from ⅡB to ⅢC (2 cases of ⅡB,2 cases of ⅡC,1 case of ⅢA,1 case of ⅢB,4 cases of ⅢC).The following main procedures were involved in the treatment:surgical hip dislocation,the extension of retinacular soft-tissue flap to protect the main blood supply of the femoral head,anterior or posterior rotational (60°-90°) of femoral head after femoral neck osteotomy.We used three compress cannulated screws to fix the femoral neck osteotomy.The postoperative Harris hip scores (HHS),Western Ontario and McMaster College (WOMAC) score,pelvic A-P view and lateral hip view radiographic characteristics were analyzed to assess the short-term outcomes.Results The average follow-up duration was 16.3 months (7-36 months).No progressive femoral head collapse was observed in 6 patients at the last follow-up.The average post-operative intact ratio was 42.90％± 10.07％.The HHS improved from 80.00±14.93 to 86.83±6.11 (4 cases improved,1 case with no change and 1 case decreased slighdy).The WOMAC score decreased from 16.00±14.53 to 9.00±3.85 (1 cases increased,1 case with no change and 4 case decreased).The remaining 4 cases,however,had the progression of the femoral head collapse.The average post-operative intact ratio was 16.57％±6.57％.The HHS decreased from 77.75±14.66 to 60.75±17.54 (1 case improved slightly and 3 cases decreased).The WOMAC score increased from 12.75±5.06 to 22.50±8.81 (4 cases increased).Conclusion The rotational osteotomy on the base of femoral neck not only shifts the necrosis area away from weight-bearing region but also improves the post-operative intact ratio.Patients with ARCO stage ⅡB-ⅢB may achieve remission of symptoms and improvement of hip function by this surgical technique.However,for patients with ⅢC stage,we should conduct preoperative design to make sure whether the surgery is worth doing or not.Some patients may suffer from post-operative progression collapse of the femoral head.

Primary outcomes of femoral head reduction osteotomy for coxa magna or coxa plana / 中华骨科杂志

Objective To investigate the clinical efficiency and safety of femoral head reduction osteotomy for young patients with coxa magna or coxa plana.Methods Between June 2012 and September 2015,the clinical characteristics of 12 patients (13 hips) with coxa magna or coxa plana who underwent femoral head reduction osteotomy were analyzed retrospectively.There were 6 males (7 hips) and 6 females (6 hips) with average age 18.1 years (range,10-25 years).The etiology of the femoral head deformity was multiple epiphyseal dysplasia in 6 hips and Legg-Calvé-Perthes sequela in 7 hips.The head reduction osteotomy was conducted through the surgical hip dislocation approach combined with extended retinacular soft-tissue flap extending technique.All patients underwent simultaneous periacetabular osteotomy and relative lengthening of the femoral neck,of which four also underwent proximal femur derotational osteotomy.All patients received the standardized rehabilitation procedures.The postoperative complications,gaits,the range of motion (ROM) of the hip,Harris hip scores,iHOT scores and VAS were analyzed postoperatively.In addition,the lateral center-edge (LCE) angle,sphericity index and coverage rate of femoral head were assessed as well.Results The average follow-up duration was 28.8 months (range,12-45 months).All patients achieved osteotomy healing of the femoral head and greater trochanter with average healing time 3.7 months (range,3-7 months).Nine of 12 patients had significant gaits improvement.The Harris hip scores (81.08± 12.36 vs.88.38 ± 8.96,t=2.41,P=0.033),iHOT score (51.90± 15.07 vs.67.69±8.70,t=3.63,P=0.003),LCE angle (-1.82°±16.57° vs.36.02°±7.72°,t=10.52,P=0.000),sphericity index of anteroposterior pelvic radiographs (71.08％± 10.32％ vs.81.22％±8.61％,t=7.17,P=0.000) and the coverage index (48.79％±11.85％ vs.87.46％± 10.44％,t=8.56,P=0.000) were all significantly improved when compared to those preoperatively.The VAS score (4.46± 2.37 vs.1.23±0.93,t=4.25,P=0.001) was significantly decreased when compared with that preoperatively.However,for the sphericity index of 65° false profile (78.96％± 10.39％ vs.80.36％±8.42％,t=0.411,P=0.688) and the average hip ROM (264.62°± 32.05° vs.255.00°±40.31°,t=0.89,P=0.391),they did not achieve statistical significant difference.One case of femoral head necrosis site was localized at the lateral-superior part of femoral head,and there was no progression after 3 years follow-up.Moreover,no revision or total hip arthroplasty were observed due to other complications (osteoarthritis,hip pain or non-union).Conclusion The femoral head reduction osteotomy can correct deformity,improve femoral head sphericity,relieve pain and improve gaits and hip function.This procedure leads to satisfied clinical outcomes for patients with coxa magna or coxa plana in early follow-up.

Modified capsular arthroplasty for young patients with developmental dislocation of the hip / 中华外科杂志

Developmental dislocation of the hip(DDH) is one of the most serious hip diseases. Patients with unilateral DDH are prone to secondary osteoarthritis, low back pain, gait disturbance and compensatory scoliosis because of the leg length discrepancy. Total hip arthroplasty(THA) is the highly effective treatment for patients with hip pain or dysfunction caused by unilateral DDH, thus decrease the demand for hip-preserving surgeries such as capsular arthroplasty which may postpone or avoid hip replacement. However, the failure rate of THA for young patients is high and the majority of young patients may require one or more revision arthroplasties throughout their lifetime. The basic principle of capsular arthroplasty is that the femoral head wrapped by capsule is placed into a newly reamed socket on the location of true acetabulum. Therefore, hip replacement for patients with previous capsular arthroplasty becomes easier and safer than primary THA. However, the early capsular arthroplasty have been abandoned due to the relatively high rates of femoral head necrosis and hip stiffness. Ganz modified the early procedure with the technique of surgical hip dislocation in 2012, and emphasized the importance of postoperative rehabilitation. The incidence of complication, therefore, decreased greatly due to the preservation of main blood supply of femoral head as well as the proper postoperative management. In order to improve the clinical outcomes of this modified procedure, the selection of indications and surgeons′ experience should also be taken into consideration.

The identification value of diffusion weighted imaging in different molecular subtypes for breast cancer classification / 实用放射学杂志

Objective To investigate the value of diffusion weighted imaging (DWI)in identification of different molecular sub-types for breast cancer classifications.Methods All patients with breast cancer were divided into four subtypes groups by immuno-histochemistry results including Luminal A subtype,Luminal B subtype,HER2-over expressing (HER2-OE)subtype,and triple negative breast cancer (TNBC),respectively.The means of maximum,average,and minimum ADC of the lesions in all patients were recorded.The analysis of ANOVA and least significant difference test (LSD-t )were used for the statistical evaluation.Results There were significant differences in maximum ADC,average ADC,and minimum ADC among Luminal A subtype (n=21),Lu-minal B subtype (n=22),HER2-OE subtype (n=1 7)and TNBC subtype (n=12)groups (P =0.025,0.039 and 0.041,respec-tively).However,paired comparison in mean of maximum ADC,average ADC and minimum ADC by LSD-t multiple comparisons among Luminal A,Luminal B,HER2-OE and TNBC respectively were not significantly different.Conclusion DWI may be difficult to discriminate the molecular subtypes of breast cancer classification before surgery or biopsy.

Imaging observation of the femoral neck anteversion in patients with developmental dysplasia of the hip / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the distribution law and study the factors related to the femoral neck anteversion angle among the patients with developmental dysplasia of the hip of Hartofilakidis type I.</p><p><b>METHODS</b>Among the patients with hip dysplasia of Hartofilakidis type I who was admitted to Department of Orthopaedic Surgery, the First Affiliated Hospital of People's Liberation Army General Hospital from June 2010 to June 2013, a total of 340 hips (25 male and 161 female) were included in the study. The average age was 28.3 years, ranging from 13.5 to 49.9 years. The observation index included: femoral neck anteversion angle, lateral center-edge angle, acetabular index angle, lateral displacement of the femoral head, superior displacement of the femoral head, continuity of Shenton's line and Calve's line. The correlation between different factors was analyzed, and the factor closest to femoral neck anteversion angle was analyzed further by regression analysis.</p><p><b>RESULTS</b>Among the patients of developmental dysplasia of the hip of Hartofilakidis type I, the femoral neck anteversion angle increased, with an average of 28°±13°. Correlation and regression analysis showed significant negative correlation with treatment age (r=-0.158, P=0.003; t=-6.892, P=0.000); positive correlation with gender (r=0.332, P=0.000; t=-4.376, P=0.000); significant positive correlation with lateral displacement of the femoral head (r=0.092, P=0.000; t=3.766, P=0.000); significant negative correlation with central-edge angle (r=-0.122, P=0.024; t=2.031, P=0.043). The femoral neck anteversion angle showed correlation with acetabular index angle, continuity of Calve's line and superior displacement of the femoral head in correlation analysis, not in regression analysis, however, it did not show correlation with side and continuity of Shenton's line.</p><p><b>CONCLUSION</b>Among the patients of developmental dysplasia of the hip of Hartofilakidis type I, the increasing of the femoral neck anteversion angle may not only lead to early onset and therefore early treatment of pain in the hip joint but also the lateral displacement of the femoral head that requires immediate medical attention.</p>

Expression and location of EV71 receptors SCARB2 and PSGL-1 in lung tissues of fatal hand, foot and mouth disease / 临床与实验病理学杂志

Purpose To investigate the location and distribution of EV71 receptors scavenger receptor class B member 2 ( SCARB2 ) and human P-selectin glycoprotein ligand-1 (PSGL-1) in lung tissues of fatal hand, foot and mouth disease (HFMD), healthy children and adults. Methods The expression of EV71 receptors SCARB2 and PSGL-1 was detected by using immunohistochemistry in lung tissues of 15 autopsies of HFMD, 3 of healthy children, 8 of healthy adults. Results SCARB2 distributed in bronchial, bronchioli ep-ithelia, alveolar epithelial cells and inflammatory cells among HFMD, healthy children and adults. No significant difference was noted of the positive rates of SCARB2 expression among these three groups (P>0. 05). PSGL-1 distributed in bronchial and bronchioli epi-thelium of adults, but no PSGL-1 expression was found in HFMD and healthy children. The positive rates of PSGL-1 were 100%, 0, 0 in bronchial and bronchioli epithelium among the three groups, respectively (P0. 05). Further, no PSGL-1 expression was observed in alveolar epithelia cells of all groups tested. Conclusions EV71 receptor SCARB2 distributes in bronchial, bronchioli, alveolar epithelial and inflammatory cells of HFMD. Meanwhile, PSGL-1 only distributes in inflammatory cells of HFMD, suggesting that SCARB2 possibly plays a role on HFMD infection.

Value of apparent diffusion coefficient histogram analysis in the assessment of response to neoadjuvant chemotherapy in patients with in locally advanced breast cancer / 中华放射学杂志

Objective To investigate the value of ADC histogram analysis in the assessment of response to neoadjuvant chemotherapy (NACT) in patients with in locally advanced breast cancer (LABC). Methods Thirty?five female patients with invasive ductal carcinoma proved by pathology before NACT and treated with operation after NACT were retrospectively analyzed. All patients were received MR examination (including non?enhanced MRI, enhanced?MRI, and DWI) breast before NACT. After neoadjuvant chemotherapy, 19 of 35 patients were categorized as responders and 16 were categorized as non?responders according response evaluation criteria in solid tumors criteria. Per?patient weighted ADC histograms were generated. Mean ADC, mode ADC, maximum ADC, minimum ADC, median ADC, skewness, and kurtosis were analyzed by using t test between responders and non responders groups. ROC curves were constructed to determine the optimum threshold for each histogram parameter to differentiate non?responders and responders in breast cancers. The optimal threshold values, determined by maximal Youden index were selected when significant differences existed in two groups. Results Mean, minimum, skewness, and kurtosis of ADC between responders and non?responders group were(0.955 ± 0.135)× 10?3mm2/s,(0.535 ± 0.115)×10?3mm2/s,0.85±0.61, 2.93±0.17,and(1.103±0.233)×10?3 mm2/s,(0.650±0.104)×10?3mm2/s,-0.42± 0.17, 3.11 ± 0.25,respectively. Significant differences were found mean ADC, minimum ADC, skewness, and kurtosis (t=2.345, 3.096, 8.051 and 2.524,P0.05).We set the optimal threshold criteria of mean ADC (0.956×10?3mm2/s), minimum ADC (0.580×10?3mm2/s), skewness (0.890), sensitivity, specificity of three parameters for predicting responders in LABC were 73.7%,62.5%, 78.9%,68.8%, and 63.2%,75.0%, respectively, and the areas under ROC curve of mean ADC, minimum ADC, skewness was 0.678, 0.770, and 0.890, respectively. Kurtosis of responders and non?responders did not get cutoff value for much more overlap. Conclusion ADC histogram analysis is valuable in predicting LABC in patients with NACT effect, the minimum and skewness of ADC is highest sensitivity, specificity, respectively.

Early results of modified Colonna capsular arthroplasty for young patients with unilateral hip dislocation / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the early clinical results and risk factors of modified Colonna capsular arthroplasty for young patients with unilateral hip dislocation.</p><p><b>METHODS</b>From July 2011 to February 2013, 25 cases (25 hips) of modified Colonna capsular arthroplasty for unilateral hip dislocation in the 1st affiliated hospital of People's Liberation Army General hospital was collected, including 7 males, 18 females; aged 9.7-25.8 years, averaging 17.8 years; left 12 cases, right 13 cases; Body mass index ranged 15.6-29.6 kg/m², averaging 20.9 kg/m². Clinical indexes were collected, including: range of motion (ROM) of the hip, the Harris Hip Score (HHS), West Ontario and McMaster University Osteoarthritis Index (WOMAC), visual analogue scale (VAS) score before and after surgery, along with the satisfaction score of the surgery, Severin grades, and Tönnis osteoarthritis grades at last follow-up. Paired t-test was applied for the indexes before and after surgery, variances components analysis was applied for the satisfaction score and the function scores at last follow-up compared in 2 groups, aging at surgery <16 years (15 cases) and ≥ 16 years (10 cases).</p><p><b>RESULTS</b>All cases were followed up for 12-18 months, mean 13.4 months. The average hip ROM decreased from 380° in average pre-surgery to 200° in average at last follow-up. Indexes decreased comparing 9 months follow-up to pre-surgery, HHS(78 ± 9 vs. 84 ± 15, t = 2.107, P = 0.046), WOMAC function score(14.8 ± 8.4 vs. 8.6 ± 9.6, t = -2.657, P = 0.014) appeared statistically difference. Indexes increased at the last follow-up, showing no statistically difference. VAS and the satisfaction score were much better in patients <16 years group compared with ≥ 16 years group at last follow-up. VAS was 1.1 ± 0.8 compared with 2.8 ± 1.4 (F = 12.810, P = 0.002), whereas the satisfaction score was 89 ± 17 compared with 66 ± 22 (F = 7.535, P = 0.012). The last radiological follow-up resulted that, Severin grade I 21 cases, grade II 1 case, grade III 2 cases, grade IV 2 cases, and the Tönnis osteoarthritis grade 0 with 5 cases, grade 1 with 12 cases, grade 2 with 7 cases, grade 3 with 1 case.</p><p><b>CONCLUSIONS</b>In this early follow up, the majority of patients who underwent modified Colonna capsular arthroplasty for their unilateral hip dislocation would obtained satisfactory results, but with long term recovery, and the younger group (<16 years) with better clinical results than the elder group ( ≥ 16 years).With strict indications, exacted surgical techniques and optimized rehabilitation, the modified Colonna arthroplasty would have better clinical results.</p>

Effect of human bone marrow mesenchymal stem cells on proliferation of peripheral blood CD8 + T lymphocytes / 实用医学杂志

Objective To investigate the effect of human bone marrow mesenchymal stem cells (MSCs) on proliferation of CD8+ T lymphocytes and its mechanism. Methods MSCs were isolated and cultured then identified through many ways. The proliferative influence of MSCs on peripheral blood mononuclear cells (PBMCs) stimulated by PHA was investigated. The effect of MSCs on proliferation of CD8 + T lymphocytes induced by PHA was explored by flow cytometry. The possible mechanism of the inhibition effect of MSCs was investigated on the proliferation of CD8+ T cells stimulated by PHA with Transwell assay. Results MSCs were successfully harvested and cultured in vitro. MSCs suppressed the proliferation of CD8+ T cells stimulated by PHA when MSCs ∶ PBMCs ≥ 1 ∶ 5, which showed a dose-dependent manner. Strong proliferative inhibition of MSCs was presented on the CD8 + T cells induced by PHA in the group of Transwell (MSCs ∶ PBMCs = 1 ∶ 1) and the influence was similar to non-Transwell group. Conclusion MSCs can affect body immunity via suppressing the proliferation of CD8+ T cells.

Mid-to long-term clinical outcome of Bernese periacetabular osteotomy in adolescents and young adults with develop-mental dysplasia of the hip / 中华骨科杂志

Objective To discuss the mid?to long?term results and possible prognostic factors of Bernese periacetabu?lar osteotomy for adolescents and young adults with developmental dysplasia of the hip. Methods Bernese periacetabular os?teotomy was performed on 162 patients (171 hips) with hip dysplasia from August 1997 to July 2009. Follow?up data was ac?quirable completely in 123 cases (137 hips), including 30 males (33 hips) and 93 females (104 hips). Age of surgery was 12-48 years (average 27.1 years). The X?ray radiographs and Harris scores were recorded preoperatively and at the last follow?up. The lateral center?edge angle (LCE), acetabular incline angle (AI), continuity of Shenton's line were also recorded. The grades of the hip osteoarthritis were classified by T?nnis classification. Insufficient corrections of osteotomy, excessive corrections of osteotomy, nonunion of the pubis, nerve injuries, and vascular injuries were recorded as complications. Results All the con?tactable cases was followed up again in June and July in 2014. Follow?up duration was 5-17 years (mean, 8.1 years). The LCE angle improved from 7.13° ± 8.86° preoperatively to 30.17° ± 14.98° at the final follow?up. The T?nnis acetabular incline angle decreased from 27.84° ± 12.85° preoperatively to 7.06° ± 10.58° at the final follow?up. The continuity of Shenton's line was in?tact in 106 cases postoperatively, compared with 87 cases preoperatively. Harris score improved from 83.34±9.82 preoperative?ly to 92.79±7.05 at the last follow?up. There was significant correlation between preoperative Harris score and Harris score at the last follow?up. Early complications were observed in 15 cases (15 hips), along with 17 cases (17 hips) of progressions of hip osteoarthritis. Survival rate of the hip at the last follow?up was 97.8%. Conclusion Bernese periacetabular osteotomies can significantly improve bone coverage and joint function of hip dysplasia patients with low rate of short?term complications. Further?more, there was little osteoarthritis progression observed, with good survival rate of the joint in mid?to long?term follow?up. Lower pre?operative Harris scores and higher pre?operative T?nnis classifications are important prognostic factors for post?operative pain.

Radiological characters of developmental dysplasia of the hip without dislocation in patients above 13 years old / 中华骨科杂志

Objective To investigate the radiological characteristics and the relationships between the parameters by X?ray and direct magnetic resonance arthrography (dMRA) in non?completely dislocated dysplasia hips. Methods We retro?spectively reviewed patients (above 13 years old) with dysplasia hips from August 2009 to August 2012. These patients were classi?fied as Hartofilakidis typeⅠand typeⅡ. 188 patients (274 hips) involved 28 males (30 hips) and 160 females (244 hips), average aged 27.3 years (range 13-47 years). Standard pelvic A?P, bilateral 65° oblique X?rays, and dMRA were conducted in each pa?tient. Lateral central?edge angle (LCE), anterior central?edge angle (ACE), femoral neck?shaft angle (FNSA), and tonnis acetabu?lar index (AI) angle were measured based on the X?ray. The dysplasia hips were classified into 4 grades (GradeⅠ:CE 11°-20° , GradeⅡ:CE 1°-10°, GradeⅢ:CE-9°-0°, and GradeⅣ:CE≤-10°). Femoral neck anteversion angle (FNA), labral tear, labral inversion, and labral cyst was observed on dMRA films. Variance analysis and rank correlation were applied to find the relation?ship between CE grades and the relevant parameters by using SPSS 19.0. Results LCE has negative correlation with AI and grade of osteoarthritis, and has positive correlation with age, ACE. However, there was no relationship between FNSA and FNA. There was significantly different in Shenton's line, labral tear, labral inversion, cartilage lesion, among different grade of LCE. Conclusion LCE is an important parameter used in evaluating for dysplasia hips without complete dislocation. LCE can reflect age of onset, ACE, AI angle and degree of joint damages. Evaluation for the severity of non?completely dislocated dysplasia hips can be conducted according to grades of CE.

The four medical teaching realms / 中华医学教育探索杂志

Classroom teaching is an important part of university education.We explore the methods to improve classroom teaching and the four criteria of it,and believe that cultivating people is much more important than barely imparting knowledge in modem society.And this,for university teachers,is duty-bound and challenging as well.

Prevalence of Avian Influenza Virus Receptor in Human Respiratory Tract / 生物化学与生物物理进展

SAαt2,6 and SAα2,3 linked sialic acid molecules on epithelial cell membrane served as receptors for influenza virus, which axe specifically recognized by human and avian influenza viruses, respectively. The distribution of these two species of sialic acids in human respiratory tract from different anatomical sites and different age groups was investigated. The results showed that SAα2,3Gal species was prevalent in respiratory bronchiole and lung alveolar epithelium, but was infiequent in trachea, bronchus and bronchiole. On the contrary, the SAα2,6Gal species was more common in the trachea and bronchus and to a lesser degree in the alveolar epithelium. When compared the expression levels of SAα2,6Gal and α2,3Gal in the respiratory tract among different age groups, no significant difference was found. In the ex vivo H5N1 virus infection study, alveolus epithelium were found to be more susceptible to avian influenza than trachea and bronchus epithelial cells. These results suggest that the human respiratory tract, to some extent, is permissive for avian influenza viruses. The currently-observed limited human to human transmission of H5N1 virus may be associated with the different abundance of SAα2,3Gal linkages in human upper respiratory tract among individuals.

Cooperative learning in European medical education / 中华医学教育探索杂志

To analyze and summarize the connotation,elements,procedure and efficacy of cooperative learning in European medical education and provide reference to innovate our medical education.

Lingual structure and writing characteristic of English title in medical papers / 中华医学教育探索杂志

Title is the "eye" of the whole paper concentrating and generalizing the basic content. The function, standardization and writing skills need to be paid attention to in the process of writing English titles in medical papers by authors.

The number and significance of CD+68 positive cells in hepatocellular carcinoma and cirrhosis tissue / 中国现代普通外科进展

Objective:To investigate the number of CD+68 cells in hepatocellular carcinoma (HCC),paraneoplastic tissues,cirrhosis tissues and normal liver tissues and their clinical significance.Methods:Surgical specimens from 60 cases of HCC,62 cases of cirrhosis and 23 cases of normal liver were investigated by immunohistochemical staining of CD+68with streptavidin-horseradish peroxidase detective system.Results:(1)The order of the mean number of CD+68cells in the tissues from the highest to the lowest was:paraneoplastic,cirrhosis,normal liver and HCC tissues(P〈0.01);(2)The number of CD+68cells in the tissues decreased successively with the decrease of HCC differentiation (P〈0.05);(3)There was no relationship between the number of CD+68cells in HCC and its clinical TNM stage;(4)The number of CD+68cells in the cases with metastasis within 15 months was significantly lower than that without metastasis (P〈0.05).Conclusion:The number of CD+68cells might be an important marker to estimate the immune status and a useful factor to predict the prognosis of HCC patients.