Fixed-bearing unicompartmental knee arthroplasty for medial compartmental knee osteoarthritis / 中国骨伤

OBJECTIVE@#To evaluate short-term clinical results of fixed-bearing unicompartmental knee arthroplasty (UKA) for patients with medial compartmental knee osteoarthritis.@*METHODS@#From January 2015 to December 2017, 62 patients with medial compartmental knee osteoarthritis were treated by fixed-bearing UKA. Among them, including 19 males and 43 females, aged from 47 to 83 years old with an average of (65.3±8.2) years old. The courses of disease ranged from 5 to 72 months with an average of(19.4±14.3) months. Postoperative complications were observed, VAS score was used to observe degree of pain relief, Hospital for Special Surgery(HSS) score was used to evaluate clinical effects.@*RESULTS@#All patients were followed up from 4 to 40 months with an average of(19.9 ±10.2) months. The incision healed well without blood transfusion, hospital stays ranged from 2 to 10 days with an average of (3.5±1.6) days. No deep infection, dislocation, loosing or per prosthetic fracture occurred after operation, while 1 patient suffered from posterior tibial vein thrombosis. HSS score improved from 69.9±7.2 before operation to 90.1±7.4 at final following-up, and 51 patients obtained excellent results, 9 patients good and 2 moderate. VAS score decreased from 3.8±0.9 before operation to 1.1±0.9 at final following-up.@*CONCLUSIONS@#Fixed-bearing UKA for medial compartmental knee osteoarthritis could obtain short-term clinical results for shorter hospital stay, less complications. with fewer complication and fast recovery.

Clinical outcome of enhanced recovery after surgery for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients / 中国骨伤

OBJECTIVE@#To analyze and evaluate the clinical outcomes of enhanced recovery after surgery(ERAS) for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients.@*METHODS@#From January 2015 to December 2016, 466 patients with femoral neck fractures were admitted in our department. Among them, 154 patients were more than 80 years old, with an average age of (83.9±3.2) years old (ranged, 80 to 96 years old), including 27 males and 127 females. According to Garden classification system, 68 cases were type III and others were type IV. ERAS for hemiarthroplasty were performed for all the patients. The time before operation, blood transfusion rate, complications rate, lenth of stay and Harris score system were evaluated.@*RESULTS@#Among 154 patients, 142 patients were followed up, with an average duration of 24.6 months(ranged, 14 to 38 months). Thirty-two patients (20.8%) completed the operation within 48 hours after admission, 67 patients(43.5%) completed the operation within 72 hours after admission, 76 patients(49.4%) discharged within 48 hours after operation, and the blood transfusion rate was 15.9%. One patient was re-hospitalized because of prosthetic dislocation. The re-hospitalization rate was 0.6%. No other patients were re-hospitalized because of superficial or deep infection or periprosthetic fracture. At the latest follow-up, the Harris hip score was 90.2±7.1, 106 patients got an excellent result, 23 good and 9 fair.@*CONCLUSIONS@#ERAS for hemiarthroplasty can effectively shorten hospitalization time, relieve pain, reduce blood transfusion rate, reduce postoperative complications, and do not increase the readmission rate of elderly patients with femoral neck fracture, which can achieve good clinical efficacy.

Muscarinic receptor 3 agonist promotes epithelial-meschymal transition in human lung cancer A549 cells by activating PI3K/AKT signaling pathway / 中国病理生理杂志

AIM: To investigate the possible signaling pathway that promotes epithelial-mesenchymal transi-tion(EMT)of the lung cancer A549 cells stimulated with muscarinic receptor 3(M3R)agonist carbachol.METHODS:The lung cancer cells A549 were treated with 400 μmol/L carbachol.The morphological changes of the cells were observed under inverted phase contrast microscope.The migration and invasion abilites were measured by Wound healing and Tran-swell assays.qPCR was used to detect the mRNA level of vimentin and E-cadherin.The protein levels of p-AKT,vimentin and E-cadherin were determined by Western blot.RESULTS:After treatment with carbachol,the A549 cells showed loss of the close connection and the cell morphology was transformed from irregular polygon to spindle -like cells.The results of Wound healing and Transwell assays showed that the migration and invasion abilites of the A 549 cells were enhanced.Car-bachol increased the vimentin expression and decreased the E-cadherin expression at mRNA and protein level(P<0.05). The phosphorylation of AKT in the A549 cells was up-regulated(P<0.05).These changes was inhibited by M3R antago-nist 4-DAMP.CONCLUSION:Carbachol promotes EMT in the human lung cancer A 549 cells by activating PI3K/AKT signaling pathway.

Evaluation of early clinical results of two stage hip replacement after failed internal fixation for femoral neck fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the early clinical results of two stage hip replacement after failed internal fixation for femoral neck fractures in young patients.</p><p><b>METHODS</b>From June 2008 to June 2010,24 patients with femoral head necrosis caused by failed internal fixation were treated with hip arthroplasty. Among them, 12 patients were male and 12 patients were female, with an average age of 42.9 years old (ranged, 18 to 58). According to Harris score and X-ray examination, the clinical result was evaluated.</p><p><b>RESULTS</b>Twenty-three cases were followed up with an average age of 34.4 months (ranged, 25 to 48). After operation, 1 case complicated with the dislocation of hip joint. No deep infection of hip joint, prosthetic loosing or peripheral fracture was found. The mean Harris score was 90.9 +/- 4.3, and 18 obtained excellent results, 4 good and 1 fair.</p><p><b>CONCLUSION</b>Although treatment of femoral head necrosis with two stage hip replacement after failed internal fixation is difficult during operation, its early result is satisfactory.</p>