[Minimally invasive small incision direct anterior total hip arthroplasty in the lateral decubitus position: complications and early outcome].

Objective: To analyze the feasibility, perioperative complications and early outcomes of minimally invasive small incision in direct anterior approach total hip arthroplasty in lateral decubitus position. Methods: From January 2015 to January 2017, 212 patients (228 hips) received minimally invasive small incision (approximately 8 cm in length) direct anterior approach total hip arthroplasty in modified lateral decubitus position and approach. Sixteen cases underwent bilateral hip arthroplasty separately. All procedures were performed by the same surgeon in the Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital. Twenty-eight patients (28 hips) were set as the complicated case group. The rest 184 patients (200 hips) had no previous hip surgeries, severe deformity and limited motion of the hip, were set as the standard group, and were divided into the first 100 cases group and the second 100 cases group in sequence. The difference between the standard group and complicated case group were analyzed. Also we compared the difference between the first 100 cases and the second 100 cases. Perioperative complications, postoperative function and radiological evaluation were recorded and statistically analyzed. The t test was applied to compare the data between groups. Results: All the patients were followed-up for 13 to 25 months[(18±5) months]. Intraoperative complications and postoperative complications happened in 9 and 34 patients respectively. The anterior dislocation occurred in 2 cases. The standard group showed significant superior outcomes when compared with complicated case group in the surgical time[(42±19) vs (67±16) min, t=-2.628, P=0.027], blood loss[(222±94) vs (579±120) ml, t=-8.371, P=0.000], postoperative Harris hip score[90±5 vs 83±7, t=2.390, P=0.024]and the rate of surgical complication (15.0% vs 46.4%, χ(2)=15.854, P=0.000). The complication rate tended to decrease in the second 100 cases when compared with that in the first 100 cases (11.0% vs 19.0%, χ(2)=3.922, P=0.037). Meanwhile, the second 100 cases showed significant excellent outcomes when compared with the first 100 cases in the mean surgical time[(34±15) vs (48±10) min, t=4.217, P=0.002]and blood loss[(182±52) vs (254±40) ml, t=2.889, P=0.018]. Conclusions: It suggests that there is a learning curve with the minimally invasive small incision direct anterior approach total hip arthroplasty in lateral decubitus position. The risk of intraoperative femoral fractures is slightly high, especially for cases with osteoporosis, stiffness and limited range of movement. Surgeons in early learning curve period should grasp the surgical indications and master the technical points.

The significance of HBD-3 and fluorescent composite carriers in the processof bone formation in rats infected with Staphylococcus aureus.

OBJECTIVE: The objective of the present study was to explore the significance of human ß-defensin 3 (HBD-3) through establishment and evaluation of the model of implant-related biofilm infection of the femoral condyle of the outer knee using Sprague-Dawley (SD) rats. MATERIALS AND METHODS: Age-matched SD rats were divided into three groups, the HBD-3 group, HBD-3 fluorescent liposome group, and the HBD-3 liposome-microbubble fluorescent composite carrier group. After biofilm infection for 24 h, the fluorescent composite vector was injected intraperitoneally 2 times/day. After the first injection, rats in each group were sacrificed on the 7th, 14th, and 28th day. The lower end of the femur bone was harvested after removing the surrounding soft tissue. H&E and immunohistochemical staining were applied and light microscopy was used for observation. Fluorescent markers including tetracycline and calcein were used to follow the formation of new bone in vivo. Undecalcified specimens were embedded in epoxy resin (thickness of roughly 150 m), and confocal microscopy was used for observation. RESULTS: By assessing cell proliferation with cell counting kit-8, the proliferation ability of cells in the HBD-3 liposome-microbubble fluorescent composite carrier group was significantly increased compared with the other groups (p<0.05). qPCR was used to measure the levels of alkaline phosphatase (ALP), type I collagen, osteocalcin (OCN), osteopontin (OPN), and bone sialoprotein (BSP) in each group. The levels of these genes in the HBD-3 liposome-microbubble fluorescent composite carrier group were significantly higher than those in other groups (p<0.05). CONCLUSIONS: The application of the HBD-3 liposome-microbubble fluorescent composite carrier can significantly promote osteogenesis in rats infected with Staphylococcus aureus, and increase the expression levels of ALP, type I collagen, OCN, OPN, and BSP.

[Direct anterior approach versus posterolateral approach for total hip arthroplasty in the lateral decubitus position].

Objective: To compare the clinical efficacy of the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip arthroplasty (THA) in the lateral decubitus position. Methods: From July to December, 2014, 104 patients randomly divided into two equal groups of the DAA group and the PLA group underwent unilateral primary THA procedures.All procedures were performed by the same surgeon in the Department of Orthopaedics, the Affiliated Anhui Provincial Hospital of Anhui Medical University.General data, perioperative index, postoperative function and radiological evaluation were recorded and statistically analyzed. Results: The patients had an average follow-up of 14 (range, 10-16) months.No significant differences were detected with respect to the operation time, incision length, preoperative Hb concentration and transfusion rate between two groups (P> 0.05 for all comparisons). However, there were significant differences associated with the intraoperative bleeding, postoperative drainage and postoperative Hb concentration in the two groups(P<0.05 for all comparisons). The DAA group showed significant superior outcomes compared with the PLA group in the Harris hip scores [(83.6±7.1) vs (79.8±6.6), P<0.05], WOMAC[ (28.9±6.1) vs (36.1±6.9), P<0.001], and VAS pain scores[ (2.2±0.9) vs (2.9±1.1), P<0.05]at 1 month after surgery. No differences were seen between the study groups in the evaluation of radiography and the incidence of adverse event (P> 0.05 for all comparisons). Conclusions: Compared with the posterolateral approach, the present study shows the exciting results in patients underwent the DAA THA in the lateral decubitus position at early follow-up.The advantages of THA using the DAA include less operative trauma, alleviation of postoperative pain, and faster postoperative rehabilitation. It is a safe, reliable and effective surgery approach.

Clinical study of Lipo PGE1-inhibiting platelet activation in acute rejection after kidney transplantation.

To observe the efficacy of the platelet activation inhibitor Lipo PGE1 therapy in the recovery of graft function after an acute rejection episode after kidney transplantation. Forty patients with acute rejection after kidney transplantation were randomly assigned into groups treated with or without Lipo PGE1. The expression levels of CD61, CD63, and PAC-1 on platelet surfaces were assayed by flow cytometry. The recovery time for graft function and 1-year patient and graft survival rates were recorded. Compared with controls, the expression levels of CD61, CD63, and PAC-1 were lower among acute rejection patients who received Lipo PGE1 therapy. The recovery time for graft function was shorter and the 1-year patient and graft survival rates higher. Lipo PGE1 therapy in patients with acute rejection episodes may inhibit platelet activation thereby benefiting graft functional recovery. The 1-year survival rates of patients and grafts might be increased if the expression levels of CD61, CD63, and PAC-1 on the platelet surfaces was decreased by Lipo PGE1 therapy.

Relationship between the expression levels of CD61, CD63, and PAC-1 on platelet surface in peripheral blood and the transplanted kidney function.

OBJECTIVE: To analyze the relationships between the expression levels of CD61, CD63, and PAC-1 on the platelet surface and the incidences of acute rejection and tubular necrosis as well as the recovery of graft function after renal transplantation. METHODS: The expression levels of CD61, CD63, and PAC-1 on platelet surfaces were assayed by flow cytometry in 86 patients with different stages of uremia before and after transplantation. Patients were divided into three groups: 29 patients with normal graft function, 30 with acute rejection, and 27 with acute tubular necrosis. Patients with acute rejection were randomly assigned into groups treated with or without anticoagulants. RESULTS: The expression levels of CD61, CD63, and PAC-1 on platelet surfaces significantly increased (P <.05) among patients with acute rejection, as compared with those with normal graft function or acute tubular necrosis. Compared with controls, the expression levels of CD61, CD63, and PAC-1 were lower among acute rejection patients who, received anticoagulant therapy. The recovery time for graft function shorter and, the 1-year patients and graft survival rates higher. CONCLUSIONS: The pretransplant expression levels of CD61, CD63, and PAC-1 on platelet surface were significantly higher among patients with acute rejection, suggesting that this complication rather than acute tubular necrosis may be related to platelet activation. Patients with acute rejection displayed benefit from anticoagulant therapy.

Electrocatalytic reduction of S-nitrosoglutathione at electrodes modified with an electropolymerized film of a pyrrole-derived viologen system and their application to cellular S-nitrosoglutathione determinations.

The preparation, electrochemical characterization, and analytical applications of glassy carbon (GC) electrodes modified with electropolymerized films of the cation N,N'-di(3-pyrrol-1-yl-propyl)-4,4'-bipyridine (DPPB) are described. Electropolymerized films of DPPB on GC electrodes exhibit two one-electron redox processes centered at -0.45 and -0.85 V, respectively. S-Nitrosoglutathione (GSNO) can be electrocatalytically reduced at electrodes modified with electropolymerized films of DPPB at approximately -0.4 V vs sodium-saturated calomel electrode, which represents a dramatic diminution of about 600 mV in the overpotential in comparison with the reaction carried out at a bare GC electrode. The kinetics of the catalytic reaction have been characterized using cyclic voltammetry and rotated disk electrode techniques from which a value of (1.3 +/- 0.2) x 10(3)M-1 s-1 was obtained. Using electrodes modified with an electropolymerized film of DPPB we have carried out preliminary studies of the determination of intracellular GSNO concentrations in two strains of the bacterium Rhodobacter sphaeroides.

[Epidermoid cysts of testicle: a report of 4 cases].

Epidermoid cysts of testicle is a kind of rare benign tumors of testicle, about 1% of all testicle tumors. In this paper, we described 4 cases of epidermoid cysts of testicle. Based on clinical manifestations, features of B-ultrasound, and other information, epidermoid cysts's histogenesis, pathology and classification were discussed. B-ultrasound is a powerful technique to derive a definite diagnosis before operation. Patients can be cured only by orchiectomy, and much attention should be paid to possible canceration.

[Primary cancer of the ureter: report of 31 cases].

Thirty-one cases of ureteral carcinoma have been treated from 1973 to 1988. 23 patients were male and 8 female. The average age was 57.1, and usually occurred in the fourth to sixth decade (77.4%). The growth was over grade T2 in 74.2%. All tumors were located in the middle and lower third of the ureter. A tendency to increasing incidence in this lesions was found, owing to the advance in diagnostic technique. The causes of delay diagnosis were discussed. The importance of retrograde pyelography including total ureter and direct biopsy through ureteroscopy are stressed. Nephroureterectomy with excision of a bladder cuff is the preferred technique.

[Squamous cell carcinoma of the bladder. Report of 19 cases].

Nineteen patients of squamous cell carcinoma of the bladder were admitted to our hospital from 1976 to 1987. It was 3.8% (19/503) of total patients of epithelium neoplasma of the bladder admitted during the same time. The symptoms, diagnosis, aetiology, clinical types and treatment of squamous cell carcinoma of the bladder are discussed.

O-acetyl sialomucin and differentiation of stomach cancer: a histochemical study.

In one hundred surgical specimens with stomach cancer, 78 cases contained intestinal metaplasia (IM) in the outer margin mucosa nearby carcinoma focus, while the remaining 22 had no IM. IM was histochemically classified into small intestinal type, sulphomucin colonic type (S), O-acetyl sialo-sulphomucin colonic type (OS) and O-acetyl sialomucin colonic type (O). The incidence of OS and O in well differentiated carcinoma (WCa) (22/27) was obviously higher than in poorly and undifferentiated carcinomas (PUCa) (17/51) (X2 = 14.5011, P less than 0.001). This suggests that O-acetyl sialomucin in IM may be correlated with the differentiation of gastric cancer, that is, OS may often be transformed into WCa if malignant change of IM occurs.