[Objective]To evaluate the long-term clinical results of Herbert screw in the treatment of intra-articular fractures by retrospective analysis.[Method]From 1991 to 2006,fifty-five patients of different parts of intra-articular fracture treated with Herbert screw were followed up effectively,including scaphoid fracture group of 19 cases,the radial head fracture group of 25 cases,the femoral head fracture group of 11 cases.[Result]After an average follow-up time of 5 years and 11 months(ranged,1-13 years),the good-to-excellent rates were 94.7%,96%,72.7% according to the modified Mayo score,the Broberg-Morrey score and the Tompson-Epstein score.[Conclusion]The Herbert screw can provide strong fixation and stability in the long-term follow-up.It is an ideal material in treating intra-articular fractures.

Objective To study the prevention,diagnosis and treatment of the pulmonary embolism after abdominal surgery.Methods The clinical data of patients with acute pulmonary embolism(PE) after abdominal surgery between July 2008 and June 2012 were analyzed retrospectively.The high-risk patients received D-dimer,deep venous ultrasound and pulmonary CT examination to confirm the diagnosis postoperatively.Anticoagulation,thrombolysis,inferior vena cava filter placement were carried out in these patients.The high-risk patients received low molecular weight heparin(LMWH) to prevent PE from January 2010.Results 5 patients with PE survived and 3 patients died.The incidence of venous thromboembolism event was 0.43％ (13/3012) before January 2010 and PE was 0.20％ (6/3012).The incidence of venous thromboembolism event was 0.15％ (7/4803) after taking preventive measures and PE was 0.04％ (2/4803).There was no PE within 1 week since using LMWH after 2010.Lower limb DVT was found in 7 patients including 2 patients with PE after LMWH discontinuance within 2-3 weeks postoperatively.Conclusions Early prevention,diagnosis and treatment of postoperative PE are important for high-risk patients.

Objective To investigate the preliminary results and complications of a tapered proximal femur modular stem in total hip arthroplasty (THA).Methods From October 2010 to December 2011,tapered proximal femur modular stems were used for THA in 50 patients (56 hips).There were 14males and 36 females,at a mean age of 61 years (range,25-82 years).Forty-four patients had unilateral THA and six bilateral THA.Hip osteoarthritis secondary to developmental dysplasia of the hip occurred in 15 patients,femoral neck fractures in 12,avascular necrosis of the femoral head in 10,primary hip osteoarthritis in nine,rheumatoid hip arthritis in two,malunion of femoral neck fracture in one,and femoral head fracture combined with posterior dislocation of the hip in one.The adopted femoral component was a tapered proximal femur modular stem.Femoral head-acetabulum interface composed metal-polyethylene in 34 hips,ceramics-polyethylene in 12 hips,and ceramics-ceramics in 10 hips.There were 48 hips with standard femoral head (28 mm) and eight hips with non-standard femoral head (＞28 mm).Results Mean period of follow-up was 11 months (range,6-19 months) and two patients (two hips) were lost to follow-up.Harris hip score improved from 36 points (range,4-71 points) preoperatively to 89 points (range,55-98 points) at the final follow-up.There was one patient with mild pain in the thigh,one moderate pain,but none severe or critically severe pain at the final follow-up.At the final follow-up,no migration or loosening of the implanted prostheses occurred; periprosthetic bone ingrowth fixation on the femoral side was achieved in 53 hips and fibrous stable fixation in one hip ; apart from one hip of ＜ 2 mm prosthetic subsidence,the remained revealed no subsidence of the prostheses.Intraoperative complications included acetabulum perforation in one hip and periprosthetic femoral fracture in one hip.Conclusion The short-term results are satisfactory,but the potential risk of fretting/corrosion and even breakage at the modular stem junction remains.

Objective The purpose of this study is to investigate the influence of comprehensive intervention on the family and social functions in patients with schizophrenia. Methods The stratified randomization, controlled experiment was designed for this study. 300 cases were diagnosed as schizophrenia in accordance with the Chinese classification and diagnostic criteria of mental disorder-3 (CCMD-3) diagnosis standard, and they were randomly divided into intervention group and control group. All the cases were followed up for three years after hospital discharge. Comprehensive interventions were only taken in intervention group, but not in control group. All of the cases were e-valuated by family assessment device (FAD) and social disability screening schedule ( SDSS) at the time of pre - therapy, hospital discharge and the end of 1st, 2nd and 3rd year after hospital discharge. Results In the 3rd year after hospital discharge, the scores of PANSS, FAD and SDSS of intervention group were significantly lower than those of control group ( P < 0.05 ). Conclusion Comprehensive intervention can significantly improve the family and social functions in the patients with schizophrenia.

From July 2006 to November 2008,16 patients with unstable intertrochanteric fractures were treated with cemented bipolar hemiprosthesis arthroplasty, including 5 males and 11 females, at a mean age of 84 years (range, 78-92 years) in the First Affiliated Hospital of Soochow University. Of them, 15 patients were followed with mean time of 14 months. The cemented bipolar hemiprosthesis was purchased from Beijing Montagne. The patients received 5-7 days of antibiotics following arthroplasty in addition to medicine of anticoagulation and analgesia. 1 case died of pulmonary heart disease 10 months after the operation and 3 cases had heterotopic ossification. There was no prosthesis loosening or dislocation. According to Harris hip scores, 3 cases were rated as excellent, 9 good, 3 fair, and 0 poor; the excellent and good rate was 80%. Results show that cemented bipolar hemiprosthesis arthroplasty is effective in treating elderly unstable intertrochanteric fractures, but operation indications require more attention.

Objective To investigate the clinical value of emergent perspective stent implantation for leftside obstructive colonic cancer.Methods The clinical data of 26 patients with obstructive colonic cancer who received emergent perspective stent implantation at the Affiliated Xuzhou Hospital of Southeast University from October 2011 to February 2014 were retrospectively analyzed.A soft and a hard guidewire and a catheter were applied in the operation.The guidewires were put through the hole of the intestinal tumor,and then the metal stent and the conveyor were guided by the guidewires and were pulled through the hole of the intestinal tumor,finally the stent was released and the conveyor was adjusted to ensure that the stent was at the right position.Patients were followed-up through outpatient examination till 4 weeks after tumor resection.Results Of the 26 patients,9 were with rectal cancer,10 with sigmoid colonic cancer,6 with descending colonic cancer,1 with splenic flexure cancer.The median length of stenosis was 4.6 cm (range,2.0-8.0 cm).The surgery of the 26 patients was successful.The mean operation time was 35.2 minutes (range,15.2-72.0 minutes),and the mean time of stent implantation was 5.6 minutes (range,2.6-26.9 minutes).Patients had watery or loose stool for 4-8 times after stent implantation.Ten hours after the operation,all the patients were given liquid diet.The remission rate of clinical symptoms was 100.0％ (26/26).No colonic perforation was detected during the operation.Two patients were complicated with slight bleeding,and was alleviated by medication.Twenty-six patients received stage Ⅰ tumor resection procedure within 7-10 days after the symptoms of intestinal obstruction were remised.The success rate of surgery was 100.0％ (26/26).No infection and other drainage were detected after tumor resection through follow-up.Conclusion Emergent perspective stent implantation for left-side obstructive colonic cancer is safe and effective.

BACKGROUND:The incidence of low serum level of vitamin D in patients undergoing hip arthroplasty and its impact has not been reported in China, indicating that it has not been brought to the forefront. OBJECTIVE:To determine the prevalence of low serum level of vitamin D in patients before total hip arthroplasty and its relationship with the hip function scores. METHODS:Forty-eight hips from 48 patients undergoing primary hip arthroplasty from July 2013 to August 2014 in the First Affiliated Hospital of Suzhou University were enrol ed. According to the serum level of vitamin D, patients were assigned to low-level (<20μg/L) and high-level (20≥μg/L) groups. The general information of patients, the hip function scores before and after replacement at the last fol ow-up in the two groups were observed and compared. The relationship between the serum level of vitamin D and the hip function scores before and after replacement was analyzed by multiple linear regression analysis. And the average fol ow-up was 12 months (11-14 months). RESULTS AND CONCLUSION:(1) The incidence of low vitamin D level was 82%(20 ng/mL serving as standard). (2) Compared with patients with high vitamin D level, patients with low level of vitamin D had lower preoperative Harris scores and Merle D′Aubigne-Postel score (P<0.05), and also at the last fol ow-up (P<0.05. (3) Based on the preoperative and postoperative Harris, the multiple linear regression analysis showed that there was a positive correlation between the level of vitamin D and Harris score both preoperatively and postoperatively (P<0.05). (4) These results suggest that there is a higher incidence of low level of vitamin D in patients undergoing arthroplasty, and hip function scores before and after replacement in patients with low level of vitamin D are lower than the high level patients. Moreover, there is a positive correlation between the level of vitamin D and the hip joint function scores. Therefore, it is advisable to supplement vitamin D and calcium preoperatively, and the level of vitamin D wil be helpful for disease assessment and prognosis.

Objective To design a wireless transmission solution of multi-parameter vital signs signal which can be applied in psychological status assessment.Methods C8051F350 SOC was used to define data frame structure,on application level,including channel number,control words,data and so on,which put all nodes data into the upper computer cache area by channel in an orderly way.A transfer rate of five seconds on a grid,each grid at least 48 groups of data was chosen in buffer,which could not only match the dynamic PC image display,but also to achieve the stability of the channel signal acquisition and orderly transfer.Results After operating test,with the communication distance within 10～15 m,the dynamical display of the upper computer showed a smooth curve data,which met the system design requirement.After optimization of the data frame,the transmission power could be reduced to 1/12 of that of normal mode.The whole system with three advantages of small size,low power and easy to carry.Conclusion Multi-parameter wireless acquisition system described in this paper eliminates the data line connected to the subjects,which does not affect their normal activities and is conducive to the real response of subjects' mental state,and provides a reliable means of detection for psychological assessment.

ObjectiveTo explore the therapeutic effect of selective antagonist-AM630 of cannabionid receptor 2 (CB2) in treatment of the titanium particles-induced inflammatory osteolysis.MethodsForty-five female BALB/c mice, 6-8 weeks old, were involved in the study, of which 15 mice were used as skull donors and the rest experimental animals were randomly divided into three groups, ie, black group, control group and treatment group, 10 mice per group.The mice model with air-pouch osteolysis induced by the titanium particles were established.The mice in the treatment group were injected with CB2 selective antagonist-AM630 (200 μg · kg-1 · d-1) intraperitoneally from two days before establishment of the air-pouch osteolysis model to two weeks after establishment of the model.Then, the mice were sacrificed and the pouch tissues were collected for molecular and histological analyses.The pouch membrane thickness and cell infiltration were tested by using computerized image analysis system and HE staining respectively.Osteoclast-like cells in the pouch membrane were determined by using tartrate-resistant acid phosphatase (TRAP) staining.Quantitative real-time polymerase chain reaction (RT-PCR) was employed to detect the mRNA levels of CB2, IL-1 β, TNF-α, receptor activator of NF-κB ligand (RANKL)and receptor activator of NF-κB (RANK).ResultsThere exhibited apparent erythematous and oedematous changes in the control group, which was mitigated around the bone implants with AM630 treatment.Quantitative image analysis of the histological sections revealed significant difference of the pouch membrane thickness among three groups, (192.2 ± 19.4)μm in control group, (88.5 ± 14.7) μm in blank group and (122.1 ± 15.2) μm in treatment group (F = 101.74, P ＜ 0.05).Intensive TRAP staining was identified much in the control group but markedly reduced after AM630 treatment in the pouch tissues.RT-PCR showed that titanium particle stimulation could enhance the expressions of CB2, IL-1 β, TNF-α, RANKL and RANK gene in the air pouch tissues.However, the mRNA levels of these genes were markedly reduced after AM630 treatment, with statistical difference compared with control group (P ＜ 0.05).ConclusionsCB2 selective antagonist AM630 can inhibit the process of titanium particlesstimulated inflammatory reaction and osteoclast activation.Therefore, CB2 represents a new suitable therapeutic candidate for the prevention and treatment of aseptic loosening of the artificial joint.

Objective To investigate the advantages, indications, operative techniques and pre-liminary curative effect of proximal femoral nail antirotation(PFNA) in surgical treatment of intertrochan-teric fractures. Methods From March 2006 to June 2007, PFNA fixation was done on 38 patients with intertrochanteric fractures including 17 males and 21 females, at an average age of 65. 4 years(35-93 years). According to AO/ASIF classification, there were 10 patients with type 31-A1 fractures, 21 with type 31-A2 and 7 with type 31-A3. All patients were reduced through longitudinal traction on the traction table, with implantation of PFNA via a mini-incision. Results The mean operation duration was 50 minutes(35-105 minutes)and mean blood loss 100 ml(50-300 ml). All patients were successful except for 1 patient with split lateral cortical bone of distal shaft of the femur during operation. All pa-fients were followed up for average 13 months(4-19 months), which showed long-team bed stay due to severe complieations in 1 patient. Function recovery in 32 and deterioration of the injured limbs in 5. Cer-ebral infarction was found 6 months after operation in 1 patient, who was able to walk under support. Pri-mary bone union was achieved in all patients, with average healing time of 9. 5 weeks. There were no complications such as infection of incisional wound, pulmonary infection, phlebothrombosis, over incision or coxa adducta, except that 2 patients had perioperative respiratory system disease. According to Harris hip rating scale system. The result was excellent in 20 patients, good in 13, common in 4 and poor in 1, with total excellence rate of 89%. Conclusions As a new technique, PFNA has advantages of litth trauma. Early get-out-of-bed exercise, few complications, rigid fixation and high bone union rate and is suitable for all kinds of intertrochanteric fractures especially for old patients with osteoporosis.