The prevalence of maternal obesity has risen dramatically in recent years. Maternal obesity increases the risk of adverse pregnancy outcomes, and can lead to chronic inflammation, oxidative stress, the change of cell factor homeostasis. The metabolic status of maternal obesity in the pre-pregnancy and pregnancy can alter the level of DNA methylation in the placenta, change the fetal programming, influence the pregnancy outcomes, and increase the risk of obesity related metabolic syndrome and other chronic diseases of offspring. Actively preventing and intervening in the maternal obesity can reduce the adverse pregnancy outcomes and increase the survival quality of the offspring.

BACKGROUND:Interstitial fluid flow around the osteocytes caused by a series of physiological activities plays an important role in the osteocyte metabolism and signal transduction.
OBJECTIVE:To review and summarize the research progress of bone structures and physiological functions, then further il ustrate how the mechanical loads make an impact on bone tissue.
METHODS:A computer-based search was conducted in PubMed database for articles related to the bone microstructure, metabolism and osteocyte signal transduction published from January 2009 to December 2015. The keywords were“osteocyte, mechanical load, permeability, lacunar-canalicular system, interstitial fluid flow, mechanotransduction, signaling pathways”in English. Data were screened firstly, dated articles or literatures with wrong research methods were excluded, and total y 40 eligible articles were enrol ed.
RESULTS AND CONCLUSION:Bone tissue can quickly adapt to the change of mechanical environment to guarantee enough osteocytes in the functional bone area indicating that osteocytes regulate the bone absorption and formation by responding to stress, which is closely related to osteocyte physiological characters. Osteocytes exist in mineralized matrix, and the special microstructures make it possible to receive mechanical loads and transform the mechanical signals into chemical signals aimed at regulating the bone absorption or formation.So the interstitial fluid flow in the lacuna-canalicular system occures, namely load-induced fluid flow, when the mechanical load is distributed on the bone. This fluid flow affects the bone tissue through two mechanisms:regulating osteocyte metabolism and participating in the mechanotransduction. In conclusion, the mechanical load plays a vital role in maintaining health bone and regulating bone adaptation.

Objective To observe the expression of the Rho kinase in perihematomal cerebral tissue after experimental intracerebral hemorrhage(ICH) and the relationship between which and the neurological function deficit.Methods The ICH models rats were randomly divided into groups 1 d,3 d,5 d and 7 d after ICH.At the certain time point,the score of neurological function in each model was measured before killed.The expression of Rho kinase protein and mRNA were detected by immunohistochemistry and in situ hybridization.Results After ICH 1 d,3 d,5 d and 7 d groups,the scores of neurological function were 1.63,2.25,3.13 and 2.88,respectively;the number of Rho kinase protein positive cells in perihematomal cerebral tissue were 26.63,30.75,38.88 and 35.00,and the number of Rho kinase mRNA positive cells were 27.25,32.25,40.88 and 38.00,respectively.There were significantly differences among the groups 1 d,3 d and 5 d in the scores of neurological function and the expression of the Rho kinase protein and mRNA(P

Objective To explore the IL-8 and ICAM-1 in premature infants with cerebral white matter damage (CWMD) and their correlations with prognosis. Methods One hundred and two cases of CWMD were selected from March 2009 to June 2012 as experimental group and 42 cases of normal preterm children were selected as control group. Serum IL-8 and ICAM-1 levels were measured during 48-72 h after birth. Motor development index (psychomotor developmental index, PDI) and mental development index (mental development index, MDI) were evaluated by Bayley scale. The correlations of IL-8 and ICAM-1 levels with prognosis were analyzed. Results Serum IL-8 and ICAM-1 levels in the experimental group were signiifcantly higher than those in the control group (P<0.05). MDI and PDI scores in the experimental group were signiifcantly lower than those in the control group (P<0.05). There were negative correlations of serum IL-8 and ICAM-1 levels with MDI (r=-0.64, P<0.05;r=-0.66, P<0.05)+and PDI (r=-0.70, P<0.05;r=-0.71, P<0.05). Conclusions Serum IL-8 and ICAM-1 levels in infants with CWMD are signiifcantly increased, and are negatively correlated with MDI and PDI scores.

Objective To investigate the accuracy of three dimensional facial measurement system based on structured light projection, and explore the methods to reduce noise of the output images. Methods The known object for calibration was measured by the measurement system to correct the parameters of the system and enhance the measurement accuracy. The mechanism of noise was analysed, and the noise and sundry of the images were eliminated. Results The parameters of each assembly of system were obtained by calculation and calibrated, and the measurement accuracy (0.028 mm) of three dimensional facial measurement system based on structured light projection was increased. Application of image processing technology reduced the noise and sundry of output images. Conclusion The accuracy of three dimensional facial measurement system based on structured light projection is high. The image output is reliable, and can be clinically used in facial scanning and three dimensional reconstruction.

Objectives To investigate the effect of different dosages of low molecular weight heparin on acute pulmonary embolism and inhibition of pulmonary intimal hyperplasia in immature rats. Methods 90 male immature SD rats were randomly divided into ifve groups: sham group, pulmonary embolism group, low-low molecular heparin group (L-LMH), medium-low molecular heparin group (M-LMH) and high-low molecular heparin group (H-LMH). The model of acute pulmonary embolism was established through jugular vein injection with gel-foam solution. The rates in the L-LMH, M-LMH, H-LMH groups were treated with low molecular weight heparin by subcutaneous injection after surgery with a dosage of 0 . 005 ml/kg, 0 . 01 ml/kg, 0 . 02 ml/kg, twice a day. Animals in the control group were given saline injection. Arterial blood gas, pulmonary artery pressure (mPAP), right ventricular pressure (RVP), wall area/tube area, wall thickness/tube diameter, and the expression of PDGF-B and MCP-1 at gene and protein levels in lung tissue were detected on the 7 th ( 7 d), 14 th ( 14 d) and 28 th ( 28 d) after opration. Results There were signiifcant differences of PaO 2 among 5 groups on 7 d, 14 d and 28 d. PaO 2 in group M-LMH ( 105 . 1 ± 4 . 6 mm Hg) were signiifcantly higher than that of embolization group, L-LMH, but not H-LMH group at 28 d. mPAP of M-LMH group was lower than that in the other three intervention groups, but showed no signiifcant difference compared with sham group (P?>0 . 05 ). There were signiifcant differences of RVP on 7 d and 14 d. PDGF-B, MCP-1 of M-LMH group were signiifcantly lower compared with the other three intervention groups (P?0 . 05 ). Wall area/tube area, wall thickness/tube diameter scores of M-LMH group had no signiifcance differences compared with sham group on 28 d (P?>?0 . 05 ). Conclusion Medium dose of low molecular weight heparin could ameliorate the acute pulmonary embolism and inhibit the proliferation of pulmonary arteries in rats.

Objective: To investigate the changes of urinary S100B protein concentrations and their relationship with brain damage in preterm infants there of . Methods: The urinary S100B protein of 84 preterm infants and 26 full term infants, which were used as control, were measured at 24 h and 120 h after birth. At the same time, routine clinical observations, neurologic patterns and ultrasound screens were recorded. The value of urinary S100B protein and brain damage were evaluated in preterm infants with different gestational age. Results: The differences of urinary S100B protein were statistical significance between the different gestations. The levels of urinary S100B protein were higher in preterm infants, whose gestations were lower than 32 W, than those of other groups. The levels of S100B protein were significantly higher in samples of 27 peri-intraventricular hemorrhage (PIVH) and 3 peri-ventricular leukomalacia(PVL) than those in samples without brain damage( P ＜ 0.05). The S100B levels were significantly higher in urine of 10 preterm infants with polycethemia than those in infants without brain damages. In addition, the S100B levels were different in urine of preterm infants with different prognosis. The S100B levels were significantly higher in urine of infants who died or deteriorated than those of others(P ＜ 0.05). Conclusion: There is an evident trend of decrease in urinary S100B protein concentration with increasing gestational age. It will be helpful to identify preterm infants with PIVH,PVL and high risk of brain damages by measurement of S100B protein in urine early after birth, which indicates further inspection, provides protective treatment and enhances follow up.

BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE:To investigate the efficacy of intra-articular injection of tranexamic acid on postoperative blood loss and limb circumference changes in patients who received unilateral total knee arthroplasty. METHODS:From March to October 2013, clinical data of 90 patients undergoing primary unilateral total knee arthroplasty were randomized to the tranexamic acid group and the control group, including 19 males and 71 females. The 30 patients in the tranexamic acid group received 50 mL of 3%tranexamic acid dilute solution inside knee joint after capsule closure, and 60 patients in the control group received the same volume of physiological saline. No significant difference in age, height, body mass index, anticoagulation, the type of prosthesis, tourniquet time and preoperative diagnosis was detected between the two groups (P>0.05). The amounts of intraoperative and postoperative blood loss and blood transfusion, postoperative drainage volume, the preoperative and postoperative limb circumference 10 cm above the operated knee were recorded. Routine blood test was reviewed after the surgery. RESULTS AND CONCLUSION:There were no significant differences in total blood loss, postoperative drainage volume and limb circumference changes between tranexamic acid and control groups (P>0.05). The amount of postoperative hidden blood loss was significantly less in the tranexamic acid group than in the control group (t=-2.683, P<0.05). These data suggested that the intra-articular injection of tranexamic acid intraoperatively in patients receiving total knee arthroplasty could significantly reduce the amounts of postoperative hidden blood loss, and did not affect the postoperative limb circumference changes.

Objective The aim of this study was to evaluate the feasibility of three-dimensional printing (3DP) for the preparation of porous titanium implant and to investigate the impacts on microstructure and mechanical properties with different sintering temperatures.Methods The CAD model of the specimens was designed to be 25 mm in diameter,20 mm in height,and with 0.5 mm pore size mesh.On every cross-section,80％ bonding area was designed.Titanium powder (purity of 98.5％,75 μm diameter) was selected as raw material.Polyvinyl alcohol powder (160 μm diameter) was selected as a binder,and polyvinylpyrrolidone powder was selected as an auxiliary binder.The green porous titanium implants were fabricated by 3DP followed by sintering at 1 200,1 300,1 400 ℃,separately,under the protection of argon gas.After sintering,the properties of porous titanium implants were evaluated,including the porosity,microstructure,microhardness,compressive strength and elastic modulus.Results After sintering,the specimen had uniform contraction and no obvious distortion.The specimen sintered at 1 200,1 300 and 1 400 ℃ sintering temperatures had porosity of (65.01±1.03)％,(46.73±0.73)％ and (41.06±0.31)％,hardness of 115.2±0.6,148.6±1.1 and 182.8±2.1,elastic modulus of (5.9±0.5),(16.2±0.9) and (34.8±1.5) GPa,compressive strength of (81.3±4.3),(135.4±8.5) and (218.6±7.1) MPa,respectively.A porous structure with three-dimensional network of connected pores was observed under scanning electron microscope.Conclusion It is feasible to fabricate porous titanium implants by three dimensional printing technique.The mechanical properties of the porous titanium implants match well with bone tissue which has excellent biomechanical compatibility.

BACKGROUND:As a more common method in the orthopedic field, the method of intra-articular injection drugs has distinct curative effects, but there are some complications. In a certain extent, this method caters to the psychological fear of surgery, and can serve as a kind of conservative treatment. But some experts believed that because of the limit of sterile conditions, intra-articular injection of drugs wil increase the risk of intra-articular infection and they opposed this method.
OBJECTIVE:To review the efficacy and adverse reactions of intra-articular injection drugs in recent years, and explain clinical applications of intra-articular injection drugs in orthopedics.
METHODS:A computer-based search was conducted in PubMed and Wanfang database for articles related to the application of intra-articular injection drugs in orthopedics published between January 2007 and December 2013. The English and Chinese key words were“intra-articular, injection, orthopaedics, tranexamic acid, hyaluronic acid, corticosteroid, drugs”. Data were checked in the first trial, old articles and repetitive studies were excluded. The relevant 43 articles accorded with inclusion criteria were reviewed.
RESULTS AND CONCLUSION:In orthopedics, the method of intra-articular injection drugs is simple, economic and effective, but at the same time, there are some side effects. Tranexamic acid by intra-articular injection can significantly reduce blood loss after total joint replacement, is safety and economic. Intra-articular injection joint lubricant can reduce internal friction of joints and improve the adhesion of joint cavity, can be used as a good conservative treatment for osteoarthritis. Intra-articular injection hormone drugs can treat inflammatory arthritis, and short-term curative effect is obvious, but due to large long-term side effects, the method is not recommended now. Intra-articular injection of analgesic drugs and other drugs have both advantages complications. The efficacy of intra-articular injection drugs in orthopedics is obvious;meanwhile, this method has some complications. Orthopedic surgeons should select related drugs by indications. We stil need to further make reasonable regimen with intra-articular injection drugs in future large-scale study.