Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of complex intraarticular calcaneal fractures.Methods A retrospective comparative study was performed on the 50 patients with intraarticular calcaneal fracture (Sanders types Ⅲ and Ⅳ) who had been treated by uniaxial locking plates (n =26) or polyaxial locking plates (n =24) between January 2013 and June 2015.Operation time,intraoperative bleeding,union time,radiological and functional outcomes and functions by the Maryland foot score were compared between the 2 groups.Results All the patients were followed up for 12 to 44 months(average,20.8 months).There were no significant differences between the 2 groups in average operation time (105.2 ± 18.2 min versus 95.5 ± 17.7 min),average intraoperative bleeding (125.2 ±23.4 mL versus 120.3 ±21.5 mL),or union time (12.1 ± 3.7 weeks versus 11.8 ± 3.7 weeks) (P ＞ 0.05).All patients obtained bony union.The polyaxial locking plates group displayed significantly better B(o)hler and Gissane angles at 3 and 12 months after operation than the uniaxial locking plates group (P ＜ 0.05).Evaluated by the Maryland foot score,the excellent and good rate for the polyaxial locking plates group [91.7％ (22/24)] was insignificantly higher than that for the uniaxial locking plates group [84.6％ (22/26)] (P =0.267).Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for complex intraarticular calcaneal fractures,but polyaxial locking plates may be superior in stability and functional recovery.

Aim To investigate the effects of Shaoqiduogan(SQDG)on cellular immunity in mice with delayed-type hypersensitivity(DTH). Methods DTH model induced by 2, 4-dinitrochlorobenzene(DNCB)and cyclophosphamide(Cy)suppressed and potentiated DTH model were used. SQDG(30, 60 and 120 mg ? kg-1)were given intragastrically(ig)once daily for 7 consecutive days. Concanavalin A(Con A)-induced T cells proliferation was measured by MTT assay. The activity of IL-2 in culture supernatants of Con A-induced T cells proliferation was measured by testing its ability to support the proliferation of Con A stimulated thymocytes which was detected by MTT assay. Results In mice with DTH, SQDG(120 mg?kg-1)reduced ear swelling, thymus index, Con A-induced T cells proliferation and the activity of IL-2 in culture supernatants of Con A-induced T cells proliferation. The suppression and potentiation of DTH in mice were induced by given an intraperitoneal(ip)injection of Cy at the dose of 150mg?kg-1 on primary sensitization day and 250 mg?kg-1 three days before primary sensitization. SQDG(60 and 120 mg?kg-1)upregulated ear swelling, Con A-induced T cells proliferation and the activity of IL-2 in culture supernatants of T cells from mice with Cy-suppressed DTH; and downregulated levels of the aforementioned indexes in mice with Cy-potentiated DTH. Conclusion SQDG possesses a dual modulatory effect on cellular immunity in mice.

BACKGROUND: High molecular materials have been proved to enhance the mechanical properties of calcium phosphate bone cement, as well as attenuate the injectability of composite materials. It thereby influences the clinical application of composite materials.OBJECTIVE: To observe the compressive strength and injectability of silk fihroin compound calcium phosphate bone cement, to evaluate the effect of silk fibroin on calcium phosphate, and to investigate the feasibility of applying silk fibroin as an injectable hone substitute to repair hone defects.DESIGN, TIME AND SETTING: Controlled study was performed in the central laboratory of Analysis and Testing Center, Soochow University from September to December in 2007.MATERIALS: Calcium phosphate cement was purchased from Shanghai Rebone Biomaterials Co., Ltd; silk fibroin was offered by Institute of Material & Engineering, Soochow University.METHODS: Six groups were set with different mass fractions (0.5%, 1%, 1.5%, 2%, 2.5%, 3%) of silk fibroin, which were mixed with bone cement at a certain liquid/solid ratio of 0.4 mL/g to prepare the calcium phosphate composite. The calcium phosphate cement without silk fibroin was served as control group.MAIN OUTCOME MEASURES: The compressive strength and injectability were determined. The characteristic microstructure was observed using scanning electron microscope.RESULTS: The compressive strength increased firstly and then decreased with the addition of silk fibroin. The compressive strength of the experimental groups was remarkably higher than the control group when the silk fibroin content was 1%-2.5% (P<0.05). The injectability of the paste diminished with the addition of silk fibroin, which was statistically different when the silk fibroin content was 1.5%-3% (P<0.05). Scanning electron microscope result revealed that the silk fihroin penetrated throughout calcium phosphate crystals, which were tightly connected.CONCLUSION: Silk fibroin can improve the compressive strength of silk fibroin/calcium phosphate cement composites without significant influence of manipulation, and can widen the application field of calcium phosphate bone substitute.

BACKGROUND:Whether lumbar spondylolisthesis needs to be treated with reduction remains controversial.OBJECTIVE:To investigate the clinical effectiveness of pedicle screw fixation combined with posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis in the patients aged more than 70 years old.METHODS:The clinical data of 30 patients with degenerative spondylolisthesis aged over 70 years old undergoing pedicle screw fixation combined with posterior lumbar interbody fusion were analyzed retrospectively.The Visual Analogue Scale,Oswestry Dysfunction Index and the Japan Orthopedics Association scores were compared and analyzed before and after surgery.RESULTS AND CONCLUSION:(1) Among 30 patients,12 were male and 18 female,the average age was (75.1±6.7) years old,and all were followed up for more than 12 months.(2) The postoperative Visual Analogue Scale,Oswestry Dysfunction Index and the Japan Orthopedics Association scores were significantly improved compared with baseline (P ＜ 0.05).According to the Japan Orthopedics Association scores,3 cases were cured,24 were significantly effective,and 3 effective.(3) Graft fusion was achieved at all patients,the average fusion time was (5.13±0.65) months.(4) The average operation time was (225.6±23.4) minutes,the average intraoperative blood loss was (470±45.5) mL,and the average follow-up time was (25.8±3.5) months.(5) Six patients presented complications (20％),including one case of dural tear,two cases of paralytic intestinal obstruction,and three transient lower extremity nerve symptoms.(6) These results indicate that if the associated disorders are strictly controlled,pedicle screw fixation combined with posterior lumbar interbody fusion can achieve good surgical results in the treatment of degenerative spondylolisthesis in the elderly.

Total hip replacement is a very effective method to cure many kinds of hip joint illnesses. About a century ago, it was first used in clinic. Since then, total hip replacement has been well developed. Hip joints sustain the most load of body, so people pay great attention to the hip prothesis' mechanics property. Especially after the finite element analysis was widely used in biomechanics investigation, the stress distribution of different designs can be easily compared with each other, and the relatively better parameters of the design could be decided. The stress distribution of different materials with the same design also can be valued. However, studies have indicated that total hip joint replacement still has some disadvantages. Loosening of the hip prothesis is still the most likely cause of the failure of surgery, and generally this is believed to stem from either mechanical failure of the fixation in response to over high density stresses, or osteolysis of the surrounding bone stock responsing to particular wear debris. Many researchers on computational studies have considered the potential for the former one, but only a few have attempted to tackle the latter. The process of osteolysis of the bone is not yet completely known. Nowadays, in order to solve the problems of loosening, investigators are trying to find different methods. Some of them are working on improving the geometry parameters and the shape of the hip prothesises, some are trying to find new suitable biomaterials, and, at the same time, the fixation methods are under deliberation.
Arthroplasty, Replacement, Hip ; adverse effects ; Computer-Aided Design ; Finite Element Analysis ; Humans ; Prosthesis Design ; Prosthesis Failure ; Stress, Mechanical ; Weight-Bearing

OBJECTIVE:To compare the therapeutic effect of surgical approach that should be used for posterior interbody fusion,posterolateral fusion with or without lumbar interbody fusion for adult spondylolisthesis.METHODS:From January 2004 to May 2008,75 patients with adult spondylolisthesis were retrospectively analyzed,comprising 22 males and 33 females,aged 53.3 years (ranging 49-70 years).There were 47 cases in L4,28 in L5;5 cases of degree Ⅰ,24 of degree Ⅱ,37 cases of degree Ⅲ,and 9 of degree Ⅳ.A total of 21 patients were treated with pedicle screw fixation and posterolateral lumbar fusion (group A),26 with pedicle screw fixation and posterior lumbar interbody fusion using cage (group B),and 28 with pedicle screw fixation and posterolateral lumbar fusion with posterior lumbar interbody fusion using cage.The satisfaction rate and fusion rate were compared among the three groups.RESULTS:All 75 patients were followed up for 6 months 3 years.The fusion rate of group A was 57%,and the satisfaction rate was 62%;the fusion rate of group B was 85%,and the satisfaction rate was 89%;the fusion rate of group C was 89%,and the satisfaction rate was 93%.There were no significant differences in the satisfaction rate and fusion rate between groups B and C (P>0.05),but the satisfaction rate and fusion rate of groups B and C were superior over group A (P<0.05).CONCLUSION:Posterior interbody fusion and posterolateral fusion with lumbar interbody fusion display similar treatment effects,which are better than posterolateral fusion.

Objective To investigate the impacts of water supply on water quality in the pipeline of the dental comprehensive treatment platform to contribute to pollution control.Methods Totally 8 platforms from the stomatological department underwent 2-a detection and tracing.The water sources included tap water,distilled water and filtered water,and the discharge water went through sampling and bacteriological analysis before and after disinfection.Results The mean numbers of colonies by tap water,distilled water and filtered water were (472±385),(380±372) and (446±382) cfu/ml respectively,and the qualification rates by tap water,distilled water and filtered water were 33.3％,45.8％ and 37.5％ respectively.All the colonies numbers were limited within 0 and 60 cfu/ml with the qualification rate being 100％ after disinfection.Conclusion Water source cannot relieve bacterial infection effectively,and disinfection eliminates bacteria and improves water quality in the pipeline of the dental comprehensive treatment platform.

Objective To explore the reproduction needs of men with spinal cord injury. Methods Data was collected with questionnaire. Results 57 men with spinal cord injury had urgent needs of reproduction meanwhile professional services were deficient seriously. Conclusion The professional services for reproduction can't meet the needs of persons with spinal cord injury

Surface transcutaneous electric nerve stimulation(TENS) was applied to treat the spasiticity resulting from spinal cord injury(SCI) in the acupoints of the subjects with SCI in order to oberve thetranscient and long-term effect of the treatment Fand its mechanism will be discussed in this paper. The results show that: 1 )more significant effect in relieving the spasiticiy was got by stimulating in high frequencyfor 30minutes,while less effect in low frequency(2Hz) ; 2)the effect in high frequency was partially ostracized by naloxone; 3)the effect in high frequency lasted for a long time i 4)compared with lumbar and sacralstimulation,the acupoint stimulation lasted for the longest time. This study also gets a hypothesis that highfrequency TENS in acupoints improves dynorphin in CSF to release and significantly relieve the spasiticityby kappa opioid receptor which decreases the excitment of anterior motor neuron.

Presented in this paper is a report on the Quadriplegia Index of Function(QIF) in usewith 16 cases of quadriplegic patients.Compared with the Barthel Index and Japan ADL Scale,QIF wasfound to be more sensitive and effective to document the small but significant funtional gains made byquadriplegics during medical rehabilitation,therefore,authors suggest that QIF should be widely usedin the rehabilitation evaluation of quadriplegic patients.