During September-October 2012,random cluster sampling method was employed to recruit 871 students from 29 classes at East China Normal University to conduct a questionnaire survey.The overall prevalence of skin diseases was 33.5％ (292/871) and those of eczema,urticaria,drug eruption and atopic dermatitis were 16.4％ (143/871),9.8％ (85/871),2.2％ (19/871) and 0.2％ (2/871) respectively.These diseases showed no statistically significant gender differences.The prevalence of contact dermatitis was 16.9％ (147/871) and there was statistically significant gender difference (P ＜0.01).

[Objective] To discuss the effect of total hip arthroplasty with structural bone-grafting for high congenital dislocation of adult hip.[Method]From August 2003 to October 2006,22 patients(29 hip)with congenital dislocation of hip were treated with total hip arthroplasty and structural bone-grafting.There were 10 males and 12 females.There were 13 left and 26 right.The ages were from 23 to 42 years old,with the average of 34.6 years.Clinical symptoms included hip pain,hip instability and limping.The preoperative average Harris scores was 46.8.The preoperative average length difference between two legs was 3.8 cm.The femoral head dislocation height from normal position was 3.9 cm on average(range,3.2 to 5.6cm).The average range of motion of the hip:flexion 66.5?,abduction 23.8?,external rotation 20.4?,internal rotation 5.3?.Posterolateral approach was used during operation and all the acetabular cups were reconstructed at the true acetabular location and were covered completely with femoral head autograft.The reduction of prosthesis was achieved by releasing surrouding soft tissue.The acetabular reconstruction was done with the cemented acetabular component in 18 hips,the small acetabular component in 5 and common cementless acetabular component in 6.Cementless shaft was used in 10 hips,common cemented shaft in 13,steno-vertical cemented shaft in 4 and long cemented shaft in 2.The clinical effects were evaluated with operative time,blood loss,Harris scale,joint range of motion,length difference between two legs and complications.[Result]The average operative time was 95 minutes(range from 70 to 135 rain).The average blood loss was 400 ml(range from 300 ml to 650 ml).Primary healing of wound was observed in all patients without infection.Position of prothesis judged by X-ray was fine at 1 week postoperatively,the average abduction angle of the cup was 39?,and the average anterior angle was 13?.Twenty-two cases were followed up from 10 months to 47 months(average 17.6 months)after surgery,the average score was 89.2 points(ranged from 72 points to 93 points),according to the evaluate of Harris.The average range of motion of the hip was 115.3? for flexion,44.6? for abduction,49.5? for external rotation,26.8? for internal rotation.The preoperative average length difference between two legs was 1.2 cm.There were 2 postoperative femoral nerve palsy which resolved completely within 4 months.Femoral head autografts were not absorbed.Neither loosening nor dislocation of the prostheses occurred in the time of follow-up.[Conclusion]Total hip arthroplasty with structural bone-grafting is an effective method for high congenital dislocation of adult hip.It improves symptoms,functions and shapes.Structural bone-grafting can provide reliable acetabular coverage and restore bone stock.In case of the altitude of femoral head dislocation upward from normal position less than 4cm,reduction of prosthesis can achieve by releasing surrouding soft tissue without femoral nerve palsy.

Objective To explore the efficacy of ZPLATE TM anterior fixation systems in the treatment of thoracolumbar fractures and dislocations.Methods 13 cases with old thoracolumbar fractures and dislocations accompanied with spinal cord injury have been treated by anterior decompression,implanting bone union and internal fixation with ZPLATE TM anterior fixation systems.Results After an average of 15 5 months followup,No plate and screw was loose and fragmentized,there is no pseudoarticulation formation,average union time are 3 7 months, and paraplegia showed different degrees of recovery.Conclusion It suggests that anterior approach provids thorough decompression and ZPLATE TM anterior fixation systems is a good spinal fixation system for the treatment of old thoracolumbar fractures and dislocations with the characteristics of strong fixation.

Objective To evaluate the different effects of the treatment of thoracolumbar fractures by pedicle of vertebral arch Tenor system and Harrington device.Methods The clinical data of 35 cases of thoracolumbar fractures were analyzed retrospectively, 23 of them were operated with Harrington device and 12 with Tenor system.Results These cases were followed up for 6 months to 2 years. The fractures treated with Tenor system got satisfied reduction, reached about 96 7% of normal vertebral height. The deformities were completely corrected and complications were significant lower than those derived from Harrington device treatment, and no delayed neurologic damage was found. Most cases got reduction with one to three Frankel grades of neurologic recovery.Conclusion The Tenor pedicle system is more effective in treatment of thoracolumbar fracture than non-pedicle device. It can get satisfied fracture reduction , reliable fixation and less complications.

BACKGROUND:Both osteopontin and hyaluronic acid involve in the pathological process of osteoarthritis, resulting in the abnormal expression levels of various cytokines and enzymes. However, the relationship between the high expression of osteopontin and hyaluronic acid in chondrocytes remains unclear.
OBJECTIVE:To investigate the effect of osteopontin on the expression of hyaluronic acid in human knee osteoarthritic chondrocytes in vitro by modulating the level of osteopontin.
METHODS:Chondrocytes from human knee osteoarthritic cartilage were cultured in vitro, and were then divided into three groups:blank control group without any treatment;osteopontin group and and pontin siRNA group were treated with 1 mg/L recombinant human osteopontin and osteopontin siRNA, respectively. Expression levels of osteopontin, hyaluronic acid synthase 1, 2 and 3 mRNA were detected by real-time PCR, and the levels of hyaluronic acid were measured using ELISA.
RESULTS AND CONCLUSION:Compared with the blank control group, the mRNA expressions of hyaluronic acid synthase 1, 2 and 3 were remarkably increased in the osteopontin group, while siRNA made the significantly inhibitory effects on the hyaluronic acid synthase 1, 2 and 3 mRNA expressions (P<0.05). The level of hyaluronic acid in chondrocytes in the osteopontin group was significantly higher than that in the other two groups (P<0.05). Our results suggest that osteopontin induces the synthesis of hyaluronic acid in osteoarthritic chondrocytes through upregulating the hyaluronic acid synthases expression levels.

Objective To evaluate retrospectively the hemiarthroplasty in the treatment of severe comminuted intraarticular fractures of the proximal humerus.Method Thirty one patients suffered from severe comminuted intraarticular fractures of the proximal humerus were treated with shoulder hemiarthroplasty through Thompson approach from March 2000 to October 2004.The results were graded into the excellent,the good,the fair and the poor according to the scoring system-modification for hemiarthroplasty(SSMH) of Los Angeles California,USA(UCLA) basing on shoulder paining,functional status muscle strength and range of motion.Rusults The average operative time cost 65 minutes(ranged from 40 to 90 minutes),average amount of bleeding during operation were 280 ml(ranged from 200 to 350 ml).The patients exercised early postoperatively.After an average duration of 14.1 months of follow-up(ranging from 5 to 42 months),there were no infection and/or nerve damage occurred postoperatively,and the position of the prosthesis was confirmed to be excellent,moreover no lessening prosthesis,prosthesis dislocation,and/or prosthesis milieu fractures occurred radiographically.The outcomes of the treatment were excellent in 13,good in 14,fair in 3 and poor in 1 out of the 31 cases. The rate of both the excellent and the good were 87.10%.Conclusion Shoulder hemiarthroplasty is a preferable technique in the treatment of severe comminuted intraarticular fractures of the proximal humerus.

0.05).CONCLUSION:①There are not significantly changes of the stress in the inferior facet joint after ADR.②ADR will not add negative influence to the inferior facet joint when it rebuilds the biomechanical characteristics of lumbar spine.

BACKGROUND: With deepening of spinal biomechanics, artificial lumbar disc replacement is considered to be the optimal choice for treating degenerative lumbar disease. However, studies concerning biomechanics of artificial lumbar disc are insufficient. OBJECTIVE: To establish the three-dimensional (3-D) finite element model of artificial lumbar disc replacement and to explore the effects of artificial lumbar disc replacement on zygapophyseal joints using biomechanical analysis. METHODS: Based on normal 3-D finite element model of lumbar motion segment, L4-5 intervertebral disc, superior and inferior endplates were removed, and then, the model of SB-Charite Ⅲ disc prosthesis was added, which remained annular fibrosus and ligaments at L4-5 intervertebral space. Thus, 3-D finite element model of L4-5 segments artificial lumbar disc replacement was constructed. Biomechanical analysis of this model was processed under axial load, forward flexion, lateral bending or posterior extension moments. The stress data were contrasted with the normal 3-D finite element model of artificial disc replacement. RESULTS AND CONCLUSION: After artificial lumbar disc replacement, the data of biomechanical analysis indicated: ①There was no significant differences between the zygapophyseal joint and normal segment of stress under axial load (P > 0.01).②Compared with normal segment, the stress of anterior, posterior of upper and lower vertebral body and bilateral zygapophyseal joint had no obviously difference under forward flexion and posterior extension moments (P > 0.01). ③The stress differences between the both sides of upper and lower vertebral body and bilateral zygapophyseal joint were not significant under lateral bending moment (P > 0.01). Artificial lumbar disc replacement can keep the stress of motion segment at normal level, which can meet the needs of spinal functional reestablishment.

Objective To examine osteopontin (OPN) levels in both synovial fluid and articular cartilage of patients with primary knee osteoarthritis (OA) and to investigate their relationship with severity of the disease. Methods Fifty patients with knee OA and 10 healthy controls were enrolled in this study.There were 15 males and 35 females with an average age of 61.8±7.4 years in OA group. The control group included 4 males and 6 females with an average age of 63.2±6.0 years. Mankin score were taken to determine the disease severity of the affected knee. The radiographic grading of OA in the knee was performed using the Kellgren-Lawrence criteria. OPN levels in synovial fluid were measured using enzyme-linked immunosorbent assay. OPN levels in articular cartilage were assessed by immunohistochemical methods. Results Compared to healthy controls, the knee OA patients had higher OPN concentration in synovial fluid ([4519.60±1830.37] pg/ml vs. [1179.70±303.39] pg/ml) and articular cartilage([0.60±0.06] vs. [0.43 ±0.07]). In addition, synovial fluid OPN levels showed a positive correlation with articular cartilage OPN levels (r=0.411,P=0.003). Subsequent analysis showed that the OPN levels in synovial fluid significantly had been correlated with severity of disease using Kellgren-Lawrence criteria (r=0.581, P＜ 0.001). Furthermore,the levels of OPN in the articular cartilage also were correlated with disease severity using Mankin score (r=0.675, P＜ 0.001).Conclusion The data suggest that OPN in synovial fluid and articular cartilage is related to progressive joint damage and could be a predictive biomarker respect to disease severity and progression in knee OA.

BACKGROUND: As it results in minimal trauma and physical influence or interference, and a better curative effect, the minimally invasive surgery is preferred in clinic. However, the perioperative stress reaction of minimally invasive surgery needs further study.OBJECTIVE: To evaluate the levels of neurohormone, C-reactive protein (CRP) and the changes of resting energy expenditure (REE) resulted from the operative stress reaction due to minimally invasive surgery in arthroscopy on knee joint.DESIGN: Controlled observation and analysis.SETTING: Department of Orthopaedics, Affiliated Hospital of Xiangnan University and Department of Orthopaedics,Xiangya Hospital of Central South University.PARTICIPANTS: Sixteen patients with meniscal lesions in knee and 26 with cruciate ligament injury, which were closed injury, were selected from the Department of Orthopaedics of Affiliated Hospital of Xiangnan University and Xiangya Hospital of Central South University between January 2003 and April 2004. Meniscal lesions were diagnosed according to the physical examination, drawer test combined CT and MRI examination, and the patients were in accordance with the indication of arthrotomy; cruciate ligament injury according to the physical examination, grinding test combined CT and MRI examination. Those with open injury, body multiple injury, combined injury and emergency operation were excluded. Ten patients with meniscal lesions and 12 with cruciate ligament injuries underwent minimally invasive surgery on knee joint as minimally invasive surgery group (MIS). The others were given traditionally invasive surgery on knee joint as the traditional group. The informed consent was obtained from the patients.METHODS: Fasting venous blood was taken on the morning of 1 day before, and 1 and 3 days after operation, which was analyzed within 2 hours after sampling. ①All hormones were quantitatively assayed. Serum insulin was determined by competitive radioimmunoassay (RIA); growth hormones levels by double-antibody RIA; serum cortisol by competitive RIA; CRP by nephelometry, respectively. ②Energy metabolism detection: The energy consumption was assessed by indirect calorimeter on the morning of 1 day before, 1 day and 3 day after operation, respectively. All the detection was performed by medical graphics critical care monitor desktop analysis system. Based on the indirect calorimeter theory,REE and respiratory quotient (RQ) were figured out.MAIN OUTCOME MEASURES: ①Concentrations of insulin, growth hormones and cortisol of patients at 1 day before, 1 day and 3 day after operation; ②Resting energy consumption, RQ and CRP of patients at 1 day before, 1 day and 3 day after operation.RESULTS: Totally 42 patients were involved in the result analysis. ①On the third postoperative day, the insulin levels of the traditional group were lower than those before operation [(12.4±1.1), (17.5±2.2) mlU/L, P ＜ 0.05]; On the first postoperative day, the levels of growth hormone of the traditional group were significantly higher than the MIS group [(2.8±0.9), (5.3±2.4) μg/L, P ＜ 0.05], and on the third day after operation, the levels of the MIS group were remarkably increased compared with those before operation [(1.4±0.5), (1.0±0.3) μg/L, P ＜ 0.05]; the cortisol levels of the traditional group on the first postoperative day were higher than the MIS group [(1.12±0.25), (0.59±0.11) μmol/L, P ＜ 0.05]. ②REE levels of the traditional group and MIS group on the first day after operation were(1437.8±415.9) and (1223.8±179.9) K,higher than those before operation [(1 186.4±297.4), (1 160.7±158.6) K, P ＜ 0.05]; on the first and third days after operation, REE levels of the MIS group were higher than the traditional group [(1 223.8±179.9), (1 151.7±150.8) K;(1 437.8±415.9), (1 329.4±350.5) K, P ＜ 0.05]. ③RQ of the traditional group and MIS group on day 1 after operation were all (0.8±0.05), lower than that before operation (0.9±0.11, 0.9±0.15, P ＜ 0.05). ④On the first and third days after operation, CRP of the MIS group were lower than the traditional group [(14.8±2.5), (34.37±7.5) mg/L; (64.1±14.4),(93.87±12.7) mg/L, P ＜ 0.05], but higher than that before operation [(8.0±0.11) mg/L, P ＜ 0.05].CONCLUSION: Minimally invasive surgery on knee joint results in less trauma, low stress reaction and slight influence on metabolism of patients, moreover, it benefits the restoration of stress hormones, nitrogen balance and energy metabolism.