In recent years, pharmacological researches of Chinese medicine found that single Chinese medicines of tonifying kidney, such as epimedium, psoralen, eucommia, dipsacus, cistanche, velvet, curculigo and cynomorium had very good effects of resisting osteoporosis, significantly improving the bone mineral density (BMD) and bone mineral content (BMC) , promoting hone formation, and preventing bone absorption. Based on the documentations from home and abroad, the overview had analyzed the current situation for providing new ideas and methods of osteoporosis prevention and treatment.

Objective To analyze causes for complications after proximal femoral intramedullary nail treating unstable femoral intertrochanteric fractures in the elderly.Methods A total of 172 cases of unstable intertrochanteric fractures treated with proximal femoral intramedullary nail from December 2001 to May 2007 were reviewed upon postoperative complications to find out the causes for complications and discuss countermeasures.Results Of all, 149 cases were followed up for 6-42 months(mean 18. 5 months), which showed excellence rate of 89. 0% in aspect of functional recovery of the hip. Postoper-ative systemic complications occurred in 26 cases and local complications in 21.Condusions Proxi-real femoral intramedullary nail can be used in most elderly patients with unstable intertrochanteric frac-tures. A thorough evaluation of physiological function, treatment of preoperative comorbidities and aug-mentation of surgical technique are prerequisites for operation safety and decrease of complications.

Objective To study the characteristic and influential factor of the hidden blood loss after total knee arthroplasty (TKA) so as to provide a reference frame for clinical work. Methods There were 75 patients with osteoarthritis of the knee who were operated with unilateral primary TKA. The patients including 21 males and 54 females at a mean age of 68.7 years were retrospectively analyzed.The perioperative blood loss and the hidden blood loss following TKA were calculated by Gross formula. It was analyzed that if the perioperative blood loss and the hidden blood loss following TKA were affected by gender, haemostasis during operation with deflating tourniquet and reinfusion of the drained blood. Results The preoperative blood loss was (1551.3 ± 369.6) ml and the hidden blood loss was (792.3 ±228.6) ml. The hidden blood loss of male was significantly higher than that of female (P ＜ 0.05). The hidden blood loss was reduced by haemostasis during operation with deflating tourniquet (P ＜ 0.05) but was not affected by postoperative shed blood reinfusion. Conclusions The lowest value of Hct is a representative parameter for calculation of the hidden blood loss. There is no significant difference between male and female about the relative hidden blood loss. Haemostasis during operation with deflating tourniquet can reduce teh hidden blood loss but not affect the total perioperative blood loss. Reinfusion of the drained blood can reduce the transfusion rate but does not affect the total preoperative blood loss and the hidden blood loss.

[Objective]To investigate diagnosis of lumbar instability,segment of spinal canal decompression and principle of fixation and fusion.[Method]158 cases of degnenerative lumbar instability from Feb 2001 and Oct 2006 in our hospital were analyzed retrospectively,the patients were operated with posterior decompression,instrumentation with pedicle screw and interbody or inter-transverse fusion.Patients all were examined with lumbar radiographys of lateral flexion and extension and with lumbar CT befor operation,Patients began to walk after operation one week,6 months later,restore to normal activities.[Result]The preoperative spinal canal area was 56~114 mm2,averaged 74 mm2,the postoperative spinal canal area 204~296 mm2,averaged 221 mm2.The patients were followed up from 6 months to 5 years(averaged 2 years and 5 months).The score was evaluated according to the JOA score.The preoperative score was averaged 3.7,the postoperative score was averaged 13.2,the improving rate was averaged 85%.108 case excellent,46 good,3 fairand 1 bad,The excellent and good rate was 97.5% in this group.[Conclusion]The spinal stability can be effectively maintained and reconstructed by decompression of spinal canal and instrumentation with pedicle screw system and fusion,which is a good method for treating Degnenerative instability of lumbar spine.

Objective To design technique of local flap transposition to refine the aesthetic appearance of reconstructed fingers by toes transfer.Methods Nine cases with 21 reconstructed finger were included,which involved 6 males and 3 females with an average age of 21.8 years(range,18-34years).A lingual contour flap with a lateral pedicle Was shifted from the inflated distal pulp to the narrow middle part of the"finger"to refine the aesthetic appearance.Overall results were evaluated in terms of the survival of the flap,the appearance improvement and the functional influence of the reconstructed finger.Results All of the flaps survived and healed perfectly.After a mean follow-up of 9.3 months(range,6-12months),the appearance of the reconstructed fingers were impmved apparently.There was little influence on the function of the finger.The results showed that all the patients gained more acceptable fingers.Conclusion From our experience,local flap transposition is a useful method for remolding of reconstructed fingers by toes transfer.

Objective:To investigate the outcomes of applying microvascular anastomotic coupling de-vices in solitary upper extremity artery injury repairs and to optimize parameters for optimal clinical out-come.Methods:From March to September 2013,19 injured arteries from 18 male patients who presen-ted at Department of Hand Surgery,Beijing Jishuitan Hospital with traumatic arterial lacerations of their upper extremities went through rapid repair procedures.COUPLER,a microvascular anastomotic coupling device was applied in these artery injury repair operations.The 19 repaired arteries included 3 brachial arteries,6 ulnar arteries and 10 radial arteries.After the procedures,all the 18 patients were then fol-lowed up by clinical specialists and examined with color doppler flow imaging for the effective recovery of artery circulation and upper extremities functionality.Results:The average time of artery repairs for all the 19 damaged arteries among the 18 patients was 278 s and the average follow-up time was (71.5 ± 40.9)d with the longest follow-up time as 116 d and shortest as 14 d.No patient returned to the opera-ting room after the procedures and after being dismissed from the hospital.None of the 18 cases were re-ported to have problems with circulation and thrombosis formation in their upper extremities.Color Doppler imaging showed that the arterial anastomotic site for all the 19 repaired arteries were unobstructed with artery blood spectrum at both ends.Three patients with radial artery repairs complained about mild pressure pain at the site of vascular anastomosis;while the other 15 patients all expressed satisfactory outcomes of the surgery and recovery.These evidences indicated that the outcomes of our initial evalua-tion for the solitary upper extremity artery injury repairs by using anastomotic coupling devices were posi-tive.Conclusion:Our observations have showed that microvascular anastomotic coupling devices can be used for repairing of solitary upper extremity artery injures.The procedures are quick,effective and safe. The clinical application of this microvascular anastomotic coupling device in artery injures is promising, however,additional evidences through further clinical investigation with more cases are warranted.

ObjectiveTo investigate the effect of intensive rehabilitation training on gross motor function in children with cerebral palsy. Methods101 children with cerebral palsy were divided into routine group (n=51) and trunk group (n=50). They were assessed with Gross Motor Function Measure (GMFM) before and after treatment. ResultsThe scores of GMFM improved in both group after treatment. There was significant difference between them 6 months after treatment (P<0.05), but not within 3 months (P＞0.05). ConclusionIntensive rehabilitation training can improve the recovery of gross motor function in children with cerebral palsy.

Objective To evaluate the method and outcomes of radiocarpal joint reconstruction via nonvascularized and vascularized fibular bone graft after distal radius bone and joint defect.Methods Between November,1966 and March,2009,27 cases with distal radius bone and joint defect due to tumor en bolc excision (24 cases) or AO C3 type fractures (3 cases) were treated with nonvascularized or vascularized fibular bone graft.There were 9 males and 18 females.The mean age of these patients at the time of surgery was 27 years (rage from 16 to 67 years).There were 14 left sides and 12 right sides and 1 bilateral side.Nine cases with vascularized and 18 cases with nonvascularized fibular bone graft for radiocarpal joint reconstruction.The bone fixed with plate or/and k-wire.DASH scores,G/W wrist scores,PRWE scores were applied for writ function evaluation and the grasp power recovery rate and bone healing time was also compared during postoperative follow up.Results All 27 patients were followed with an average follow-up time being 9 years (range from 3.5 years to 44.0 years).The average length of fibular bone harvested was 10 cm for vascularized bone graft and 9 cm for nonvascularized.The all fibular bone was healed and the average healing time was 4.7 months (range from 3-8 months).No tumor recurrence or distance metastasis occurred during the follow-up.The average DASH scores was 7.97 (2.5-17.0),G/W scores of 24 patients ranged from 1 to 2,the wrist function result was excellent,account for 88.9％,and 3 cases from 3 to 7,function was good,account for 11.1％; the average grasp power recovery rat was 85.81％ (75％-104％); the average PRWE scores were 25.3(10.5-38.0).Comparison outcomes between the nonvascularized and vascularized fibular bone graft for radiocarpal wrist joint reconstruction,there was no significant statistics difference for bone healing time,DASH,G/W,PRWE scores and grasp power recovery rate (P ＞ 0.05).There were no other complications occurred except 3 patients had mild leg pain after long distance walking and 1 case fracture following patient's accident postoperative 11 years,and healed through conservative treatment.Conclusion The nonvascularized or vascularized fibular bone graft is an excellent choice and has less complication with maximal wrist function recovery for radiocarpal joint reconstruction following distal radius bone and joint defect due to all kinds of reasons,such as tumor en bloc excision,distal radius AOC3 type comminuted fracture.The vascularized fibular graft is recommended for larger than 12 cm bone graft.

Objective To study the efficacy of transcutaneous prostaglandin E 1( PGE 1) cream in relaxing the vascular spasm in rabbits, to find an ideal vascular dilation drug. Methods Sixty rabbits were randomly divided into six groups:experiment group 1(using 0.1% transcutaneous PGE 1 cream),experiment group 2(using 0.2% transcutaneous PGE 1 cream),experiment group 3(using 0.4% transcutaneous PGE 1 cream), experiment group 4( using 0.8% transcutaneous PGE 1 cream),PGE 1 control group (without using transcutaneous PGE 1 cream, but using PGE 1 cream only),control group(withous using PGE 1). 0.1% adrenlin was injected to the root of the rabbite ear to induce a model of vascular spasm. After a typical vascular spasm appeared,transcutaneou PGE 1 cream or PGE 1 cream was used on the skin of the ear. The vascular diameter and blood folw rate of the ear were determined before adrenalin injection, 10min after vascular spasm and 10,15,30,60,90 and 120 min after the drugs were used. Results The vascular diameters and blood flow rate were recovered to the levels of before adrenalin injection in experimental group 3, 4 after topical used of transcutaneous PGE 1 cream, and those parameters were significamly increased compared with other 4 groups(P0.05). Conclusions Tramscutameou PGE 1 cream can effectively relax the vascular spasm caused be adrenalin injection.The effect of vascular dilation is related to the dosage of the drug. Transcutaneous PGE 1 cream as a topical vascular dilation drug has advantages snch as wide indications,taking effect quick and enduring, and less side effect. So it might be a new simple, safe and effective drug for the treatment of vascular spasm.

Objective To explore the clinical outcomes of Ligament reconstruction tendon interposition (LRTI) arthro-plasty for first carpometacarpal joint osteoarthritis. Methods From January 2008 to January 2011, 19 patients (21 thumbs) had surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radia-lis (FCR). There were 1 male and 18 were females with an average age of 60 years (range, 52-75 years);8 thumbs were on the left side and 13 thumbs on the right side. According to Eaton-Glickel classification, 1 thumb belonged to stageⅡ, 14 thumbs to stageⅢ, and 6 thumbs to stageⅣ. Pain level, grip strength, tip pinch strength, range of motion, and radiographic measurement were re-corded. According to the first metacarpal subsidence, the cases were classified in mild, moderate, and severe groups. Clinical out-comes of different group were evaluated and compared. Results All patients were followed up for 9-28 months with an average of 13.9 months. Comparision with the preoperative X-rays showed the first metacarpal had subsided 54.8% of the arthroplasty space after surgery. Grip strength improved from 18.6±10.1 kg to 20.5±11.9 kg, and tip pinch strength increased from 4.4±2.1 kg to 4.5 ± 1.9 kg after the surgery. Radial abduction increased from 55.7° ± 8.2° to 60.6° ± 7.2° and palmar abduction improved from 56.7° ± 8.5° to 63.5° ± 8.2° after the procedure. Patient pain levels (visual analogue scale, VAS) were significantly reduced, from 6.6 ± 1.4 to 0.5 ± 0.7. There was no difference of grip strength, tip pinch strength, thumbs range of motion, and VAS after LRTI in mild, moderate and severe groups. Conclusion LRTI resulted in excellent relief of pain and increase in range of motion. Howev-er, LRTI cannot sustain the arthroplasty space. Compared with the preoperative X-ray, the first metacarpal subsided more than 50%. Subsidence of the first metacarpal doesn't affect the pain relief, range of motion and strength improvement.