Recently,more and more researches focus on the relationship between bone marrow fat and osteoporosis.From a pathological point of view, osteoporosis is traditionally regarded as the dysfunction of osteoblastic bone formation and osteoclastic bone resorption.Actually, bone marrow adipose tissue that constitutes a large proportion of bone marrow cells is indispensable for the balance of bone metabolism.Bone marrow fat, which is abundant in yellow bone marrow, increases gradually with aging.Bone marrow adipocytes and osteoblasts differentiate from a common progenitor, bone marrow mesenchymal stem cells(BMSCs).It is generally acknowledged that they are reciprocal repellent in the process of BMSC differentiation.Exploring the association between bone marrow adipocytes and osteoporosis is critical for better understanding its role in the pathogenesis and the future treatment of osteoporosis.In this review, we summary the recent progress in the association between bone marrow adipocytes and osteoporosis.

[Objective]To discuss the method and effectiveness of arthroscopically assisted mini-incision arthrolysis for the stiff knee.[Method]A small lateral suprapatellar incision was made in all 26 patients suffered from stiff knee,and the scissors were introduced the joint to release the adhesive tissues of patellofemoral joint.All adhesive tissues between the medial,lateral retinaculum and the femur,and the between vastus intermedius and femur were released subsequently.After the release of the adherence between the fat pad and femoral condyle,the lateral retinaculum was dissected 1 cm lateral to the patellae,and the dissection of medial retinaculum was applied at the insertion of the vastus medialis.Eventually,arthroscopic debridement and hemostasis combined with manipulative release was applied to remove all remanent adhesive bundles and scar tissues.[Result]Follow-ups were maintained for an average of 19 months(range,from 8-32 months).An increase in the average range of motion of the knee was attained from 32 degrees preoperatively to 113 degrees postoperatively.No complications such as skin necrosis,wound dehiscence,tendon rupture and fracture had occurred during the follow-up period.[Conclusion]The advantages of arthroscopically assisted mini-incision arthrolysis for the stiff knee include simple procedure,minimal trauma,and quick rehabilitation.Otherwise,reservation of the insertion of vastus medialis is of great importance not only for the maintenance of extensive strength and stability of the knee,but also for the functional recovery and the reduction of complications.

[Objective]To investigate the clinical results and significance and mechanism of early dislocation rate after total hip arthroplasty following the posterolateral approach with posterior capsulotendinous repaired.[Method]The incidence of early dislocation and the prosthetic range of rotation motion among 212 consecutive primary THAs with the posterior capsule and the short external rotators which had been sutured to the medius tendon was reviewed retrospectively,and was compared to the results of 486 consecutive unilateral primary THAs with a complete posterior capsulectomy.[Result]During a 6 months to 5 years(3.7 years in average)following-up,there were significant differences between two groups.In patients with posterior capsulotendinous repair,two of 224 primary total hip arthroplasty(0.9%) had an early posterior dislocation.In patients with a complete posterior capsulectomy,27 of 486 primary total hip arthroplasty(5.6%) had an early dislocation.The difference was statistically significant(x~2=8.51,P

Objective To study the prevalence rate of nonalcoholic fatty liver disease (NAFLD)and its correlation with the metabolic syndrome among professional crowd in Yichang city ,and analyze the characteristic of prevalence of NAFLD .Methods Physical check‐up and liver ultrasonography were done and fasting blood GLU ,TG ,HDL‐C ,UA ,CRP were measured for sampling survey professional people in Yichang city .We sampled 6 450 people in 15 company ,including 3 284 men ,3 166 women(20 to 70 years old) ,the results were analyzed .Results The NAFLD prevalence rate of Yichang professional crowd was 21 .71% ,28 .68% in male and 14 .47% in female respectively(P<0 .01) .The prevalence rate in male was higher than that of female before 60 years old . NAFLD prevalence rate in women showed a trend of increasing along with the age growth ,the incidence rate come up to 31 .31%when women were over 60 years old .The highest prevalence rate of MS related components in NAFLD group were obesity (69 .98% )、high blood TG level(61 .10% ) .Conclusion Male before 60 years old and female over 60 years old of Yichang profes‐sional crowd belong to NAFLD high‐risk groups ,the group should be focused on as regular monitoring ,prevention and interven‐tion .NAFLD prevalence rate significantly increased in people with MS .The most important factors of suffering from NAFLD are o‐besity ,high blood TG level .

Objective To investigate the effect of dexmedetomidine on patients with pancreatic cancer treated by high intensity focused ultrasound (HIFU) under general anesthesia.Methods One hundred and twenty ASA Ⅱ or Ⅲ patients with pancreatic cancer undergoing HIFU treatment,were divided into control group (group C) and dexmedetomidine group (group D) by random digits table method,each group with 60 cases.Dexmedetomidine was intravenously infused at 0.2 μ g/(kg· h) until the end of operation after a loading dose of 0.7 μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with intravenous injection of fentanyl 2-3 μg/kg and propofol 1.5-2.0 mg/kg and cisatracurium 0.2 mg/kg at 5 min after administration of the loading dose.Anesthesia was maintained with sevoflurane,remifentanil,propofol,cisatracurium.The propofol,remifentanil and sevoflurane consumption,the incidence of postoperative agitation,delirium,delayed recovery were recorded.Results The intraoperative heart rate in group D was significantly lower than that in group C (P ＜ 0.05).The propofol,remifentanil and sevoflurane consumption in group D were significantly shorter than those in group C [(341.4 ± 45.7) mg vs.(520.5 ± 50.8) mg,(1.7 ± 0.5) mg vs.(2.3 ± 0.8) mg,(11.6 ± 4.1) ml vs.(16.7 ± 3.8) ml,P ＜ 0.05].The incidence of postoperative agitation and delirium in group D were significantly lower than those in group C [6.7％(4/60) vs.21.7％(13/60),8.3％ (5/60) vs.26.7％ (16/60),P ＜ 0.05].There was no statistically significant difference in the incidence of delayed recovery between group D and group C [3.3％ (2/60) vs.1.7％ (1/60),P ＞ 0.05].Conclusions Dexmedetomidine given HIFU treatment of pancreatic cancer patients can reduce the amount of general anesthetic,reduce the incidence of postoperative agitation and delirium,intraoperative heart rate.

Objective To evaluate radical gastrectomy combined with cholecystectomy for gastric cancer patients with concomitant gallbladder disease.Methods Clinical data of 702 gastric cancer patients undergoing radical gastrectomy (614 patients) only or combined with cholecystectomy during radical gastrectomy from October 2009 to September 2014 in our department was retrospectively analyzed.Results The operating time of patients with simultaneous cholecystectomy was(348 ± 111)min.the operating time of patients with radical gastrectomy only was (274 ± 89) min (t =3.812,P ＜ 0.05).Perioperative and postoperative complications,hospitalization expenses and 5-year survival rates were not statistically significant (P ＞ 0.05).Conclusions Radical gastrectomy with cholecystectomy for gastric cancer with gallbladder disease patients is safe and feasible.

Objective To investigate the feasibility and clinical effects of suture anchors technique for acute distal avulsion fracture of patella. Methods From January 2007 to July 2009, 33 patients(18males and 15 females, ranging from 28 to 72 years, with an average of 49.3 years) were treated with the suture anchors technique. The average time from injury to surgery was 3.5 days(2 to 7 d). Injury reason: traffic accident in 12 cases, injured in daily life in 11 cases, sports injury 9 cases, no clear trauma history in one case. The Bostman evaluation system, follow-up X-ray, and knee mobility were used to analyze the clinical effects of suture anchors technique. Results All patients obtained the follow-up and the average time was 16.5 months(12 to 23 months ). One patient suffered foreign body reaction, and his wound healing was good after operation. The remaining patient wound healing was good. No complications were found in all patients,such as popliteal fossa artery, tibial nerves or peroneal nerve complication. Bostman patella fracture functional score 27.3±2.3 points at the sixth months follow up, 28 cases were rated as excellent, 5 cases were good, and the excellent and good rate was 100%. Six months later, X-ray showed bone healing, knee activity recovered well. The Range of Motion was extension for -2.5°±2.1° and flexion for 122°±5.3°. Conclusion Suture anchors fixation in treatment of acute distal avulsion fracture of patella has a good efficacy, safety and reliability advantages, and without the second operation. This technique provides an alternative in lower pole patella fracture.

Objective To evaluate the clinical outcomes of a hovel porous β-tricalcium phosphate (β-TCP)and control allograft for the repair of lacunar bone defects caused by solitary bone cyst curettage.Methods From January 2003 to December 2008,the patients with solitary bone cyst were randomized into an experimental(55 cases)and a control(40 cases)group.The control group received particulate allograft bone as the graft material,and the experimental group received β-TCP.At 1 week,1,2,3,6,12,24,48months after surgery,a new radiographic scoring system was employed to calculate the biodegradation of bone graft and evaluate the influence of multiple factors.Histologic characteristic of the degradation process of β-TCP were also evaluated.Results All the cases were followed up for average 28.4 months.Radiographic semi-quantitative analysis revealed that the biodegradation effieiencies were not significantly difierent between β-TCP and allografts(P=0.424).Degradation percentage of the implanted β-TCP or allograft was higher in younger patients than those in the older ones.Degradation of β-TCP was significantly higher than that of allografts over 3 years after surgery(P=0.04).In the experimental group,β-TCP degradation was greater in the loose packing treatment than that in the dense packing treatment (P=0.03).Histological observation demonstrated that the process of new bone formation accompanied the degradation of β-TCP.Conclusion The interporous β-TCP could be an advantageous alternative to allografts for repair bone defects caused by bone cyst.The clinical application of β-TCP is safe and reliable,which shows better biodegradation and osteogenesis than allografts in long-term follow-up.

Purpose: To investigate the clinical effect of Yin-reinforcing and Blood-nourishing Drink plus electroacupuncture in the treatment of senile skin pruritus. Methods: Eighty patients were randomly divided into two groups. The treatment group was treated with Yin-reinforcing and Blood-nourishing Drink plus electroacupuncture and the control group, with Western medicine. Results: The total effective rate was 100.0% in the treatment group and 67.5% in the control group (P＜0.01). Conclusion: This therapy has a better effect on senile skin pruritus.

ObjectiveAim at the problems in the treatments of the children malignant bone tumor of distal femur,we put forward the concept of the dual mobility hemi-knee prosthesis and try to perform the motion parameters analysis and the pilot clinical trials.MethodsBase on the CT data from samples of knee joint in adult,we adopted the Mimics/Geomagic/Pro-E software and computer numerical control milling machine technology to design and produce the dual mobility hemi-knee artificial prosthesis,and then motion parameters was analyzed in vitro test,and at last pilot clinical trial was performed.ResultsIn vitro experiment showed that the displacement of the internal femoral condyle flexion facet center was(2.59±0.43) mm in normal knee group,(2.22±0.52) mm in dual mobility hemi-knee prosthesis group,and (1.18±0.43) mm in total knee arthroplasty group; the displacement of the external femoral condyle flexion facet center was (11.95±6.62) mm in normal group,(11.25±6.19) mm in dual mobility hemi-knee prosthesis group,and (1.26±0.42) mm in total knee arthroplasty group; the maximum relative rotation angle was 13.17°±7.58° in normal knee group,11.69°±6.49° in dual mobility hemi-knee prosthesis group,and 5.40°±1.29° in total knee arthroplasty group.After that,we accomplished the pilot clinical trials successfully for a patient with malignant bone tumor in distal femur.The patient recovered well and the treatment outcome was satisfactory.ConclusionThe motion parameters analysis showed that the motion mode of the dual mobility hemi-knee prosthesis is similar with that of the normal knee.The dual mobility hemi-knee prosthesis provides a whole new concept and method for the treatment of malignant bone tumor of distal femur in children,and the device and concept of ligament reattachment provide a solution to the reconstruction of knee ligament.