OBJECTIVE:To investigate the development of implants for internal fixation of spinal tuberculosis,and to evaluate the clinical effect and biocompatibility. METHODS:Articles were retrieved from CNKI and Medline database from 1998 to 2008 with the of "spinal tuberculosis,thoracic spine,internal fixation,bone fusion,biocompatibility" in both Chinese and English. Among 50 retrieval articles,20 were included in the final evaluation according to inclusion and exclusion criteria. This study was designed to summarize therapy development of spinal tuberculosis and selection of implants for internal fixation,and to investigate clinical development of spinal tuberculosis therapy,types of implantation,biocompatibility of implants,and complications. RESULTS:Spinal tuberculosis treated by debridement bone graft and internal fixation characterized by reconstructing spinal stability,enhancing bone graft fusion ratio,reducing relapse rate,and preventing loss of corrected angle degree,thus it became a tendency for treatment of spinal tuberculosis. Implants which were implanted in focus of spinal tuberculosis were safe because they could not cause infection diffusion or formation of tuberculose focus in the local region. Otherwise,the implants had a good biocompatibility to host. Individualized program was chosen according to lesion degree and site in order to thoroughly clean focus,reconstruct spinal stability,and provide a stable environment for rehabilitation. Implantation of autologous ilium and titanium-net cancellated bone were widely used on clinic,and both of them had an excellent fusion ratio. Artificial bone did not have immunological rejection to organism,and it was gradually degraded and provided sufficient bone source. CONCLUSION:Spinal tuberculosis treated by debridement bone graft and internal fixation is an effective method to treat severe spinal tuberculosis. At present,autologous ilium and titanium-net cancellated bone are frequently used for clinical internal fixation,because both of them have good biocompatibility. Artificial bone characterizes by well clinical effect and biocompatibility,but the long-term effect and safety need to be further studied.

BACKGROUND:Meniscus plasty and prosthesis under an arthroscopy are widely used in treating discoid meniscus or normal meniscus injury.The normal shapes of meniscus are maintained by excising medial partial tears and suturing the lateral partial tearsOBJECTIVE:Injury classification and special features of discoid meniscus and normal meniscus were observed,and corresponding trearing methods were used,to discuss the therapeutic effect of repair.METHODS:Totally 260 cases of meniscus injury in knee ioint were selected from the First Aftiliated Hospital of Xinxiang Medical University from September 2003 to June 2008.They were divided into normal meniscus injury group(n=215),and discoid lateral meniscus injury(n=45).People with complete clinical data before operation and following data,confirmed by arthroscopy were selected.Meniscus injury in 260 cases was examined by arthroscopy,and plasty,or partial excision or incomplete resection or full resection was performed according to the injury types and surgical circumstance.RESULTS AND CONCLUSION:All subjects were followed for half a year to 2 years The knee function was evaluated by the Tenger criterion.Four tear types of Discoid meniscus were as follows:73.3% horizontal,15.5% complex,4.4% radial,and 2.2% longitudinal.Five tear types of normal meniscus were as follows:47.9% longitudinal,28.8%radial,1 1.6%horizontal,6 5% transverse and 5.1% complex.In 215 cases of normal meniscus,there were 165 knees with excellentfunction,35 with good,8 with fair and 7 with poor.The excellent and good rate was 93.0%.In 45 cases of discoid meniscus.there were 25 knees with excellent function,16 with good,3 with fair and 1 with poor.The excellent and good rate was 91.1%.Discoid meniscus is different from normal meniscus in anatomical feature and histological structure,therefore,the arthroscopic surgery for discoid meniscus is also different.The most function of meniscus should be remained and the degeneration of knee ioint should be delayed.Meniscus plasty should be performed in all discoid meniscuses except the patients with severe tear of meniscus.

Objective To investigate the feasibility of osteoarthritis (OA) model in rabbits by injuring medial meniscus so as to understand the role of interleukin-1 beta (IL-1β) and matrix metalloproteinase-13 (MMP-13) in pathological mechanism of articular cartilage and synovial fluid of OA model in rabbits.Methods We randomly divided 40 New Zealand white rabbits into experimental group (n =30) and control group (n =10).Pathological changes in articular cartilage of the femoral condyle were scored at weeks 2,6 and 12 after surgery.We detected the expressions of IL-1β and MMP-13 by immunohistochemistry.The cell fractions of IL-1β and MMP-13 were recorded by ELISA.Results The articular cartilage score and HE staining significantly differed at various time points of gross and pathological observation between control group and experimental group (P＜ 0.05).Immunohistochemistry showed that IL-1β was expressed in both groups and that the cell fraction differed significantly at weeks 6 and 12 (P＜0.05),but not at week 2 between the two groups.MMP-13 protein expression was not detected in articular condrocytes in control group,but was detected in experiment group with a significant difference (P＜0.05).IL-1β expression was consistent in articular cartilage and synovial fluid.Conclusion The reasonable rabbit animal OA model could be established by knee meniscus injury caused by surgical method.Expressions of IL-1β and MMP-13 change obviously in the pathomechanism of OA.Further clinical studies are needed to determine whether they can be used as markers in early diagnosis of OA.

Objective To study the clinical results of grafting of vascularized fibular and ilium to repair bone defects of limbs. Methods From January 1992 to January 2004, 49 cases of bone defects of limbs were treated with vascularized fibular grafting (33 cases) and vascularized iliac grafting (16 cases). Their limb functions were graded according to Ennekings system. The changes of the vascularized fibular and iliac grafts were evaluated radiographically according to the International Symposium on Limb Salvage. Results All the patients were followed up for 1 to 12 years. In the vascularized fibular group, the recovery rate for the operated limbs was 82.7%, the average healing time of the bone was 16.8 weeks and the healing rate of the bone was 87.9%. In the other group, the recovery rate of the operated limbs was 88%, the average healing time of the bone was 15.2 weeks and the healing rate of the bone was 93.8%. Conclusion The vascularized fibular graft can be adopted to repair long bone defects of lower limbs and distal radius, while the vascularized iliac graft can be adopted to repair the bone defects of upper limbs.

Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.

Objective To systematically review the efficacy and safety of solifenacin in the treatment of patients with bladder spasm after transurethral resection of prostate based on current evidence.Methods We searched Pubmed,EMbase,the Cochrane Library,CBM,CNKI,VIP and Wanfang Database from the establishment to October 2016 for the published literature on the treatment of patients with bladder spasm after transurethral resection of prostate with solifenacin.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 11 RCTs involving 621 patients were included.The results of meta-analysis showed that:compared with the no-solifenacin group(n=311),the numbers of bladder spasm episodes[MD=-1.38,95%CI(-1.97,-0.97)P<0.00001],duration of bladder spasm[MD=-0.26,95%CI(-0.41,-0.11),P=0.0008],the time of bladder perfusion clearance[MD=-0.59,95%CI(-0.88,-0.29),P<0.0001],indwelling catheter delivery[MD=-0.29,95%CI(-0.48,-0.11),P=0.09]in solifenacin group(n=310) reduced significantly,and there was no statistical difference in the incidence of overall adverse events between the two groups[RR=0.71,95%CI(0.17,2.98),P=0.64].Conclusion Current evidence indicates that solifenacin is more effective and safe in the treatment of patients with bladder spasm after transurethral resection of prostate.Due to the limited quantity and quality of the include studies,more high quality studies are needed to verify the above conclusion.

Objective To analyze the clinical characteristics of children with knee joint diseases and discuss the curative effect of arthroscopy.Methods Eighty-nine children with knee joint diseases in Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical University from October 2012 to October 2015 were selected,and they were given knee arthroscopic surgery according to the disease types and characteristics,such as meniscal suture,suture plus angioplasty and synovectomy etc.All the symptoms,signs and the joint functions were recorded preoperatively and postoperatively.At the end of follow-up,surgical results were analyzed according to Lysholm score and International Knee Documentation Committee Knee evaluation form (IKDC) classification standard.Results The patients with discoid meniscus tear were the most,accounting for 55.55％ (55/99 knees).All patients were followed up for 6-30 months(the average time was 21 months) to find that all symptoms were relieved or disappeared within 1 year after operation.The outcome was evaluated according to the Tegner knee function:76 knees (76.76％) were markedly effective,16 knees (16.16％) were effective,6 knees (6.06％) were invalid and 1 knee (1.01％) was poor,and the excellent rate was 92.92％.The curative effect was evaluated according to Lysholm knee function score and IKDC score at the last follow-up.The Lysholm score in preoperation [(52.46 ± 4.79) scores] improved to (96.52 ± 3.97) scores in postoperation,and the difference was significant (t =-36.24,P ＜ 0.05);the IKDC score in preoperation [(46.52 ± 10.25) scores] improved to (90.67-± 5.89) scores in postoperation,and the difference was significant (t =-50.69,P ＜ 0.05).There was no joint infection,blood vessel or nerve damage and so on.Conclusions Meniscus tear is common in children with knee joint diseases,and most common is discoid lateral meniscus tear,and arthroscopy can have satisfactory outcome,with no obvious complications.Therefore,arthroscopic surgery is an ideal method for surgical treatment of children with knee joint disease.

Objective: To investigate the prevalence of daily smoking among residents at ages of 15 years and older in Wuhan City, so as to provide insights into tobacco control. Methods: A total of 2 700 permanent residents at ages of 15 years and older were sampled using a multistage random sampling method in three districts of Wuhan City in July, 2019. Residents' demographics, tobacco use, secondhand smoke exposure and awareness of harmful effects of tobacco were collected using the core questionnaire of the Global Adult Tobacco Survey, and the factors affecting daily smoking were identified among residents at ages of 15 years and older using a multivariable logistic regression model. Results: A total of 2 700 questionnaires were allocated, and 2 551 valid questionnaires were recovered, with an effective recovery rate of 94.48%. The respondents included 1 272 men (49.86%) and 1 279 women (50.14%), and the proportion of daily smoking was 19.84% among the respondents, with a mean daily tobacco use of 16.6 cigarettes. Multivariable logistic regression analysis identified men (OR=66.191, 95%CI: 25.344-172.873), ages of 45 to 64 years (OR=2.586, 95%CI: 1.158-5.775), farmers (OR =8.477, 95%CI: 1.126-63.786), secondhand smoke exposure at home (OR=9.395, 95%CI: 5.401-16.340), secondhand smoke exposure in workplaces (OR=1.923, 95%CI: 1.081-3.423) and no smoking at home (OR=0.459, 95%CI: 0.277-0.763) as factors affecting daily smoking among residents at ages of 15 years and older in Wuhan City. Conclusions There is a high likelihood of daily smoking among men, the middle-aged and elderly, farmers and individuals with exposure to secondhand smoke in workplaces at ages of 15 years and older in Wuhan City. Health education pertaining to tobacco control requires to be reinforced among high-risk populations, and creation of a tobacco-free home is recommended in public places and workplaces based on the complete smoking ban.

Objective: To investigate the use of e-cigarette and analyze its influencing factors among high school students in Wuhan City, so as to provide insights into developing control measures for adolescents. Methods: From September to November 2019, high school students in Wuhan City were selected by the multi-stage stratified cluster random sampling method, and basic information, e-cigarette use and second-hand smoke exposure were collected through questionnaire surveys. Proportions of e-cigarette current use and attempt to use were analyzed, and factors affecting the current use of e-cigarettes were identified using a multivariable logistic regression model. Results: Totally 5 700 questionnaires were allocated, and 5 602 valid questionnaires were recovered, with an effective rate of 98.28%. The respondents included 2 925 males (52.21%) and 2 677 females (47.79%); 4 033 high school students (71.99%) and 1 569 vocational high school students (28.01%). The proportion of attempt to use e-cigarettes was 9.23%, and the proportion of current e-cigarette use was 2.03%. Multivariable logistic regression analysis identified male (OR=2.112, 95%CI: 1.285-3.471), vocational high school (OR=1.967, 95%CI: 1.214-3.186), private high school (OR=9.684, 95%CI: 5.648-16.605), family second-hand smoke exposure (OR=3.064, 95%CI: 1.741-5.392), second-hand smoke exposure in public places (OR=4.402, 95%CI: 1.687-11.484) and having close friends who were smokers (OR=6.432, 95%CI: 3.219-12.852) as factors affecting current e-cigarette use among high school students. Conclusions The proportion of current e-cigarette use among high school students in Wuhan City was 2.03%. Male, vocational high school, private high school, second-hand smoke exposure and having close friends who were smokers may be promoting factors for e-cigarette use.

Objective: To understand the level of health behaviors related to prevention and control of Corona Virus Disease 2019, COVID-19 among primary school students in Wuhan during the epidemic, and to provide a basis for further targeted health education and promotion. Methods: Stratified random sampling was used to select 12 primary schools in Wuhan. Relying on the "questionnaire star", the head teacher of the selected school sent the questionnaire link to students through the QQ or WeChat group, and all students participated in the survey voluntarily. Results: A total of 8 569 valid questionnaires were collected. The rate of prevention and control of COVID-19 among primary school students in Wuhan was 39.3%. Among them, wearing masks, hand hygiene and other healthy behavior accounted for 53.4%, 42.0% and 75.2%, respectively. Multivariate logistic regression analysis showed that girl, grade 3-4 and 5-6, higher maternal education (>graduate degree) were more likely to have overall health behaviors in the prevention and control of COVID-19, and the OR values were 1.13(95%CI=1.04-1.24), 1.18(95%CI=1.06-1.31) 1.58(95%CI=1.41-1.75) and 1.62(95%CI=1.00-2.62)(P<0.05), respectively. Compared with fathers whose occupations were state agencies, managers of enterprises and institutions, students whose fathers’ occupations were professional technicians and ordinary employees were less likely to have level of overall health behaviors in the prevention and control of COVID-19, and the OR values were 0.78(95%CI=0.61-0.99) and 0.72(95%CI=0.58-0.90)(P<0.05), respectively. Conclusion The level of health behaviors of primary school children in Wuhan against COVID-19 was not high and targeted health education and promotion should be provided.