Objective:To compare the efficacy and safety between direct anterior approach (DAA) and posterior approach (PA) in total hip arthroplasty.Methods: This study evaluated postoperative results of 92 consecutive total hip arthroplasties performed by a single surgeon;44 from the DAA,and 48 from PA.The age,body mass index,operation time,blood loss,hospital stay,positioning of the artificial hip,postoperative Harris score and postoperative complications were recorded and analyzed.Results: Both the average age of the patients separately (58.0±11.9) years in DAA group and (61.0±10.4) years in PA group and the body mass index (25.1±3.7) in DAA group and (24.7±3.3) in PA group,showed no significant difference between the two groups.The DAA group had significantly reduced the hospital stay (3.8±1.7) days vs.(4.9±2.3) days for the PA group (P<0.05) and operation time was (76.0±17.4) min in DAA group,and (71.0±14.3) min in PA group (P>0.05).The amount of blood loss: in group DAA (238.0±55.3) mL,and in group PA (387.0±61.2) mL (P<0.05).There was no statistical difference in the positioning of the artificial hip: the cup anteversion in DAA group and PA group was 17.3°±5.3° vs.18.6°±5.1°,the cup inclination was 38.5°±5.7° vs.37.7°±5.2°.In DAA group,there was significantly less use of assistive devices [(24.6±7.8) d vs.(31.7±10.2) d,P<0.05],and the pain was significantly lower.Harris score at the end of 6 weeks of the follow-up: in DAA group 85.7±5.4,and in PA group 81.3±6.1 (P<0.05);at the end of the last follow-up: in DAA group 93.4±4.7,and in PA group 92.3±5.3 (P>0.05).Complications were encountered in the two groups.There were two intraoperative complications (4.4％),1 great trochanter fracture and 1 lateral cutaneous nerve injury in DAA group.No dislocation was observed in DAA group.One dislocations and 1 groin pain were recorded in PA group.No prosthesis loosening,deep vein thrombosis,sciatic nerve injury and other complications occurred in the two groups.Conclusion: Total hip arthroplasty using the anterior approach allows for superior recovery and better stability.

Objective To propose a stream-media technology based on the new transmission technology. Methods Firstly,we explored the advantages and disadvantages of exiting PACS image in LAN (Local Area Network) and WAN (Wide Area Network) and then expounded distance diagnosis related to HIS and PACS,VPN technology,wireless network applications,more points consultation applied technology. At last,we made an analysis of the characteristics of the stream-media transmission technology. Results The characteristics of low bandwidth occupied,high security,and high scalability of stream-media transmission technology fit the needs of PACS development. Conclusion Application of streammedia technology transferred in PACS image provides a new economical and practical technical solution to break through limitation of network bandwidth in medical imaging integrated information,and to thoroughly make use of medical resource.

OBJECTIVETo investigate the effects of α3 neuronal nicotinic acetylcholine receptor (nAChR) on apoptosis and p38 signal transduction pathway in SH-SY5Y cells and to assess the roles of α3 nAChR in the pathogenesis of Alzheimer's disease (AD).

METHODSThe levels of α3 nAChR mRNA and protein were measured by real-time PCR and Western blot, respectively, in SH-SY5Y cells transfected with α3 nAChR siRNA. The mRNA level of bcl-2 and bax was measured by the real-time PCR. The siRNA transfected SH-SY5Y cells and control were then treated with 10 µmol/L Aβ25-35 for another 48 h, and the change in apoptotic rate and the levels of p-p38 and p38 were measured by flow cytometry and Western blot. Subsequently these SH-SY5Y cells were exposed to a blocker of p38 protein, and the apoptotic rate was measured again.

RESULTSCompared to the controls, the expression of α3 nAChR at mRNA and protein levels in the SH-SY5Y cells transfected with α3 nAChR siRNA decreased by 95% and 86%, respectively; the mRNA levels of bax increased 2.11 times and that for bcl-2 decreased 0.53 times. The apoptotic rate was unaffected (3.40% ± 0.20%); but it increased after Aβ25-35 treatment (24.52% ± 1.59%); the level of p-p38 protein also increased by 178% in the α3 nAChR inhibited cells treated with Aβ25-35. Compared to controls, the Aβ25-35-treated SH-SY5Y cells and the Aβ25-35-treated and siRNA-transfected cells both showed a reduction in apoptosis after treatment with p38 blocker, especially in the former.

CONCLUSIONThe siRNA silencing of α3 nAChR mRNA may enhance the effect of Aβ25-35 on the cell apoptosis by increasing the levels of p38 protein and bax mRNA and decreasing the level of bcl-2 mRNA, which may play a role in the pathogenesis of AD.

Alzheimer Disease ; etiology ; Amyloid beta-Peptides ; metabolism ; Apoptosis ; Cell Line, Tumor ; Gene Silencing ; Humans ; Neuroblastoma ; metabolism ; pathology ; Peptide Fragments ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Receptors, Nicotinic ; genetics ; metabolism ; Signal Transduction ; Transfection ; bcl-2-Associated X Protein ; genetics ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective:To analyze the status of ethical management of biobanks in Shanghai public hospitals. Methods :A questionnaire survey on ethical management of biobanks was conducted in 9 representative ethics com-mittees, which were established in public hospitals with biobanks in Shanghai. Results: The ethics committees in Shanghai public hospitals had paid relatively high attention to ethical review of protocols were related to biobanks. Nonetheless, the ethical supervision and training on biobanks in Shanghai public hospitals should be enhanced. Con-clusion:The unified ethical guideline on biobanks should be developed in Shanghai for strengthening the standard-ized ethical management and ethics training to promote the development and use of biological samples library re-sources.

Objective To study the efficacy and complications of reconstruction of failed urethro-plasty for hypospadias with pedicle flap , bladder mucosa , buccal mucosa , and biological patch . Methods 23 patients were enrolled from Jul .2005 to Dec.2011.8 patients, with good local skin condition , were performed with pedicle flap urethroplasty .The other 15 patients, with bad local skin condition or with long segment urethral stricture , were performed with free grafts , including 6 bladder mucosa , 7 buccal muco-sal and 2 biological patch. Results Of the 23 cases, 7 cases were cured by one phase operation .There were 16 (16/25) cases had complications.3 (3/16) cases were failed because of serious infection (2 pedi-cle flap, 1 bladder mucosa ) .The failed cases were implemented with urethroplasty 6 months later by the buccal mucosa installments operation .4 (4/16) cases had solitary urethral fistula (1 pedicle flap, 2 bladder mucosa, and 1 buccal mucosal), who were successfully treated with simple fistula repair 3 to 6 months later. 9 ( 9/16) cases had urethral stricture ( 2 pedicle flap , 3 bladder mucosa , 3 buccal mucosal , and 1 biologi-cal patch graft ) , who were treated with urethral sound and got good result .We had reconstructed the urethra using mucosa graft onlay urethroplasty .All of the 23 patients were followed up with an average of 14.5 ( 6-24) months.23 cases were satisfied with the stretched penis , urination and no need to expand the urethra more than 6 months.3 cases were not satisfied with penile appearance .After communication, these patients did not require a further penis orthopedic surgery . Conclusions Pedicle flap, bladder mucosa , buccal mucosa and biological patch can be used in urethral repair and construction of failed urethroplasty for hypos -padias.Urethral sound dilation plays an important role in hypospadias repair .

Abstract: Objective　To analyze the distribution characteristics of the main pathogens of HIV/AIDS patients with wound infections and provide basis for clinical diagnosis and treatment. Methods　The clinical data of 294 patients with positive secretions or pus specimens from 2016 to 2020 were analyzed retrospectively. Results　A total of 357 strains of pathogenic bacteria were isolated from 294 cases, of which 123 strains of Gram-negative bacilli (G-b), accounting for 34.5%, were mainly Escherichia coli (15.4%), Klebsiella pneumoniae (3.9%), and Pseudomonas aeruginosa (3.6%); Gram-positive bacilli (G+b) 14 strains, accounting for 3.9%; 108 Gram-positive cocci (G+c), accounting for 30.3%, of which 44 strains were coagulase-positive Staphylococcus aureus (12.3%), Coagulase-negative staphylococci were mainly Staphylococcus epidermidis (4.2%) and Staphylococcus hemolyticus (2.8%); 37 strains of fungi, accounting for 10.4%, were mainly Candida albicans (5.9%); 75 strains of Mycobacterium, accounting for 21.0%, including 41 strains of Mycobacterium tuberculosis (11.5%) and 34 strains of non-tuberculosis mycobacteria (9.5%). 52 of the 294 HIV/AIDS patients had mixed infections, accounting for 17.7%. There was significant difference in the distribution of G+c, G-b, mycobacteria and mixed infection among different specimen sources (P<0.05), and there was significant difference in the distribution of mycobacteria among different CD4+T lymphocyte counts (P<0.05). There was significant difference in the level of CD4+T lymphocytes between patients of different ages (P<0.05), and there was significant difference in the level of CD4+T lymphocytes from postoperative incision and other parts (P<0.05). Conclusions　Patients with HIV/AIDS are prone to combined wound infections with various pathogenic bacteria. We should strengthen the research on wound infection in HIV/AIDS patients, and timely send patients with a low number of CD4+T lymphocytes for secretion or pus culture, so as to carry out targeted treatment and improve the prognosis of patients.

Objective To explore the effect on metabolism of glucose and lipids, potential toxicity mechanism and possible biomarker candidates by analyzing urine metabonome changes of rats after oral administration of polychlorinated biphenyl congeners( PCBs) and high fat diet alone or in combination.Methods Male SD rats were divided randomly into control group,high fat diet group, PCBs group and combination group of PCBs and high fat diet.Urine samples were collected after 6-week treatment, 1 H NMR spectra were performed and analyzed by principal component analysis ( PCA) . Results The PCA scores plot of urine 1 H NMR data showed that the combined group could be easily distinguished from the other three groups, suggesting great difference in metabolism.The loading plot of the PCA revealed significant increase in the levels of lactate, glucose, creatine, 2-hydroxy-isovaleric acid and reduction in the levels of citrate, succinate, taurine, hippurate and trimethylamine oxide ( TMAO) in the combined exposure group after six-week exposure.Conclusion The altered levels of metabolites induced by combined exposure of PCBs and high fat diet may be related to the injury to mitochondrial function, reduction of energy metabolism in tricarboxylic acid cycle (TAC).These effects possibly lead to perturbations in the metabolism of glucose, lipid and amino acids.The altered metabolites may be considered biomarker candidates of toxicity induced by exposure to PCBs and high fat diet.

Nowadays, a great number of traditional Chinese patent medicine (TCPM) are used more and more widely to treat cerebral infarction in China. When great attention is paid to using TCPM in the real world, several problems can be identified: ignoring the Chinese medicine (CM) therapeutic principle based on syndrome differentiation, a lack of appropriate dosage and usage based on individual patient conditions, and a shortage of evidence from randomized, double-blind, placebo-controlled clinical trials. Furthermore, in terms of evaluation of the TCPM effectiveness, few comprehensive criteria and evaluation methods recognized by the international community exist. This article addresses some opinions regarding the above mentioned problems.
Animals ; Cerebral Infarction ; drug therapy ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Patents as Topic

Alleles ; Amelogenin/genetics* ; Chromosomes, Human, Y ; Humans ; Male ; Sex Determination Analysis

OBJECTIVETo report the therapeutic effect of reverse fasciocutaneous flap pedicled with perforator branch of anterior medial malleolus artery for soft tissue defect on the dorsal side of foot.

METHODSThe perforator branch was located under the guidance of Doppler flowmeter. The flap was designed along the saphenous neurovascular axis. Then the flap was transferred reversely with the perforator branch as rotation point.

RESULTSFrom Feb. 2002 to Mar. 2008, 12 cases were treated and followed up for 6 - 18 months. All the flaps survived completely. The flap size ranged from 13.5 cm x 3.0 cm to 8 cm x 3 cm. The perforator branch located at 0.5 - 1.5 cm anterior-inferior to the medial malleolus. Both the cosmetic and functional results were satisfactory.

CONCLUSIONSThe flap has a reliable blood supply and a flexible design. It is easily performed for soft tissue defect on the dorsal side of foot. It is a new type flap which combined neurocutaneous vascular flap with the perforator flap.

Adult ; Fascia ; transplantation ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation