Objective To simplify the management of multi-version data.Methods Oracle workspace manager technology was implemented to manage corresponding table in different version.Results The management of multi-version data in a single Oracle database could be achieved.Conclusion The method can make database management easier and save the cost of hardware.[Chinese Medical Equipment Journal,2008,29(3):45-46]

The infection of 2019-nCoV can lead to overexpression of inflammatory factors, triggering cytokine storm and causing serious damage to the body. Glucocorticoids have anti-inflammatory properties and may be an effective treatment option. The use and dosage of glucocorticoids in coronavirus disease 2019 (COVID-19) remains controversial. This article reviews the theoretical basis, clinical evidence, debates and specific measures of glucocorticoids in the treatment of COVID-19, to provide reference for rational application of glucocorticoids in the future.

Objective To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO) for the treatment of tibial fracture. Methods From August 2005 to January 2007,a total of 26 patients with tibial fracture were treated with MIPPO in our hospital.Among the patients,the facture was located at the proximal tibia in 8,the distal tibia in 7,and the shaft in 11.Results The incision size was 4.0-8.5 cm with a mean of 6.6 cm;the intraoperative blood loss ranged from 80 to 400 ml(mean,180 ml);and the operation lasted 40-120 minutes(mean,87 minutes).The swelling subsided 1-6 days after the operation(mean,2.5 days).All the incisions healed primarily.The patients were followed up for 6 month on average(3 to 15 months).The fractures healed in 3-13 months(mean,4.2) after the operation.No complications,including delayed incision healing,incision infection,parenchymal necrosis,bone exposure,delayed union,and non-union,occurred in the series.According to the Johner-Wruhs criteria,the knee and ankle functions were excellent in 19 patients,good in 4,fair in 2,and poor in 1.Conclusions The MIPPO provides biological fixation and results in minimal parenchymal injury in patients with tibial fracture.By using the technique,the patients recover quickly with few complications and mild reaction to the trauma.The method is an optimal approach that is worth being promoted.

[Objective]To study the effect of femoral offset and hip joint center on joint function after total hip replacement,radiographic measurements were taken postoperation.[Method]A series of 92 hip joints(87 patients)were followed up.The average follow up priod was 25 monthes.The femoral offset and the position of the prothesis head center were measured in the orthophoric hip joint X-ray photograph and were compared with anatomic Fo and HJC.H arris evaluation system was used to evaluate joint function in four groups.The results were statistically analyzed,with Fisher' exact probability and P value less than 0.05 indicating significant difference.[Result]The coincidence rate of group A(both FO and HJC,27 hips)was 29.35%,group B(only Fo,23 hips)25.00%,group C(only HJC,31 hips)33.70%,group D(neither FO nor HJC,11 hips)11.96%.93.0% patients got the Harris score more than 80 for group A,73.19%(group B),74.19%(group C),27.27%(group D).The difference of Harris evaluation between A and B,A and C,A and D was significant statistically.[Conclusion]Based on the results of the study,the recovery of femoral offset and hip joint center should be considered to contribute to the healing effect after total hip replacement directly.

[Objective]To explore the effect of hip joint center on the stability of hip joint,the radiographic measurements were compared between preoperation and postoperation.[Method]A total of 155 hips from 120 patients with primary total hip replacement from resent years were studied,the hip joint center difference through radiographic measurements between preoperation and postoperation were compared.[Result]The coincident rate and the incoincident rate were 63.23%(group A,98 hips) and 36.77%(group B,57 hips) respectively.For loose,dislocation or low back pain,the rate of revision in group A and group B were 6.12% and 29.82% respectively.[Conclusion]The comeback of hip joint center was essential for stability of hip joint.

BACKGROUND:Currently, there are few researches on the effect of punicalagin on the formation and differentiation of osteoclasts, and fewer researches on the mechanism of bone resorption diseases induced by wear particles. OBJECTIVE: To establish a model of titanium particles induced mouse monocyte/macrophage cel line (RAW264.7) differentiating into osteoclasts and to observe the effect of different concentrations of punicalagins on osteoclast proliferation and differentiation. METHODS: Mouse monocyte/macrophage cel lines (RAW264.7) were divided into five groups, cultured in the culture medium of common (blank group), 0.1 g/L titanium particle suspension, 0.1 g/L titanium particle suspension with 25 μmol/L punicalagins, 0.1 g/L titanium particle suspension with 50 μmol/L punicalagins, 0.1 g/L titanium particle suspension with 100 μmol/L punicalagins, respectively. The cel proliferative activity was detected by cel counting kit-8 assay at 1, 3 and 5 days. At 5 days after culture, number of osteoclasts was measured by tartrate-resistant acid phosphatase staining, the phosphorylation of IκBα and NF-κB p65 was detected by western blot assay, the mRNA expressions of nuclear factor of activated Tc1, tartrate-resistant acid phosphatase and matrix metaloproteinase-9 were measured by reverse transcription-PCR. RESULTS AND CONCLUSION:Compared with control group, titanium particles and different concentrations of punicalagin had no effect on the proliferation of RAW264.7 cels (P > 0.05). The number of tartrate-resistant acid phosphatase staining -positive cels, the phosphorylation of IκBα and NF-κB p65 as wel as the mRNA expressions of nuclear factor of activated Tc1, tartrate-resistant acid phosphatase and matrix metaloproteinase-9 were significantly increased compared with those of control group (P < 0.05,P < 0.01). And punicalagins in a concentration-dependent manner decreased the expression of the above indicators. These results indicate that punicalagin can inhibit osteoclast formation and differentiation.

BACKGROUND: The main reason for the postoperative loosening of cemented prosthesis is interfacial debonding and bone cement internal damage. Most studies have suggested that both of them occur in the process of fatigue damage, however, little is reported on primary loading that results in the initial damage to the bone cement-stem interface and inside of bone cement. OBJECTIVE: To study the mechanical properties of bone cement-stem interface, and the effect of crack formation in bone cement on interfacial loosening. METHODS: The cement-titanium al oy handle implant components were prepared. The maximum adhesive force of bone cement-stem interface was measured using push-in experiment. The cement damage and crack in the process of bone cement-handle interfacial debonding were monitored online using acoustic emission tester. The non-destructive testing on the metal surface and the inner layer of bone cement cylinder was conducted using three-dimensional surface profiler, ultrasonic microscopy and X-ray detector. RESULTS AND CONCLUSION: The online monitoring results of debonding experiment and acoustic emission tester demonstrated that the initial damage of bone cement initiated in the primary loading of patients after operation, rather than at fatigue damage stage. Bone cement coffin caused cracks initiation mainly due to the combination effect of radial and axial stress. The bone cement-stem interfacial shear lag effect could not prevent the gradual extension of interface and inner coffin crack from top to bottom. The bone cement defects formed in solidification process was likely to affect the mechanical properties of the material, and eventual y induced the crystal face and macromolecular chain fractures, forming silver striated cracks and leading component failure.

Objective To explore the effect of diphosphonate on expression of matrix metalloproteinase-9(MMP-9) and cathepsin K(CK) in subchondral bone of unstable rabbit knee joints.Methods Fifty male New Zealand white rabbits were divided randomly into three groups according to random digits table:the control group (n=10),the model group (n=20).the diphosphonate group (n=20).Hulth model of unstable rabbit knee joint was achieved in the right knee joint.Ten rabbits from the diphosphonate group and 5 rabbits from the control group were sacrificed by aeroembolism at the second and tenth week postoperatively,respectively.Then the medial femoral condyles of the right knee were harvested.Specimens were processed for immunohistochemical analysis of MMP-9 and CK.Results Cells with expression of MMP-9 and CK could be found in the three groups at the second and tenth week after operation.Compared with the control group,there was a significant increase in the number of cells with expression of MMP-9 and CK in model group at the second and tenth week after operation.Diphosphonate could inhibit expression of MMP-9 and CK in cells.Compared with the model group,the number of cells with expression of MMP-9 and CK in diphosphonate group was fewer; there was a statistical significance between them.Conclusion Diphosphonate can inhibit the expression of MMP-9 and CK in subchondral bone of unstable rabbit knee joints,which can resist the bone resorption and protect articular cartilage.

BACKGROUND:The use of cemented or uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly remains controversial.Therefore,it is necessary to conduct a comparative study on the effectiveness and safety of these two methods.OBJECTIVE:To compare the clinical efficacy of cemented and uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly.METHODS:Clinical data of 93 elderly patients with unstable intertrochanteric fractures in Department of Orthopedics,Shandong Energy Zaozhuang Mining Group General Hospital from May 2009 to May 2014 were analyzed retrospectively.All patients were divided into cemented (cemented bipolar hemiarthroplasty for fractures,n=54) and uncemented (uncemented bipolar hemiarthroplasty for fractures,n=39) groups.RESULTS AND CONCLUSION:(1) The amounts of postoperative drainage and blood transfusion in the cemented group were significantly less than those in the uncemented group (P ＜ 0.05),but the operation time was significantly longer (P ＜ 0.05).(2) There were no significant differences in the intraoperative blood loss,ambulation time,hospitalization time,postoperative complications,hip function,and mortality at 3 and 12 months postoperatively between two groups (P ＞ 0.05).(3) Postoperative X-ray showed that all patients had good prosthesis position.There were 10 patients (3 cases in the cemented group,7 cases in the uncemented group) with postoperative prosthesis subsidence,but all of them were less than 3 mm.(4) None of patients had heterotopic ossification,osteolysis around the prosthesis and acetabular cartilage wear during follow-up.Additionally,25 patients (16 cases in the cement group,9 cases in the uncement group) died during follow-up,without prosthesis loosening,and the remaining 68 patients were followed up for 2-7 years,(4.5±2.3) years on average,and none needed revision because of prosthesis loosening.(5) These results indicate that for senile unstable intertrochanteric fractures,both cemented and uncemented hemiarthroplasty can achieve satisfactory curative effectiveness and exhibits good safety.Notably,the cemented prosthesis has advantages in reducing postoperative drainage volume and blood transfusion.

Objective To investigate the efficacy of external fixators in the treatment of unstable pelvic fractures( Tile B and Tile C ). Methods The different results of 78 patients who had been treated with or without external fixator were compared. Results In 38 cases who were treated without external fixator, the cure rate for hemorrhagic shock was 76%, the mortality 10.6%, and the average ISS score 11.6. In 40 cases who were treated with external fixator, the cure rate for hemorrhagic shock was 90%, the mortality 2.5%, and the average ISS score 9.8. Conclusion The treatment of unstable pelvic fracture with external fixator is simple and reliable, and can reduce the mortality significantly.