The lateral wall,a new concept in the study of trochanteric hip fractures,has a great influence on the choice of internal fixation methods,stability of the fracture and prognosis of the patients.Currently,the research on the lateral wall focuses on the factors leading to its rupture,its anatomical features and its effect on internal fixation,but results in controversial views which are mostly influenced by the subjective and experimental factors.This review deals with how the concept of lateral wall was proposed,the importance and anatomical features of lateral wall,the causes for lateral wall rupture and current treatment perspectives of trochanteric hip fractures,aiming at increasing the awareness of the lateral wall among orthopedic surgeons and related researchers.

microRNAs (miRNAs) are small,non-coding,regulatory RNA molecules group expressed in tissues and cells in specific manner.They are well-known as playing crucial roles in cell homeostasis and carcinogenesis.In recent years,numerou of studys on individual miRNAs or miRNA patterns have been published.These study provided strong evidences that miRNAs might play important roles in malignant melanoma development and progression.Melanoma associated miRNAs often located in genomic regions with frequent gains and losses in tumours.This article focus on some individual miRNAs which involved in melanoma biology,by which may regulate many different target genes by several ways.The current therapy of this disease is also described.

BACKGROUND:Biodegradable implants cannot only rebuild bone defect site, moreover, with the gradual degradation of the materials, new bone tissue can completely replace the graft materials to fil bone defects. OBJECTIVE:To summarize the research progress of biodegradable materials combined with osteogenic factor in orthopedics. METHODS: We took the “biodegradable materials, factors, cel active factor, bone tissue engineering” as the search terms in Chinese and English, respectively, to retrieve the related literatures from PubMed, Wanfang and CNKI database during 2000 to 2015 by computer. RESULTS AND CONCLUSION: Biodegradable medical polymer materials can be divided into natural polymer materials and synthetic biodegradable materials. Natural polymeric materials have good biocompatibility, but poor mechanical strength. The mechanical strength of synthetic biodegradable materials is higher than that of natural polymer materials, but the synthetic biodegradable materials are likely to cause local accumulation of acidic substances, produce local inflammation. The biodegradable medical polymer materials combined with osteogenic factor can improve the mechanical strength and osteoinductive ability of materials, but as a bone repair material, it stil has many problems to be solved.

Objective To explore the mechanism of six-segment classification of femur intertrochanteric fracture in a three-dimensional finite element model of upper thigh-bone and its clinical relevance.Methods The left upper thigh-bone of a normal male volunteer of 60 years old was scanned using 64-slice CT.After the images were stored in the format of JPG,they were input into photoshop 7.0 for three-dimensional creation.The three-dimensional images were used to make a three-dimensional finite element model of upper thigh-bone using software Super 93.The model consisted of 764 nodes and 531 units (including 306 compact bone units and 225 cancellous bone units).In this model,the stress distribution at the trochanter during human tumbling was analyzed by imitating adduction,abduction,adduction-intemal rotation and abduction-external rotation of the hip,as well as intense muscular contraction of gluteus medius,piriformis and iliopsoas during adduction-internal rotation of the hip.Results Analysis of stress nephogram showed that the stress was distributed mainly at the exterior cortical bone and spread to the inter-trochanteric part in simple hip adduction (two-part fracture) and distributed mainly at the interior cortical bone and spread to the inter-trochanteric part in simple hip abduction (two-part fracture).In adduction-internal rotation or abduction-external rotation of the hip,the stress was focused on the anterior and posterior walls of the greater trochanter and trochanteric part and spread to the exterior and interior cortical bone and the inter-trochanteric part (three-or four-part fracture).During intense muscular contraction of gluteus medius,piriformis and iliopsoas during adduction-internal rotation of the hip,the stress was focused on the anterior and posterior walls of the greater trochanter,lesser trochanter and trochanteric part and spread to the exterior and interior cortical bone and the inter-trochanteric part (five-or six-part fracture).Conclusions The six-segment classification of femur intertrochanteric fracture explains complex stress distributions after human falling.When combined with three-dimensional CT reconstruction,it is more intuitive than other classifications so that it can provide more definite surgical advice for different types of fracture.

Objective To determine the role of angiogenesis in the prognosis of breast carcinoma and its relationship with p53 expression and ER statue in 59 cases of breast cacinoma. Methods Factor Ⅷ related antigen (FⅧ RA) and p53 were evaluated by immunohistochemical staining,and the microvessel endothelial area (MEA) of tumor microvessels was detected by computer aided image analysis system. Results (1) The expression of MEA significantly increased with tumor size and histologic grade(P

Objective To investigate biomechanical analysis of poly DL-lactic acid (PDLLA)biodegradable fusion cage of the lumbar vertebrae in vivo degradation. Methods Forty-eight healthy adult porcine were divided into experimental group and control group at randomly. PDLLA cage full of autogenous bone and bone block with the same size were planted in L45 intervertebrae respectively. At the 1st, 3rd, 6th,9th, 12th, and 18th month postoperatively, the animals were sacrificed and the surgical spinal segment was observed. The range of motion (ROM) was measured. Results The ROMs had no statistical differences at all motion directions between the two froups at the 1st month postoperatively. But the ROMs of experimental group were greater than those of control group at extension direction at the 3rd and 6th month postoperatively. The ROMs of extension was the greatest while the ROMs of right rotation was the least in both groups. At the 9th month postoperatively: the ROMs of experimental group greater than those of control group except at rotation. The ROMs of right rotation was the least in both groups. The greatest ROMs was at extension in experimental group and at right bending in control group. ALL ROMs tended to decrease and the ROMs of extension had comparability between tow groups. At the 12th month postoperatively, experimental group had greater ROMs at extension and left bending and less ROMs at other directions. Likewise statistical differences showed only at extension. 18th month postoperatively all ROMs were close between two groups. Conclusion After PDLLA cage is planted, the first 3 months is autologous stable stage. The period of 3rd to 6th months is easily released stage. The operative segments are stable from 9th to 12th months and acquired.Critical period between stability and instability is from 6th to 9th months. Bone fusion is from 12th to 18th months postoperatively.

Breast cancer and dyslipidemia are common diseases in women.It is reported that breast cancer and dyslipidemia have some relevance.Breast cancer patients have a relatively high incidence of dyslipidemia,which is easily undiagnosed for lacking of obvious clinical manifestations and will affect the treatment and prognosis of breast cancer.In breast cancer patients,screening and diagnosis of dyslipidemia through blood lipid detection should be strengthened.

Postoperative adjuvant therapy for primary invasive breast cancer patients with synchronous ax-illary metastases is mainly based on the characteristics of biomarker of the primary tumor. Recently, some studies have showed the discordance and clinical significance of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status between primary breast cancer and synchronous axillary lymph node metastases. As local metastasis, the synchronous axillary metastases may represent the potentially metastatic breast cancer cells much better than the primary tumor. Hence, determination of biomarkers status should be performed in synchronous axillary metastasis, together with primary tumor, to guide therapy management and evaluate the prognosis of primary invasive breast cancer patients with synchronous axillary metastases.

BACKGROUND:Posterior lumbar interbody fusion is a typical therapeutic method of lumbar degenerative disease. Present studies suggested that adjacent segment degeneration occurs after fusion. Recently, more and more scholars paid attention to the development of non-fusion of the spine. ＜br> OBJECTIVE:To compare clinical effects of Dynesys dynamic stabilization system fixation and posterior lumbar interbody fusion in treatment of lumbar degenerative disease. ＜br> METHODS:From July 2009 to July 2011, clinical data of 56 patients with lumbar degenerative disease were retrospectively analyzed. There were 28 cases of Dynesys dynamic stabilization system fixation, and 28 cases of posterior lumbar interbody fusion. Operation time, bleeding volume, and postoperative hospitalization time were compared in both groups. Visual analog scale was used to assess pain. Oswestry disability index was utilized to evaluate clinical effects. ＜br> RESULTS AND CONCLUSION:A total of 56 patients were fol owed up for 18-24 months. Visual analog scale and Oswestry disability index scores were significantly improved at 12 months after treatment in both groups (P＜0.01). Significant differences in operation time, bleeding volume, and postoperative hospitalization time were detected between both groups (P＜0.01). Dynesys dynamic stabilization system group was better than posterior lumbar interbody fusion group. Range of motion was better in the Dynesys dynamic stabilization system group than in the posterior lumbar interbody fusion group (P＜0.01). During fol ow-up, nail rope system and polyester sleeve loose were not detectable in the Dynesys dynamic stabilization system group. These results verified that compared with posterior lumbar interbody fusion, Dynesys dynamic stabilization system for lumbar degenerative diseases has a high safety and smal trauma, and can keep advantages of a fixed segment, and exert a certain effect on degeneration of intervertebral disc in the adjacent segment.

BACKGROUND:Metal vertebral fusion cage can induce some disadvantages and pseudoarticulation formation such as stress dodge,fusion cage subsidence,bone resorption,prolapse and bone collapse.Biodegradable absorbing material-made vertebral fusion cage can avoid disadvantages mentioned above.There are no studies on correlation of material function to design of absorbing fusion cage of lumbar vertebrae.OBJECTIVE:To design and fabricate the poly DL-lactic acid biodegradable fusion cage of lumbar vertebrae,and to analyze the material characteristics.DESIGN,TIME AND SETTING:The material in vivo experiment was performed at the Chengdu Institute of Organic Chemistry of Chinese Academy of Sciences from January 2003 to December 2006.MATERIALS:Twenty dogs aged 12 months were obtained from Animal Laboratory of West China,Sichuan University.Poly DL-lactic acid biodegradable fusion cage of lumbar vertebrae was produced by the Chengdu Institute of Organic Chemistry of Chinese Academy of Sciences.METHODS:According to the anatomical characters and measured data of lumbar intervertebral disc,we designed the poly DL-lactic acid biodegradable fusion cage of lumbar vertebrae.The rectangle cage consists of two styles:23 mm and 25 mm,13 mm in width,and 9,10,11 and 12 in depth(anterior wall).The depth was small half-moon shape from anterior to posterior,and the posterior wall was thinner than anterior wall about 1.5mm to accord with the shape of intervertebral discs.The depth of four walls of the fusion cage was 2.5 mm,with several 1-mm diameter holes on bilateral walls.The posterior wall had 3.5-mm diameter spiral hole,which was used for connecting with the implanted tool.Using precise shaping processing craft,the produce process was DL-lactic acid→raw material storage→lactide preparation→lactide purification→polymerization→drying package→product.After general anesthesia,bilateral thighs were incised in 20 dogs,and then a fusion cage was implanted into each dog to detect compressive strength and viscosity in the process of biodegradation.MAIN OUTCOME MEASURES:Preparation of fusion cage;compressive strength and viscosity in the process of biodegradation in vivo.RESULTS:The size of the products is 23 mm?13 mm?10 mm and the appearance of the products were saw tooth shape,which could prevent the slide,enhance the solid strength between fusion cage and the surface of vertebra.Small holes on the bilateral wall were beneficial for vascular growth and nutrient fluid exchange,resulting in bony fusion.Compressive strength and viscosity decreased at 3,6 and 9 months after implantation(r=0.961,P=0.009),but compressive strength and viscosity were good at 12 months(163 MPa and 0.66 dl/g).CONCLUSION:Poly DL-lactic acid biodegradable fusion cage has a big loading implanted bone mass and high stability.The integrity and supportive effect of the fusion cage can meet the requirement of bony fusion.