It has been demonstrated by animal and human experiments that the growth promoting effect of soybean milk substitute formula 5410 is comparable with that of human milk or cow's milk formula commonly used in infant feeding. It was assumed that such a favorable effect is due in part to the inclusion of 5% of egg yolk powder in the formula. However, such an assumption remains to be confirmed.In the present animal experiment, the 5% egg yolk powder was either removed (diet 5700), or substituted with 5% whole egg powder (diet 5411), 5% whole cow's milk powder (diet 5720), 10% whole cow's milk powder (diet 5721).It was fouad that the growth promoting effect of diet 5411 is the, same as that of 5410, while that of the other, diets are all significantly inferior than that of 5410. The role played by the definite amount of egg yolk in the soybean milk substitute is postulated.

ObjectiveTo investigate the influence of selective soft tissue release on the tension around hip joint through posterolateral approach, and to ascertain the sequence of soft tissue release in total hip arthroplasty. MethodsFive fresh frozen cadavers with ten intact lower extremities were used in the study. All the pelves of cadavers were fixed on the operating table by a special designed fixer on a lateral position. Femoral supracondylar bone traction was employed for axial traction. The force for traction was 15 kg. Posterolateral approach was used for exposure and two sequences for soft tissue release were studied. One Kirschner wire was fixed at the bone near the anterior superior iliac spine, and the wire was perpendicu-lar to the operating table. Another Kirschner wire was fixed into the bone at lateral femoral shaft. The two Kirschner wires were parallel to each other. The distance between the two Kirschner wires was measured be-fore and after each soft tissue structure release. ResultsThere were no significant changes of the distance measured before and after applying traction alone, releasing external rotation muscles, opening the posterior capsule and releasing the gluteus maximus insertion. There were significant changes of distance measured before and after resection of femoral head, release of tensor fasciae latae and/or iliotibial band, excision of anterior capsule, and release of iliopsoas tendon had. The average lengthened distance was 1.5 mm (range, 1-3 mm) after resection of femoral head, and 8.0 mm (range, 2-19 mm) after release of tensor fasciae latae and/or iliotibial band, 5.5 mm (range, 1-13 mm) after excision of anterior capsule, and 1.8 mm (range, 1-3 mm) after release of iliopsoas tendon respectively. The distance lengthened after both release of tensor fasci-ae latae (and/or iliotibial band) and excision of anterior capsule was the most significant, average 13.5 mm (range, 11-20 mm). ConclusionRelease of anterior capsule, tensor fasciae latae and/or iliotibial band, and iliopsoas tendon will decrease the soft tissue tension around hip joint. Among all the soft tissue structures we investigated, the anterior capsule and tensor fasciae latae (iliotibial band) make the most effective result. To maintain the soft tissue tension around hip joint depends on different structures working together, releasing one structure alone may not obtain the optimal result. Careful evaluation of tension of tensor fasciae latae and iliotibial band can help avoiding the limb length discrepancy during hip arthroplasty surgery.

Objective To investigate normal patellar morphology,then to explore its possible instructive significance in the design of patella prosthesis for Chinese people and in the process of resurfacing patella.Methods CT scan examinations were performed in 60 normal knees (left or right knee was selected randomly； scan region,from half proximal tibia to half distal femur) of 60 healthy Chinese adults (32 males,28 females； age range,18-54 years； mean age,33.7 years),then mimics software was used to reconstruct the 3-D morphology of each patella and new coronal and sagittal planes were created.Each patella's height,width,thickness,the position of the dome,the ratio of height/width,and the residual thickness after patella was resected at the level of the subchondral bone of the lateral facet during the stimulating process of patella resurfacing were measured or calculated.Results Patella of Chinese male:height 31.95±2.77 mm,width 45.02±2.70 mm,thickness 22.38 ±1.63 mm,the residual thickness after patella was resected 13.18±1.62 mm； Patella of Chinese female:height 28.72±2.17 mm,width 39.57±2.57 mm,thickness 19.88±1.36 mm,the residual thickness after patella was resected 11.20±1.20 mm.Significant differences existed between male and female for all the above four parameters.Patella of Chinese male:the ratio of width/height 1.42 ±0.11,the position of the dome (medial 42.9％)； Patella of Chinese female:the ratio of width/height 1.38±0.10,the position of the dome (medial 42.6％).No significant differences existed between male and female for the above two parameters.Conclusion The patella of Chinese people is small,thin and slim,especially in Chinese female.These findings should be considered in selecting or designing patella prosthesis to fit the Chinese people.For Chinese female,more attention should be paid to keep appropriate residual thickness after the patella was resected during the process of patella resurfacing.

Objective To analysis the modified Gleason scoring system for predicting the prognosis after radical prostatectomy.Methods A total of 242 patients who received radical prostatectomy from April,2006 to October 2011 were recruited.The patients who lost follow-up or had adjuvant radiation or hormonal therapy or had visceral or bone metastasis were excluded,the remaining 168 patients were evaluated in the present study.The patients' age ranged from 53 to 85 years old (mean age 69 years old).The mean PSA level was 13.31ng/ml (ranging from 4.59 to 36.12 ng/ml).According to the traditional Gleason scoring system,there were 50 patients in Gleason ≤ 6 group,86 patients in Gleason 7 group and 32 patients in Gleason≥8 group.Patients were divided in five groups according to the modified Gleason scoring system.There were 50 patients in Gleason ≤6 group,67 in Gleason 3 + 4 group,19 in Gleason 4 + 3 group,15 in Gleason 8 group and 17 in Gleason 9-10 group.The biochemical-free-survival curve was drawn by Kaplan-Meier method and the multivariate Cox regression models were used to evaluate the clinical and pathological variables for the development of biochemical recurrence.ROC curve analysis was used to determine the predicted value for 5-year BCR of modified and traditional Gleason scoring.Results Significant differences were noted between the modified Gleason scoring groups and traditional Gleason scoring groups in PSA value (P =0.005),pathological stage (P =0.002),extraprostatic extension (P =0.003),seminal vesicle invasion (P =0.004),lymph node involvement (P =0.049) and positive surgical margin (P =0.006).With a median follow-up of 68 months(ranging from 7 to 98 months),5-year BFS rates for men with Gleason grade ≤6,3 + 4,4 + 3,8 and 9-10 tumours on RP pathology were 84.0％ (42/50),76.1％ (51/67),57.9％(11/19),40.0％ (9/15),29.4％ (5/17),respectively.On multivariate analysis,the HR value of Gleason 3 + 4 group and Gleason 4 + 3 group were 1.736 and 2.075 (P ＜ 0.05).The area under the curve in modified and traditional Gleason scoring were 0.698 (95％ CI 0.609-0.788) and 0.674 (95％ CI O.584-0.764),respectively.Conclusions The modified Gleason scoring system is related to the prostate cancer grade and its survival rate.Therefore,it can predict prognosis accurately in patients with prostate cancer.It can potential to reduce overtreatment in patients with Gleason 3 +4 prostate cancer.

Objective:To find out whether it is accurate to estimate femoral version based on femoral broach after femoral neck osteotomy using computed tomography scans.Methods:In 32 total hip arthro-plasty (THA),we performed CT scans before and after operation.Four possible levels (lesser trochan-ter,5 mm above,10 mm above and 15 mm above the lesser trochanter)of broach version were calculated based on the pre-operative CT scan.Stem versions were measured on the post-operative CT scan.We de-termined the difference between the preoperative broach version and the postoperative stem version using the Student’s t-test for paired samples assuming equal variance.Results:For the operated hips,pre-operative hip version differed according to the level of measurement.Our findings showed that the average femoral version was 37.0°±11.0°at the level of the lesser trochanter (section 1),34.3°±10.6°at 5 mm above the lesser trochanter (section 2),28.1°±10.9°at 10 mm above the lesser trochanter (sec-tion 3),and 22.4°±13.7°at 15 mm above the lesser trochanter (section 4),and that the average ver-sion for the femoral neck (FNV)was 12.9°±13.8°.The postoperative hip version was the stem version (FSV),which we found to be an average of 26.1°±11.0°.The mean femoral version for section 1 and 2 was larger than the mean postoperative stem version (P<0.01);the mean version for sections 3 and 4 did not differ from the mean postoperative stem version (P>0.05).The mean femoral neck version was less than the mean postoperative stem version (P<0.01);the difference was 13.2°±11.1°of the in-creased anteversion on average for the FSV compared with FNV.Conclusion:The accuracy of estimated femoral version after arthroplasty depends on broach level.When it is 10 mm above the lesser trochanter, stem version estimation is accurate,but below that level,there is a tendency to overestimate.

Objective To investigate alterations of balance function in patients with mild-moderate Alzheimer's disease (AD) and with amnestic mild cognitive impairment (aMCI),and the possibility of using posturography to differentiate aMCI,mild-moderate AD and normal subjects. Methods The balance function of 20 patients with mild-moderate AD and 20 patients with aMCI were evaluated by posturography,and 20 healthy subjects of the same age range were recruited as controls.Results All posturography measures were significantly altered in mild-moderate AD patients compared with normal controls,with limits of stability( ( 15 398 ± 926 ) mm2 vs ( 31 654 ± 2132 ) mm2 ),open-eyed Mean X ( ( 10. 2 ± 4. 1 ) mm vs (5.8 ± 1. 4)mm) ,Mean Y(( -29.8 ± 10.2)mm vs ( -14.9 ±4.4) mm),Max X((30.5 ±9.5)mm vs (18.3 ±4. 1)mm ),Max Y((42.7 ± 11.4)mm vs (23.3 ±6.8)mm),LSKG((528.4 ± 105.4)mm vs (390. 3 ± 68.4 ) mm ),SSKG ( ( 252. 5 ± 89. 7 ) mm2 vs ( 178.8 ± 40. 9 ) mm2 ),close-eyed Mean X ((13. 1 ±4. 5) mm vs (7.9 ± 1.5)mm) ,Mean Y (( -58.2 ± 16. 9) mm vs ( -25.6 ±5.4) mm) ,Max X ((37.7±10.5)mm vs (24.7 ±7.3) mm ),Max Y ((78.5±18.7)mm vs (39.9 ±9.9) mm),LSKG ((816.6±171.3) mm vs (533.5 ±97.4) mm),SSKG((649.0 ± 129.7) mm2 vs (290.5 ±73.3) mm2),respectively ( t = 8.57; open-eyed F = 17.41,38. 10,60. 46,102. 10,29. 31,27. 85; close-eyed F = 37.20,541.79,34. 51,185.56,122. 83,384. 27 ;all P ＜0. 05) ;limits of stability ( (23 921 ± 1637 )mm2 vs (31 654 ±2132 ) mm2 ) and mean Y ( Antero-posterior sway,( - 39. 8 ± 8. 6 ) mm vs ( - 25.6±5.4 ) mm) were the only parameters which discriminated between aMCI and normal controls,respectively ( t = 6. 50,P = 0. 038; t =- 15.34,P = 0. 012). Conclusions Impairment in balance is a feature not only of mild-moderate AD,but also of aMCI,and posturography may be used as a possible test in differentiating between normal subjects,patients with aMCI and patients with mild-moderate AD whose motor performance and balance features are otherwise clinically normal,limits of stability and mean Y are the most sensitive parameters.

Objective To investigate the early outcomes of reconstruction of severe acetabular bone defects by the use of tantalum trabecular metal cup combined with tantalum augment in total hip replacement.Methods From April 2014 to December 2015,23 patients (24 hips) underwent total hip arthroplasty by the use of tantalum trabecular metal cups combined with tantalum augments.There were 11 males (12 hips) and 12 females (12 hips),with the average age 54 years (range,38-65 years).We tried to reconstruct an annular support for the cup.If an annular support cannot be reconstructed,the cup obtains primary stability based on the three point fixation rationale.Flexible placing of the TM cup combined with the augments helped reconstruction of the socket ring or supporting points,thus achieving rigid primary stability of the cup and restoring center of rotation.Harris hip score and Western Ontario and McMaster Universities (WOMAC) osteoarthritis index score were recorded.Any severe intraoperative complications including vascular or nerve injury and severe postoperative complications such as periprosthetic joint infection,dislocation or periprosthetic fracture were reported.The vertical position of the center of rotation from the interteardrop line and the horizontal position of the center of rotation from the teardrop were measured and analyzed.Results The average follow-up duration was 16 months (range,7-28 months).The mean Harris hip score was 35.3±12.1 preoperatively and 82.7±8.3 postoperatively (t=-16.991,P＜0.001).The mean WOMAC score was 39.1 ±24.0 preoperatively and 87.2± 11.4 postoperatively (t=-7.671,P＜ 0.001).The average vertical location of the center of rotation was 44.02± 11.65 mm preoperatively and 22.96±8.24 mm postoperatively.All the tantalum cups and augments were stable.There was no periprosthetic joint infection,dislocation,nerve injury or periprosthetic fracture.Conclusion Reconstruction of Paprosky Ⅲ acetabular bone defects by the use of tantalum trabecular metal cup combined with tantalum augment can achieve good primary stability and restore the center of rotation with almost normal hip biomechanics.The short-term outcomes are satisfied.

[Objective]This study was designed to determine growth inhibition of diallyl trisulfide(DATS)in human prostate cancer cells by inducing apoptosis and further to investigate the mechanism underlying such effect.[Methods]Growth inhibition by DATS was estimated by the tetrazolium(MTr)assay.Apoptosis induction in DATS-treated cells was assessed by fluorescence microscopy analysis of cells with condensed and segmented nuclei following staining with DAPI and flow cytometric analysis of cells with sub-G1 DNA content following staining with propidium iodide.Protein levels of apoptosis regulating proteins were determined using western blot.The activity of caspase-3 was measured using a colorimetric assay.[Result]DATS showed tumor growth inhibition in a time-and dose-dependent manner,IC_(50) of DATS was 14 μmol/L at 72 h.DATS evoked apoptosis as confirmed by cell morphology and by the analysis of flow cytometry.The expression of Bcl-2 and Bcl-xL,the apoptosis-suppressing proteins,was more down-regulated.The activity of caspase-3 was enhanced by DATS.[Conclusion]DATS inhibits growth of prostate cancer cells by inducing apoptosis in association with down-regulation of Bcl-2 and Bcl-xL and activation of caspase-3.

Objective To evaluate the safety and efficacy of the modified subclavian vein cathetrization (SVC) in Neurosurgical Intensive Care Unit (NICU).Methods The clinical data of 292 patients experienced SVC in NICU over a 3-year-and-9-month periodwere retrospectively analyzed,and they were divided into groups by the method of SVC,in which 227 patients underwent modified SVC were identified and compared with 65 patients who underwent routine SVC during the same period.Medical charts of the patients were reviewed to collect demographic information,such as age,sex,rate of success at first-puncture and complications.Statistical comparisons between the two groups were made using Chi-square analysis for the variables and were considered to be statistically significant if P ＜ 0.05.Data were analyzed using SPSS 19.0 (Armonk,NY:IBM Corp,USA).Results In the SVC group,the total success was achieved in 61 patients (93.8％),and the incidence rate of complications related to puncture and cathetrization was 29.5％.In the mSVC group,the total successful rate was 99.1％,and the incidence rate of complications related to puncture and cathetrization was 7.1％.The mSVC was better than traditional SVC in successful rate and incidence rate of complications related to puncture and cathetrization (x2 =4.61,7.32,all P ＜ 0.05).Conclusion mSVC for the patients in NICU is a safe and effective technique with low morbidity and mortality.

Objective To investigate the early outcomes of revision hip arthroplasty using restoration modular (RM) stem.Methods Fifty-nine patients underwent revision hip arthroplasty with RM stem from April 2012 to June 2015 in our center with a minimal of two years follow-up.The patients including 24 male and 35 female had a median age of 61.0 (56,66) years.The median BMI was 24.0 (22.5,26.0) kg/m2,while the median interval from the primary surgery was 10.5 (6.0,14.5) years.The rea sons for revision inculded infection in 8 patients,aseptic loosening in 45,recurrent dislocation in 1,and periprosthetic fracture in 5.There were 3 cases of type B2 and 2 cases of B3 periprosthetic fracture according to Vancouver classification.The bone defects severity was conducted according to Paprosky classification that 14 patients in type Ⅱ,31 in type ⅢA,8 in type ⅢB,and 1 in type Ⅳ.Acetabular component were revised in 56 cases.Patients were followed up at 3 months,6 months,1 year and annually thereafter for clinical and radiological evaluation.Results All the patients were followed up with a median duration of 30.4 (27.3,37.9)months,the median Harris score significantly improved from 37 (31,53) points preoperatively to 84 (80,95) points at the last follow up (Z=-6.681,P=0.000).There were 3 patients had perforation or fracture intra-operatively,two of them were fixed by strut allograft.The other one who did not compromise the implant stability was not fixed.Extended trochanteric osteotomy was applied in 14 cases and they healed well at 3-6 months during follow-up.There was one case of early dislocation at 6 days postoperatively,which was treated with close reduction and immobilization without recurrence.No infection,stem fracture,hematoma formation and sciatic nerve injury were reported.No femoral component loosening was identified at the latest follow-up.Median subsidence was 1.0 (0,2.0) mm with the maximum case 6.0 mm and 3 cases 3.5 mm.All of subsidence developed within the first year postoperatively but without further aggravation.The affected leg lengthened 17.5± 10.1 mm (range 2-40 mm) after operation.The affected leg was shorter 17.5± 12.6 mm (shorter 44.4 mm to longer 3.0 mm) than that in the normal side pre-operatively.However,the distinction decreased to 0.1±9.6 mm postoperatively (shorter 24.8 mm to longer 22.4 mm,t=-10.538,P=0.000).Conclusion Early satisfactory results are achieved in hip revision using RM modular stem at the femoral side.The modular design could simplify the surgical procedure with better control of leg length and joint stability.Long-term follow-up is still required for further evaluation.