[Objective]To research short-term results of primary total hip arthroplasty using the cementless modular S-ROM prosthesis for the treatment of severe developmental dysplasia of the hip.[Method]Eighten patients(19 hips) with severe developmental dysplasia of the hip underwent primary total hip arthroplasty using the S-ROM prosthesis.Of the patients,6 were male and 12 were female.The average age was 32 years.According to the Crowe classification system,there were 11 hips in type Ⅲ and 8 hips in type Ⅳ.The acetabulums were deepened at the level of the true acetabulum.The S-ROM modular stems were used on the femoral side.Subtrochanteric shortening osteotomy was performed when it was difficult to reset.The Harris hip score(HHS) and radiography were used to evaluate the hip function preoperatively and at the follow-up.[Result]One proximal femur tissure fracture occurred,and was bundled up with circle wire.There were 2 postoperative sciatic nerve irritation,which disappeared completely within 3 months.All patients were available for follow-up.There was one heterotopic ossification above greater trochanter.But the mobility of the hip was normal.There was no loosening or infection during the follow-up.Average follow-up period was(2.8) years(range,6 months-5 years).The HHS increased from 38.4 preoperatively to 85.2 at the time of final follow-up.[Conclusion]S-ROM is a perfect choice for the teatment of severe developmental dysplasia of the hip.Short-time clinical results were excellent.

ObjectiveTo investigate the clinical features and high risk factors of invasive pulmonary fungalinfection(IPFI) to facilitate its diagnosis and treatment.MethodsA retrospective investigation on the clinical data from 68 cases of IPFI patients in our hospital's data banks between Jan.2007 and Mar.2011 was performed.ResultsThe average age of 68 patients was 61 years old.Candida albiacns(36 cases ,52.94％)was the major pathogen for the infection, and the next was aspergillus species(18 cases, 26.47％) and then cryptococcus species(10 cases, 14.71％) .For the primary IPFI,cryptococcus species was the first cause of infection.The main risk factors included severe underlying disease, long-term joint use of antibiotics as well as glucocorticoid usage.Fourty-seven of the 68 cases were cured or improved, 7 were unimproved and 14 died.Conclusion Effective measures to reduce the morbidity and mortality include positive supportive care,curing underlying disease, avoiding invasive surgical procedures and timely and reasonable antibiotics, antifungal and glucocorticoid drugs.

[Objective]A modified femoral resection method Was introduced for total knee replacement,by which the resection ofthe posterior femoral condyle was increased.This study is to verify the accuracy of resection.[Methods]In 81 knees undergoingtotal knee replacement,the thickness of vKrious cuts were measured and compared with the height of the implants.The mean val-ues of these measurements were calculated,and eompqrisons were made according to the mechanical axis using Student's t-test.[Results]On average,the thickness of bone resection in both the flexion and the extension gap was smaller than the thickness otthe prosthesis.In the varus group a minimum lateral over-resection in the flexion gap Was found,and in valgus group a minimummedial over-resection in the flexion gap was found.[Conclusion]The early clinical results with this modified resection method aregood.

Objective: To evaluate the preemptive analgesia of intravenous tramadol preoperatively in neck-surgery. Methods: Eighty patients, ASAⅠ-Ⅱ,were scheduled for neck-surgery under local anesthesia. Patients were randomly divided into 2 groups (40 cases/group).In group P intravenous tramadol was administered as a bolus dose of 3mg/kg 15min prior to skin incision. Group C received saline as a placebo. The patients-controlled analgesia(PCA) devices were used in all patients after operation. We observed BP, HR,VAS score, the time of first PCA activation, the valid number of press PCA and the total consumption of analgesic after operation. Results:The postoperative VAS was markedly lower in group P compared with the group C in 0-24h( P

[Objective]To evaluate the effect of treating the osteochondral defects with implanted cell-scaffold composites,cultured MSCs as seed cells and PLGA as scaffolds,and to acquire desirable seed cells and scaffold materials.[Method]BMSCs were induced to differenciatiated into chondrocytes,co-cultured with PLGA scaffold respectively in vitro,then implanted into osteochondral defects on canine models by using techniques of mosaicplasty,induced BMSC-PLGA scaffold composites in the top of the defect and BMSC-PLGA scaffold composites in the bottom of the defect,osteochondral composites were constructed in vivo,and repair was observed with naked eyes and histology.[Result]At 16 weeks after transplantation the defects of expeirmental group were covered with semi-transparent smooth white tissue and the margins between the repair tissue and the surrounding cartilage were not recognized.Histologically,most of the repair tissue was consisted with chondrocytes,maintained their thickness to the full depth of the original defects.The subchondral bone was well remodeled.The tidemark was observed.The defects of positive control group were covered with repair tissues,and partial were conformed with original cartilage.The repair tissue was partly filled with chondrocytes.However,the defects of negative control group were repaired with soft fibrous tissues without luster,and an obvious boundary between reparative and original cartilage was seen.[Conclusion]MSCs-PLGA scaffold composites,constructed into osteochondral composites by suppressing closely in vivo,are the ideal materials for repairing cartilage defects.

[Objective]To evaluate the feasibility of repairing cartilage defect with tissue-engineered cartilage ,which was made of chondrocytes and osteoblast seeded onto a biodegradable porous bioceramic ?-tricalcium phosphate (?-TCP).[Method] A porous bioceramic template of ?-TCP was created in the shape of a circular cylinder. Chondrocytes and osteoblasts induced from dog bone marrow stem cells were seeded onto the ?-TCP and then kept them growing together for 1 week prior to transplantation into the cartilage defects. After 12 , 16 weeks ,the specimens were harvested and examined macroscopically, histologically and immunohistochemically. [Result] Gross morphological and histological analysis of the specimens from the ?-TCP complex demonstrated new cartilage construction. The result was better than that in control group. [Conclusion] These findings suggest that porous bioceramic (?-TCP) is a good "matrix" for chondrocytes and osteoblasts, and can be used for cartilage engineering.

[Objective]To study the clinical result of Endo-Model rotating-hinge prosthesis in the treatment of severe knee deformity. [Method]Twenty-two patients(10 males and 12 females;12 right knees,8 left knees,and 2 bilateral knees) were selected for total knee arthorplasty using Endo-Model rotating-hinge prosthesis.The average age was 56.2 years.All the patients were evaluated by HSS score system.[Result]All incisions healed at one-stage and all malformations were corrected.The functional result was good.Mile deep vein thrombosis was found in one case after operation.All the patients were followed up for 6-55 months.No infection or prosthetic loosening was developed.[Conclusion]Endo-Model rotating-hinge prosthesis is an effective and reliable prosthesis for severe knee deformity.

Objective To modify femoral resection method in primary total knee arthroplasty and verify the operative results of this modification through measurement of the thickness of the bone resection and clinical follow up. Methods The femoral resection measurement guide was modified so that the resection of the posterior femoral condyle was increased 3 mm in thickness. A total of 81 cases undergoing total knee replacement were divided into varus group and valgus group, in which the thickness of various resections were measured and compared with that of the prosthetic implants. The average follow-up time was 27.1 months. Results On average, the thickness of bone resection in both the flexion and the extension gaps was smaller than that of the prosthesis. In both groups, except for the thickness of the posterior femoral condyle, there were significant differences in other indices ( P

The medical care insurance system has been gradually adopted in Chinese society,whose steady movement is dependent of the benefit balance among all stakeholders of the medical insurance system.Based on Rolles's social justice theory,this article analyzed the equality in the medical insurance payment approaches of prospective payment system and post payment system,pointing out their respective influences on each stakeholder in the medical insurance system.

[Objective] To study the effect of arthroscopic reconstruction of anterior cruciate ligament using RIGIDfix and Intraflx system with quadruple-strand hamstring tendons.[Method]Thirty-six cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with four strands of hamstring tendons,and the grafts were fixed with RIGIDfix and Intrafix system.Ptients were treated with systematic rehabilitation therapy and relevant complications were managed post-operatively.The patients were followed up for 6~12 months,ask the patients' subjective symptom,examine the knee range of motion,anterior drawer test,Lachman test and Pivot shift test,were managed to evaluate clinical result according to Lysholm rating.[Result]All patients had no serious complication,and were followed up for 6~12 months post-operatively.All patients had returned his post,knee range of flexion achieved 130?,extention achieved 0?.Three cases sometimes felt his knee soft and instabilization during exercise violently,the other patients had no sensation of soft and instabilization.When patients were followed up,anterior drawer test:negative 35 cases,positive 1 case;Lachman test:negative 33 cases,positive 3 cases;Pivot shift test of all patients were negative.The Lysholm score increased from 51.3?4.2 to 85.6?4.6,the difference was significant(P