Alternative designs have been explored in an attempt to improve the longevity of acetabular prostheses in revision surgery. Many studies had been designed to test the result of the extra-large uncemented hemispherical acetabular components used for acetabular revision in the presence of bone loss. A clinical study of a new acetabular component consisting of a porous metal shell with three wings and an all-polyethylene liner had attained a satisfying result. The purpose of this study was to evaluate the new acetabular component by comparison with the hemispherical acetabular component. The finite-element models of the two acetabular components and the acetabulum in the presence of bone loss were established to calculate the interface stresses during a normal gait cycle with use of the finite-element formulations. Results of the finite-element analysis demonstrated that stress and strain of the two acetabular components had the same direction of change, but the new component had higher stress at the root of wings. In the study, the result indicated reduced contact stresses with a reduced abduction angle of wings. The stress was lower in the new acetabular component of 15° angle of wings compared with the new acetabularcomponent of 30°of wings and hemispherical acetabular component (P < 0.05). The stress of acetabular component with wings showed no remarkable difference by comparison with the extra-large uncemented hemispherical acetabular component. Reducing abduction angle of wings seemed to be a viable means of reducing the stress of the acetabular component while improving its stability.

0.05).The acute toxicity was more severe in the no-response group and response-LCAF group than in the response-CF group.Conclusion:LCAF did not improve the local control rate and survival rate on grades Ⅰ&Ⅱ esophageal carcinoma when 40Gy had been given by CF.Grades Ⅲ&Ⅳ esophageal carcinoma will get benefit from LCAF.

AIM: To explore the effect of atorvastatin on cardiac remodeling in spontaneous hypertension rats(SHR).METHODS: Twelve spontaneous hypertension rats were divided randomly into two groups: group of atorvastatin(atorvastatin 50 mg?kg~(-1)?d~(-1)) and group of SHR(0.5% mucilage of arabic gum,10 mL?kg~(-1)?d~(-1)).Additionally,six male Wistar-Kyoto rats(0.5% mucilage of arabic gum,10 mL?kg~(-1)?d~(-1)) were selected as control group.Systolic blood pressure was assessed with the tail-cuff method.After six weeks,entire heart,and left ventricle were weighed.The left ventricular weight index was calculated and myocardial hydroxyproline and collagen protein concentration were measured.The serum high sensitivity CRP(hs-CRP) was measured by nephelometry.The localization of vascular cell adhesion molecule(VCAM) in myocardium was investigated by immunohistochemistry assays.The level of NF-?B mRNA expression was detected with in situ hybridization.Ultrastructure in cardiac muscle was also observed under transmission electron microscope.RESULTS: The expression of myocardial VCAM and NF-?B in SHR group was stronger than that in WHY group.Compared with SHR group,entire heart weight,left ventricular weight,left ventricular weight index,serum hs-CRP,myocardial hydroxyproline and collagen protein concentration was decreased,the expression of myocardial VCAM and NF-?B in SHR group was weaker than that in atorvastatin treatment group.The myocardial pathological change such as incomplete karyotheca in cardiac muscle cells,no clear of transverse striation and the mess in myofibril alignment,and hyperplasy in interstitial collagen fibre were observed in SHR group and these changes were improved in atorvastatin treatment group.CONCLUSION: The cardiac remodeling in SHR is improved by atorvastatin.The molecular mechanism may be related to its down-regulating the expression of VCAM protein and NF-?B and inhibiting myocardial chronic inflammation.

Objective To analyze and evaluate a new acetabular revision component with three wings. Methods The finite-element models of a new acetabular component and acetabulum with bone loss were established to calculate the interface stresses during a normal gait cycle with use of the finite-element formulations. Results The finite-element analysis demonstrated that stress and strain at the interfaces of bone-shell and metal-polyethylene liner had the same direction of change but no remarkable difference between them. In the study, the result indicated increased contact stresses with an increased joint load and orientation. The peak stress was tested at the second stage of gait cycle. The stress of wings increased gradually from rim to root. Its peak stress that was significantly lower than yield force of the Co-Cr alloy was at the joint between the wing and the shell. The stress of graft had the same change rule as the joint force. The part of graft near to acetabular component was subjected to higher stress conditions. Conclusion The hip forces can transfer from acetabular component and implant to acetabulum. The result of the finite-element analysis underlined the importance of wings of the new acetabular component. The wing can help to improve the antitorsion ability of acetabular component and to minimize its aseptic loosening rate. Therefore, based on results of this study and clinical application, the acetabular component with wings is known a viable means for acetabular revision in the presence of bone loss. But further research is needed as to this acetabular component.

BACKGROUND:Alternative implants affect stability of prostheses,and freeze-dried bone allografts are most selected as implants.The crack between grafts and host bone is unavoidable,which would weaken the bone integration.Bone cement can fill the cracks quickly and completely,however,the effects of bone cement on the stress of prostheses and its own remains poorly understood.OBJECTIVE:To evaluate the effect of the different grafting for bone loss in the presence of the new acetabular component with wings at the time of acetabular revision.METHODS:The finite-element models of acetabular component with three wings and acetabulum with bone loss were established.Following prostheses implantation,the gaps were filled with bone cement and freeze-dried bone allograft,respectively,stress of the graft and its effect on prostheses were analyzed under 2 158 N and 426 N acetabular loads.RESULTS AND CONCLUSION:The finite-element analysis demonstrated that stress and strain at the interfaces of bone-shell and metal-polyethylene liner had the same direction of change but no significant difference between them.In the study,the result indicated increased contact stresses with an increased hip force and orientation.The stress of wings increased gradually from rim to root.Its peak stress was at the joint between the wing and the shell.The different grafts did not affect the stress of the acetabular component.But the stress of bone cement was significantly higher than that of particulate bone.The study demonstrated that change of the graft could not make remarkable effect on the stress of the acetabular component.But the stress of bone cement increased significantly.The result of the finite-element analysis indicated that particulate bone graft is benefit to improving itsstability and to minimize aseptic loosening rate of acetabular component.

The pathological changes of pulmonary fat emdoiksm were studied in ratsby means of an intravenous injection with autosnbcutaneous fat.The resultsshowed that most fat ernboli appeared in pulmonary arterioles and capillariesafter 24 hours.By 4 days,large number of sudan Ⅲ-positive emboli were seenthroughout the lungs.The inflammatory cellular infiltration including the histoc-ytes,macrophages,polymorphonuclear leucocytes and occasional eosinophils,pulmonary edema and focal hemorrhage were observed.After 7 days,most fatemboli disappeared.No fat embolism in other organs was found.

Drug-induced Parkinsonism (DIP) is a common complication of antipsychotic drugs, calcium channel antagonists, gastrointestinal prokinetic drugs, and antiepileptic drugs and the most common secondary Parkinsonism in the elderly. DIP caused by various drugs is not uncommon in clinic. However, it is easy to omit diagnosis and treatment. Withdrawal of offending drugs is the main treatment and lower risk drugs should be switched if the drug in use cannot be discontinued. The advances in definition, risk factors, pathogenesis, clinical features, diagnosis and treatment, and prognosis of DIP are reviewed in this paper, in order to improve cognition for this curable iatrogenic disease in clinical practice.

BACKGROUND: Studies have demonstrated that platelet-rich plasma can promote osteogenesis and proliferation of bone marrow mesenchymal stem cells, adipose-derived stem cells and skeletal muscle satellite cell, but whether it can promote the proliferation and osteogenesis of human umbilical cord mesenchymal stem cells (hUC-MSCs) is unclear. OBJECTIVE: To investigate the effects of different concentrations of platelet-rich plasma on the proliferation and osteogenic differentiation of hUC-MSCs. METHODS: Passage 5 hUC-MSCs were cultured in medium containing different concentrations of platelet-rich plasma (0, 250, 500, 750, 1000, 2000 ng/L), respectively. Cell proliferation was detected at 1, 3, 5, 7 days after culture, and the best platelet-rich plasma mass concentration was screened. Afterwards, passage 5 hUC-MSCs were divided and cultured in complete medium (blank control group), optimal concentration of platelet-rich plasma (platelet rich plasma group), osteogenesis induction medium (osteogenic induction group), or the osteogenesis induction medium containing the optimal concentration of platelet-rich plasma (combined group). Cell activity of alkaline phosphatase was detected after cultivated for 3, 7, 14 days. Osteopontin, bone specific transcription factor, and osteocalcin mRNA relative expression levels were detected after cultivated for 7, 14, 21 days. Mineralization of the extracellular matrix was detected after cultivated for 21 days. RESULTS AND CONCLUSION: After 5 and 7 days of culture, the cell proliferation was higher in 500, 750, 1000 ng/L platelet-rich plasma groups than 0 ng/L group (P < 0.05), and 750 ng/L platelet-rich plasma showed the best effect on cell proliferation, which was used in the following experiments. Compared with the other groups, the combined group had significantly increased alkaline phosphatase activity (P < 0.05), and up-regulated osteopontin, bone specific transcription factor and osteocalcin mRNA relative expression levels (P < 0.05) at different culture times. In addition, the degree of extracellular matrix mineralization in the combined group was also higher than that in the other three groups (P < 0.05).To conclude, 750 ng/L platelet-rich plasma can promote hUC-MSCs proliferation and osteogenic differentiation.

BACKGROUNDThe trachea, bronchus, blood vessel and left atrium plasty can maximumly remove tumor tissus and preserve the functional pulmonary tissues so as to improve patients' quality of life and prolong their survival.

METHODSFrom January 1990 to August 2004, 125 patients with lung cancer underwent trachea, bronchus, bloood vessel and left atrium plasty.

RESULTSThere were 116 patients who underwent bronchoplasty, in which angioplasty was performed concurrently in 26 cases. And reconstruction of superior vena cava was performed in 3 patients, and left atrium plasty in 6 patients. Three patients died after operation.

CONCLUSIONSTrachea, bronchus, blood vessel and left atrium plasty may be a promising direction in thoracic surgery.

OBJECTIVESTo evaluate clinical manifestations of 21 patients with subclinical pituitary apoplexy and their diagnosis and treatment.

METHODClinical data from 21 patients with subclinical pituitary apoplexy treated from October 1989 to November 2001 were analyzed retrospectively.

RESULTSTheir clinical manifestations included chronic headache, visual deficit and field cut. Three patients showed no clinical signs. Microsurgery was performed in 20 patients, of whom 3 were treated by emergency operation. Microsurgery included transsphenoidal decompression in 17 patients, and transpterioral approach in 3. One patient was given conservative therapy, and 12 were given endocrine replacement therapy. Nineteen patients recovered with marked visual improvement (7), partial improvement (8), no changes (4); deterioration was noted in 1.

CONCLUSIONSSubclinical pituitary apoplexy characterized by atypical clinical manifestations may be misdiagnosed or in appropriately treated. MRI is superior to CT scan for the diagnosis of subclinical pituitary apoplexy. Patients with persistent chiasmatic syndromes are indicated for emergency surgery. Endocrine replacement and transsphnoidal decompression are effective for the improvement of severe visual disturbance.

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Apoplexy ; diagnosis ; surgery ; Tomography, X-Ray Computed