Objective To explore the indication, to describe the key of operative technique in detail and to summarize the early results in mini-incision and minimally invasive surgery (MIS) total hip arthroplasty (THA) for hip disorders. Methods From Mar. 2003 to Mar. 2005, 43 patients (49 hips) were performed with MIS THA. The mean age of patients was 53.2 years ranging from 22 to 79 years. There were 22 males and 21 females. The average body mass index (BMI) was 23.4 ranging from 17.1 to 30.2. Using the modified postero-lateral approach, MIS THA was performed with cementless prostheses. For comparison, 35 patients (43 hips) were performed with standard THA at the same period. The age and BMI of patients in both groups were similar, but the pattern of disorders was different. The comparative items included preoperative bleeding, operative time, incisional length, postoperative functional recovery, and prosthetic position. Results 31 patients (MIS THA) and 25 patients (standard THA) were followed from 6 to 24 months (mean 13.1 months). No complications occurred in MIS THA. Dislocation appeared in one patient with standard THA at the two days after operation. The length of incision was 9.3 cm (range, 8.7 to 10.5 cm) in MIS group and 16.8 cm (range, 14 to 20 cm) in standard THA group. The difference was significant statistically (P

Objective To assess the effect of IL 1Ra gene transfer on amelioration of symptoms and cartilage injury of osteoarthritis (OA) in rabbit. Methods Thirty New Zealand rabbits were divided into 3 groups. Synovial membrane was harvested from the left knee, and synovial fibroblasts were isolated and cultured. Fibroblasts from each rabbit were traanfected using the retrovirus with either IL 1Ra gene (group 3) or marker gene (group 2) in vitro . OA was induced in the right knee of all rabbits by anterior cruciate ligament transection (ACLT). The autologous cells tranfected with IL 1Ra gene or marker gene were respectively injected into the right knee of group 3 and 2. At the end of 2nd and 4th week, IL 1Ra level in synonival fluid (SF) of the right knee were determined by ELISA. The results were evaluated by grading local pain stimulating response, change of gait, joint swelling, and range of joint motion. The degree of injury to the cartilage was graded by the staining of India ink and pathological examination. Results The IL 1Ra level in the right knee SF of group 3 were 20 16?1 8 ng/ml and 4 82?0 52 ng/ml at the end of 2 and 4 weeks after gene delivery, respectively, while that in the group 2 and group 1 was very low. In IL 1Ra gene transfection group, the symptoms of the joint injury and the degree of cartilage lesion were less severe compared with control group. Conclusion This study showed that IL Ra transfer could raise IL 1Ra level in knee joints, thereby alleviate the symptoms and cartilage injury in experimental osteoarthritis

Objective To investigate the influence and the clinical significance of interleukin-2 (IL-2) on T lymphocyte subgroup after chemotherapy in acute myeloid leukemia patients. Methods Fiftyfour acute myeloid leukemia patients were divided into treatment group (chemotherapy combined with IL-2,28 cases) and control group (pure chemotherapy,26 cases) by radom digits table. In treatment group, IL-2400 000 U was dripped after chemotherapy for 14 days. Then the T lymphocyte subgroup change before and after treatment was examined. Results After 14 days' treatment, the levels of CD3 (0.6026±0.2275 ),CD4(0.4972±0.1224),CD56(0.3016±0.1053 ) in treatment group were significantly higher than those before treatment(0.3926±0.2010,0.2264±0.1190,0.1729±0.1226) and in control group (0.4352±0.1930,0.2738±0.1362,0.1937±0.1268)(P< 0.05). Conclusion IL-2 treatment can obviously raise the levels of T lymphocyte subgroup and can raise the immunologic function.

Objective To compare inhibitory effects among extract of Radix tripterygii wilfordii (RTW),dexamethasone and diclofenac sodium on nitric oxide (NO) production and inducible isoform of nitric oxide synthase (iNOS) activity in chondrocytes of patient with rheumatoid arthritis,and to explore cartilage protection of three kinds of medicines in the treatment of rheumatoid arthritis (RA).Methods Chondrocytes from the resected knee joint cartilage of patients with RA were isolated and cultured.The chondrocytes were stimulated by IL 1,and at the same time the cells were treated with RTW,dexamethasone and diclofenac sodium in different concentration overnight.Supernatants were collected to detect the content of NO with Griess reagent.Chondrocytes were collected to examine the iNOS activity by detecting the conversion of L 14 C arginine into L 14 C citruline.The total RNA of chondrocytes was extracted and the iNOS mRNA was examined by Northern blot.Results RTW inhibited NO production and iNOS activity in different concentration (2,4,8 and 16 mg/L).The maximal inhibitory rates were 81 1% and 84 3% respectively.Such inhibitory effects were dosage dependent.Corresponding to NO and iNOS,RTW inhibited the expression of iNOS mRNA induced by IL 1 in chondrocytes.Dexamethasone inhibited NO production,iNOS activity and iNOS mRNA expression significantly,the maximal inhibitory rate around 50%,but not dosage dependent.Diclofenac sodium only had 12 9% inhibitory effect.Conclusion RTW and dexamethasone both inhibited NO production by chondrocytes,but inhibitory effect of dexamethasone was limited.Diclofenac sodium only had weak inhibitory effect.

This article was aimed to study the chemical constituents in Tragopogon porrifolius L. and their activities by pharmacological experiment in order to provide evidences in the further development of the usage of this medical resource. Under the guidance of pharmacological activities screening results, compounds were isolated by repeated silica gel, macroporous resin column chromatography and HPLC. Their structures were identified by means of UV, IR, MS, NMR and other chemical evidences. The results showed that T. porrifolius L. (i.e., n-butanol extraction part) can increase survival time of mice in the oxygen-lacking state (P < 0.05). Two compounds of biological alkaloids, which were identified as 1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid (Ⅰ) and adenine (II), were isolated. It was concluded that compound Ⅰ and II were obtained from T. porrifolius L. for the first time.

Objective To explore suppression of chondrocyte apoptosis by IL-1Ra gene transfer to the knees of experimental osteoarthritis (OA).Method ①Thirty New Zealand white rabbits were divided into 3 groups,partial synovectomy of the left knee had been done.Synovial fibroblasts (SF) were isolated and cultured.②Fibroblasts from each rabbit were transduced by using the retrovirus with either IL-1Ra gene (group 3) or marker gene to (group2) in vitro.③ OA was induced in right knee of rabbits by anterior cruciate ligament transection (ACLT).④ The autologous cells transduced with IL-1Ra gene or marker gene were injected into the right knee of group 3 or 2.⑤At the second week and at the forth week,IL-1Ra level in SF was determined by ELISA.⑥Cartilage section were stained for checking histologic changes and chondrocyte apoptosis were determined using TUNEL method.Results The IL-1Ra level in the SF of group 3 were (20.6?1.8)ng/ml and (4.82?0.52)ng/ml after 2 and 4 weeks,after gene delivered respectively,and the IL-1Ra level in the group 2 and group 1 were very lowat both 2 and 4 weeks.Approximately 40% of chondrocytes underwent apoptosis in group 2,whereas apoptosis were inhibited in group 3,only 18% of chondrocytes underwent apoptosis,and 2%~5% of chondrocytes underwent apoptosis in normal joint.Conclusion This study showes that a local increase IL-1Ra level in OA keen joints by intraartilcular injection of IL-1Ra gene transduced synovial cells can suppress articular cartilage chondrocyte apoptosis.

Objective To evaluate the early and middle-term results of in-situ single-screw fixation and subtrochanteric osteotomy of femur with external fixator for slipped capital femoral epiphysis(SCFE).Methods From June 1998 to July 2008, eleven patients (12 hips) with SCFE were treated, including 7males (8 hips) and 4 females (4 hips) with an average age of 14.3 years (range, 9-18). The average BMI was 31.1 g/m2. According to the Southwick measurement, mild (＜30°) in 6 cases (7 hips), moderate (30°-50°) in 2 cases (2 hips), and severe (＞50°) in 3 cases (3 hips). All the mild and moderate cases were undergone insitu single screw fixation, and three severe cases were performed subtrochanteric osteotomy of femur with external fixator. All the cases were evaluated at 3 months, 6 months and every year postoperatively. Results All the cases were followed up for average 5.6 years (range, 2-12). The Harris hip score increased from mean 74.8 points preoperatively to 90.6 points postoperatively, with 10 hips excellent, 1 hip good, 1 hip fair and 0 hip poor. The excellent and good rate was 91.7% (11/12). The X-ray showed the epiphyseal closure in in-situ single screw fixation cases, and no further increase in epiphyseal-shaft angle. Partial reduction of slipped epiphysis with normal joint spaces was observed in subtrochanteric osteotomy of femur with external fixator cases. Conclusion In-situ single screw fixation provides a surgical treatment option to treat mild and moderate SCFE with satisfactory clinical outcome, and profit to the prevention further slip. Subtrochanteric osteotomy of femur with external fixator is suitable for severe SCFE with late deformity. The realignment procedure can correct deformity and postpone or avoid the occurrence of osteoarthritis.

This retrospective study was to compare the clinical effects of arthroscopie drilling with arthroscopic microfracture technology on full-thickness chondral defects in 68 patients treated between March 2003 and June 2005. The patients were followed up for an average of (20 ± 5 ) months. Lysholm score and Tegner scale were used to evaluate the efficacy. For the arthrescopic drilling group (n = 15 ) and the microfracture surgery group (n =27) , total effective rates were 12/15 and 85% (23/27), respectively. Our data suggest that those two methods provide simple and effective surgical procedure for the treatment of chondral defects of the knee; the results of arthroscopic microfracture were significantly better than arthroscopic drilling.

BACKGROUND:It is a clinical difficult in the treatment of osteonecrosis with joint preservation, and to solve this problem, a variety of bone graft substitutes are at the exploration stage. OBJECTIVE:To evaluate the clinical outcome of lightbulb operation with porous bioceramic β-tricalcium phosphate in a consecutive series of patients with osteonecrosis of the femoral head. METHODS:From January to December 2008, 58 patients (88 hips) who had undergone lightbulb operation with porous bioceramic β-tricalcium phosphate were involved in this study. Al patients were evaluated both clinicaly and radiographicaly at postoperative 3, 6, 12 months and annualy. Functional improvement was assessed with the Harris hip score. RESULTS AND CONCLUSION: Among these patients, 56 patients (85 hips) were folowed up for 2-5 years. According to the ARCO staging system, there were 27 hips of stage II, 40 hips of stage IIIa, 18 hips of IIIb. According to the hospital’s classification, type C was in 4 hips, L1 in 15 hips, L2 in 28 hips, and L3 in 38 hips. According to the Harris hip score system, excelent outcome was in 55 hips, good in 12 hips, fair in 5 hips and poor in 13 hips. Nine of 11 patients who failed to preserve their own joints were subjected to hip replacement. The  mean preoperative and postoperative Harris scores were 61.2 and 85.3, respectively, with a mean improvement of 24.1 points (P < 0.001). All hips were radiologically stable, with no progress of osteonecrosis, and bone density in the bone graft area increased obviously. The replacement time of porous bioceramic β-tricalcium phosphate was 1-1.5 years. These findings suggest that the porous bioceramic β-tricalcium phosphate provides an option to treat osteonecrosis of the femoral head with satisfactory clinical outcomes, and profits the repair and reconstruction of femoral head osteonecrosis. When in the lateral column of femoral head, the porous bioceramic β-tricalcium phosphate can play a supporting role in the lateral column of the necrotic area, and further prevent collapse, which is suitable for patients with osteonecrosis of the femoral head, especially for those with joint preservation.

0.05).On 1,3 and 5 days after the operation,the PHS and PVAS of Group B decreased significantly than those of Group A(P