Objective To evaluate the clinical effects and experiences of short stem ceramic-on-ceramic total hip arthroplasty in the treatment of young and middle-aged patients with femoral head necrosis.Methods From December 2009 to March 2011,40 patients with femoral head necrosis were treated primarily with short stem ceramic-on-ceramic hip arthroplasty (43 hips) through posterior-lateral or anterior-lateral approach.There were 23 males,17 females； with the mean age of 40.5 years (range,27-55 years).All cases were stage Ⅳ or more according Steinberg stage.The patients were followed up at the 3,6,12 months after operation,and then once each year.Standard X-ray films were taken at the follow-ups.Femoral prosthesis subsidence was assessed through X-ray films.Harris scores system and WOMAC Osteoarthritis Index were recorded before and after operation to evaluate clinical effects of surgery.Results Thirty-eight patients (41 hips) were followed up for 21-36 months,with an average of 31.3 months.The femoral stem subsided 0.68±2.90 mm at the last follow-up.After operation,hip pain of patients was relieved obviously.The Harris score improved from 38.7±12.1 (15-66) preoperatively to 95.2±4.49 (83-100) postoperatively,WOMAC Index from 66.7±12.0 (49-94) to 12.8±5.6 (0-24).During follow-up period,there was no serious complication such as femoral neck fracture,infection of wound,pulmonary embolism,et al.No dislocation,implant prosthesis failure and infection were observed.Conclusion The short stem hip arthroplasty preserves bone stock to a great extent.The short stem implant showed a good stability and osseous integration.The wear rate of ceramic-on-ceramic bearing surface is extremely low.Short stem hip arthroplasty plus ceramic-on-ceramic bearing surface might be a good option for the young and middle-aged patients with femoral head necrosis.

BACKGROUND: Tuberculosis clearance, bone graft, internal fixation with or without plate for patients with spinal tuberculosis always lead to C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) changes, which are associated with bone graft union time to certain degree.OBJECTIVE: To analyze the correlation between CRP, ESR and bone graft union time in patients with spinal tuberculosis.METHODS: A total of 60 patients with spinal tuberculosis underwent tuberculose focus clearance, autologous iliac bone grafting, and internal fixation without or with plate, including 38 undergoing fixation and 22 not undergoing fixation. They were divided into mild elevation, moderate elevation, high elevation, and extremely high elevation groups according to CRP and ESR. Correlation between CRP, ESR and bone graft union time was analyzed.RESULTS AND CONCLUSION: (1) CRP: there were 18 cases of mild elevation, 21 of moderate elevation, 13 of high elevation and 8 of extremely high elevation. There were significant differences in bone union time among groups (P=0.003). Spearman correlation analysis showed a correlation coefficient r=0.420, P=0.001, indicating positive correlation between CPR and bone union time. (2) ESR: there were 16 cases of mild elevation, 20 of moderate elevation, 13 of high elevation and 11 of extremely high elevation. There were significant differences in bone union time among groups (P=0.003). Spearman correlation analysis showed a correlation coefficient r=0.414, P=0.001, indicating positive correlation between ESR and bone union time. (3) Bone union was rapider in fixation group compared with non-fixation group, indicating that immediate, strong fixation can benefit bone union.

Objective To investigate the frequencies of genotype and allele distribution of IL-12A gene single nucleo?tide polymorphisms (SNP) rs568408 and IL-12B gene SNP rs3212227 in Zhuang populations in Guangxi, and to compare the distribution of IL-12A and IL-12B polymorphisms among different races. Methods The IL-12A SNP rs568408 and IL-12B SNP rs3212227 were detected by SNaPshot SNP genotyping technique in 165 Zhuang people in Guangxi, frequen?cies of genotype and allele of IL-12A gene rs568408 and IL-12B rs3212227 polymorphisms were analyzed in Zhuang popu?lations compared with the other four populations(HapMap-HCB, HapMap-JPT, HapMap-YRI, HapMap-TSI)from Hap?Map database. Results There were polimorphisms of IL-12A and IL-12B gene in Zhuang populations in Guangxi. The fre?quencies of allele and genotype distribution of IL-12A gene rs568408 polymorphisms were not significantly differenct com?pared with HapMap-HCB, HapMap-JPT and HapMap-TSI(P>0.05), but were significantly different compared with Hap?Map-YRI(P<0.01);The frequencies of allele and genotype distribution of IL-12B rs3212227 polymorphisms were not sig?nificantly differenct compared with HapMap-HCB and HapMap-JPT(P>0.05), but were significantly different compared with HapMap-YRI and HapMap-TSI(P<0.01). Conclusion There are significant differences in the frequencies of allele and genotype distribution of IL-12A gene rs568408 and IL-12B gene rs3212227 between Zhuang populations and other eth?nic populations, and this variation might contribute to a variety of clinical manifestation and morbidity of some IL-12 related diseases.

BACKGROUND: Clinical practice showed that there are certain correlations between postoperative C-reactive protein levels and bone graft fusion time following focal debridement,autologous iliac bone graft,with or without plate internal fixation,for the treatment of spinal tuberculosis.OBJECTIVE: To analyze the correlation between postoperative C-reactive protein levels and bone graft fusion time of spinal tuberculosis patients.METHODS: A total of 60 cases with spinal tuberculosis were selected from January 2007 to December 2009.All patients were underwent focal debridement,autologous iliac bone graft,with or without plate internal fixation,and confirmed by pathology.The C-reactive protein levels were determined at 1,7 and 14 days after operation,and then,according to average changes of C-reactive protein levels,the cases were assigned into 4 groups: 10-25 mg/L served as the mildly increase group,26-50 mg/L as the moderately increase group,51-100 mg/L as the highly increase group,and greater than 101 mg/L as the extremely increase group.Postoperative C-reactive protein levels were examined at 12,16,and 24 weeks after operation,the bone graft fusion was observed by X-ray or CT examination,in addition,bone block fusion time was recorded.All groups of patients with spinal tuberculosis postoperative C-reactive protein diversity and bone graft fusion time were analyzed by variability and correlation analysis.RESULTS AND CONCLUSION: There were 18 cases in the mildly increase group,21 cases in the moderately increase group,13 cases in the highly increase group,and 8 cases in the extremely increase group.The bone fusion time showed that: there were8 cases equal to or less than 12 weeks,34 cases equal to or less than 16 weeks,and 18 cases equal to or less than 24 weeks.There were significant differences among 4 groups in bone graft fusion times(X2=13.990,P=0.003).Spearman correlation analysis showed that,there was a positive correlation between postoperative C-reactive protein levels and bone fusion time(r=0.420,P=0.001).

Objective: To assess dietary and urinary risk factors for urolithiasis by a case-control study. Methods: A retrospective analysis was made on the pathogenic factors of 1 151 patients with urolithiasis admitted to the People′s Hospital of Chenghai District from January 2016 to June 2018, and including external environmental factors and internal personal factors. Results: The proportion of male and female patients was 1.69∶1, and the peak age at onset of disease ranged from 21 to 60 years.Most of patients were diagnosed as upper urinary tract calculi.The following variables were found to have significant effects on the morbidity of urinay calculi: less intake of water, over intake of protein, fat and salt. Conclusion The diet and increase water intake and with low-protein, low-fat and low-salt diet are helpful to prevent urolithiasis.

Objective: To study the effects of platelet-rich fibrin extract (PRFe) and platelet-derived growth factor (PDGF) released from PRFe on the proliferation of human gingival fibroblasts (HGFs) and to provide an experimental basis for its application in promoting gingival soft tissue increment. Methods: Platelet-rich fibrin (PRF) was transformed into PRFe by tissue culture. The three-dimensional structure of PRF was observed by electron microscopy, and the content of PDGF in PRF was quantitatively determined by ELISA. The ratios of PRFe examined were 2.5% PRFe, 5% PRFe, 7.5% PRFe, 10% PRFe, 12.5% PRFe and 15% PRFe. Gingival fibrosis was detected by the CCK-8 method. After determining the optimal concentration of PRFe, flow cytometry was used to detect the effect of PRFe on the proliferation cycle of human gingival fibroblasts, and the effect of PDGF on the proliferative activity of gingival fibroblasts was observed by neutralizing the release of PDGF. Results : PRF is a three-dimensional reticular structure that contains a large number of growth factors. PDGF release peaked on the 7th day. The proliferative activity of HGFs cultured with different concentrations of PRFe was concentration-dependent, but the effect was optimal at 5% PRFe (P < 0.05). There were no significant differences in the effect of subsequent concentration increases on the proliferation of HGFs (P > 0.05). The flow cytometry results showed that 5% PRFe could significantly stimulate the S-phase division and proliferation of gingival fibroblasts, while the PDGF neutralization test showed that the proliferation of gingival fibroblasts was significantly inhibited by the neutralization of PDGF. Conclusion Overall 5% PRFe had the best effect on promoting gingival fibroblast proliferation in vitro. PDGF released from PRF plays an important role in promoting the proliferation of gingival fibroblasts.

Objective : To construct a Miller class Ⅲ gingival recession animal model and to lay the foundation for exploring the treatment of Miller class Ⅲ gingival recession. Methods: Two adult male beagle dogs were selected, and four teeth from each beagle dog were selected to establish an experimental Miller class Ⅲ gingival recession model. The root surface was revealed by removing the soft and hard tissues of the buccal side. The success of the model was determined by measuring the vertical gingival retraction (VGR), horizontal retraction (HGR), keratosis tissue width (KTW), gingival tissue thickness (GTT), and probing depth (PD) at 1, 2, 4, 6, and 8 weeks after modeling. Results: After observing the clinical indexes, the PDs before and after the modeling were all smaller than 3 mm and no deep-period pockets were formed. The VGR before modeling was 0 mm, and the VGR range after modeling was 5-6.38 mm. A comparison of the before and after modeling results showed that this difference was statistically significant (P < 0.05). The postoperative VGR results were grouped according to timepoint. A comparison between the two groups showed that the differences at 2, 4, 6 and 8 weeks postoperatively were not statistically significant (P > 0.05). The HGR before the modeling was 0 mm, and the HGR fluctuated around 10.5 mm after the modeling, and this difference was statistically significant (P < 0.05). The HGR results were grouped by timepoint after surgery, and a one-way analysis of showed that the differences between the two groups were not statistically significant (P > 0.05). The KTW range before modeling was 6~9 mm, and it fluctuated around 2 mm after modeling, and this difference was statistically significant (P < 0.05). The KTW results were grouped by timepoint after surgery, and they indicated that significant differences did not occur between the groups postoperatively (P > 0.05). The pre-modeling GTT was 1.5 mm, and the GTT range after modeling was 1.5-2 mm. The preoperative and postoperative GTT results were grouped by timepoint, and the results showed that significant differences did not occur between 1 week and 2 weeks after surgery (P = 0.123), although a statistically significant difference was observed at 1 week postoperatively between this group and the other groups (P < 0.05). Conclusion The method used in this experiment can successfully build a Miller class III gingival recession animal model, and the model remains stable after wound healing.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.