The selection of the prosthetic material determine the success or failure of hip arthroplasty. Currently, the metals, ceramics, polymer composites and carbon materials are the main prosthetic materials of artificial hip joint. They have some progresses in biocompatibility, elastic modulus,mechanical properties, useful life, but they still can't reach the ideal standard of design. In this essay, we mainly review the characteristics and applications of the current artificial hip joint materials through its classification in order to provide a reference for choosing appropriate hip joint materials in clinic and increasing characteristic of materials. We consider the polymer composites has more advantages such as biocompatibility, mechanical properties, corrosion resistance and price, even if it has shortages in abrasion resistance. As the researches of polymer composites are main focus on abrasion resistance, articular surface and strength,and its performances are increased fast, it has a wide prospect in future.
Animals ; Hip Dislocation ; surgery ; Hip Prosthesis ; standards ; utilization ; Humans

Objective To investigate the clinical results of minimal invasion spinal surgery (MISS) in treating tibial plateau fractures to provide best procedure for such treatment.Methods The study involved 36 cases with tibial plateau fractures resulted from traffic injury,fall-from-height injury and strain injury including 24 males and 12 females at age of 19-65 years (average 42.6 years).According to Schatzker classification,there were seven cases of typeⅠ,five typeⅡ,five typeⅢ,five type IV,sev- en typeⅤand seven typeⅥ.All cases were treated by different methods of MISS.Results Follow up for 8-24 months in 35 cases showed fracture healing within 3-4 months,without severe complications such as poor wound healing,infection or osteofascial compartment syndrome.Meanwhile,no traumatic knee osteoarthritis,inversion or eversion of the knee were found.The mean range of knee motion was 94?,with fine knee function in 32 cases (91.4%) according to Merchant score.Conclusions Treatment of tibi- al plateau fractures should adopt limit incision,indirect reduction and biofixation to take place widespread exposure and rigid plate fixation.MISS is safe and effective for tibial plateau fractures.

BACKGROUND:The research and application of platelet-rich plasma in tissue regeneration and restoration have always been an issue of concern in the medicine and bioengineering fields.OBJECTIVE:To analyze the effects of platelet-rich plasma in combination with tendon stem cells on histomorphology change and matrix metalloproteinase 1 expression of the tendon tissues in a rabbit model of Achilles tendinopathy.METHODS:Forty New Zealand white rabbits were randomly divided into model group (n=32) and blank control group (n=8).In the model group,the animals were injected about 2 cm distant to the attachment point of the left calcaneus with prostaglandin E2 (once a week,for totally 4 weeks) to make the animal model of tendinopathy.The rabbits in the blank control group were injected the equal amount of normal saline.After 4 weeks,model rabbits were randomly divided into four subgroups:combination group,tendon stem cell group,platelet-rich plasma group and model control group,with eight rabbits in each group.Platelet-rich plasma and tendon stem cells,alone or in combination,and normal saline were injected into the corresponding group,twice with an interval of 3 weeks.At 6 weeks after injection,the tendon tissue was collected and stained for histological examination and detection of matrix metalloproteinasa 1 expression.RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining:the tendon fibers in the combinationgroup were intact and arranged orderly;in the tendon stem cell group,the tendon fibers were almost arranged orderly despite some fractured fibers;in the platelet-rich plasma group,fiber breakage and loose fiber structure were observed;in the model control group,there were no intact tendon fibers,with the presence of inflammatory cell filtration.(2) Masson staining:The tendon fibers in the combination group had slight wave-shaped changes but the fibers were not cut off;in the tendon stem cell group,the tendon fibers were slightly in disorder,but with the intact structure,and obvious inflammatory cell filtration was observed;in the platelet-rich plasma group,fiber breakage,reduced collagen fibers and inflammatory cell filtration were obviously observed;in the model control group,there were no intact tendon fibers,and inflammatory cell filtration was clearly visible.(3) The expression of matrix metalloproteinase 1:Compared with the blank control group,the expression of matrix metalloproteinase 1 was significantly higher in the other groups except the combination group (P ＜ 0.05).There was no significant difference in the expression of matrix metalloproteinase 1 between the combination group and blank control group (P ＞ 0.05).To conclude,the combination of platelet-rich plasma and tendon stem cells can inhibit the vicious cycle of degeneration of collagen and extracellular matrix,reduce the expression of matrix metalloproteinase 1 in tenocytes,and delay inflammation responses and degeneration due to tendinopathy.

Objective To study hemodynamics of cerebral blood flow in newborns with asphyxia.Method Bilateral cerebral electrical admittance plethysmogram(BCEAP) was used to explore characteristics of cerebral blood flow in 20 healthy newborns and 20 newborns with asphyxia respectively from first to fourth day after birth.Results Both the ratio of Hs to b-S(Hs/ b-S) and index of admittance differential loop(ADL) Ⅰ+Ⅱ decreased significantly in newborns with asphyxia compared to normal control from first to fourth day after birth(P

Objective To evaluate the association of thrombin activatable fibrinolysis inhibitor (TAFI)and its encoding gene CPB2 polymorphism with myocardial infarction.Methods CPB2 gene (Thr325Ile)polymorphism were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)in patients of myocardial infarction(n=100)and a control group(n=90).The antigen(Ag) and the activity(Act)of TAFI were determined by ELISA and chromogenic assay respectively.The relationship between Thr325Ile gene polymorphism and TAFI Ag and Act were also analyzed.Results In MI group TAFI Ag and Act[TAFI Act(51.4?9.3)?g/ml,TAFI Ag(145.6?33.5)%]were significently higher than those of control group[TAFI Act(25.7?5.6)?g/ml,TAFI Ag(76.5?24.8)%] (t=22.927 2,P

OBJECTIVETo evaluate the therapeutic effect and safety of thoracic aortic replacement with concomitant endoluminal stent grafting in the treatment of DeBakey type I aortic dissection.

METHODSFrom September 2007 to January 2010, 6 patients with DeBakey type I aortic dissection (including one with aortic dissection relapse) received ascending aortic (or Bentall) and total aortic arch replacement and simultaneous stent graft implantation into the descending aorta. Multi-slice spiral CT scans (MSCT) were performed in each patient regularly after the surgery. Cardio-pulmonary bypass including deep hypothermic circulatory arrest with selective antegrade cerebral perfusion were used during the surgery.

RESULTSAll the patients recovered smoothly after the surgical procedure without serious complications. The time of cardiopulmonary bypass ranged from 208 to 291 min (mean 242 min), arrest time of the ascending aortic was 112-194 min (mean 145 min), and selective cerebral perfusion time was 63-102 min (mean 76 min). The patients were followed up for 4-32 months (mean 15.5 months), and MSCT revealed smooth blood flow in the prosthesis, complete thrombus formation in the false lumen in the perigraft space and shrinkage of the distal false lumen without internal fistula or stent dislocation.

CONCLUSIONThoracic aortic replacement with concomitant endoluminal stent grafting is a safe and effective treatment of DeBakey type I dissection.

Adult ; Aneurysm, Dissecting ; classification ; surgery ; Aortic Aneurysm ; classification ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

In the current revision of neonatal resuscitation training course material and its in-depth learning, referring to the American original textbook on neonatal resuscitation, the authors have some recognition and discussion about its several technical details or translated words. These include the location and time period of postnatal rapid assessment, the expression of respiratory questions, the pressing position in the tracheal intubation, and the expression of respiratory questions in the flow chart of resuscitation, etc. The accurate understanding and interpretation of the above will help grass-roots training to be carried out more accurately and effectively.
Humans ; Infant, Newborn ; Intubation, Intratracheal ; Resuscitation

Objective To explore the clinical and imaging features of Parkinson plus syndromes and its differentiation points. Methods Seventy-three patients with idiopathic Parkinson's disease (IPD),68 patients with multiple system atrophy (MSA),10 patients with dementia of Lewy bodies (DLB),15 patients with progressive supranuclear palsy (PSP) and 6 patients with corticobasal degegnration (CBD) were recruited between January,2004 and April,2009 from our hospitals.All patients were given detailed investigation, physical examination, mini-mental status examination and brain CT/MRI examination.Part of patients were performed 18F-FDG PE.Statistical analysis was performed with SPSS 11.0 software. Results Except for postural abnormity, all the other main clinical features differed significantly between each 2 groups (P＜0.05).Brain MRI examination showed that Olivopontocerebellar atrophy was seen in 48 MSA patients (48/59,81.4％),putaminal hypointensities on T2-weighted images were seen in 4 MSA patients (4/59,6.8％) and the "hot cross bun" signal in pons was seen in 30 MSA patients (30/59, 50.8％); hummingbird-like changes were noted in midsagittal view of MRI in 3 PSP patients (3/15, 20.0％); all 6 CBD patients presented asymmetric cortical atrophy, especially in the frontoparietal areas,and 1 also presented putaminal hypointensities on T2-weighted image.Brain 18F-FDG PET indicated that 18F-FDG intake presented different distribution among groups. Conclusion Each atypical Parkinsonian syndrome has its specific clinical features which attribute to rule it out from either IPD or other Parkinson plus syndromes; brain MRI examination and 18F-PET scan can help to diagnose and differentiate Parkinson plus syndromes.

OBJECTIVEOptimization of combining electroencephalography (EEG), short latency somatosensory evoked potentials (SLSEP) and transcranial Doppler (TCD) techniques to diagnose brain death.

METHODSOne hundred and eleven patients (69 males, 42 females) from the major hospitals of Zhejiang Province were examined with portable EEG, SLSEP and TCD devices. Re-examinations occurred < or =12 h later.

RESULTSThe first examination revealed that the combination of SLSEP and EEG led to more sensitive diagnoses than the combination of SLSEP and TCD. Re-examination confirmed this and also revealed that the combination of TCD and EEG was the most sensitive.

CONCLUSIONThe results show that using multiple techniques to diagnose brain death is superior to using single method, and that the combination of SLSEP and EEG is better than other combinations.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Death ; diagnosis ; diagnostic imaging ; Child ; Electroencephalography ; methods ; Evoked Potentials, Somatosensory ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Doppler, Transcranial ; methods ; Young Adult

BACKGROUNDAn apnea test is essential in the clinical determination of brain death. This study was conducted to analyse complications associated with the apnea test in the determination of the brain death.

METHODSOn 93 adult patients in coma in Zhejiang Province of China from January 2003 to December 2006, 179 apnea tests were performed as a part of the determination of brain death. Potential risk conditions and complications were analysed during apnea tests.

RESULTSDuring apnea, serious cardiac arrhythmia did not occur in all patients. Complications occurred in 37 of 179 (21%) apnea tests. Hypotension occurred in 30 patients (17%) and it was observed in 8/94 (9%) tests with baseline value of systolic arterial blood pressure not less than 120 mmHg, and 22/85 (26%) less than 120 mmHg (P < 0.05). Severe hypoxaemia occurred in 10 patients (6%) of which 3/138 (2%) tests with baseline value of arterial oxygen pressure not less than 200 mmHg, and 7/41 (17%) less than 200 mmHg (P < 0.05).

CONCLUSIONSThis study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation. Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Apnea ; physiopathology ; Brain Death ; diagnosis ; Carbon Dioxide ; blood ; Female ; Humans ; Hypotension ; etiology ; Hypoxia ; etiology ; Male ; Middle Aged