[Objective]To evaluate the operative technique and the short-term clinical results of total hip arthroplasty(THA) for developmental dysplasia of the hip(DDH) in adults. [Method]Sixty-one patients(77 hips) with DDH who received THR without cement between December 1997 and October 2006 were followed up.In this group,53 cases were female,and 8 cases were male.The average age was 31.4 years(range,17~56 years).According to the classification of Hartofilakidis,fifteen cases were type I(eighteen hips);twenty-three cases,type Il(thirty hips);and twenty-three cases,type III(twenty-nine hips).The average Harris Hip Score was 40 points(range,16~61).All of patients were exposed through the.posterolateral approach.The threaded cup with coating were put in or near the level of the true acetabulum in all of cases.Full coating stems were used in femoral side,shortening osteotomy below lesser trochanter of femur were performed in twelve cases. [Result]The mean duration of follow-up was 49 months(range,12~118 months),the average Harris Hip Score increased from 40(range,16~61) preoperatively to 91(range,82~95) at the time of the latest follow-up.All the hips acquired union of osteotomy and bone ingrowth.None of the patients had radiographic evidence of aseptic loosening of prosthesis. [Conclusion]Uncemented total hip arthroplasty for the developmental dislocation of the hip in adults can get better results significantly,although it presents greater technical difficulty.

Objective: To study the effect of B 2O 3 and P 2O 5 on fluorosilicic mica glass-ceramic sintering process.Methods: Six sets of K 2O-MgO-SiO 2-MgF glass were prepared by using B 2O 3 and P 2O 5as sintering aid respectively. Green bodies of the glass powder were formed by gelcasting and sintered at 800,850,900,950 and 1 000 ℃ for 6 h respectively. The sintering and crystallization behavior were studied by thermal shrinkage , X-ray diffraction (XRD) and SEM.Results:The shrinkage rate of the glass with 2% B 2O 3 and P 2O 5 was the highest ,while that of the glass with 5% P 2O 5 the lowest. The size of the precipitated crystal from the glass ceramics containing 2% B 2O 3 and 2% P 2O 5 was bigger.Conclusion:The density and shrinkage measurements of the sintered bodies show that the glass powder of pure K 2O-MgO-SiO 2-MgF system has poor sinterability, while minor addition (

Objective:To investigate the effect of sintering temperature on the shrinkage and microstructure of dental fluorosilicic mica glass-ceramic with two different particle size. Methods:Fluorosilicic mica glass powder with average particle diameter of 72.8 ?m was named PO and that with average diameter of 4.5 ?m was named Pm. PO and Pm were molded by cool isostatic pressing technique and then sintered at different temperatures between 600-1 000 ℃. The shrinkage and microstructure of the sintered blocks of PO and Pm were systematically compared with each other. Results:The shrinkage of PO and Pm blocks were all increased as the temperature ascended. However, the shrinkage curves were distinctly different. At the same sintering temperature the shringkage of Pm was larger than that of PO. Moreover, the turning points of temperature (reflecting transition of the sintering mechanisms) of Pm was higher than that of PO. The microstructure observation showed that sintering at 950 ℃ resulted in mica crystal in glass-ceramics and the best compactness of the sintered blocks of both PO and Pm. Conclusion:Sintering glass powder of smaller particle size at 700-850 ℃ may achieve better sintering compactness.

Objective To investigate the effect of one-stage total hip arthroplasty (THA) for advanced active tuberculosis of the hip.Methods Data of 19 patients who had received one-stage THA for advanced active tuberculosis of the hip in our hospital from September 1998 to October 2010 were retrospectively analyzed.There were 14 males (15 hips) and 5 females (5 hips),aged from 21 to 74 years (average,44.1 years).According to the clinicoradiologic classification of tuberculosis of the hip introduced by Babhulkar and Pande,there were 3 cases of grade Ⅲ and 16 cases of grade Ⅳ.The average time interval from onset of symptoms to THA was 15.1 weeks (range,5-26 weeks).Chest radiographs showed old pulmonary tuberculosis in 3 patients.One patient had a sinus tract in hip skin.The diagnosis was confirmed by histopathology in all patients.The antituberculous medication was applied for at least 2 weeks preoperatively and 9 to 12 months postoperatively.Results All patients were followed up for 12 to 142 months (average,57 months).Dislocation of the hip occurred in 1 patient 6 days after operation,which was cured by manual reduction.Tuberculosis recurrence occurred in 1 patient 5 months after operation,which was cured after debridement without removing component and antituberculous medication for 1 year.Cup loosening was found in 1 patient 9 years after operation.No reactivation of infection or implant loosening was found in other patients.The average Harris score improved from preoperative 35 (range,27-46) to 90 (range,65-96) at final follow-up.Conclusion One-stage THA can be safely performed in advanced active tuberculosis of the hip,which can relief symptoms and improve hip function.

Objective To study the effect of mental intervention on pregnant result in patients undergoing IVF-ET treatment.Methods 206 patients undergoing IVF-ET treatment in the hospital from February 2012 to Jan-uary 2013 were selected and randomly divided into two groups. The experiment group (n=103) was followed by mental intervention after the patients enrolled the IVF-ET treatment, the control group (n=103) enrolled the IVF-ET treatment without mental intervention.Results The HAMA and HAMD quantity grades for anxious and depression of patients in the experiment group were significantly lower than those of control ( <0.01), and the pregnancy rate of experiment group (45.63%) was higher than that of control (30.10%) <0.05. Conclusion Mental intervention for patients undergoing IVF-ET treatment could alleviate their anxiety-depression and improve the pregnancy rate of IVF.

Objective To investigate the feasibility and clinical effect of one-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis.Methods From January 2003 to December 2010,11 patients with old femoral condyle fracture combined with knee osteoarthritis,including 4males and 7 females,aged from 38 to 77 years (average,58.3 years),underwent one-stage total knee arthroplasty.There were 8 cases of supracondylar fracture,and 3 cases of intercondylar fracture.Moreover,there were 2 cases of knee fibrous ankylosis with mild amyotrophy,3 cases of collateral ligaments injury of the knee,2 cases of fibrous union,and 2 cases of infective nonunion.Results All patients were followed up for 6 to 72 months (average,41.3 months).The HSS score improved from preoperative 6.65±7.01 (range,0-13)to 88.5±6.18 (range,81-95) at final follow-up.The range of motion of the knee improved from preoperative 32.7°±17.6° (range,0°-50°) to 101.3°±9.8° (range,85°- 115°) at final follow-up.One case underwent knee disarticulation 6 years after operation owing to infection.For other patients,there were no complications such as infection,deep vein thrombosis,knee instability,component loosening and inequality of lower limb.Conclusion One-stage total knee arthroplasty is a technically difficult but effective method for patients with old femoral condyle fracture and knee osteoarthritis.

Objective: To study the efficacy,safety and relative characteristics of formulated Chinese medicinal herbs as a vascular embolizing agent. Methods: We prepared a mixture as a vascular embolizing agent from several Chinese medicinal herbs,they served as anticarcinogen and/or coagulant according to the Chinese Pharmacopeia.We studied the characteristics of the mixture through embolizing the hepatic artery in eight pigs with it. Results: The mixture was prepared as a suspension.It was easily injected through catheters and showed good histocompatibility and hemo-compatibility without pyrogenetic response and toxicity.The mixture mainly embolized peripheral arteries,maintaining occlusion for 5 weeks and without formation of collateral circulation.We found injuries of normal hepatic tissues as slight hepatocyte hydrops and focal endochyloma necrosis through optical and electronic microscope. Conclusion: This suspended mixture of Chinese medicinal herbs is safe and effective as a potential peripheral embolizing agent.

Recent studies have shown that TCM treatment for bone metabolic diseases, such as steroid-induced avascular necrosis of the femoral head, has definite efficacy and has received extensive attention. However, due to lack of molecular biological basis of pharmacodynamics mechanism, it has not yet reached the standard of scientific treatment. The discovery of OPG/RANK/RANKL system has become a new breakthrough point in the prevention and treatment of bone metabolic diseases. The pathogenesis of deficiency of spleen and kidney - blood stasis - caused by phlegm arthralgia caused by blood stasis is closely related to the system. The effect of the final control of the system from the deficiency theory can be expressed through the axial micro-information. This article discussed the TCM syndrome differentiation of steroid-induced osteonecrosis of the femoral head and the relation of regulation of bone metabolism combined with the OPG/RANK/RANKL system, and provided the basis for prevention and treatment of this disease.

Objective To investigate the molecular characteristic,the virulence factors and antimicrobial resistance of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from pediatric patients.Methods Ninety-eight non-duplicate strains of and 49 non-duplicate strains of Methicillinsusceptible Staphylococcus aureus (MSSA) isolated from the three children's hospitals in Shanghai in 2008 were investigated.Panton-valentine leukocidin (PVL) gene was detected by polymerase chain reaction (PCR).The genotypes of staphylococcal cassette chromosome mec (SCCmec) of the MRSA isolates were confirmed by multiplex PCR.The sequence type (ST) of each strain was determined by multilocus sequence typing (MLST),and the algorithm eBURST was used to identify groups of clonal complex (CC).The minimal inhibitory concentrations (MIC) of fourteen antibiotics for all isolates were determined by agar dilution method.Results Among 98 isolates of MRSA,the positive rate of PVL genes was 6.1％ (6/98).In contrast,the positive rate of PVL genes was 4.1％ (2/48) of the MSSA strains.Among 98 isolates of MRSA,4.1％ (4/98),23.5％ (23/98),53.0％ (52/98) and 15.3％ (15/98) of the strains harboured SCCmec types Ⅱ,Ⅲ,Ⅳ and Ⅴ,respectively. The remaining four isolates (4.1 ％) presented a unique SCCmec pattern that could not be classified to any known types by the employed typing assays.Combining the ST and SCCmec type,the predominant clones were ST59-SCCmec Ⅳ (30 strains) and ST239-SCCmec Ⅲ (23 strains),followed by ST5-SCCmecⅣ and ST1-SCCmecⅣ (8 strains for each clone),ST239-SCCmec Ⅴ (6 strains),ST88-SCCmecⅤ (5 strains),ST5 SCCmecⅡ (4 strains),ST59-SCCmec Ⅴ (3 strains),ST8-SCCmecⅣ and ST88-SCCmecⅣ (2 strains for each clone),ST22-SCCmecⅣ,ST910-SCCmecⅣ and S45-SCCmec Ⅴ (1 strain for each clone),eBURST analysis distributed the MRSA isolates into several CC.ST8 and ST239 belonged to ST8 CC,ST1 belonged to ST15 CC,ST910 belonged to ST 30 CC,ST59,ST5,ST88,ST45,ST22,ST9 and ST7 were the origin of their own CC.The results of MIC showed that the 67 strains of MRSA harboring SCCmec type Ⅳ or SCCmec type Ⅴ were more susceptible to various non-β-lactam antibiotics than 27 strains of MRSA harboring SCCmec type Ⅱ or SCCmec type Ⅲ,and no vancomycin-resistant strain was found.Conclusions In three children's hospitals in Shanghai,the PVL gene-positive rate of MRSA isolates is relatively low,SCCmec type Ⅳ and SCCmec type Ⅴ could spread among hospitals to cause a small scale epidemic and have a variety of ST.

Objective To study the indication,surgical technique and clinical results of the uncemented hip arthroplasty for unstable intertrochanteric fractures in elderly patients.Methods Twenty-three elderly patients with unstable interthochanteric fractures were treated with uncemented hip arthroplasty,including 6 males and 17 females with an average age of 77.6 years (range,73-95 years).According to the Evans-Jensen classification,there were 2 cases of type ⅡA,9 of type ⅡB,and 12 of type Ⅲ.Osteoporosis was classified according to the Singh index,there were 2 cases of Ⅳ,8 of Ⅲ,12 of Ⅱ and 1 of Ⅰ.Results All patients were followed up with an average of 31 months (range,12-64 months).The average Harris score improved from 33.1 1±6.58 points preoperatively to 87.12±5.05 points at the time of the last follow-up.Radiologically,there were 16 cases of fixation by bone ingrowth; nonunion of lesser trochante fracture was noted in 3 cases; proximal displacement of greater trochante was found in one patient.Intraoperative proximal femoral fracture was encountered in two cases; deep venous thrombosis was found in three cases and one case died of pulmonary embolism.One case who experienced acute left ventricular failure recovered by medical treatment.There was no aseptic loosening,peri-prosthetic infections,dislocation or ectopic ossification.Conclusion The short-term results of uncemented hip arthroplasty in elderly patients with unstable intertrochanteric fractures were satisfactory.