BACKGROUND:Primary dislocation after total hip arthroplasty is a major complication, besides prosthesis loosening. It is controversial whether joint capsule and external rotators should be repaired during total hip arthroplasty through posterolateral approach.
OBJECTIVE:To explore the clinical significance of joint capsule and external rotator repair on preventing hip dislocation after primary total hip arthroplasty through posterolateral approach.
METHODClinical data of patients with primary or secondary hip osteoarthritis after primary total hip arthroplasty through posterolateral approach were retrospectively analyzed. They were assigned to two groups according to different strategies of soft tissue repair. Control group did not receive posterior soft tissue repair. Combined repair group received the repair of joint capsule and short external rotators. Al patients were fol owed up for more than 1 year. Early dislocation was defined as the dislocation occurred within 1 year after operation. The effects of different repair methods on early dislocation rate were compared.
RESULTS AND CONCLUSION:There were 362 patients. Total y 390 case-times of primary total hip arthroplasty were included. Early dislocation occurred in 7 cases, of which 6 case-times in the control group (2.2%, 6/268), and 1 case-time in the repair group (0.8%, 1/122). There were significant differences in the incidence rate of early dislocation between the repair group and control group (P=0.012). These findings confirmed that the combined repair of posterior joint capsule and short external rotators could decrease the rate of early dislocation after primary total hip arthroplasty through posterolateral approach.

The abdominal visceral fat content in obese SD rats induced by high fat diet for 10 weeks was significantly higher than that in control group [(26±6 vs 13±3)g,P<0.01] ,along with increased CRP mRNA expression in abdominal visceral fat (0.901±0.085 vs O. 402±0.036, P<0.01). As compared with normal control group, in the high fat group the concentrations of CRP in portal vein [(743.8±95.8 vs 558.3 ±118.3) mg/L, P<0.01] and peripheral vein[(596.3±38.9 vs 485.8±30.2) mg/L,P<0. 05] were higher. The concentration of CRP in portal vein was significantly higher than that in peripheral vein in high fat diet group(P<0.01) ,but this was not evident in control group. These results suggest that the increased CRP expression in visceral adipose tissue may partially account for the elevation of serum CRP in obesity.

Information department in hospitals shoulders the tasks of construction,operation,maintenance and super-vision of hospital information system ( HIS) . The work load increases with the update of HIS. The key issues con-cerned by the chief of HIS include the over planning of resources,optimizing the allocation of techniques,enforcing the means of management, improving the level of service and the efficiency of support. The principles for the design of performance appraisal program and the specific appraisal indicators in Information Department of Chinese PLA Second Artillery Forces were thus described in this paper in an attempt to provide reference for the information management in other hospitals.

Objective To investigate the level of serum free fatty acid (FFA )after improving the life style in patients with coronary heart disease complicated metabolic syndrome and the effect of therapeutic life style on traditional risk factors of coronary artery disease.Methods A total of 395 patients with coronary heart disease complicated metabolic syndrome were recruited.Pa-tients were divided into intervention group (group A,conventional drug therapy+ intensive life style intervention,n=97)and non-intervention group (group B,conventional drug therapy,n=38)according to the scores of life style.Serum free fatty acid (FFA) was determined by ELASA.The scores of life style was obtained bylife style questionnaire.Results (1)The serum FFA of pa-tients with coronary heart disease complicated metabolic syndrome were positively related to waist circumference and waist-high-ra-tio.(2)Waist circumference,BMI and FFA of group A were significantly lower than those in group B after therapeutic life style in-tervention(P <0.05).(3)Compared with the baseline,the constitution index and FFA in group A were significantly lower after 6-months therapeutic life style intervention(P <0.05).Conclusion Therapeutic life style can reduce the level of FFA and constitution index of the patients with coronary heart disease complicated metabolic syndrome.

Objective To explore the effects of Bawei Shangke Huoxue Tablets on hypercoagulable state of patients with hip fracture. Methods Seventy-two hip fracture patients at hypercoagulable state were randomly divided into treatment group and control group, 36 cases in each group. Both groups were given conventional orthopedic treatment including raising up the affected limb, external application of Huoxue Zhitong Paste on the affected area, and instructions for affected limb functional exercise. Additionally, the treatment group was given oral use of Bawei Shangke Huoxue Tablets together with subcutaneous injection of low-molecular-weight heparin calcium, and the control group was given subcutaneous injection of low-molecular-weight heparin calcium. Before and after treatment, we observed the plasma D-dimer (D-Di) and blood von Willebrand factor(vWF) levels as well as the incidence of deep venous thrombosis (DVT) of both groups before and after treatment. Results (1) All of the cases of both groups completed the clinical trial, and no severe adverse reaction such as increased bleeding occurred. (2) On the admission day, the D-Di and vWF levels of both groups were higher than the normal levels, and were decreased obviously one day before the operation (P < 0.05). On the first post-operative day, the levels were increased as compared with those before operation (P < 0.05), and then decreased on the twelfth post-operative day (P < 0.05) compared with those on the first post-operative day). The treatment group had better effect on improving D-Di and vWF levels than the control group (P < 0.05). (3) The results of follow-up for 3 months showed that 61 cases got the follow-up, 31 cases from the treatment group and 30 from the control group. The DVT incidence of treatment group was 9.68% and that of the control group was 16.67%, the difference being insignificant(P>0.05). Conclusion Bawei Shangke Huoxue Tablets are effective on improving hypercoagulable state of patients with hip fracture, and can be used at early stage and are beneficial to lowering the risks of anticoagulant drugs. Bawei Shangke Huoxue Tablets plus low-molecular-weight heparin calcium have certain effect on preventing DVT.

Objective By analyzing the epidemiological characteristics of brucellosis in Shanxi Province,to provide a scientific basis in formulation of strategies for effective prevention and control of the disease.Method Surveillance data of human brucellosis from China Information System for Disease Control and Prevention between 2004 and 2013 were statistically analyzed by descriptive epidemiological method.The regional,time,age and sex,occupational distribution of brucellosis were analyzed.The prevalence trend of brucellosis in Shanxi Province was summarized.Results From 2004 to 2013,the total incidence presented a rising tendency and the highest reported incidence was 19.10/10 million in 2013.A total of 43 061 cases of brucellosis occurred in Shanxi Province.The average incidence of brucellosis was 12.52/10 million.Regional distribution range was relatively focused on the north areas of Shanxi Province,the number of reported cases of Datong City was the largest (12 157 cases),being 28.23％.The incidence of Shuozhou City was the highest (42.97/10 million).The epidemic was spreading through all county areas.The disease was found each month throughout the year,the obvious incidence peak seasons were between March and June.The disease was most commonly found in 15-64 age groups(87.19％,37 545/43 061).Occupation distribution of patients was mainly farmers (83.34％,35 887/43 061).Conclusions The situation of brucellosis epidemic in Shanxi Province is relatively serious;the reported incidence of brucellosis in Shanxi Province is in a rapid upward trend year by year,even highly active in some particular areas.Different regions should establish regional mechanisms for joint prevention and control and implement different prevention and control measures to comprehensively and sequentially control brucellosis.

Objective To investigate the effects of reactive oxygen species (ROS) inhibition on the down-regulation of adiponectin (ADPN) in mouse 3T3-L1 adipocytes by advanced glycation end-products (AGEs).Methods AGEs were prepared for incubating with cell.3T3-L1 preadipocytes were cultured in vitro and differentiated into mature adipocytes.Cell differentiation and lipid accumulation were determined by oil red O staining.After being intervened with AGEs,2',7'-dichlorofluorescein diacetate (DCFH-DA) was used as a reactive oxygen species (ROS) capture agent and the fluorescent intensity of 2',7 '-dichlorofluorescein (DCF) was detected by flow cytometry.Adiponectin expression under AGEs in 3T3-L1 adipocytes pretreated with N-acetyl-L-cysteine(NAC) or not was detected by real-time fluorescent PCR and ELISA.Results The level of ROS in 3T3-L1 adipocytes treated with AGEs was increased.mRNA and protein of ADPN were down-regulated.After inhibition with ROS,mRNA and protein expressions of ADPN injured by AGEs were ameliorated.Conclusion Exposure of 3T3-L1 adipocytes to AGEs induces oxidative stress in vitro,which decreases the expression of ADPN,and causes functional impairment of adipose cells and insulin resistance.

Objective To investigate the effects of advanced glycation end products (AGEs) on NADPH oxidase expression in rats′ pancreatic cells. Methods Isets of rats were isolated and intervened with AGEs for certain times (2, 12, 24, 48 h). The Nox2 mRNA expression was assayed by reverse transcription polymerase chain reaction (RT-PCR) and Real-time PCR. NADPH oxidase activity was detected by lucigenin-enhanced chemiluminescence. Results Nox2 mRNA level was 1.75, 2.31-fold higher in AGEs intervened group than control at 12 h and 24 h respectively. The NADPH oxidase activity was increased by AGEs stimulation in a time dependent manner. A distinct peak was at 24 hours and then with a decline , which is still higher than that of the control. Conclusion Exposure of rat islet to AGEs induces NADPH oxidase expression and leads to injury of islet.

To investigate the effects of hypoxia chemically induced by CoCl2 on the expression of monocyte chemoattractant protein-1 ( MCP-1 ) in mouse 3T3-L1 adipocytes.3T3-L1 preadipocytes were cultured in vitro and differentiated into the matured adipocytes.Cell differentiation and lipid accumulation was determined by Oil Red O staining.CoCl2 was used as a chemical hypoxia-inducible reagent to mimic hypoxic microenvironment.The effect of CoCl2 on cell viability was estimated by MTT assay.Hypoxia-inducible factor-1α(HIF-1α) expression under hypoxia was detected by realtime fluorescent PCR and Western blot,while MCP-1 expression was detected by real-time fluorescent PCR and ELISA.CoCl2 induced hypoxia led to a marked recruitment of HIF-1α in mouse 3T3-L1adipocytes.Similarly,both mRNA and protein levels of MCP-1 were up-regulated.Exposure of 3T3-L1 adipocytes to CoCl2 induced hypoxic microenvironment in vitro,and hypoxic induction of MCP-1 expression and secretion may be mediated by HIF-1 α and may contribute to chronic low grade inflammation in adipose tissue.

BACKGROUND:Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative stil deserves further exploration. OBJECTIVE:To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc. METHODS:From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle. RESULTS AND CONCLUSION:Process deflection angle at L 4 and L 5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z=-10.609,-12.074, P<0.01). There was not significant statistical difference between the lower lumbar disc herniation group and the control group on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle at various ages (P>0.05). There only was significant difference on lumbosacral angle between male group and female group (P=0.007<0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P<0.01), and there was significant difference between 45-54 age group and 25-34 age group (P<0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration.