Objective To summarize the early results of total hip replacement with a proximally hydroxyapatite-coated femoral component. Methods From February 2000 to October 2003, 65 cases (70 hips) underwent uncemented total hip replacement with a proximally hydroxyapatite-coated femoral component (U2, United Orthopedic Corporation, Taiwan, China). The diagnosis included femoral neck fractures in 30 cases, osteoarthritis in 15 cases, avascular necrosis of the femoral head in 9 cases, loosening of artificial femoral head in 8 cases, rheumatoid arthritis in 2 cases, and arthrodesis in 1 case. Clinical and radiographic evaluations were performed at 1 week, 3 and 6 months postoperatively, and yearly afterwards. Bone mineral density (BMD) of the proximal femur was measured with dual-energy X-ray Absorptiometry (DEXA) for 44 cases. Results Postoperative X-ray films showed that the initial fixation was excellent or good in all the stems. The follow-ups averaged 3 years (2 to 5.5 years). The mean preoperative Harris hip score was 32 (25 to 52) points, which were improved to 96 points at the latest follow-ups. There was no reported incidence of thigh pain at any time throughout our study. And no case needed revision. By the measurements on the X-ray films taken within 1 year postoperatively, 7 of the 70 stems had subsidence of less than 1.5 mm. No hip experienced extensive proximal end osteolysis, intramedullary osteolysis, or loosening. DEXA showed that the BMD values decreased after operation, and then returned rapidly to the normal or near normal ones 3 to 6 months after operation, especially in zones Ⅱand Ⅵwhere the increase was even more significant than at the control side. All the stems were radiographically stable with evidence of osseous ingrowth typically seen in HA-coated zones, according to the criteria proposed by Engh et al. Conclusions Since HA-coating on femoral implants can enhance the initial fixation of implants, accelerate bone ingrowth and osseous fixation of the femoral component, and seal the interface between the implant and bone to prevent ingress of polyethylene particles, it is helpful in improving clinical results of the cementless total hip replacement.

Objective To explore the correlation between serum Lipoxin A4 and clinical grading of chronic hepatitis B patients. Method The serum Lipoxin A4 was detected by Enzyme-Linked Immunosorbent Assay in 94 chronic hepatitis B patients. Results It was found that the level of serum Lipoxin A4 of severe hepatitis patients were significantly lower than mild hepatitis patients and moderate hepatitis patients ( =0.04 and =0.03) . The serum Lipoxin A4 levels were correlated negatively with the ALT and AST levels,respectively =-0.41, =0.019 and R=-0.37,P=0.034. Conclusion These findings support the fact that the serum Lipoxin A4 may contribute to clinical grading of chronic hepatitis B patients.

BACKGROUND: It is manifested in epidemiology and clinical observation that lipoprotein (a) is a new risk factor of cerebrovascular disease and is closely related to cerebral ischemic stroke.OBJECTIVE: To discuss the relationship between levels of high serum lipoprotein (a) and stroke.DESIGN: Case controlled analysis.SETTING: Neurological Institute of Xiangya Hospital of Central South University.METHODS: Totally 294 patients with stroke were selected from Neurological Department of Xiangya Hospital of Central So, uth University between September 1999 and March 2002. Of them, 159 cases were regarded as cerebral infarction group and other 135 cases as acute hypertensive cerebral hemorrhage group. In cerebral infarction group, 109 patients had atherosclerotic cerebral infarction and 50 patients had lacunar cerebral infarction, and 94patients with contimuous health examination were regarded as health examination group. Serum lipoprotein (a) in each group was assayed with "sandwich enzyme-linked immuno-sorbent assay". According to whether the value of lipid was normal or not, patients with atherosclerotic cerebral infarction and acute hypertensive cerebral hemorrhage were divided into two groups. Comparisons between the two groups were assayed with single sample t test, and multiple liner regression was used to assay whether sex, hypertension and value of lipid were related to the level of serum lipoprotein (a).MAIN OUTCOME MEASURES: ① Comparisons of serum lipoprotein (a)among atherosclerotic cerebral infarction group, lacunar cerebral infarction group, acute hypertensive cerebral hemorrhage group and health examination group. ② Correlated analysis between serum lipoprotein (a) and lipid.RESULTS: Among 294 patients, 94 cases in control group entered the final analysis. ① Comparisons of serum lipoprotein (a) among atherosclerotic cerebral infarction group, lacunar cerebral infarction group, acute hypertensive cerebral hemorrhage group and health examination group: Levels of serum lipoprotein (a) in atherosclerotic cerebral infarction group and cerebral hemorrhage group were higher than those in health control group (P ＜ 0.05), and concentration of lipoprotein (a) in atheroosclerotic cerebral infarction group was increased as compared with that in acute hypertensive cerebral hemorrhage group (P ＜ 0.05). Also, level of lipoprotein (a) in lacunar cerebral infarction group was a little higher than that in control group,but the difference was not significant (P ＞ 0.05). ② Correlated analysis between serum lipoprotein (a) and lipid: Levels of lipoprotein (a) in both normal lipid group and abnormal lipid group were assayed with single sample t test, and the results showed that levels in the two groups were similar (P ＞ 0.05). Multiple liner regression was used to assay whether sex,hypertension and value of lipid were related to level of serum lipoprotein (a).CONCLUSION: Levels of lipoprotein (a) may be an independent risk factor for cerebral hemorrhage and atherosclerotic cerebral infarction.

BACKGROUND: Alginic sodium diester (ASD) possesses neuroprotective function because of its selective calcium antagonist effects.OBJECTIVE: To compare the influences of ASD on intraneuronal Ca2+content and nerve cell apoptosis before and after reperfusion in focal cerebral ischemic rats.DESIGN: Randomized controlled observation.SETTING: Neurological Department of Xiangya Hospital Affiliated to South China University; Laser Orthopedic Surgery of the First Hospital Affiliated to Southern China University.MATERIALS: This experiment was carried out between November 2003and April 2004 at the Neurological Department of Xiangya Hospital Affiliated to South China University. A total of 65 male SD rats were recruited and randomized into 6 groups; 17 got lost during the experiment, and the other 48 rats completed the experiment with 8 rats in each group.METHODS: In sham operation group, an incision was made on rats' cervical skin and sutured. Right cerebral middle artery was occluded in rats of ischemic group, ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group, and ASD 10 mg/kg postischemic group. After that, rats in all but ischemic group were subjected to intraperitoneal injection of various dosage of ASD or excipient 30minutes before reperfusion and 5 hours after reperfusion. FCM was used to determine intraneuronal Ca2+ content and rate of nerve cell apoptosis;meanwhile, neurological dysfunction was scored.MAIN OUTCOME MEASURES: [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia. [2]Correlation of behavioral obstacle score with intraneuronal Ca2+ fluorescence intensity and neuronal apoptosis in rats with right cerebral middle artery ischemia.RESULTS: Totally 65 rats were enrolled in this study, 17 of which got lost and the other 48 rats entered the result analysis. [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia: The score was obviously reduced in ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group and ASD 10 mg/kg postischemic group as compared with ischemic group (1.80±0.21, 2.20±0.23, 1.20±0.11, 2.00±0.22, 3.40±0.65); moreover,functional improvement was more obvious due to pre-reperfusional administration than post-reperfusional administration. Intraneuronal Ca2+ concentration was reduced after ASD administration at different degrees and lower than that of ischemic group. Decrement of intraneuronal Ca2+ concentration was found most obvious due to 10 mg/kg ASD administration 30 minutes before reperfusion, approximately reduced by 70%; moreover, neuronal apoptosis rate on the ischemic side was obviously suppressed by ASD administration, displaying time-dependent manner, with apoptotic suppression effect more obvious in pre-reperfusional group than in post-reperfusional group (5.68%, 10.03%; 4.00%, 9.91%). [2] Correlation of behavioral obstacle score of right cerebral middle artery ischemic rats with intraneuronal Ca2+ fluorescence intensity and membrane associated protein/propidium iodide apoptosis: Obvious positive correlation was found between behavioral obstacle score and intraneuronal Ca2+ fluorescence intensity and detection rate of membrane associated protein/propidium iodide apoptosis (r=0.51,0.62, P ＜ 0.05); intraneuronal Ca2+ fluorescence intensity was also positively correlated with the detection rate of membrane associated protein/propidium iodide apoptosis (r=0.84, P ＜ 0.05).CONCLUSION: [1] ASD can exert anti-apoptosis effect by suppressing the increment of intraneuronal Ca2+ concentration, thus having neuroprotective function and ultimately improving neurological dysfunction. [2] Its effect displays time-dependent manner, and neurological functional improvement is more obvious by pre-reperfusional administration than by post-operational administration.

Superior mesenteric vein (SMV) thrombosis is a relatively rare disease. Most patients may be successfully treated with anti-coagulation alone. However, bowel stricture may develop due to intestinal ischemia which may require surgical treatment. This report describes a rare case of small bowel stricture occurring one month after successful treatment of SMV thrombosis. After segmental resection of strictured bowel, the patient's post-operative course was uneventful.

AIM: Changes of endoxin level, ATPase activities, intramitochondrial Ca2+ concentration, and gene expression of Na+-K+-ATPase isoforms in myocardium of rats with MIR and effect of verapamil were observed, in order to investigate mechanism of endoxin mediating intracellular calcium overload of myocytes. METHODS: Twenty four male Sprauge Dawley rats were randomized into 3 groups. Sham operation group: silk suture was threaded the left anterior descending coronary artery without ligature; MIR group (MIR): left anterior descending coronary artery was subjected to 30 min ligation followed by 45 min reperfusion; verapamil group: MIR model was given 5 mg/kg verapamil. Verapamil was injected via femoral vein 5 min before reperfusion. Left ventricle myocardium samples were processed immediately after reperfusion in order to measure the activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase, endoxin level, and intramitochondrial Ca2+ concentration. The levels of ?1, ?2, ?3 and ?1 isoforms of Na+-K+-ATPase were measured by immunohistochemical assay. RESULTS: After MIR, the level of endoxin in myocardium was substantially increased; the activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in myocardial membrane were significantly decreased while the concentration of intramitochondrial Ca2+ was increased; the levels of the ?1, ?2, ?3 and ?1 isoforms of Na+-K+-ATPase were reduced markedly. Verapamil had only effect on reducing the concentration of intramitochondrial Ca2+. CONCLUSION: MIR increases endoxin secretion. The latter may depress the activity of Na+-K+-ATPase by changing the gene expression of ?1, ?2, ?3 and ?1 isoforms of Na+-K+-ATPase in myocardial membrane, inducing intramitochondrial Ca2+ overload.

Endoscopic retrograde cholangiopancreatonraphy (ERCP) is the main treatment modality for common bile duct stone.Biliary hemorrhage easily occurred in patients suffering from cirrhosis during and after ERCP.From May 2012 to May 2016,8 cases diagnosed with cirrhosis and common bile duct stones who developed post-ERCP refractory biliary hemorrhage were treated with full-covered self-expanding removable metal stents (FCSERMS),including 5 cases with perioperative hemorrhage of ERCP and 3 cases with delayed onset of biliary hemorrhage post ERCP.All the patients were successfully implanted with FCSERMS.Seven patients had successful hemostasis,and the other one case with ineffective hemostasis was treated with interventional arterial embolization later.Four stents were removed within 4 weeks and one in 8 months after ERCP.No evidence of biliary hemorrhage,intestinal fistula and other complications was observed during removal procedures.Spontaneous stent dislodgment occurred in one patient in postoperative 4 weeks,one patient died of liver failure in postoperative 6 months and one patient carried FCSERMS for 23 months.

Objective To investigate the effect of gemcitabine on the cell cycle and apoptosis of the human pancreatic cancer cell line MiaPaCa-2 with Beclinl gene silencing.Methods siRNA targeting at Beclinl gene was constructed,then it was inserted into an expression vector and transfected into MiaPaCa-2 cells.The Beclinl mRNA and protein expression were detected by RT-PCR and Western blot.Gemcitabine was used to treat MiaPaCa-2 with Beclinl gene silencing,then the cell cycle and apoptosis were detected by flow cytometry.Results The MiaPaCa-2 cells with Beclinl gene silencing were successfully constructed,and the expression of Beclin1 mRNA was decreased from 1.0 in control group to 0.295,and number of cells in S and G2 phase was decreased,but number of cells in G1 phase was increased,and there was no change in apoptosis.After gemcitabine treatment,number of cells in S phase was further decreased,but number of cells in G1,G2 phase was increased,and apoptosis was inhibited.Conclusions Beclinl gene silencing can change the cell cycle of pancreatic cancer cells MiaPaCa-2,and influence the effects of gemcitabine on cell cycle and apoptosis.

Objective To compare the value of ERCP plus EST and laparotomy in the treatment of common bile duct stones.Methods 56 cases of common bile duct stones were treated with ERCP and EST in our hospital from June 2012 to June 2013 (endoscopy group),78 cases were treated with laparotomy and common bile duct exploration (laparotomy group).The two groups were compared on success rate of stone removal,operation time,intraoperative bleeding volume,incidence of infection and pancreatitis and hyperamylasemia,common bile duct stone recurrence rate,hospital stays,hospital costs.Results Operation time,intraoperative bleeding volume and infection rate in endoscopic group was lower than the laparotomy group,the incidence of hyperamylasemia,hospital costs in the endoscopic group was higher than laparotomy group.The success rate of stone removal and the recurrence rate of common bile duct stone in the endoscopic group was lower than the laparotomy group,incidence of pancreatitis in the endoscopic group was higher than the laparotomy group,though the differences were not statistically significant.Conclusions ERCP and EST is a time saving procedure fast relieving the bile duct obstruction,less traumative,spelling lower infection rate,less hospital stays,though causing higher incidence of hyperamylasemia and hospital costs.

AIM: To observe the effect of endoxin antagonist,anti-digoxin antiserum,on endoxin level,ATPase activities,intramitochondrial total calcium concentration and gene expression of sodium pump isoforms in myocardium of rats with myocardial ischemia reperfusion(MIR).METHODS: Fifty-six male Sprauge Dawley rats were randomly divided into 7 groups.Sham operation group: silk suture threading the left anterior descending coronary artery without ligature;MIR group: left anterior descending coronary artery was subjected to 30 min ligation followed by 45 min reperfusion;normal saline group: MIR model was given 5 mL/kg normal saline;verapamil group: MIR model was given 5 mg/kg verapamil;low dose antidigoxin antiserum group: MIR model was given 8.6 mg/kg antidigoxin antiserum;middle dose antidigoxin antiserum group: MIR model was given 17.3 mg/kg antidigoxin antiserum;high dose antidigoxin antiserum group: MIR model was given 34.5 mg/kg antidigoxin antiserum.All drugs were injected into vessel via femoral vein within 5 min before reperfusion,respectively.After reperfusion,left ventricle myocardium samples were processed immediately in order to measure the activity of Na+-K+-ATPase and Ca2+-Mg2+-ATPase,endoxin level,intramitochondrial total calcium concentration and the experssion of ?1,?2,?3 and ?1 isoforms of sodium pump on mRNA and protein levels by RT-PCR and Western blotting and immunohistochemical assay,respectively.RESULTS: After MIR,the level of endoxin in myocardium was obviously increased.The activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in myocardial membrane were significantly decreased while intramitochondrial total calcium concentration increased.The gene expression of the ?1,?2,?3 and ?1 isoforms of sodium pump at both mRNA and protein levels were reduced markedly.Only the effect of verapamil on reducing intramitochondrial total calcium concentration was observed.Antidigoxin antiserum significantly reduced the level of endoxin in myocardium,restored the activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase,reduced intramitochondrial total calcium concentration,and up-regulated the expression of ?1,?2,?3 and ?1 isoforms of sodium pump at both mRNA and protein levels.CONCLUSION: MIR results in increase of endoxin secretion.The latter depresses the activity of Na+-K+-ATPase by down-regulating the gene expression of ?1,?2,?3 and ?1 isoforms of sodium pump in myocardial membrane,and also induces intramitochondrial calcium overload,thereby mediates MIR injury.