BACKGROUND:Prosthesis selection for total hip replacement is determined by geometrical matching with femoral medullary cavity of patients and the optimal biodynamics.It is of great significance for elevating outcomes of total hip replacement.OBJECTIVE:To evaluate the biomechanics of four groups of femoral stem prostheses matched with a femar and to get a stem whose mechanics distribution is similar to the normal femur.DESIGN:Controlled observation.SETTING:Department of Orthopaedics of Oriental Hospital Affiliated to Tongji University,Department of Orthopaedics of Changhai Hospital of Second Military Medical University of Chinese PLA,and Department of Mechanical and Power Engineering of Shanghai Jiao Tong University.MATERIALS:Experiments were performed at the Laboratory of Life Quality and Machinery Engineering of Department of Mechanical and Power Engineering of Shanghai Jiao Tong University from December 2004 to October 2005.A male volunteer aged 40 years with the normal proximal ferout(175 cm height and 78 kg weight),free from hip disease,were selected.X-ray image of the eutopic femar was shot and wrote into memory in the format of DICOM.The volunteer signed an infonned consent.The experiment was approved by Hospital Ethical Committee.No.Ⅰ prosthesis,Zimmer versys Fiber Metal Taperl 1#,No.Ⅱ prosthesis,Plus APL 2#,No.Ⅲ prosthesis,Welink Ribbed system cementless01#,and No.Ⅳprosthesis,Lima F2L 1# were used in this study.METHODS:The ezDICOM software was used to read files with DICOM format of femoral X-ray image,which was converted into files with bmp format.The image files with bmp format of the proximal femar X ray were introduced with Matlab software after regulation,and the two-dimensional contour data of femar were extracted.Prosthesis matched with the template was set in PhotoShop 7.0 software.The two-dimensional contour data of prosthetic femar were extracted in MATLAB software.The ANSYS software was used to establish the model of geometrical and two-dimensional nonlinearity finite element ncluding femur and femur-femoral stem.Stress distribution in the proximal femur was analyzed and compared by loading.MAIN OUTCOME MEASURES:Stress istribution of the proximal femur.RESULTS:Stress value and distribution of No.Ⅰ prosthesis and No.Ⅳ prosthesis in proximal femur were similar to the normal femar.Moreover,No.Ⅰ prosthesis was better than No.Ⅳ prosthesis.CONCLUSION:The biomechanics of femoral stem prostheses has been evaluated by analyzing and comparing the two-dimensional biomechanics of the femoral stem prostheses based on X-ray and template,which can offer support in optimal rosthesis selection.

Objective To evaluate role of intracoronary electrocardiogram (IcECG) in examining early myocardial damage during elective percutaneous coronary intervention (PCI). Methods Eighty-six patients of coronary heart disease with normal serum levels of creatine kinase-myoglobin (CK-MB) and cardiac troponin T (cTnT) before the procedure and undergone elective PCI were enrolled in the study.Their IcECG were recorded by a intracoronary guidewire and serum levels of CK-MB and cTnT were measured at baseline and eight and 24 hours after the procedure, respectively. The patients were divided into two group, abnormal and control, according to whether they had significant shift at ST-segment in IcECG.Cardiac events after intervention in the patients were followed-up and recorded. Myocardial damage was defined as serum level of cTnT increased to above the upper normal value after intervention. Results Significant shift at ST-segment in IcECG during PCI in 30 (35%, abnormal group) and no shift in other 56patients (65%, control group) of 86 patients with normal serum levels of cardiac markers before the procedure was observed, and all the procedure were successful Serum levels of cTuT and CK-MB significantly increased after intervention in 30 patients of abnormal group than those in control one ( P <0. 01 ). Sensitivity of intracoronary ST-segment shift was 77 percent for predicting myocardial damage, and specificity was 94 percent, with positive and negative predictive values of 90 percent and 86 percent,respectively. More cardiac events were observed at 4-week follow-up after intervention in abnormal group than those in control one (P<0. 05) and major coronary event-free survival was significantly lower in those with post-procedural ST-segment elevation in IeECG (P < 0. 05). Conclusions ST-segment shift in IcECG may be helpful for predicting myocardial damage during PCI procedure on time.

Objective To evaluate, the long-term results of pacemaker implantation in 122 elderly patients. Methods A long-term follow-up was carried out in 122 elderly patients (≥ 70 years old, elderly group)and 109 non-elderly patients (< 70 years old,non-elderly group)who received pacemaker implantation. The elinical characteristics, complications and quality of life were compared. Results The mean follow-up time was (8.22±6.01) years and (7.74±5.82) years respectively. The successful rate of the follow-up was 100%. The overall postoperative complications about pacemaker pocket and the prevalence of atrial fibrillation occurred in elderly group were higher than those in non-elderly group (4.10% vs 0, 21.31% vs 10.09%, P< 0.05).The heart function failure was the main cause of the death in elderly group. The stroke and uremia were the main causes of the death in non-elderly group. There was no significant difference in the improvement of the life quality in both groups (P>0.05). Conclusions The pacemaker implantation is a safe and effective therapy for treatment of elderly patients with bradyeardia, and can improve the quality of elderly patients' life. Optimal mode for elderly patients will be given according to the physiological characteristics and the types of bradycardia.

rvice employees had a low scores as comparing with their salaries, benefits and workloads.And 28.2% employees had once the idea of resigning.

Objective: To observe the therapeutic efficiency of adenovirus-mediated interleukin-12 gene(AdmIL-12) and CD40 ligand gene(AdmCD40L) intratumoral transfer in established murine melanoma in vivo. Methods: C57BL/6 mice were inoculated subcutaneously with B16 cells to establish the murine melanoma model. The tumor-bearing mice were injected intratumorally with murine IL-12 gene and CD40L gene recombinant adenovirus. Tumor growth and the survival of tumor-bearing mice were observed. The CTL activity was measured in vitro by lactate dehydrogenase(LDH) release assay. Results: Both AdmIL-12 and AdmCD40L can be efficiently expressed in vitro and in vivo. The treatment with AdmIL-12 could significantly inhibit the tumor growth and prolong the survival period of the tumor-beraing mice. Splenic CTL activity of the mice was also enhanced after IL-12 gene transfer. But the anti-tumor effects of AdmCD40L gene were not significant. In contrast, Co-delivery of IL-12 gene and CD40L gene lead to stronger antitumor effects than IL-12 gene alone. Conclusion: Adenovirus-mediated interleukin-12 gene and CD40 ligand gene transfer together intratumorally has significant therapeutic effects on mice melanoma in vivo.

Objective To learn the current culture of the hospital and identify its future development pathway. Methods The current culture types of the hospital are evenly distributed among the four quadrants. Results These types are found to be identically distributed among the tribe type, temporary system type, hierarchy type and market-oriented type of culture. Among these four type, the hierarchy type and market-oriented type score higher (27 scores both) and take the lead. Conclusions Hospitals are expected to enhance its exchange and communication with the employees, and head to its desired direction of a hospital culture type.

Objective To study the correlation between immune imbalance mediated by Th 17 and Treg cells and impaired lung function in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Ninety-five patients with moderate or severe COPD , thirty-five smokers with normal lung function and thirty-one healthy non-smokers from Yinzhou People′s Hospital from January 2009 to December 2012 were recruited in this study .The percentages of circulating Th 17 and Treg cells in peripheral blood samples were determined by flow cytometry .The concentrations of cytokines in serum samples and supernatants of in-duced sputum samples were measured by enzyme-linked immunosorbent assay (ELISA).The expression of ROR-γt and Foxp3 at mRNA level in peripheral blood mononuclear cells ( PBMC) were determined by quan-titative real-time PCR.The potential association between ratios of Th 17/Treg cells and lung function was evaluated.Results Compared with smokers and healthy subjects , patients with moderate or severe COPD showed high levels of Th17 cells, IL-17A, IL-6 and IL-23, and an up-regulated expression of ROR-γt at transcriptional level .However, the percentage of Treg cells , IL-10 level and the expression of Foxp 3 at mRNA level were down-regulated in patients with COPD .The levels of cytokines in supernatants of induced sputum samples varied in the same way as that of Th 17/Treg in peripheral blood samples .The ratio of Th17 to Treg cells was negatively correlated with the values of forced vital capacity ( FVC) , forced expiratory vol-ume in one second (FEV1), and FEV1/FVC.Conclusion Th17/Treg cells imbalance was closely associ-ated with the deterioration of pulmonary function in patients with moderate or severe COPD .Th17/Treg cells imbalance might be involved in the progression of COPD .

Vascular endothelial growth factor (VEGF)165 cDNA were inserted into the expression plasmid pcDNA3.1 site in an antisense orientation to produce antise VEGF165 expression vector.Then electrophoresis and sequencing were carried out,the antisense vector were verified and could be used for related study of antisense gene expression.

Vascular endothelial growth factor(VEGF) is a kind of protein facilitating the angiogenesis,which can combine with its special receptor. The 2 major functions of VEGF are:(1) accelerate the proliferation of endothelial cells,leading to the formation of new vessels;(2) up regulation of the vessels permeability.The activity of the VEGF is regulated by various factors at different levels,such as: hypoxia, oncogene,the cytokine, the intercellular matrix, etc .The biological character and role of VEGF were summarized in this article with special emphasis on VEGF function and regulation.

Objective:To analyze and compare the clinical outcomes of total knee arthroplasty with patella arthroplasty and patella replacement. Methods: From May 1999 to January 2004, 251 knees in 203 patients (45 males and 158 females; age range: 25 to 91 years, average 62.8 years) with osteoarthritis (206 knees) and rheumatoid arthritis (45 knees) were evaluated using a questionnaire during physical examination. Totally 137 knees underwent patella arthroplasty and 114 underwent patella replacement, with a mean follow-up of 28.1 months. The patients were scored using KSS Score, Feller Score and British Orthopedics Association Patient-satisfaction Score. Results: Patella arthroplasty and replacement showed no obvious difference in post-operative improvement of the knee score, knee function score, patella function score and range of flexion and extent of knee. Compared with patella replacement group, patella arthroplasty group had a higher patient satisfaction rate (P