Good clinical results were shown in nasopharyngeal carcinoma (NPC) patients received radiotherapy. The patients with long term life partially had radiation induced injuries that severely affect the quality of life (QOL). The study on QOL of those patients is important. Our article reviewed the effects of NPC QOL by treatment options, health education, rehabilitation therapy, traditional chinese medicine and qigong. The current measurement scale of NPC QOL in China was also discussed.

In this review,concepts concerning etiology and nonoperative and operative treatment methods have been analyzed.This article is based almost exclusively on peer-reviewed studies.The etiology of nontraumatic osteonecrosis of the femoral head may have genetic basis.The interaction between certain risk factors and a genetic predisposition may determine whether this disease will develop in a particular individual.Early diagnosis and intervention prior to collapse of the femoral head is key to a successful outcome of joint-preserving procedures.The rational for use of joint-sparing procedure in the treatment of this disease is based on radiographic measurements and findings with other imaging modalities.The results of joint-preserving procedures are less satisfactory than the results of total hip arthroplasty for femoral head than have already collapsed.New pharmacological measures as well as the use of growth and differentiation factors for the prevention and treatment of this disease may eventually alter our treatment approach,but it is necessary to await results of clinical research with long-term follow-up of these patients.

Objective To evaluate the effect of arthroscopic reshaping procedures on symptomatic discoid meniscus and compare the outcomes between children and adults. Methods The medical records of those who had undergone arthroscopic reshaping procedures for symptomatic discoid meniscus between January 1997 to December 2000 were reviewed. Results Fifty-four patients had been followed up more than 7 years, including 38 children and 16 adults. The average Lysholm score increased from (65.0?10.0) preoperatively to (72.0?10.0) postoperatively. The average 8.2-year follow-up showed no obvious clinical symptoms and signs or osteoarthritis in children. Fourteen knees in adults were found osteoarthritis on X-ray film, of which 6 showed the symptoms and signs of osteoarthritis. Conclusion The midterm efficacy of arthroscopic surgery for symptomatic discoid menisci and the occurrence of postoperative osteoarthritis are related to age and injury course.

To investigate the behavior of meniscal fibrocartilage cells in vitro ,human meniscal fibrocartilage cells were harvested from adolescents and sequentially digestied with 0 50% trypsin and 0 2% collagenase (type2). The isolated cells were cultured in Ham'sF 12 medium and identified by histochemical methods. Cell proliferation, morphology and ultrastructure were observed by phase contrast microscope and electronic microscope. In primarily cultured cells, fusiform cells dominated and they were confirmed by the positive result of immunohistochemical examination for type collagen staining. Our results indicate that it is a simple and highly effective method.

0.05). Conclusion Compared with the Whiteside′s line, the transepicondylar axis seems to be more reliable to determine the rotational alignment of femoral component in total knee arthroplasty. The posterior femoral condylar angle of the Chinese people is larger than that of the Caucasians. If the widely used way of 3? lateral rotational orientation of the femoral component referring to the posterior condylar surfaces of the femur in total knee arthroplasty is adopted, it tends to produce internal malrotation of the femoral prosthesis after operation.

To investigate the repairing effect of fibrochondrocyte collagen construct in meniscus lesion, fibrochondrocytes were isolated and expanded in vitro , then seeded onto collagen construct .18 dogs with wedged shape lesion in the lateral meniscus were randomly divided into 3 groups: the lesion were filled with either cell collagen construct or collagen or untreated. The lateral meniscus was then examined grossly and histologically at different periods. The results showed that the lesions that had been filled with fibrochondrocyte collagen construct healed with fibrocartilage tissue. The results suggest that tissue engineering method is practical.

Objective By analyzing the cesarean delivery rate (CDR) and the indications of cesarean section in Jiangsu Province from 2012 to 2014, to find the strategy to reduce CDR.Methods Data of 40 hospitals whose number of delivery was over 2 400 per year from the database of the Quality Control Center of Gynecology and Obstetrics of Jiangsu Province from 2012 to 2014 were selected.The cohort was divided into two groups, one was specialized hospital including 11 maternal and child health hospitals and the other included 29 general hospitals.After analyzing the current status of cesarean section of the whole province, the average CDR and the distribution of the first indications of cesarean section in two groups were compared using Chi-square test.Results The average CDRs at year 2012, 2013 and 2014 were 53.8％(96 347/178 970), 51.8％ (97 509/188 142) and 48.8％(106 323/217 877), which had a trend of decrease (x2=1 026.2, P ＜ 0.01).CDR without medical indications for each year were 15.7％ (28 098/178 970), 15.5％ (29 162/188 142) and 12.8％ (27 888/217 877).The rate had decreased apparently from both 2012 and 2013 to 2014 (x2=217.6, P ＜ 0.01;x2=341.3, P ＜ 0.01).The CDRs of specialized hospitals for year 2012, 2013 and 2014 were 51.2％ (45 496/ 88 916), 50.6％ (45 853/90 607) and 49％ (55 404/113 105), while the CDRs of general hospitals for each year were 56.6％(50 851/90 054), 53.0％(51 656/97 535) and 48.6％(50 919/104 772).Both showed significant decreasing trend (x2=105.8 and 1 215.7, both P ＜ 0.01).The average CDR of general hospitals was obviously higher than that of specialized hospitals in 2012 and 2013 (x2=505.6 and 104.3, both P ＜ 0.01).However, the difference disappeared in 2014 (x2=3.2, P ＞ 0.05).The three main first indications of cesarean section were associated and postoperative pregnancy complications, and no medical indications.Interestingly, from 2012 to 2014, the CDR for scarred uterus in specialized hospitals raised from 5.4％ to 20.3％, and that in general hospitals increased from 6.7％ to 21.6％, which became the first.Conclusions The average CDR in Jiangsu Province tends to decrease each year, so does the CDR without medical indications.The first indication of cesarean section is associated or postoperative pregnancy complications, while scarred uterus becomes the most common in cesarean section.

BACKGROUND: Previous artificial ligament is easy to break for material fatigue and to appear synonitis for materialbiocompatibility.OBJECTIVE: To observe the application effect of ligament advanced reinforcement system (LARS) artificial ligament inreconstruction of anterior cruciate ligament via follow-up.DESIGN, TIME AND SETTING: An own control, follow-up observation was performed between August 2004 andJanuary 2007 at the Department of Orthopedics and Joint Surgery, Shanghai Changzheng Hospital, Shanghai, China.PARTICIPANTS: Twenty-eight patients with anterior cruciate ligament injury, including 16 with sport injury and 12 withvehicle accident injury.MATERIALS: The main component of LARS artificial ligament (Laboratoire d'Applieation et de Recherche Scientifique,France) is the high-tenacity polyester fiber polyethylene terephthalate.METHODS: Twenty-eight patients with anterior cruciate ligament injury were performed arthroscopic reconstruction of theligament with LARS artificial ligament and were averagely followed up for 20 months.MAIN OUTCOME MEASURES: Patients' anterior drawer test, Lysholm score, range of motion prior to transplantationand in follow-up.RESULTS: The knee unstable symptom of 28 patients disappeared, anterior drawer test was negative, joint function wasgood with the flexion of 5.71 to 129.64 degrees. Average Lysholm score raised from (45.7±9.82) points prior totransplantation to (86.5±6.44) points after transplantation (P < 0.001). All patients resumed normal activities at 2 monthsafter transplantation, without acute or chronic synovitis and host response to materials.CONCLUSION: LARS artificial ligament is a relatively safe transplantation material and especially suitable to reconstructanterior cruciate ligament with sport injury. Mid-/short-term follow-up shows good result.

Objective To explore the prognosis and related factors of brain glioma .Methods 133 patients who have been con-firmed pathology with brain glioma from Jan .2001 to Dec .2010 were retrospectively analyzed .The factors such as sex ,age ,func-tional status ,histological character ,the longest diameter of tumor ,surgical excision of part or all of the tumor ,whether or not being radiotherapy after surgical excision were selected to evaluate by single factor and multiple factors analysis .Results The median fol-low-up time was 36 months ,The follow-up rate was 93% .73 cases were followed up for 3 years ,the 1- ,2- and 3- year survival rate was 93% ,82% and 70% ,respectively ,the median survival time was 62 .7 months .Multiple factors regression analysis showed that histological character ,the longest diameter of tumor and whether or not being radiotherapy after surgical excision were related to prognosis .Conclusion High-grade of histological character ,the longest diameter of tumor≥6 cm predict poor prognosis ,postop-erative radiotherapy can improve the survival of glioma .

Objective To assess the clinical significance of modular femoral component in restoring femoral offset after total hip arthroplasty.Methods Data of 75 patients,who had undergone THA with modular femoral component from June 2009 to June 2012,were retrospectively analyzed.There were 42 males and 33 females,aged from 44 to 83 years (average,64.7±12 years).There were 40 cases of left hip and 35 cases of right hip.The average Harris hip score was 54±6 (range,32 to 65) before operation.The Zimmer M/L Taper hip prosthesis with Kinectiv technology was used in all patients.Preoperative templating was utilized to accurately predict the prosthetic size and the femoral offset.During the surgery,the femoral offset was measured accurately,and the appropriate femoral neck prosthesis was selected in order to restore the femoral offset and reconstruct hip abductor moment arm.The femoral offset and leg length were measured according to X-rays after operation.The Harris hip score was used to assess the clinical results.Results The femoral offset was reconstructed in all patients,ranging from-3.0 to 3.0 mm (average,1.3±0.3 mm).The average leg length discrepancy was improved to 3.0±0.8 mm.All patients were followed up for 6 to 36 months (average,19.7 months).The average hip abduction angle was 40°±10° at 12 weeks after operation.The average Harris hip score was 86±13 (range,65-94) at 12 weeks after operation and 95±15 (range,78 to 98) at final follow-up.There was no hip dislocation and femoral acetabular impingement syndrome.Conclusion Modular femoral component can restore femoral offset without changing the leg length,which can result in good hip abductor strength,range of motion of the hip and stability,as well as less complications.