Objective To compare hip arthroplasty versus internal fixation for treatment of displaced femoral neck fractures in the elderly patients in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.Methods All the randomized controlled trials (RCTs) up to May 2013 on hip arthroplasty versus internal fixation for displaced femoral neck fractures in the elderly were electronically searched for in Pubmed/Medline,EMBASE,Cochrane CENTRAL,CNKI,WanFang and VIP databases.The 2 treatments were compared in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.The Meta analysis was performed with RevMan 5.2.5 software.Results Five eligible RCTs involving 1 288 cases were included for this review.The rate of reoperation (including implant removal and other operations),either within 2 years or over 2 years,in the internal fixation group was significantly higher than that in the arthroplasty group (P ＜ 0.05).The surgery-related complications in the internal fixation group was significantly higher than that in the hip arthroplasty group [OR =8.82,95％ CI (6.45,12.07),P ＜0.001].No significant difference was found in the postoperative 1-2-year mortality between the 2 groups (P ＞0.05).Conclusion In the treatment of displaced femoral neck fractures in the elderly,compared with internal fixation,arthroplasty should be recommended as the first choice,because it can significantly reduce surgery-related complications and reoperations though it cannot decrease the postoperative 1-2-year mortality.

[Objective]To investigate the advantages, risks and kye points of minimally invasive total knee arthroplasty with subvastus approach. [Method] From April 2005 to December 2006, 204 primary total knee arthroplasties were performed, among them 146 cases with convention incision (CI), 58 cases with minimally invasive subvastus approach(MIS). All knees were implanted with the same prosthesis (NEXGEN-LPS, Zimmer).The anesthesia time,operation time, hospitalization time were recorded.The first walking time, walking distance, active knee range of motion, preoperative and postoperative HSS Score and the complications were compared. [Result] Totally 204 cases were followed up and the mean follow-up time was 22 months (range, 13-36 months). The difference of anesthesia time, length of incision, operation time, hospitalization time, walking time had significance between the CI and MIS groups ( u test, P0.05). The difference of active range of motion in 24 hours, 1 week, 2 weeks postoperation had significance between the two groups ( u test, P0.05).The difference of HSS score in 24 hours, 1 week, 2 weeks after operation had significance between the two groups ( u test, P0.05). [Conclusion] The minimally invasive total knee arthroplasty with subvastus approach reduces the quadriceps injury, offers early active knee motion and quickly recovery of knee function. However there is no significant difference in long-term walking distance, range of motion and HSS score.

[Objective]To explore the surgical plan of lumbar degenerative de novo scoliosis combined with vertebral stenosis(LDDS) and evaluate the surgical efficiency.[Method]From July 2003 to Jan.2007,32 LDDS patients were diagnosed and operated in the author’s hospital.The X-ray,computed tomography and MRI radiological data were measured carefully preoperately which included the Cobb’s angle,vertebral rotational and lateral subluxation degree.All the patients were treated by posterior decompression and pedicle screw internal fixation,and the surgery,fluoroscopic time and bleeding amount were recorded.Patients were administered pre- and postoperatively with clinical outcome surveys of Visual Analogue Pain Score(VAS),Low Back Outcome Score(LBOS).Pre- and postoperative measurements of the Cobb's angle and lumbar lordosis of the involved segments were analyzed.[Result]The surgery time was 4?0.5 hours,the average bleeding amount was 400?30 ml,the fluoroscopic time was 30?5 min.All the patients were followed from 8 months to 4 years,and radiography was proceeded on 8 and 16 months respectively post surgery.Twenty-four cases got good bone fusion,and mean Cobb's angle decreased from 37.2 to 18.4 degrees,mean focal lordosis increased from 13.1 to 16.4 degrees,mean vertebral rotation angle decreased from 14.2 to 9.8 degrees,mean preoperative measures of VAS and LBOS improved from 5.3?2.2 and 24.8?15.6,respectively to 2.2?2.1 and 44.8?18.0 at last follow-up,the Cobb’s angle,lumbar lordosis and the degree of vertebral rotation had significantly difference pre and post surgery(t test,P

[Objective]To study the clinical characteristics of osteochondrosis of lumbar posterior vertebral edge(OLPV) and evaluate the efficiency of surgical treatment. [Method]From August 2000 to August 2003,41 cases of OLPV patients were treated,all cases underwent decompression of posterior approach and selective resection of the compressive things.Furthermore,1 case was treated with trans-vertebral pedicle internal fixation and inter-transverse process bone graft because of excessive decompression and preoperative lumbar instability.[Result]Low back and leg pain disappeared or obviously being relieved in all cases,and the results of histological analysis suggested the diagnosis of OLPV in all cases.Forty-one cases were followed from 5 to 8 years,average 6.8 years.No lumbar instability or spondylolisthesis was found in any case.Six cases suffered slight low back pain occasionally without obvious impaired quality of life.The preoperative JOA score was 14.73?2.06,when followed by 3 months,the score changed into 27.14?4.13,there was statistical significance between them(P

[Objective]To analyze the dynamic changing of inflammatory markers in second stage revision for infected TKA and to explore the sensitive indicators. [Methods]From June 2004 to April 2008,20 cases of infected TKA were admitted and treated by the two stages knee revision.The inflammatory markers included full blood count,erythrocyte sedimentation rate(ESR).C-reactive protein(CRP) were examined weekly,and to evaluate the dynamic changes and the most sensitive indicators.[Results]CRP was the most sensitive index for infection control,and its maximum presented in the first week post antibiotic bone cement implantation,followed by rapid reduction in the second week and there was statistical difference compared to the CRP level before surgery(t=105.84,P

Objective: To investigate the anatomical characters of the sustentaculum tali (ST), accurate entry point and direction for the placement of ST screw from posterior subtalar joint facet to the constant fragment (CF) in calcaneal fractures. Methods: A total of 100 patients with calcaneal fractures performed ankle CT scans were enrolled between January 2016 and April 2016. According to the inclusion criteria, the clinical data of 33 patients were analyzed, including 18 males and 15 females, with a median age of 41.0 years (range, 18-60 years). There were 16 cases on left side and 17 cases on the right side. Three-dimensional (3D) calcaneal model was reconstructed by Mimics 17.0 software, and the ST anatomical references were measured, including the length of upper and lower edge, the length and height of the midline, the horizontal angle between the midline and foot plantar surface. The parameters of the optimal entry point position (P' point) and placement angle of the ST screw were determined. The length of ST screw was also measured. The differences between males and females or left and right sides were compared. Results: The length of upper edge of the ST was (16.60±2.23) mm, lower edge (20.65±2.90) mm, midline (20.56±2.62) mm, and the height of midline was (9.61±1.36) mm. The horizontal angle between the midline and foot plantar surface was (23.43±3.36)°. The vertical distance from P' point to the lowest point of the tarsal sinus was (3.09±1.65) mm, while the horizontal distance was (14.29±2.75) mm. The distance from P' point to the apex of the lateral talus, subchondral bone of subtalar joint, calcaneocuboid joint was (11.41±3.22), (6.59±2.22), (34.58±3.75) mm, respectively. The horizontal angle between the ST screw and foot plantar surface was (-1.17±2.07)°. The anteversion angle of ST screw was (16.18±2.05)° and the length was (41.64 ± 3.09) mm. There were significant differences in the length of upper and lower edge, the length and height of the midline, the distance from P' point to the apex of the lateral talus, subchondral bone of subtalar joint, and calcaneocuboid joint, and the anteversion angle and length of the ST screw between males and females ( P<0.05). There was no significant difference in above all parameters between left and right sides ( P>0.05). Conclusion: After appropriate reduction of the calcaneal fractures, the entry point of ST screw was recommended at about 14 mm posterior and about 3 mm upper related to the foot horizontal line through the lowest tarsal sinus point; and the direction of ST screw placement was about 17° anteversion for males and 15° anteversion for females.

AIM: To establish the fingerprint chromatography of Yujin Injection (Herba Houttuyniae, Flos Lonicerae) by GC. In the paper the authors examine the similarity among standard and sample chromatogra-phies. METHODS: GC was used to analyze the volatile ingredients, SGE 30QC3 colume (30m? 0.32mm? 0.5?m) was used with column temperature from 100℃ to 170℃ with 2℃?min -1 below 150℃ and 5℃?min -1 above 150℃, flow rate at 1.0mL?min -1 and detector temperature at 200℃. RESULTS: Standard fingerprint consisted of 17 marker peaks, the comparison of similarity's RSD to the injection of different batch had no more than 2%. CONCLUSION: According to the selected chromatographic conditions, a good fingerprint of the injection has been described. The method is simple, accurate with good reproducibility. It may be practical for the quality control of Yujin Injection.

Objective To compare the efficiency of compressive bandage dressing and drainage on the blood loss after total knee arthroplasty (TKA). Methods Patients (n=120) who visited Tianjin General Hospital Bin Hai Branch and Tianjin People's Hospital due to varus knee osteoarthritis and underwent TKA were retrospectively analyzed.There are 20 males and 100 females with, mean age was 65.18±6.88 years. Depending on whether placement of drainage, patients were divided into drainage group (60 cases) and pressure bandage dressing group (60 cases). Blood loss, blood transfusion and full blood count (FBC) were all analyzed after TKA in both groups. Results Blood loss after TKA in drainage and pressure dressing group were (1 026.85±274.44),(789.52±251.58) mL respectively. Blood loss was less severe in pressure dressing group than that in drainage group (t=4.938, P<0.01). Allogeneic transfusions were needed in 14 cases of drainage group and five cases of pres?sure bandage dressing group. The circumstances that requires blood transfusion was significantly lower in pressure bandage group than that in drainage group (χ2=5.065, P<0.05). The postoperative limb swelling and postoperative joint mobility did not show statistical significance (P>0.05). Conclusion Application of compressive bandage dressing in TKA surgery is easy to be operate and can reduce perioperative blood loss and allogeneic transfusion incidence.

Objective: To review the progress of total ankle arthroplasty (TAA) in treatment of end-stage ankle osteoarthritis (AOA). Methods: The domestic and foreign literatures about TAA in recent years were reviewed. The current status and progress of TAA were summarized from the results of traditional and computer-assisted TAA clinical outcomes. Results: End-stage AOA often leads to severe pain and dysfunction, and arthrodesis is still the main selective treatment option. In recent years, with the advancement of surgical techniques and prosthesis design, TAA which can remain joint mobility has increased gradually, and the surgical results also have significant progress. Accurate prosthesis implant and mechanical alignment restoration are critical factors for TAA, and surgery-related malalignment is correlative to the prosthesis failure. Computer assisted patient-specific guide can simplify the TAA procedures and obtain the accuracy of tibia and talus osteotomy. Conclusion: The clinical efficiency of preoperative CT based patient-specific guide technology for TAA needs further clinical follow-up. Meanwhile, it is necessary to further develop intraoperative navigation and robotic surgery system suitable for TAA.

Objective To evaluate the femur biomechanical changes of finite analysis with different femoral stem ex-tension implants in total knee arthroplasty (TKA). Methods The full-length femoral CT scan was performed in selected healthy volunteers. The femoral digital model was established with Mimics 10.0 and Geomagic Studio 10.0 software. The models of femoral prosthesis and stem extension implant were created by laser scanner. According to the common three hip loading modes (1 586 N, 1 690 N and 2 132 N), the maximum principal stress (MPS), the maximum principal elastic deforma-tion (MPES) and MPES distribution changes were recorded and analyzed by three-dimensional finite element analysis with ANSYS Workbench13.0 software. Results The MPS values before TKA were 98.54, 147.36 and 143.51 MPa respectively when values of femoral head loading were 1 586 N, 1 690 N and 2 132 N. With the increase in the length of the femoral pros-thesis extension rod, the MPS and MPES showed a decreasing trend. There was a positive correlation between free femur ra-tio (FFR) and MPES (P<0.05). The MPES distribution was gradually concentrated at the top point of femur stem extension implant with the increase in the length of the femoral prosthesis extension rod. Conclusion The values of MPS and MPES were gradually decreased with the increase in the length of the femoral stem extension implant. There was a positive linear correlation between FFR and MPES. The stress concentration was focused obviously at the top end of femoral stem extension implant with its length more than 120 mm.