Objective To explore the therapeutic effect of total hip replacement (T HR) in treating osteonecrosis of the femoral head (ONFH) after failed internal fixation of femoral neck fracture .Methods From January 2003 to June 2012 ,32 cases (19 left hips and 13 right hips) of ONFH after failed internal fixation of femoral neck fracture were treated with THR .There were 18 males and 14 females with an age range from 35 to 62 years (mean ,50 .6 years) .The ONFH was diagnosed at 8-26 months (mean ,17 .1 months) after internal fixation ;the THR were conducted 15-48 months after first surgery (mean ,27 .2 months) .According to Fi‐cat classifi cation ,there were 8 cases at stage Ⅲ and 24 cases at stage IV .The Harris score was (40 .9 ± 9 .8) .The prosthesis of bi‐ology was used .Results All wounds healed by first intention .All cases were followed up for 6-48 months (mean ,28 .3 months) . The Harris score was (90 .8 ± 4 .4) at last follow‐up ,showing significant difference when compared with the preoperative value (P<0 .05) .The hip function were excellent in 25 hips ,good in 5 hips ,fair in 2 hip ,and the excellent and good rate was 93 .8% . There were 1 cases of periprosthetic femoral fracture(type C) ,2 cases of proximal femoral splitting fractures fractures .After corre‐sponding treatment ,fracture was healed in all cases .There were no complications (infection ,loosening dislocation or subsidence , etc) .Conclusion Total hip replacement is an effective method for the treatment of ONFH after failed internal fixation of femoral neck fracture .

ObjectiveTo study the anatomical characteristics of the renal pedicle and its clinical application during retroperitoneoscopic nephrectomy.MethodsThe imaging, surgical video and clinical data of 278 cases undergoing retroperitoneoscopic nephrectomy between July 2007 and September 2009 were retrospectively analyzed. The renal pedicle was found located at the psoas and the medial arcuate ligament of the diaphragm for anatomic landmark before the gap of the psoas. A statistical analysis of the mean operative time, the mean time to look for the renal pedicle, the mean intraoperative estimated blood loss, the mean time to ambulation, the mean time to resuming oral intake, the mean postoperative hospital stay day and the rate of complications was performed.ResultsAll the operations were performed successfully, with no conversion to open and blood transfusion. The mean time to find the renal pedicle was (3.5 ± 1.3 ) min, the mean operative time was (95.6 ±23.8) min, the mean estimated blood loss was (72.4 ±27.5) ml, the mean time to resuming oral intake was (2.1 ±0.7) d, the mean time to ambulation was (1.8 ±0.9) d, the mean postoperative hospital stay was (8.5 ± 2.7 ) d.ConclusionsDuring retroperitoneoscopic nephrectomy, the best anatomical space to look for the renal pedicle is the space before the psoas muscle. The exact location of the renal pedicle is under the diaphragm medial arcuate ligament about 2 - 4 cm, in the gap of the psoas muscle and the vena cava (abdominal aorta). Following this procedure could reduce the time to look for the renal pedicle, thus reducing operative time.

[Objective]To study Bone microdmage to osteoavascular epiphysis caput humeralis in teenagers of the guts outbreak mechanism and make a diagnosis and give treatment in early stage important point.[Method]The review was from 138 patients of the shoulder department ache with shoulder joint movable function obstacle that orthopedics out-patient service of 2004~2005.There was X-rays / CT,the blood bio-chemical 5 example among the teenager of the patients,it was observed by medium short-term curative effect.We was combined a related cultural heritage study,put forward to make a diagnosis and gave treatment to have the instruction meaning to the clinic of four expect to categorize a method,and to early,medium,later period the non-surgical operation treatment observation.[Result]In 138 patients,there were 5 teenager patients who were the epiphysis of head humeralis bone microdamage ON,through the function instauration was normal:Earlier period 2 cases of 1~4 weeks,middle period 2 cases of 5~8 weeks,the later period 1 case of 4~6 months.We choose the medicine of prescription with the independence,"Huo xue hua yu","Bu shen zhuanggu","Tong luo zhi tong" medicinal broth,the right amount internal use outside use,having already obtained good result.We have already observated the serious bone arthritis/canceration,resulting in serious result(in another report).[Conclusion]Once or more shoulder was bone microdamage lead the caput epiphysis humeralis occurrence ON of guts.We observe the sufferer whom had the clinical symptom,physical sign,according to the clinical performance,course of disease's long/short,imageology atc.The suggestion is divided into early,medium,night and most late four periods,for the convenience of the choice treatment measure.Because of various reason,long and non-healing cases might develop to the most later period of case,such as the avascular osteo arthritis/canceration.

Objective To analyze the form and classification of adult knit supercilium,at the same time,to explore the principle and clinical effects of botulinum toxin type A injections in knit supercilium treatment.Methods Retrospective analysis of morphology and treatment was carried out in 104 Chinese adults knit supercilium.The patients were randomly enrolled in study group that were subjected to botulinum toxin type A injection for the first time in treatment of glabella wrinkles.Forms of wrinkle supercilium were classified;Targeted point injection of botulinum toxin type A was adapted,with the minimum dose to achieve satisfied effect.The treatment interval was over 4-6 months.treatment methods and effects were explored.Results Chinese knit supercilium according to the form was divided into 6 different types:U-shaped (19 cases),Ⅲ shaped (30 cases),V-shaped (20 cases),hanging needle shaped (19 cases),Ω shaped (10 cases),and reverse Ω shaped (6 cases).During observation period,there was no serious adverse reactions after treatment.Conclusions Stand ardization of personalized botulinum toxin type A injections for patients with knit supercilium plays a positive role.

Objective To provide imaging anatomy basis for percutaneous nephrolithotomy ( PCNL) by measuring relative displacement and changes in anatomical position of kidney and colon under the prone and low-oblique supine positions.Methods Forty-six patients scheduled for PCNL underwent 64-slice spiral CT scan under the prone and low-arch oblique supine position before the PCNL.The horizontal distance of kidney and colon,the distance from colon and analog puncturing line,the distance between the kidney and colon were measured and compared between the 2 positions.Results The distance from colon and analog puncturing line under the low-oblique supine and prone positions were as follows,the left (26.56 ±15.36) mm versus (12.25 ±13.16) mm (t=3.527,P<0.05),the right (25.85 ±14.26) mm versus (13.57 ± 12.53) mm (t=3.234,P<0.05).The differences of the rest distances between the 2 positions were not significant ( P>0.05).Conclusions The distance between colon and analog puncturing line increases in the low-arch oblique supine position,because the colon shifts to the ventral.The PCNL in low-arch oblique supine position may reduce the incidence of colon injury,and improve surgical safety.

BACKGROUND: Autologous bone marrow is the only tissue that contains abundant osteoinductive osteogenitor cells and is the first-choice transplantation materials for treatment of bone nonunion. Artificial bone with osteoinductive capacity can provide a supporting effect for the in-growth of osteocytes. Iliac periosteum can be used for treatment of bone nonunion due to the advantages including abundant blood circulation, easy harvesting, and able to improve local arterial blood supply. BJECTIVE: To treat refractory bone nonunion in limbs using artificial bone with autologous bone marrow combined with iliac periosteum transplantation, and to compare the therapeutic efficacy to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation. METHOD: Thirty-nine refractory bone nonunion limbs from 36 patients were assigned to three groups: artificial bone with autologous bone marrow combined with iliac periosteum transplantation (combination group, n = 19), artificial bone with autologous bone marrow (bone marrow group, n = 9), and autologous iliac periosteum (iliac periosteum group, n = 11). The time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score were evaluated. RESULTS AND CONCLUSION: All initial 39 limbs acquired bone union and were followed up for an average period of 18.5 months. The combination group yielded better therapeutic effects than the bone marrow group and the iliac periosteum group in terms of the time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score (P < 0.05). These findings indicate that artificial bone with autologous bone marrow combined with iliac periosteum transplantation exhibits better clinical therapeutic effects in treatment of refractory bone nonunion in limbs.

Objective To explore the structure of Chinese personality based on natural language and to develop a Chinese personality vocabulary data bank.Methods Based on the sub-factors of Chinese personality scale(QZPS),Chinese personality assessment inventory 2(CPAI-2) and Chinese personality five factors inventory (CPFFI),a self-reported personality questionnaire with 116 items was developed.An exploratory factory analysis and parallel analysis were made to the data collected from 1455 Chinese participants.Results A Chinese Personality Seven Factors Inventory (CPSFI) was developed,which included seven factors with 52 items.51.63％ of the total variance of the seven factors was explained and the internal reliability coefficient was 0.800,while the internal reliability coefficients among the factors were between 0.663-0.912.The retest reliability coefficients of the factors were between 0.700-0.874 (P ＜ 0.01).Conclusions Outgoing and emotion are the core contents of the crossculture personalities.Most of the factors in QZPS,CPAI-2 and CPFFI can be found in the seven factors structure,of which the structure is clearer.

Objective To evaluate if 18F-FLT PET imaging could be used as a new clinical method to predict tumor radiosensitivity.Methods MDA-MB-231 and LN229 cells were irradiated with doses of 0,8 and 16 Gy of 6 MV photon energy,then soft agar assay and cellular uptake of 18F-FLT were performed on the 2 cell lines.The t test and one-way analysis of variance were used for the two groups and data before and after irradiation.The MDA-MB-231 and LN229 tumor xenografts were prepared by injecting the tumor cells into the right limbs of female BALB/c nu/nu mice.Once tumors reached a diameter of 10 mm,the two types of mice were divided randomly into 3 groups (20 mice per group) according to the irradiation doses (0,8 and 16 Gy).After irradiation,18F-FLT PET imaging and immunohistochemical staining were conducted.Then correlations between 18F-FLT SUVtumor/SUVmuscle ratio (T/M ratio) and TK1 labeling index percentages (LITK1) were tested using linear correlation analysis.Results The survival fraction of MDA-MB-231 and LN229 cells after irradiated with 8 Gy were (59.73 ± 4.3) ％ and (93.41 ± 3.75) ％,respectively (t =-13.20,P ＜ 0.001).When the dose increased to 16 Gy,the survival fraction decreased to (43.57 ±4.06) ％ and (81.77 ± 4.42) ％,respectively(t =-14.24,P ＜ 0.001).In MDA-MB-231 cells,the cellular uptake of 18F-FLT after irradiation with 8 Gy declined rapidly to (18.32 ± 1.38) kBq/105 cells ((128.22 ± 8.24) kBq/105 cells with the dose of 0 Gy,F =266.41,P ＜ 0.01),and maintained this low level till 72 h.For the LN229 cells,the cellular uptake decreased to (9.87 ± 1.30) kBq/105 cells after 8 Gy irradiation ((134.88 ± 6.59) kBq/105 cells with the dose of 0 Gy,F =346.06,P ＜ 0.01),then increased gradually to (127.17 ± 9.08) kBq/105 cells at 72 h (F =346.06,P ＞ 0.05).The dynamic changes of 18F-FLT cellular uptake in the two cells had the same pattern after being treated with 16 Gy irradiation.In the 18F-FLT PET image of MDA-MB-231 tumor mice after 8 Gy radiotherapy,the T/M ratio decreased to 0.78 ± 0.39 at the first day,but it was 2.84 ± 0.29 before radiotherapy (F =39.78,P ＜0.01).Then the ratio increased slowly,and it was still lower than the baseline at 7 d after radiation (F =39.78,P ＜0.01).The same pattern could be seen in the group of 16 Gy irradiation.In LN229 tumor mice treatment with 8 Gy irradiation,the T/M ratio increased to 2.41 ±0.47 at the first day,and it was 1.58 ±0.29 before radiotherapy (F =34.01,P ＜ 0.05).The ratio decreased steadily to 0.66 ± 0.32 (F =34.01,P＜0.05) at 7 d after radiotherapy.However,in the treatment group with 16 Gy,the T/M ratio decreased gradually and reached 0.44 ± 0.22 at 7 d (F =41.85,P ＜ 0.01).A correlation was found between 18F-FLT T/M ratio and LITK1 (8 Gy:r=0.67,0.73; 16 Gy:r=0.73,0.69; all P＜0.01) in both tumor models.Conclusion 18F-FLT PET imaging may be used as a new assay to predict tumor radiosensitivity,but further investigation is needed before clinical application.

Objective To study methods and effect of granule bone grafting into the vertebral pedicle pyramid under endoscope for treatment of thoracolumbar fractures. Methods There were 26 cases (7 males and 19 females; age range of 32 79 years, average 51.2 years) with thoracolumbar fractures. The fractures included 8 cases (30.8%) of thoracolumbar compression burst fractures with no compression of the spinal cord by broken bone fragments and 18 (69.2%) compression fractures due to senile osteoporosis. Posterior to a preliminary reduction of the lumbar region on the operating table, all cases underwent vaginal vertebral pedicle reduction under endoscope and autogenous or hererogeneous granule bone graft in order to restore the height of the fractured vertebra pyramid. The patients kept in bed for two months postoperatively; meanwhile, the excise for the back muscle was performed. Results The mean follow up period was 3 18 months. Twenty one cases (80.8%) got excellent therapeutic result, four (15.4%) moderate and one (3.8%) poor. (1) The vertebral height recovered average 29%, with mean height loss of 5% through six month follow up. (2) The posterior convex cobb angle of the spine recovered for 10? 20? (mean 13.8?). (3) No lumbago or nerve compression symptoms were found in 21 cases. Conclusions Granule bone graft into vertebra pyramid under endoscope in the treatment of thoracolumbar fractures is a minimally invasive procedure that can enhance the bone capacity of the vertebra, alleviate pain, restore the height of the fractured vertebra pyramid and accelerate bone healing.

Objective To investigate the effect of N-myc downstream regulated gene 2 (NDRG2) on the apoptosis of bladder cancer cells by regulating the signal transducer and activator of transcription 3(STAT3) signaling pathway.Methods The expression level of NDRG2 in human bladder cancer cell BIU-87 and immortalized cell SV-HUC-1 was detected by Western blot.NDRG2 over expression vector and empty vector control (pcDNA3.1),siRNA-NDRG2,siRNA control were transfected into BIU-87 cells.After transfected 48 h,the expression level of NDRG2,Cleaved caspase 3,STAT3,p-STAT3,JAK2,p-JAK2 were detected by Western blot,the cell proliferation and apoptosis were measured by MTT and flow cytometry.After adding inhibitor AG490 of 45 μmol/L in cultured BIU-87 cells,MTT assay was used to detect cell proliferation and flow cytometry was used to detect the cell apoptosis,Western blot to detect the expression level of Cleaved caspase 3,STAT3,p-STAT3,JAK2,p-JAK2.Results The expression level of NDRG2 in bladder cancer cells was higher than that in bladder epithelial cells.The cell survival rate of pcDNA3.1/NDRG2 group was lower than that of pcDNA3.1 group,the difference was statistically significant (P ＜ 0.01).The cell survival rate of siRNA-NDRG2 group was higher than that of siRNA control group (P＜ 0.01).The apoptosis rate of pcDNA3.1/NDRG2 group was higher than that of pcDNA3.1 group (P ＜ 0.01).The apoptosis rate of NDRG2 siRNA group was lower than that of siRNA control group (P ＜ 0.01).The level of p-STAT3 and p-JAK2 in pcDNA3.1/NDRG2 group was lower than that in pcDNA3.1 group (P＜ 0.01).The survival rate and apoptosis rate of BIU-87 cells cultured with AG490 were in agreement with the trend of pcDNA3.1/NDRG2 after transfection.Conclusions NDRG2 could promote the apoptosis of bladder cancer cells,and its mechanism may be related to STAT3 signaling pathway.