Animals ; Humans ; Neurotoxins ; toxicity ; Pesticides ; toxicity ; Pyrethrins ; toxicity ; Toxicology

Objective To evaluate mid-term clinical and radiographic outcomes associated with cementless total hip arthroplasty(THA) in a consecutive series of patients with osteonecrosis of the femoral head. Methods This study examined the mid-term (equal to or more than 5 years) results of THA. From January 1998 to March 2001, a series of 71 patients (80 hips) who had undergone THA with cementless components in our hospital were involved in this study. All patients were evaluated both clinically and radiographically. Clinical outcomes were evaluated according to Harris evaluation score. Components migration, bone changes around the implant, the polyethylene wear rate and direction of the acetabular polyethylene wear were measured radiologically. Kaplan-Meier analysis was performed to evaluate the survival of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular component, and revision of the femoral component for any reason. Results 62 hips in 54 patients were followed up at least 5 years. The mean Harris hip score improved from preoperation (44.0?8.4) points to (92.4?5.7) points at the time of final follow-up. No component was seen to be loose radiographically or had been revised because of any reason at the time of final follow-up. Only one focal area of pelvic osteolysis in one patient and twelve small focal areas of femoral osteolysis in another patient were identified. The mean linear wear rate was (0.125?0.074) mm/year. When loosening was used as the end point for failure, the survival rate of the acetabular and femoral components was 1.0 (95% confidence interval, 0.98 to 1.00) in both groups. Conclusion Cementless THA in patients with osteonecrosis of the hip had a satisfactory clinical and radiographic outcome at a minimum of five years follow-up. Because polyethylene wear and osteolysis can not avoided, radiographical follow-up for cementless components is very important.

[Objective]To evaluate the safety and efficacy of total hip resurfacing arthroplasty in treating osteoarthritis secondary to congenital dysplastic hip.[Method]From May 2005 to June 2005,13 hips in 12 cases with osteoarthritis secondary dysplastic hip were adopted in this study.There were 8 females and 4 males,aged from 30 to 59 years,average 47 years.All the 13 hips were subluxation according to Hartofilakidis classification system.Posterolateral approach was used during operation and all the acetabular cups were reconstructed at the true acetabular location.The pronthesis were cementless acetabular cup and cement femoral head.[Result]The average operation time was 110 min,blood loss volume was 387 ml during operation,drainage volume was 200 ml and the extremity was lengthened for about 9 mm.All the incision healed well and there have not any complications such as femoral neck fracture,infection,dislocation and neurovascular injury.Follow-up for 12 to 13 months,all the joints had good or excellent clinical results.The average range of motion of the hip:flexion improved from 106.7? to 120?,abduction improved from 25.8? to 46.4?,external rotation improved from 20.8? to 45?,internal rotation improved from 3.3? to 28.6?.The Harris score increased from 42 preoperatively to 96 postoperatively.Radiographically,the positions of the prostheses were normal,the average abduction angle of the cup was 39?,the average stem-shaft angle wes 141?,the positions of acetabular rotation centre were moved down and medially for average 9 mm and 11.5 mm respectively,the acetabular superolateral bone coverage of the hips was 89.5%,no radiolucent line was observed.[Conclusion]Total hip resurfacing arthroplasty has got good short-term results in the treatment of osteoarthritis secondary to dysplastic hip.Because of the less quantity and short follow-up time,the long-term results and indications for other kinds of dysplastic hip are worthy of further studying.

Objective To analyze the effect of reconstruction for the proximal or distal femoral defect by a composite of massive frozen allograft and prosthesis replacement. Methods According to Enneking's classification, malignant bone tumors of the proximal or distal femur were widely resected in 28 cases. Reconstruction of the affected hip or knee joint after major joint removal was done by a composite of allograft and prosthesis. A conventional femoral component with a stem long enough to provide good fixation in the femoral shaft was threaded over a customized allograft. After the assembly had been reduced and checked for size and position, the allograft was cemented to the femoral component, and the composite was in turn cemented into the femoral shaft with PMMA. Results 26 patients were followed up from 6 to 78 months with an average of 41 months. 3 cases died within 18 months following operation; 4 case sustained recurrences within 8 months postoperatively, and underwent re-resection; and the others were alive without diseases. All patients had no dislocation, loosening or breakage of prosthesis. X-rays showed the time of bone healing between allograft and host femur was an average of 7.4 months (range, 5 to 11 months), and the rate of bone healing was 92% (24/26). Absorption was seen around allograft greater trochanter of femur in 9 cases and at femoral condyle in 6 cases. 13 cases with total hip composite replacement had good active extension-flexion degrees of an average of 85?( range, 71? to 124?), and 13 with total knee composite replacement had a rang of motion of 92?(range, 68? to 135?). The postoperative average ISOLS scale score of 26 cases by Enneking's system was 26.2 point (range, 22 to 28). Conclusion The clinical result demonstrated the composite of massive frozen allograft and prosthesis replacement has the advantages of both allograft and prosthesis. Its best indications are that the patients with a major femoral defect from benign or low grade malignant tumor have longer survival expectancy.

Objective To estimate an automatic DNA extracting method, and evaluate the quantity and quality of these DNA samples.Methods Genomic DNA was extracted automatically from blood samples by MiniPrep 75-Ⅱ workstation. The yield and purity of DNA samples were detected by UV-spectrophotometer, and the integrality of these DNA samples were measured by agarose gel electrophoresis.Results The yield of genomic DNA extracted from 100?l whole blood were (7.33?2.58)?g. The average purity of these DNA samples was 1.647?0.135 (A260/A280) and the molecular weight of them was about 21 kb.Conclusion High quality and intact genomic DNA can be extracted rapidly from whole blood by using MiniPrep 75-Ⅱ workstation, and these DNA samples were suitable for downstream molecular biology experiments.

Objective To discuss the diagnosis and operative treatment of the complex acetabular fractures of Letournel classification. Methods On the basis of the three- dimensional computed tomography, 75 cases of complex acetabular fractures were diagnosed and classified according to Letournel classification. They were treated through the anterior, posterior, combined anterior- posterior and the improved iliofemoral approaches. All the fractures were fixed with screws and AO reconstruction plates. Results All the cases were followed up for 6 to 96 months, with an average time of 46 months. They were evaluated according to D' Aubigne and Pestel criteria for joint functions and Epstein criteria for radiographic manifestation. 34 cases of the series were rated as excellent (45.23% ), 28 case as fine (37.33% ), 8 cases as fair (10.67% ) and 5 cases as poor (6.67% ). Conclusion Enough image data, simulation in vitro on a pelvic specimen, maximal anatomical reduction and appropriate approach are the basis for satisfactory outcomes.

Objective To discuss a new method of BMSCs culture which can reduce the lead-in of extraneous antigenic substances in the process of cell culture, and can thus better meet the demand on the quantity and biological characteristics of BMSCs in the clinical use of tissue engineering bone. Methods BMSCs from a human adult in vitro were induced by using autologous platelet-rich plasma instead of animal serum in high-carbohydrate DMEM (Dulbecco's minimum essential medium). After the cultured BMSCs were amplified rapidly by Rotary Cell Culture System, their growth status was observed and their biological characteristics were detected. Results The cells were in good growth status and presented fine biological characteristics. Their growth speed in Rotary Cell Culture System was observed to be evidently faster than that by conventional methods. Conclusions Rotary Cell Culture System by autologous platelet-rich plasma instead of animal serum is a good culture method to induce human BMSCs in vitro. The quantity and biological characteristics of BMSCs cultured in this way can meet the demand in clinical use.

Objective To observe the influences of VEGF transfection on the proliferation and ultrastructure of hBMSCs. Methods Three groups were enrolled in the experiment: group of Ad-VEGF transfection, group of empty Ad transfection, and the control group. Cells were observed continually by inverted phase contrast microscope, and stained by HE. Proliferation of cells was tested by MTT and by flow cytometry analysis. Results Histological observation and observation through inverted phase contrast microscope showed that the cells were of the similar morphology in the 3 groups. As time elapsed, the amount of cells increased, but still no obvious differences were found in optical density (OD) value of hBMSCs.Groups B, C, A had a similar percentage of DNA G1 period and a similar proliferation index (PrI) ( P >0. 05). Conclusion Transfeetion of VEGF has no obvious influence on the prohferation and morphologyof hBMSCs in vitro.

Objective To summarize the experiences of total hip replacement in the treatment of osteoarthritis secondary to congenital dislocation of hip in adults. Methods From April 1998 to April 2000, fourteen hips in nine adult patients with osteoarthritis secondary to congenital dislocation of hip undergone total hip replacement were included in this study. There were seven females and two males. The age of the patients at surgery ranged from 27-53 years (mean, 45.56 years). Five patients underwent bilateral total hip replacements and 4 had unilateral total hip replacement. Results The incision healed smoothly. The duration of follow up ranged from 6 months to 2 years. All the patients could walk independently after the surgery. They could take care of themselves and restored to previous job. The average Harris score was increased from 33.93 to 89.21 points after the surgery. Conclusion Total hip replacement is an effective method in the treatment of osteoarthritis secondary to congenital dislocation of hip in adults. The four special problems encountered in the procedure such as the position of the acetabular component, the implantation of the femoral stem, the reconstruction of the abductor power, and correction of the leg length discrepancies should be considered. It is a challenging work to the orthopaedic surgeon and the careful preoperative planning is recommended.

Limb lengthening has been applied to deal with inequality of lower limb for a long time. In some special cases femoral lengthening can be chosen for the treatment, though this technique is more difficult than tibial lengthening. We have reviewed in this paper the indications, different methods, newest devices and skills, prevention and cure of complications in femoral lengthening. Because of the high incidence of complications due to this operation, doctors should be very cautious when they determine the cases for the operation.