OBJECTIVE: Aseptic prosthetic loosening is a primary problem of total hip arthroplasty. For this reason, several prosthesis interfaces with different characteristics have been studied, such as ceramic-on-ceramic prosthesis. The purpose of this study wasto investigate the mid- and short-term curative effects of ceramic-on-ceramic total hip arthroplasty in treatment of avascularnecrosis of the femoral head (ANFH) and to evaluate its clinical application value.METHODS: A total of 23 patients (28 hips) with ANFH who received ceramic-on-ceramic non-cement hip prosthesis replacementwere followed up. All hip prostheses were BiCONTACT~((R)) ceramic-on-ceramic hip prostheses. Functional evaluation was assessedaccording to the Harris hip score. Radiographic analysis was performed using the Gruen's zonal method for the stem and the zonal classification of Delee-Charnley for the cup implants.RESULTS: All patients were followed up for an average of 28 months. The mean Harris hip scores ranged from 39.45 points prior to surgery to 88.57 points after surgery, with a difference which was significant (P < 0.05). Radiographically, no obvious prosthesis loosening or subsidence was observed. CONCLUSION: The ceramic-on-ceramic total hip arthroplasty can produce good short-term curative effects in treatment of ANFH.Radiographic findings do not show obvious prosthesis loosening.

BACKGROUND: Achilles peritendinitis can change characteristics of mechanical and viscoelastic properties in Achilles tendon, especially the biomechanical properties of Achilles tendon after heparin local injection. OBJECTIVE: To examine the changes of mechanical and viscoelastic properties in Achilles tendon of overuse injuries and the effects of heparin on the mechanical and viscoelastic properties in Achilles tendon. DESIGN, TIME AND SETTIMG: Control animal specimen study was performed at the Biomechanical Laboratory of Sichuan Province Orthopaedic Hospital between March and December 2005. MATERIALS: Fifty Achilles tendon samples from Japanese White rabbits weighing (4.10±0.23) kg were used in this study. METHODS: Rabbits were divided into a control group (n=20), an exercise group (n=12) and a heparin treatment group (n= 18) at random. The rabbits were exercised for 3 weeks, simultaneously the heparin solution were injected into the peritendineum around the insertion of Achilles-calcaneus from the 4th week to the 6th week, twice a week. Then the cyclic stretching on the Achilles tendon was performed for 25 cycles and the tendon was stretched to the constant load to determine the stress relaxation vs, time. Finally the preparation was loaded to failure to measure the biomechanical characteristics of the tendon. MAIN OUTCOME MEARES: The cross-sectional area of the tendon, the cyclic creep lengths versus time, hysteresis loop, the stress relaxation versus time, the strength properties and the stress versus strain characteristics. RESULTS: The normalized area of hysteresis from exercise and heparin groups were significantly reduced in the most cycles, and the stress relaxation reduced more quickly in the exercise and heparin groups. The mean values for yield load and failure energy, yield energy, and yield stress, strain energies from the exercised preparations were higher than those of the controls. All of the mechanical properties from the heparin treated preparations were improved significantly. CONCLUSION: The results showed that the tensile strength and viscoelastic properties of tendon were improved by the management of heparin. It is indicated that the local injections of heparin at the location of peritendineum and tendon-bone insertions are beneficial to viscoelastic and tensile behaviors of the Achilles tendon system.

Polylactic acid (PLA) is a biocompatible and biodegradable polymer, thus it is widely used in the medical area and is much more attractive. There are two main methods to synthetizing PLA, ring-opening polymerization of lactide and condensation polymerization of lactic acid. In this paper, the process of the new research of the PLA synthesis was reviewed. Beside, the PLA synthesis methods of reactive extrusion and direct melting polycondensation were introduced, which are two high efficiency methods. Finally, the foreground of PLA synthesis was prospected.

ObjectiveTo observe the effcacy of isoflurane supplemented with ropivacaine for sacral block in indirect inguinal hernia.Methods120 cases of children who were going to be operated in inguinal hernia repairs were randomly divided into isoflurane group( A),ropivacaine group( B ),and isoflurane supplemented with ropivacaine group(C).Sacral block was performed after induction with different anesthetics.Haemodynamics( MAP、HR 、SpO2 ) in three groups were compared,and anesthesia effect,waking time,drug dosage and adverse reactions were analyzed.ResultsHaemodynamics in isoflurane supplemented with ropivacaine group were more stable than the other two groups,and anesthesia effect was better than isoflurane group and ropivacaine group( all P ＜0.05).Moreover,waking time,drug dosage and adverse reactions in group C were statistical differently conpared with controls( all P ＜ 0.05 ).ConclusionIsoflurane supplemented with ropivacaine for sacral block was helpful for respiration and circulation management applied in indirect inguinal hernia and could be a perfect anesthetic methods.

Objective To explore the value of ultrasound on the early bone erosion of finger joint in patients with rheumatoid arthritis (RA).Methods Sixty-three cases of RA patients (patients group) with 486 finger joints was examined by high-frequency ultrasound,X-ray films and MRI,and compared with 20 controls (control group).Results The ultrasound results were significant difference between two groups (P＜0.01).The positive rate was 84.2％(409/486) in high-frequency ultrasound,and 56.2％(273/486) in X-ray films,there was significant difference between the two (P ＜ 0.05 ).The positive rate by high-frequency ultrasound was 63.8％ (136/213) in X-ray check-negative patients,and 68.1％ (145/213) by MRI.The results of the MRI contrast sensitivity of 97.6％,specificity of 75％,accuracy of 96.5％ by high-frequency ultrasound.Conclusion The high-frequency ultrasound on the X-ray check-negative patients with rheumatoid hand early joint bone erosion have some diagnostic value.

Type 2 Diabetes is the consequence of the disturbances of both α- and β-cell secretions.Glucagon-like peptide-1 ( GLP-1 ),which regulates the function of alpha and beta cells,has led to the emergence of a new class of oral anti-diabetic drugs.DPP-4 inhibitors,which increase the concentration of GLP-1 and consequently improve HbAlC,have become a choice for patients in different stages of diabetes.

The adenosine triphosphate-binding cassette subfamily member 4 (ABCB4) gene encodes multidrug resistance rotein 3 (MDR3),which is expressed on the cannalicular membranes of hepatocytes and translocates major phospholipids from the inner to the outer leaflet.Phospholipids are the major carrier and solvent of cholesterol,and in combination with bile salts form mixed micelles.Defects in ABCB4 function cause a low phospholipid content in bile,resulting in cholesterol supersaturation and crystal formation.Low phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and a low biliary phospholipid concentration,resulting in symptomatic gallstones starting before age 40 years,a high serum gamma glutamyl transferase (γ-GT) activity,intrahepatic microlithiasis,and recurrent biliary symptoms despite cholecystectomy.LPAC is an autosomal recessive condition caused by a rare single-gene mutation,commonly occurring in ABCB4,and can include homozygous and heterozygous point mutations in introns,coding exons,and 5 UTR regions.

With Chira's proposal of building an innovative country and implementing national intellectual property strategy,the rapid development of intellectual property,reward system of science and technology had a profound effect.This article made preliminary discussion from the level of scientific and technological achievements,the evaluation system and the types of science and technology rewards.

Objective To observe the clinical effect and side effect of Xiaozhitang combined with western medicine .Methods Eighty male patients with hyperlipidemia in our hospital was selected from January 2010 to January 2013 and divided randomly into observation group(n=40)and control group(n=40) .Patients in the control group received treatment with atorvastatin calcium (10 mg/d)while patients in the observation group were administrated with Xiaozhitang besides the routine measures .The values of total cholesterol (TC) ,triglyceride(TG) ,high density lipoprotein cholesterol(HDL‐C)and low‐density lipoprotein cholesterol(LDL‐C) serum creatinine(Scr) ,alanine transaminase(ALT) ,aspartate aminotransferase(AST) ,creatine kinase(CK)were assessed before and after 8 ,16 weeks treatment .Drug‐induced adverse effects were also observed .Results TC ,TG ,LDL‐C were (5 .87 ± 0 .89) , (1 .62 ± 0 .62) ,(3 .62 ± 0 .55)mmol/L in the observation group before treatment and significantly reduced after 16 weeks treatment [(4 .59 ± 0 .52) ,(1 .53 ± 0 .53) ,(2 .69 ± 0 .41)mmol/L](P<0 .05) .TC ,LDL‐C were(5 .88 ± 0 .91) ,(3 .78 ± 0 .43)mmol/L in the control group before treatment and also significantly reduced after 16 weeks treatment[(5 .01 ± 0 .49) ,(2 .97 ± 0 .27)mmol/L](P<0 .05)while TG remained unchanged during 16 weeks in the control group(P>0 .05) .The observation group achieved a significantly greater reduction in LDL‐C and TC than the control group (P<0 .05) .There was a significantly differences in adverse reaction(P<0 .05)but all could be well tolerated .The quality of life score of the observation group was significantly higher than that of the con‐trol group(P<0 .05) .Conclusion The Xiaozhitang combined with atorvastatin calcium could achieve a significantly greater reduc‐tion in lipid‐lowering effect than pure western medicine ,and it shows satisfactory safety and have less side effect .

BACKGROUND:There are many internal fixation methods for tibial plateau fractures with their own merit and demerit. Knee joint internal fixation for Schatzker type V and VI bicondylar tibial plateau fractures has better outcomes, but it is unclear about the specific difference in the repair of these two kinds of fractures.
OBJECTIVE: To observe the repair effects of metal implants insertedviaanterolateral and posteromedial knee joint approach on Schatzker type V and VI bicondylar tibial plateau fractures.
METHODS: From January 2009 to December 2012, 67 patients with Schatzker type V and VI bicondylar tibial plateau fractures were admitted at the Department of Orthopedics, Beijing Changping Hospital, China, including 38 cases of Schatzker type V and 29 cases of Schatzker type VI. Al these patients underwent internal fixation with metal implantsvia the anterolateral and posteromedial knee joint approaches. During the folow-up, differences in fracture healing and functional recovery between the two groups were observed.
RESULTS AND CONCLUSION: The wounds of al patients after active treatment were healed. By the last folow-up, Schatzker VI patients had better outcomes than Schatzker V patients in the aspects of varus-valgus scores, Rasmussen radiology scores, flexion and extension scores, joint range of motion, joint stability scores and good rate of knee joint function (P < 0.05). In addition, there were insignificant differences in colapse, condyle widening scores, ability to walk, knee pain scores, fracture healing time, and incidence of complications between the two groups (P > 0.05). Schatzker V patients showed better recovery of the articular surface and reliable internal fixation. These findings indicate that the internal fixation viathe anterolateral and posteromedial knee joint approaches has better clinical efficacy in the treatment of Schatzker type V bicondylar tibial plateau fractures than Schatzker type VI bicondylar tibial plateau fractures.