BACKGROUND:Unicompartmental knee arthroplasty for osteoarthritis can be accepted by more and more scholars, but some scholars believe that total knee arthroplasty is a better choice. OBJECTIVE:To compare knee scores between patients before and after unicompartmental knee arthroplasty and total knee arthroplasty. METHODS:A total of 53 patients with knee osteoarthritis, who underwent unicompartmental knee arthroplasty in the First Affiliated Hospital of Xinjiang Medical University from March 2013 to November 2014 and obtained fol ow-up, were enrol ed in this study. Simultaneously, 53 patients, who received total knee arthroplasty in the same period and obtained fol ow-up, were selected. Knee scores before surgery and in final fol ow-up were recorded in both groups, including KSS score, WOMAC score, OKS score and HSS score. The knee maximum flexion and patient satisfaction were recorded in final fol ow-up. RESULTS AND CONCLUSION:Patents with complications were excluded in both groups. Knee scores were significantly higher in final fol ow-up than in pre-operation (P<0.05). No significant difference in knee scores was detected in final fol ow-up between the two groups (P>0.05). Maximum range of motion in final fol ow-up was significantly larger in unicompartmental knee arthroplasty group than in total knee arthroplasty group (P<0.05). Patient satisfaction was similar between the two groups. Moreover, the association between WOMAC scores and OKS scores was high. These results suggest that unicompartmental knee arthroplasty could improve patient’s quality of life as total knee arthroplasty so long as physicians grasp strict indications;standard replacement operation and good functional exercise after replacement, but its long-term outcomes stil need further investigations.

Objective To investigatc thc short-term clinical and radiographic outcomes of tantalum trabecular metal (TM) components associated with TM augments for Paprosky type Ⅱ and type Ⅲ acetabular defects in revision hip arthroplasty.Methods From June 2014 to April 2016,seventeen patients with aseptic loosening underwent revision total hip arthroplasty for Paprosky type Ⅱ or type Ⅲ acetabular defects with TM revision acetabular cups and TM augments.The subjects consisted of 5 males and 12 females with mean age of 56.6 years (range 30-75).Acetabular bony defects were Paprosky type Ⅱ A in 4 hips,Ⅱ B in 3 hips,Ⅲ A in 8 and Ⅲ B in 2 hips.The whole hip revision was performed in 13 hips and acetabular reconstruction in 4 hips.Preand post-operative functional outcomes were accessed by the Harris Hip Score.The vertical and horizontal position of the rotation center from the intertear drop line were measured and analyzed.Complications were recorded during the follow-up.Radiographic examination was performed after operation immediately by X-ray.The recent X-ray was conducted to assess bone ingrowths at the cup-bone or augments-bone interface,radiolucent lines and implant migration.Results All of the patients were followed-up for an average of 23 months (range 11-33 months).There was no infection,dislocation or periprosthetic fracture complications at the last followed-up.The Harris Hip Score was improved from 45.8±3.4 pre-operatively to 79.2±7.5 post-operatively (t=-16.8,P=0.00).The mean vertical distance of the center of rotation was 32.1±4.3 mm preoperatively and 14.5±2.3 mm postoperatively (t=14.8,P=0.00).The mean horizontal distance of the center of rotation was 33.6±6.1 mm preoperatively and 27.8±3.2 mm postoperatively (t=3.5,P=0.00).More than 3 radiographic signs of osseointegration were observed in 11 hips.No progressive radiolucent lines or component migration was observed.All the TM components were well-fixed at last follow-up.Conclusion Using tantalum TM cups with TM augments in revision hip arthroplasty could be regarded as an effective management for Paprosky type Ⅱ and type Ⅲ acetabular defects.This technology can avoid using over-large cup,provide reliable primary stability,restore the center of rotation with almost normal hip biomechanics and improve the functional outcome.

BACKGROUND:There are a lot of reports about the association between estrogen receptor α polymorphism and osteoarthritis susceptibility, but the results are stil some controversial. OBJECTIVE:To investigate the relationship between the estrogen receptor α gene PvuII, XbaI site polymorphisms and genetic susceptibility of osteoarthritis. METHODS: A computer-based search of PubMed, web of science, Wanfang, CNKI, Weipu and China Biology Medicine Disc was performed for the published case-control studies addressing the association between estrogen receptor α gene PvuII, XbaI site polymorphism and osteoarthritis susceptibility. Odds radio (OR) and 95% confidence interval were used to analyze the correlation between estrogen receptor α gene PvuII, XbaI site polymorphism and osteoarthritis. Fixed or random effect models were selected for pooledOR calculation. Publication bias was assessed. Al statistical analysis was constructed with Revman5.1 software. RESULTS AND CONCLUSION:Nine case-control studies including 3 228 cases of osteoarthritis and 6 327 healthy controls were included. Overal, the pooledOR values of PvuII loci aleles and genotypes (Cvs. T; CTvs. TT; CCvs. TT; CT+CCvs. TT; CCvs. CT+TT) were less than 1; the pooled OR values of Asian which grouped by region were greater than 1 (except CTvs. TT); the pooledOR values of Europe and the Americas were less than 1. The pooledOR values of XbaI loci aleles and genotypes (Gvs.A; GAvs. AA; GGvs. AA; GA+GGvs. AA; GGvs. GA+AA) were less than 1; the pooledOR values of Asian which grouped by region were less than 1; the pooledOR value of Europe and the Americas were less than 1 (except GGvs.GA+AA). Estrogen receptor α gene PvuII, XbaI site polymorphism is not associated with osteoarthritis susceptibility. However, the susceptibility of PvuII loci in the Asian is a little higher compared with that of the Europeans and American population. On the contrary, the susceptibility of XbaI loci in the recessive genetic model of Europeans and American population is a little higher compared with that of the Asian, suggesting a possible role of ethnic differences in genetic backgrounds.

To deepen the teaching reform on comprehensive medical function experiment in our school,the mode of opening system of experiment teaching of medical function is proposed.The definition and characteristics of the opening system is discussed in this paper,and its theoretical foundation,guideline,goal location,effect and pending problems are also explored preliminarily.

Objective In order to observe the role of genetically modified Schwann cell (SC) with pSVPoMcat in the regeneration of injured spinal cord.Method The cells were implanted into the spinal cord.Ninety SD rats were used to establish a model of hemi- transection of spinal cord at the level of T8,and were divided into three groups,randomly, that is,pSVPoMcat modified SC implantation(Group A), SC implantation(Group B),and without cell implantation as control(Group C).After three months the presence of axonal regeneration of the injured spinal cord was examined by means of horseradish peroxidase(HRP)retrograde labeling technique and stereography.Result The results indicated that HRP labeled cells in Group A and B could be found in the superior region of injured spinal cord and the brain stem such as the red nuclei and oculomotor nuclei. The density of ventral horn neurons of the spinal cord and the number of myelinated axons in 100 μ m of the white matter was A >B >C group.Conclusion In brief,the pSVPoMcat modified SC intraspinal implantation could promote regeneration of the injured spinal cord.

Objective To supervise military training by application of clinical classification of fatigue fracture so as to decrease the occurrence and development of fatigue fracture. Methods From Feb.1999 to Feb.2002, the knowledge of clinical classification of fatigue fracture was applied in the military training in which it was essential to prevent and treat fatigue fracture. Results From 1999 to 2002, the incidence of fatigue fracture decreased year by year. Types Ⅱand Ⅲof fatigue fracture decreased significantly. Conclusion Clinical classification plays an important role in decreasing the occurrence and development of fatigue fracture.

Objective:To study whether early leukocytosis after total joint arthroplasty (TJA) requires further workup to exclude infection by observing changes in peripheral blood white blood cell (WBC) count after TJA.Methods:This study included the 294 patients (infection-free group) who had undergone primary hip or knee TJA from June 2019 to June 2020 but reported no periprosthetic joint infection (PJI) within one month after surgery and the 31 patients (infection group) who had undergone the same TJA but reported infection within one month after surgery from May 2012 to June 2020 at Department of Joint Surgery, The First Affiliated Hospital to Xinjiang Medical University. Peripheral blood WBC counts were measured and recorded before surgery and 1 to 5 days after surgery. Differences were compared between time points and multiple linear regression analysis was used to screen the factors associated with early postoperative leukocytosis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of WBC for early PJI.Results:The peripheral WBC level in the infection-free group showed a trend of increasing at first and then decreasing. It reached the peak on day 2 after surgery, increasing by 8.08×10 9/L±2.33×10 9/L compared to pre-surgery, and then began to decrease to a level slightly higher than the preoperative value on day 5 after surgery. The changes in WBC count in the first 2 days after surgery ranged from 6.24×10 9/L to 26.32×10 9/L. The incidence of leukocytosis in the first 5 days after surgery was 95.6% (281/294). The factors associated with postoperative leukocytosis included preoperative WBC count and bilateral surgery. For every increase of 1.00×10 9/L in preoperative WBC count, the postoperative WBC value increased by an average of 0.98×10 9/L [ β=0.984, 95% confidence interval (95% CI): 0.821-1.148, P<0.001]. The postoperative WBC count in the patients undergoing bilateral surgery increased by an average of 1.03×10 9/L compared with that in the patients undergoing unilateral surgery ( β=1.026, 95% CI: 0.565-1.486, P<0.001). The area under the curve (AUC) for prediction of early PJI by absolute WBC count difference (the absolute difference between the maximum postoperative WBC value and the baseline) was 0.655 (95% CI: 0.546-0.764, P<0.05), providing a threshold of 7.96×10 9/L, a sensitivity of 57.5% and a specificity of 74.2%. Conclusions:Leukocytosis is a common phenomenon after TJA, indicating a normal physiological response to surgery. The preoperative WBC count is a predictor for postoperative leukocytosis. In the absence of abnormal clinical symptoms or signs, there is no need for further workup to check infection if the postoperative WBC does not deviate from its changing range and trend.

Objective:To investigate the relevant factors on serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) which did not meet the 2011 Musculoskeletal Infection Society (MSIS) diagnostic criteria in patients with periprosthetic joint infection (PJI).Methods:During December 2011 to December 2019, a total of 328 patients with PJI were hospitalized for surgery or antibiotic administration, including 152 males and 166 females, aged 62.10±13.74 (range 24-87) years. All patients underwent CRP and ESR before the antibiotic administration or the revision surgery. PJI was diagnosed based on the 2011 MSIS diagnostic criteria. There were 172 knee PJIs (52.4%), 151 hip PJIs (46.0%), 4 elbow PJIs (1.2%) and 1 shoulder PJI (0.3%). Patients were classified according to Tsukayama type, pathogen and immune status. We, further, analyzed relevant factors on CRP and ESR levels in PJI patients.Results:There were 119 patients with CRP and ESR did not meet the MSIS diagnostic criteria, accounting for 36.3% (119/328). Furthermore, there was no significant difference in Tsukayama types among them (χ 2=7.224, P=0.065). In addition, the ratio was 46.4% in patients with negative culture results, which was higher than that in positive culture results (27.4%, χ 2=12.276, P<0.001). The ratio was 42.9% in patients with normal immune status (grade A), which was higher than that of immune grade B (30.6%) and of immune grade C (23.8%) (χ 2=6.586, P=0.037). Multivariate logistic regression analysis showed the negative association between positive culture results and immune grade B with nonconformity ( OR=0.420, P=0.001; OR=0.578, P=0.04). Conclusion:The serum tests level unmet the threshold in MSIS criteria usually present in PJI patients with normal immune status and negative culture results. Thus, we should utilize other methods for diagnosing PJI.

Objective To compare the effects of different surgical techniques for treatment of concealed penis. Methods A retrospective review of 219 patients underwent surgical correction of concealed penis between 1986 and 2007 was performed. The mean age was (10.3±2.4) years(3-15 years). The penile length was (1.9±0. 5)cm(0. 5-3. 0 cm)before operation. Ninty-three patients were the severe degree of concealed penis. The others were the moderate degree. All patients under-went operation with different techniques, including Johnston's technique in 34, Devine's technique in 42, modified Devinds technique in 125 and Brisson's technique in 18. The increased length of penile af-ter operation was compared among the 4 groups with different surgical techniques by statistical meth-od. Results The postoperative increased length of penile in Johnston's technique, Devine's tech-nique, modified Devine's technique and Brisson's technique was (1.8 ± 0. 4) cm, (2. 0 ± 0. 5) cm, (2.1±0.4)cm and (2.3±0.4)cm respectively. The difference was significant by ANOVA test (F=13.1,P<0. 001). Devines technique, modified DevineSs technique and Brisson's technique were better than Johnston's technique considering the increased length of penile. The complication of severe penile lymphedema of 4 groups developed in 8, 5, 6 and 2 patients respectively. Conclusion Modified De-vine's technique has the satisfactory increasing of penile length for treatment of concealed penis and less complication rate after operation.

BACKGROUND: Halofuginone has been proved to ameliorate the pathogenesis of osteoarthritis.OBJECTIVE: To further verify the protective effect of halofuginone on early osteoarthritis.METHODS: Forty-five healthy male C57BL6J mice were randomly divided into three groups (n=15 per group): the mice in sham operation group were only subjected to right knee capsulotomy; in the other two groups, animal models of osteoarthritis were established by cutting off the right anterior cruciate ligament, followed by treated with distilled water (placebo group) or 0.5 mg/kg halofuginone (halofuginone group) via gavage, once daily beginning at 3 days after modeling. Twenty-eight days after treatment, all mice were sacrificed and the right knee was removed. The morphology and structure of the joint tissue were observed by hematoxylin-eosin staining and safranin fast green staining; the expression of transforming growth factor-β1 (TGF-β1) was detected by immunohistochemistry.RESULTS AND CONCLUSION: The structure of articular cartilage in the sham operation group was normal, the cells arranged in neat rows, and the articular surface was not worn. In the placebo group, the articular cartilage layer became thinner, the cartilage surface was worn and even fragmented, and cells arranged in disorder. In the halofuginone group,the cartilage cell layer was clear and tidy, with regular cell morphology. The hyaline cartilage thickness and hyaline cartilage thickness/calcified cartilage thickness were ranked as follows: sham operation group > halofuginone group >placebo group. The calcified cartilage thickness was the highest in the placebo group, followed by halofuginone group,and lowest in the sham operation group. Osteoarthritis Research Society International scores and TGF-β1 positive cells/chondrocytes in the halofuginone group were significantly lower than those in the placebo group, and all above indices showed significant differences among groups (P < 0.05). These results suggest that halofuginone via gavage can partially prevent articular cartilage degeneration in early osteoarthritis mice probably by downregulating the expression of TGF-β1, thus delaying the progression of osteoarthritis.