Objective To investigate the effect of horizontal platform supported (HPS) prosthesis on cementless total hip replacement for surgical treatment of arthritis in a long-term follow-up study.Methods Clinical and radiographic follow-up of 65 consecutive primary cementless porous coated HPS total hip replacements, which were implanted in 60 patients between 1982 and 1989, was carried out.Results The 53 hips in 50 patients were evaluated both clinically and radiographically. The average follow-up was 6.8 years (range: 5 to 12 years). According to the Harris hip score, 52 (98%) of the hips had sustained an excellent or good result with an average score of 92. At the time of final assessment, no patient experienced anterior thigh pain. There were two revisions performed early in the series due to technical failures. Radiographically, osteolysis and bone re-modelling were assessed. Conclusion The findings suggest that the clinical and radiographic results after cementless total hip replacement for primary hip arthroplasty may be favourably influenced by the use of the proximal stress loaded HPS femoral component.

Objective To approach the effect on mechanical barricade of the mucous membrane of small intestine caused by non-steroidal anti-inflammatory drugs(NSAIDs).Methods Thirty-two male SD rats were randomly divided into control group and model group.The rats of the model group were given 7.5 mg/kg diclofenac by gavage,bid;the rats of the control group were given the same dose of saline.Then thev were further randomly divided into two subgroups(n=8)at the first day and the fifth day after making the models to observe the scores of anatomical lesion on stomach and small intestine and the scores of tissue damage of mucous membrane and to quantitatively analyze the height of villi,as well as the thickness and the section area of mucous membrane with Carl Zeiss Imaging Systems.Observation of the change of ultrastructural organization of mucous membrane was carried out with transmission electron microscope.Results The mucous membrane of stomach of the model groups was slightly edematous.There was no difference between the scores of the model groups and control groups.It was seen that the mucous membrane of small intestine of the first day model group presented with erythema,anabrosis and ulcer.The ulcer was distributed along mesentery.The mucous membrane of small intestine of the fifth day model group showed bleeding,perforation and sinus tract formation,and the scores of anatomical lesion was higher than that of the control group(P＜0.05).The scroes of the lesions of the first and fifth day model groups were 3.5 and 5.0.The difference had statistical significance when compared with those of the control groups(the scores were O)(P＜0.05).Cell degeneration and cellular necrosis of epithelial mueosa of small intestine wag also seen in the first day model group.The top of villi was ablated.The height of the pile on jejunum was (126.9±32.0)μm and that on ileum wag(118.6±22.9)μm They were lower than those of the control group(P＜0.05).However there was no difference of the thickness and section area between them,but the thickness and section area showed a tendency of decrease.It was also seen that there were apomorphosis and sphacelism of epithelial cells in the fifth day model group.Some villi were ablated and laminae propna exposed.The height of villi on jejunum[(73.4±25.4)μm]and that on ileum[(109.3±17.6)μm]decreased significantiy.The thickness of mucous membrane[(123.8±51.6)μm and(165.7±37.4)μm]decreased alnd the section area[(2.48±1.01)mm2 and(3.27±0.76)mm2]became smaller(P＜0.05 vs control group).The mucous membrane of the villi on small intestine wag continuous but arranged disorderly.Cytochondriome swelled,endocytoplasmic reticulia expanded with different degrees,intercellular junction widened Dartly.The microviili in the fifth day model group were ablated more obviously and intercellular iunctions were broken and destroyed gravely.Conclusions Diclofenac can cause damage to the function of mucous membrane barricade of small intestine.It could also lead to shortening of the villi,thinning of the mucous membrane,ablation of the microvilli,and widening of the tight intercellular junction as the characteristic morphological change.

Objective To study the time extended for getting emergency intervention in different modes of transportation and factors influencing the modes of transportation of patients with ST elevation myocardial infarction (STEMI).Methods A total of 564 consecutive patients with STEMI admitted from September 2013 to June 2016 were enrolled in the study.The clinical data about time consumed for getting emergency intervention and modes of transportation were collected.Results According to the mode of transportation,patients were divided into three groups:emergency care system (EMS) transportation group (n =96),self-transportation group (n =206) and referral group in which the patients were sent in from other hospitals (n =262).EMS transportation group had significantly shorter total ischemic time before emergency treatment than self-transportation group (229 rin vs.418 min,P ＜ 0.05) and referral group (229 min vs.512 rin,P ＜ 0.05),and significantly shorter length of pre-hospital time than self-arrival group (55 min vs.110 min;P＜0.05) and referral group (55 min vs.372 min;P＜0,05).The referral group had longer pre-hospital time and the self-transportation group had longer door-to-balloon time,but there was no difference in total ischemic time between the self-arrival and referral group (Z =-1.882,P =0.068).Multivariate logistic regression was used to analyze influence factors in mode of transportation:(1) patients characterized with high school or university education,profession of civil service,and their transportation distance more than 30 km were greater in number than referral group (P ＜ 0.05);(2) patients identified with senior middle school education,staff member of public sectors or company,their transportation distance less than 30 km,and with killip grade above Ⅱ were more likely to have EMS transport (P ＜ 0.05);(3) patients defined as businessmen without taking out new rural cooperative medical insurance,taking up transportation distance less than 80 km,and subjecting to killip grade Ⅰ had a higher proportion of individuals of this kind taking self-transportation (P ＜ 0.05).Conclusion Mode of transportation is an important factor that affects the time extended to get emergency intervention.Education level,occupation,medical insurance type,transportation distance,killip grade are associated with modes of transport.