Wear of polyethylene (PE) tibial inserts is a significant cause of implant failure of total knee arthroplasty (TKA). PE inserts wear measurement and evaluation is the key in TKA researches. There are many methods to measure insert wear. Qualitative methods such as observation are used to determine the wear and its type. Quantitative methods such as gravimetric analysis, coordinate measuring machines (CMM) and micro-computed tomography (micro-CT) are used to measure the mass, volume and geometry of wear. In this paper, the principle, characteristics and research progress of main insert wear evaluation method were introduced and the problems and disadvantages were analyzed.
Arthroplasty, Replacement, Knee ; Humans ; Knee Prosthesis ; Polyethylene ; Prosthesis Design ; Prosthesis Failure ; Tibia ; Tomography, X-Ray Computed ; X-Ray Microtomography

[Objective]To explore the relationship between peripheral arterial disease(PAD)and diabetic retinopathy(DR)in type 2 diabetes patients.[Methods]A total of 99 patients diagnosed with PAD were classified into grade 1-3 by their total scores of peripheral arterial stenosis assessed by color doppler ultrasound examinations,where the degree of stenosis 30% ~ 49% scored 0, 50%~99%scored 1,lumen occlusion(i.e. degree of stenosis 100%)scored 2,and therefore the total score 0-2 was categorized into Grade 1 ,3~4 into Grade 2 ,5~12 into Grade 3. The bilateral anterior tibial artery ,posterior tibial artery and dorsalis pedis artery of these patients were analyzed. The presence of diabetic retinopathy(DR)was graded from retinal photographs using a standard protocol.[Results]Among 99 cases of type 2 diabetic patients with peripheral arterial disease ,58.6%of them were male with average age of 67.3 ± 7.9 years old. Patients of Grade 1,Grade2,Grade 3 lesion accounted for 45.4%,30.3%,24.2%,respectively. Age, gender,smoking history,SBP,DBP,BMI,FBG,TC,TG,LDL-C,HDL-C,HbA1C among 3 groups were not statistically signifi-cant. The associations of DM duration and HbA1C value were significantly larger in DR than in PAD. The proportion of DR patients increased with the severity degree of PAD(p for trend=0.004). Degree of stenosis Grade 2 and Grade 3 could be predictive for DR.[Conclusions]DR is associated with the severity degree of PAD in type 2 diabetes patients as evaluated by duplex ultrasonography.Degree of stenosis Grade 2 and 3 could be used for screening or finding DR. Strategies for optimum treatment and early prevention are needed.

Objective To investigate the effects of quetiapine and risperidone in the treatment of behavior and psychiatric symptom of dementia(BPSD).Methods 56 cases of Alzheimer's disease and vascular dementia pa- tients were all met for the classification and diagnostic criteria for mental illness in China(CCMD-3)and randomly divided into two groups(27 in quetiapine group,29 in risperidone group),experimental dosage were 0.05～0.3g/d and 1～2mg/d,respectively.The treatment lasted for 8 weeks.Results The total efficiency of quetiapine was 66.67% and that of risperidone was 65.5%,and the statistical difference was significant.As for the adverse effects, there was no significant difference,but incidence of EPS in quetiapine group was less than that of risperidone group. Conclusion Quetiapine can be widely administrated in clinic application as the high efficacy of control BPSD with low minor adverse effect.

Objective To study the genome DNA methylation in rheumatoid arthirits(RA)and the re- lated factors of DNA methylation.Methods Twenty-first cases with RA and 20 controls were recruited to par- ticipate the study.Plasma Hcy,SAM,SAH,the MTHFR gene C677T polymorphism and the expression of LFA-1 in CD4~+T cells was measured in all patients and controls.Results①The SAM levels were lower sig- nificantly in RA groups than in controls.The SAH levels were higher significantly in RA groups than in con- trols.②There was significant inverse correlation between plasma Hcy level and SAM level(r=-0.932,P＜0.01). There was significant positive correlation between plasma Hcy level and SAH level(r=0.924,P＜0.01).③The expression of LFA-1 in CD4~+T cells was higher significantly in RA groups than in controls.There was a signif- icant positive correlation between LFA-1 expression level and Hcy level(r=0.557,P＜0.01),a significant in- verse correlation between LFA-1 expression level and SAM level(r=-0.651,P＜0.01).④The MTHFR gene mu- tation lead to dramatically increase of Hcy,SAH level and the expression of LFA-1 level in CD4~+T cells and genome DNA hypomethylation.Conclusion①Hypomethylation of genome DNA is found in most RA pa- tients.②The factors associated with genome DNA hypomethylation include MTHFR gene mutation and hyper- homocysteinemia.③The expression of LFA-1 in CD4~+ T cells is higer in RA groups than in controls,which re- lates to the DNA methylation level and the MTHFR gene C677T polymorphism.

· AIM: To search an easy and simple way for intraocular implantation after the eye evisceration.· METHODS: Fifteen healthy New Zealand rabbits were divided into 5 groups according to the sacrifice time, and each group included 3 rabbits; the left eye received the injection of polymethyl methacrylate (PMMA) bone cement (2g per mL), while the right eye served as control. Under general anesthetia, a 3mm incision was made on the sclera,and the eye contents and pigment tissues were extruded out with fingers. Then, PMMA bone cement (2g per ml) was injected through the scleral incision. Both the operated eye and control eye of the rabbits were enucleated and weighed,The reaction of the operated eye (macroscopically and histopathologically) was noted at frequent interval. The obtained data were then analyzed with ANOVA (SPSS11.5).· RESULTS: There was swelling of eyelids and conjunctiva at the early time after the injection, but no significant difference between the weight of the left and right eyes was noted,Histopathologic examination showed scleral and other tissues necrosis at early period, and then the tissues reaction turned into a great deal of cell proliferation and finally into extensive fibro-connective tissues. Three months after the operation,neovascularization was observed in the cornea of the operated eyes. Histopathologic examination showed formation of fibro-membrane around the intraocular implant,and disappearance of the inflammation.· CONCLUSION: The method of injecting PMMA bone cement (2g per ml) to form an intraocular implant is quite simple and economical; this method is also easy to use clinically.

Objective To analyze the present situation of iodine deficiency disorders (IDD) in Henan Province,and to promote implementation of sustainable control strategies.Methods In 2011,a stratified proportion to population probability sampling (PPS) method was used to survey 1200 children aged 8 to 10 in 30 counties of the province.One primary school was selected in each chosen county.Goiter,intelligence quotient (IQ),urinary iodine and salt iodine level were studied.Meanwhile,12 families per capita salt intake was investigated.In each school,30 5th-grade students and 30 pregnant and lactating women in the school townships and adjacent neighboring townships were selected to carry out questionnaire survey on health education with unified papers.Results ①The goiter rate of children aged 8 to 10 by B ultrasound was 4.5％ (54/1201) ; the IQ of 1080 children was 107.75 ± 16.81 ; median urinary iodine level of 358 children was 201.4 μg/L.②The median of salt iodine content was 28.6 mg/kg,the coverage rate of iodized salt was 98.8％ (1186/1200),and qualified rate of iodized salt was 93.0％ (1116/1200).③The residents average daily salt intake was 10.5 g.④Average score of the questionnaire survey of 1084 5th-grade students was 4.2 points.Average score of 961 housewives was 4.4 points.Conclusions Various technical indicators show that IDD is in a sustained elimination state in Henan Province.Strengthen health education,enhance public awareness of disease prevention is still the important work ahead.

Objective To analyze the examination results of external quality assessment(EQA) at all levels of iodine deficiency disorders(IDD) laboratories in Henan province and the network operation to further standardize and improve the laboratory,and to provide reliable laboratory quality assurance for surveillance and control of IDD.Methods The examination results of EQA at all levels of IDD laboratories in Henan province were statistically analyzed in accordance with the National Reference Laboratory (NRL) of IDD (1999-201 1).Results The survey results showed that the provincial level laboratory was all qualified in testing urinary iodine and salt iodine in the past 13 years.In prefectural level,the laboratory response rates were 100.0％,and through participation in EQA,laboratory capacity had been significantly increased and stabilized.From 1999 to 2001,the passing rate of check up of urinary iodine was 22.2％ (4/18),72.2％ (13/18),94.4％ (17/18),respectively,and the rate was stable at 100.0％(18/18) from 2002 to 2011 except 94.4％ (17/18) in 2003.Since 2000,the prefectural level laboratory began to take part in the salt iodine EQA,and the laboratory response rate was 100.0％ (18/18) from 2000 to 2011.Except 88.9％(16/18) in 2003,the passing rate of check up of urinary iodine was 100.0％(18/18)from 2000 to 2011.In 2003 and 2004,6 to 7 county-level laboratories participated in the EQA of urinary iodine in Zhengzhou city,respectively,and all qualified.The number of county-level laboratories that participated in the salt iodine quality control network increased from 29 in 1999 to 148 in 2011.Response rate was 94.4％(68/72),96.7％(58/60) and 92.3％(144/156)in 2003,2006 and 2007,respectively,and the rate remained stable at 100.0％ in the remaining 10 years.In 1999,the passing rate was 69.0％ (20/29),then increased significantly,except 86.7％ (26/30) in 2001 and 84.6％(132/156) in 2007,the rates were all above 90.0％ in other years,especially in 2000 and 2009,the passing rates were both 100.0％.Conclusions The accuracy of test results of external quality controls and the normal operation of the network at all levels of laboratories is closely related to the IDD laboratory conditions and detection techniques.

Adrenalectomy ; Adult ; Angiomyolipoma ; pathology ; surgery ; Follow-Up Studies ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; pathology ; surgery ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Nephrectomy ; Ureter ; surgery

OBJECTIVETo study the overexpression of Sox9 gene on rabbit bone marrow mesenchymal stem cells for repairing articular cartilage injury in vivo.

METHODSRabbit bone marrow mesenchymal stem cells (BMSCs) were transduced with lentivirus vector containing Sox9 gene and then cartilage specific molecule was detected by RT-PCR in vitro. Total 48 knee joints of 24 mature New Zealand white rabbits were randomly divided into 3 groups according to different defect treatment. After animals anesthesia,a full-thickness cylindrical cartilage defect of 4 mm diameter and 3 mm deep was created in the patellar groove using a stainlesssteel punch. Meanwhile, the transfected cells were implanted to repair the rabbit model with full-thickness cartilage defects. Cartilage defects tissue was observed with light microscope, electron microscope, HE and immunohistochemistry staining to assess the repair of defects by the complex at 6 weeks or 12 weeks after the implantation.

RESULTSAt 3 days after the transfection, Sox9 gene expression was highest and Sox9 gene expression decreased with the increase of time. At 3 days after the transfection, the expression of collagen type II began and reached the peak at 14 days. It showed that the bone marrow mesenchymal stem cells went into chondrogenic differentiation after transfected by Sox9 gene. Histological observation showed that at 6 weeks after the operation, the defects in the experimental group was filled with hyaline like cartilage tissue, 12 weeks after operation,the defects of cartilage and subchondral bone had satisfactory healing. Both at 6 and 12 weeks postoperatively, the defects were filled with fibrous tissues in control groups. Meanwhile, immunohistochemical staining of sections with type II collagen antibodies showed the proteins in the regenerated tissue stained positive for type II collagen and stronger than the control groups. The histological scoring system indicated that the cartilage repair of experiment groups were better than the two control groups with statistical significances.

CONCLUSIONOverexpression of Sox9 gene on rabbit bone marrow mesenchymal stem cells (BMSCs) promote the repair of cartilage defect.

Animals ; Bone Marrow Cells ; metabolism ; Bone Marrow Transplantation ; Cartilage, Articular ; injuries ; metabolism ; Cell- and Tissue-Based Therapy ; Female ; Genetic Vectors ; genetics ; metabolism ; Humans ; Lentivirus ; genetics ; metabolism ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; metabolism ; Osteoarthritis ; genetics ; metabolism ; therapy ; Rabbits ; SOX9 Transcription Factor ; genetics ; metabolism ; Tissue Engineering

BACKGROUND: Aseptic loosening and infection are difficult to diagnose due to their similar clinical manifestations following total hip replacement.There lacks routine examinations or gold standard to diagnose peri-prosthetic infection.OBJECTIVE: To evaluate the clinical effectiveness of technetium-99m-labelled triphase isotope scinitigraphy in the diagnosis of peri-prosthetic infection following total hip arthroplasty.METHODS: A total of 11 patients with suspected peri-prosthetic infection were selected,with continuous hip pain,prosthesis loosening and abnormal serum indexes,including 7 males and 4 females,with an average age of 63.8(53-74)years.The average time of prosthesis usage was 14.5(0.5-30)years.The technetium 99m-labelled bone scintigraphy images were obtained to observe the density variation of the infection region during the blood flow phase,blood pool phase and late phase and compared with normal lateral limb.Time-radioactive uptake curve was made using software to analyze the diagnostic results.In addition,the diagnostic value of the triple-phase bone scinitigraphy was analyzed using the intraoperative frozen section results(neutrophil < 5 under 10 high power visual fields: no infection).RESULTS AND CONCLUSION: Of 11 patients,2 cases showed negative result of triple-phase bone scinitigraphy,and intraoperative frozen section analysis showed < 5 polymorphonuclear cells per high-power field,who underwent one-stage revision surgery; 8 displayed positive result of tdple-phase bone scinitigraphy,and intraoperative frozen section analysis showed > 5polymorphonuclear cells per high-power field,who underwent two-stage revision surgery; 1 case showed negative result of triple-phase bone scinitigraphy but intraoperative frozen section analysis showed > 5 polymorphonuclear cells per high-power field,who also underwent two-stage revision surgery.Results show that positive results of triple-phase bone scintigraphy were related to peri-prosthetic infection,which has great value for revision surgery in combination with histopathological examination.