0.05).RGR showed that the toxicity level of magnesium alloys was 0.And there was no significant abnormality found in biochemical indicators and pathological analysis after inplant in vivo.[Conclusion]Magnesium alloys showed good biocompatibility to L929 mouse fibroblasts,and had no cacoethic effect to test animals,so the magnesium alloys is possible to be a new type and potential of bone surgery implant materials.

[Objective]To observe mouse osteoblasts vitality,histomorphology and growing development in vitro co-culture combined with magnesium alloys,confirm the biocompatibility of magnesium alloys and osteoblasts,and try to find out the possibility of magnesium alloys to be a new type of bone surgery implant material.[Method]Mouse osteoblasts were checked by Gomori and Von kossa stained,cultured and developed in vitro.Then the osteoblasts were mixed with magnesium alloys in a cell density of 3?104/ml.After 24、48、72 hours co-culture,the surface of magnesium alloys were observed by scanning electron microscopy(SEM) and confocal microscopy to find the change of osteoblasts.[Result]After culture in vitro,the osteoblasts well developed,and expressed stable character.After co-culture with magnesium alloys,the cells adhered and proliferated on the surface of alloys very well from SEM and confocal microscopy observation,which showed the osteoblasts had great activity and reproduce capability.[Conclusion]Magnesium alloys showed good biocompatibility and bone conduction capability with mouse osteoblasts,so the magnesium alloy is very possible to be a new type of bone surgery implant material.

[Objective]To study the mechanism of magnesium alloy degradation and bone formation at the bone-implant interface after implanting a magnesium alloy into rat femur.[Method]SD rats femur were filled with magnesium alloy stick.Nine weeks later,animals were killed and femur were retrieved.Systematic investigations on the surface morphology,composition,structure of bone-implant were performed by means of metallurgical microscope,scanning electron microscopy(SEM),and energy dispersive spectrum(EDS).Decalcified sections were prepared,and histologic examination was carried out.[Result]The bone response happened both on the surface of surrounding bone and the surface of magnesium alloy degradation layer while magnesium alloy degradating in rat femur.It was formed three layers at the interface of bone-implant: the metal layer,the degradation layer,and the new bone layer.Discontinuity connective tissue could be seen on the new bone layer but no inflammatory cells were found.[Conclusion]The new bone response at the interface of bone-implant is consistent with normal bone tissue.Magnesium alloys have good characters of degradation ability,osteogenesis ability,and histocompatibility.And the rate of degradation is corresponding to the rate of new bone formation.

Objective :To assess the clinical efficacy of proximal femoral locking plate for the treatment of subcapital femoral neck fracture .Methods :A total of 15 patients with the subcapital femoral neck fracture who were admitted and treated with proximal femoral locking plate in Tong Ren Hospital ,Shanghai Jiao Tong University School of Medicine during Jun .2013 and Jun .2014 were enrolled .Regular postoperative follow-up was done .Fracture healing was assessed by X-ray and function of hip joint was evaluated with Harris score .Results :All the 15 patients were followed up for 12-24 months (mean 16 .7 months) . All the cases were well healed and there was no wound infection .Partial necrosis of the femoral head was found in 1 case , however there was no joint function limitation .The delayed union of fracture or bone nonunion was not found ,and there was no internal fixation loosening ,nail off ,broken nail ,neck rotation ,or neck shortening .The Harris score indicated that the excellent and good rate was 86 .67% (13/15) .Conclusions :Proximal femoral locking plate provides good fracture reduction , stable fixation ,good postoperative recovery ,high healing rate for the treatment of subcapital femoral neck fracture .

Objective:To explore the effect of interactive self-management education model in the self-management behavior of outpatients with type 2 diabetes (T2DM) .Methods:Convenience sampling method was used to select 98 patients with T2DM who were treated in the Outpatient Department of Heping Hospital Affiliated to Changzhi Medical College from March 2018 to March 2019 as the research objects. Patients were randomly divided into control group and observation group by lottery, with 49 cases in each group. On the basis of hypoglycemic and basic disease treatment, control group carried out the conventional self-management education model, and observation group implemented the interactive self-management education model. We compared the score of Summary of Diabetes Self-Care Activities (SDSCA) , fasting blood glucose (FBG) , 2-hour postprandial blood glucose (2 hPBG) , glycosylated hemoglobin (HbA1c) between the two groups of patients before and after intervention, as well as compliance after intervention to understand the self-management behavior, blood glucose control and compliance of patients.Results:After intervention, except for the smoking dimension, the scores of all dimensions of SDSCA in observation group were higher than those of control group, and the differences were statistically significant ( P<0.05) . After intervention, FBG, 2 hPBG and HbA1c of observation group were (5.11±0.62) mmol/L, (6.83±0.59) mmol/L and (4.62±0.34) % respectively, which were lower than those of control group [ (7.28±0.73) mmol/L, (8.41±0.72) mmol/L, (7.23±0.35) %], the differences were statistically significant ( t=15.860, 11.881, 37.442; P<0.05) . After intervention, there was a statistically significant difference in the compliance of the two groups of patients ( Z=7.170, P<0.05) . Conclusions:The interactive self-management education model can improve the self-management ability of patients with T2DM and effectively control the blood glucose of patients, which is worthy of clinical promotion.

BACKGROUND:A large number of studies have confirmed that tissue engineering scaffolds can almost completely repair osteochondral defects.However,when osteochondral defects are complicated with infection,even after thorough debridement in the early stage,the repair effect of simple osteochondral tissue engineering scaffolds is often unsatisfactory. OBJECTIVE:To prepare fibroin/chitosan/nano-hydroxyapatite scaffold loaded with vancomycin hydrochloride sustained release microspheres,and to investigate the repair effect on infected osteochondral defect in distal femur of rabbit. METHODS:(1)Vancomycin hydrochloride sustained release microspheres were prepared by emulsified solvent evaporation method.The sustained-release microspheres of different weights(7.5,10,and 12.5 mg)were mixed with fibroin protein-chitosan nanohydroxyapatite solution,and the scaffolds of fibroin protein/chitosan/nano-hydroxyapatite were prepared by chemical crosslinking method.The porosity,water absorption and expansion rate,hot water loss rate of the scaffolds,and drug sustained-release in vitro were characterized.(2)Forty-five New Zealand white rabbits were randomly divided into blank group,control group,and experimental group,with 15 rabbits in each group.The osteochondral defect and infection model of the distal femur of the right hind limb was established in both groups.The blank group was not treated,and the control group was implanted with fibroin protein-chitosan-nano-hydroxyapatite scaffold.Vancomycin hydrochloride sustained-release microspheres(10 mg)of fibroin/chitosan/nano-hydroxyapatite scaffold were implanted in the defect of the experimental group.The levels of C-reactive protein and leukocytes in blood samples were detected 1 week after operation.At 4,8 and 12 weeks after operation,the tissue of the operative area was taken for gross observation and pathological observation. RESULTS AND CONCLUSION:(1)With the increase of sustained-release microspheres content,the porosity of scaffolds decreased,and there was significant difference among groups(P＜0.05).There were no significant differences in the pore size,water absorption expansion rate and hot water loss rate among the three groups(P＞0.05).Vancomycin hydrochloride was released sustainably in vitro for more than 30 days in all three groups of scaffolds.(2)The levels of C-reactive protein and leukocytes in blood samples of the experimental group were lower than those of the blank group and control group(P＜0.05).The repair of gross cartilage in the experimental group was significantly better than that in the blank group and the control group.Hematoxylin-eosin,Masson,Alcian blue and type Ⅱ collagen immunohistochemical stainings showed that the osteochondral repair effect of the experimental group was significantly better than that of the blank group and the control group at each time point.(3)The results showed that fibroin/chitosan/nano-hydroxyapatite scaffolds loaded with vancomycin hydrochloride sustained-release microspheres could effectively promote the repair of open osteochondral defects.