Objective To compare the long term efficacy of total hip arthroplasty and half hip arthroplasty in the treatment of elderly patients with femoral neck fracture .Methods 70 elderly patients with femoral neck fracture who needed hip replacement were randomly divided into the observation group and control group ,35 cases in each group.The observation group was given total hip arthroplasty ,while the control group was given half hip arthroplasty . The postoperative long term effect was compared between the two groups .Results The overall incidence rate of post-operative infection of the observation group was higher than the control group ,the postoperative revision rate of the ob-servation group was lower than the control group ,but the differences between the two groups were not statistically sig-nificant(P>0.05).The overall incidence rate of postoperative chronic pain in the control group was 22.86%,which was higher than 2.28%of the observation group,the difference was statistically significant (χ2 =5.130,P<0.05). The postoperative Harris score of the observation group was (93.25 ±4.51)points,which was significantly higher than (82.76 ±3.82)points of the control group,the difference was statistically significant (t=6.973,P<0.05).The ex-cellent and good rate of the observation group was 91.43%,which was significantly higher than 71.43%of the control group,the difference was statistically significant (χ2 =6.492,P<0.05).Conclusion Total hip arthroplasty in the treatment of femoral neck fracture can reduce the incidence of postoperative pain ,improve hip function of the patients , and its long-term effect is better than single hip replacement surgery ,which should be widely applied in clinical .

Objective Preparing platelet rich gel through two-times centrifugal technique and co-culturing chondrocytes with PRG, then observing the proliferation and gene expression of chondrocytes, in order to provide a favorable way to prepare tissue engineering cartilage. Methods Centrifugating venous blood of rabbit through two-times centrifugal technique to obtain platelet rich plasma( PRP) ,then detecting the concentration of various growth factor in PRP. Admixing PRP with chondrocytes of rabbit and activating them with activator. After co-culti-vation,the proliferation of chondrocytes through MTT method and expression of ACAN,CollagenⅡand SOX-9 through realtime-PCR were ob-served,and compared with common cultured chondrocytes. Results The concentrations of PDGF-AB,TGF-β1,IGF-1 and VEGF in PRG were significantly higher than those in blood(P<0. 05). After co-cultivation, the proliferation rate of chondrocytes and the expression of ACAN,Collagen Ⅱ and SOX-9 were significantly higher than that of common cultured chondrocytes(P<0. 05). Conclusion Co-culturing chondrocytes with PRG is able to promote the proliferation and gene expression of chondrocytes. We considered that it is a excellent method to construct tissue engineering cartilage.

Objective To discuss the diagnosis value of transrectal ultrasound and transabdominal ultrasound in fat sufferers with bladder tumor.Methods In own control,transabdominal and transrectal ultrasound were used to examine 87 fat patients with suspected bladder tumor.The tumors were confirmed by cystoscope and pathological section.They were divided into 3 groups according to the size:＜10 mm,10-20 mm,and＞20 mm,the detection rates of the tumors and blood flow in tumors,the diagnose accordance rates of the tumor stage of the two methods were analyzed.Results Of the 92 lesions pathologically confirmed to be bladder tumors,the diagnose accordance rate of transabdominal ultrasound was 79.3%,missed diagnosis rate was 1 7.4%,misdiagnosis rate was 3.3%,while the diagnose accordance rate of transrectal ultrasound was 95.6%,misseddiagnosis rate was 4.4%,misdiagnosis rate was 0.There was statistical significance on the detection rate of thetumor and blood flow in tumor of the two methods(P＜0.05).Also there was statistical significance on the diagnosis accordance rate of the tumor staging on Ta,T1,T2(P＜0.05).Conclusions As to detecting bladder tumors in fat sufferers,transreetal ultrasound iS obviously superior to transabdominal ultrasound.

OBJECTIVETo evaluate the safety and reliability of percutaneous internal fixation for pelvic ring injuries with cannulated screws.

METHODSForty-eight patients (21 male and 27 female, aged from 17 to 61 years with an average age of 38 years) with unstable pelvic ring injuries were treated with closed reduction and percutaneous cannulated screws fixation under C-arm fluoroscopic guidance. According to Tile's classification, the patients were classified into type B1 in 4 cases, B2.1 in 8, B2.2 in 10, B3 in 4, C1 in 11, C2 in 7 and C3 in 4. Among them, 39 patients were treated with anterior and posterior fixation, 4 were treated with anterior fixation, and 5 were treated with posterior fixation alone. Anteroposterior, inlet and outlet X-ray radiographs and CT scans of the pelvis were taken preoperatively to evaluate the stability and deformities, and after surgery the plain radiographs and CT scans were taken to evaluate the reduction and the location of screws.

RESULTSThe average operative time was 55 minutes (range, 15 to 95 minutes), and the average intraoperative blood loss was 60 ml (range, 15 to 150 ml), no patient accepted blood transfusion during or after operation. All 48 patients were inserted 157 cannulated screws (mean 3.3, range 2 to 8 per patient). Forty-two patients (135 screws) underwent postoperative pelvic CT scan and 91.11% (123 screws) of them was considered in optimal location; 7 screws penetrated the wall of pelvis and acetabulam because of overlength (<0.5 cm) or deviation, 5 screws interfered with the sacral canal or foramen. Fortunately, these 12 screws did not cause any symptom to the patients. The average follow-up period was 13 months (range 8 to 49 months), the displacement of injured pelvis was satisfactorily corrected in 45 patients (93.75%) and the fractures were healed at one stage. Among all patients, 40 cases (83.33%) had returned to their original works, 4 were still in the process of recovery at the last follow-up and the other 4 were unemployed as sciatic nerve injury or amputation. According to Lindahl improved standard of functional assessment of pelvic injury, the result was excellent in 35 cases, good 10 and fair 3, the average score was 78.7.

CONCLUSIONWith better understanding of the pelvic anatomy, and under C-arm fluoroscopic guidance, treatment of closed reduction and percutaneous cannulated screw internal fixation for unstable pelvic ring injuries is a safe, reliable and feasible method. The clinical outcome is satisfactory.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Pelvic Bones ; injuries

Objective: To investigate the differences in the intake of macronutrients between boarders and resident students in China, and to provide a scientific reference for relevant policies and preventive measures. Methods: The difference of macronutrients level between boarders and resident students were analyzed with the multilevel model (MLM) by using the data from Chinese Health and Nutrition Survey and the indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results: The daily intake of energy, carbohydrate, fat and protein were (1 597.59±557.15)kcal, (216.2±84.66)g, (57.88±31.96)g, (52.69±21.2)g respectively, with a rate of meeting DRIs of 17.32%, 84.17%, 50.30% for energy, carbohydrate and protein. There were significant differences in amount of energy, carbohydrate between boarders and resident students, but no significant difference in rate of meeting DRIs (15.09%, 87.28%, 17.54%, 83.86%, P>0.05 ). No difference in the amount of fat and protein intake between boarders and resident students, but the protein rate of meeting DRIs among resident students was significantly lower than that in boarders(34.91% vs 51.82%, χ2=4.45, P<0.01). Conclusion The results revealed an imbalanced intake of macronutrients among primary and secondary school students, which highlight the insufficiency in energy intake and the worse meeting rate of DRIs for protein among resident-student. The nutritional education targeting at boarder-students should be strengthened.

Purpose To evaluate the diagnostic significance of non-contrast enhanced magnetic resonance angiography (NCE-MRA) for lower extremity arterial stenosis on a 3.0T MR scanner, in order to provide a reliable method for clinical application. Materials and Methods Thirty patients with arterial disease in lower extremity underwent NCE-MRA before contrast enhanced magnetic resonance angiography (CE-MRA). Image quality of the two methods was compared. The diagnostic accuracy for significant stenosis ( ≥50%) of NCE-MRA was assessed using CE-MRA as a golden standard. The consistency of the two methods in diagnosis of significant stenosis ( ≥ 50%) was analyzed. Results All patients successfully underwent both NCE-MRA and CE-MRA examination. There were 532 arterial segments detected by NCE-MRA. In the calf region, venous artifacts presented more frequently on CE-MRA (Z=4.92, P<0.01), while in the abdominal and the femoral regions, venous artifacts presented more frequently on NCE-MRA (Z=4.58 and 3.56, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NCE-MRA for the diagnosis of significant stenosis ( ≥ 50%) were 97.89%, 97.69%, 97.74%, 93.92% and 99.22%, respectively. There was good agreement (Kappa=0.94, P<0.05) between the two methods. Conclusion For the imaging of lower extremity arterial stenosis, NCE-MRA shows similar image quality and diagnostic accuracy with CE-MRA, thus can be used as an alternative method for lower extremity arterial stenosis in patients who have renal insufficiency or other contraindication of contrast media.

Objective To assess the value of magnetic resonance diffusion weighted imaging(DWI) and apparent diffusion coefficients(ADC) values of hepatic alveolar echinococcosis(HAE) in children.Methods 20 cases of children(≤14 years) with HAE were collected in this restrospective study.PNM staging was determined, the HAE peripheral area of DWI lesions with different P stages was observed, and the ADC value of the peripheral area was measured.The comparison of alveococcus lesions in different stages of DWI with continuous edge degree and ADC value difference was done to evaluate the growth activity.Results There were 5 cases of P1 lesions, 7 cases of P2 lesions, 2 cases of P3 lesions and 6 cases of P4 lesions.DWI features of peripheral area were as follows: High signal ring band between HAE lesion edge and adjacent normal hepatic parenchyma was observed.P1 lesions showed almost complete obviously high signal peripheral area, indicating the most active proliferation, P2 and P3 lesions of peripheral area were continuous and with high signal, and still had obvious growth activity.P4 lesions of peripheral area were not continuous, while the signal decreased, indicating the activity also decreased.The highest ADC value was detected in P1 lesions group of and the ADC value of P2 lesions group were lower than P1, and the ADC value of P4 lesions group were the lowest.P3 lesions samples were too small and thus no statistical analysis was done.Differences of ADC value between the three groups were statistically significant (P<0.05).Conclusion DWI image features could be used to assesse the growth activity of HAE in children with different stages to a certain extent.ADC values measurement provides important reference value for evaluating the growth activity at various stages of the lesions.

BACKGROUND:It is notable to treat cervical spondylosis using the anterior cervical discectomy and fusion, but there are such complications as cervical instability and low fusion rate. Titanium plate with cage can solve those defects, while anterior unfamiliar matter and dysphagia appear. A new anterior cervical interbody fusionZero-Pwith support and fixation function has been widely used in clinic.
OBJECTIVE:To analyze early stability in repairing cervical spondylosis using a newZero-Pinterbody fixation and fusion system, and compare with a titanium plate with cage interbody fixation andfusion system.
METHODS:We retrospectively analyzed the clinical date of 31 patients with cervical spondylosis who underwent the anterior cervical discectomy and fusion in the Department of Orthopedics, Affiliated Hospital of Jiangsu University between August 2010 and August 2014. Fifteen patients were treated with aZero-P implant (Zero-Pgroup) and sixteen patients with a titanium plate with cage (cage group). We recorded operation time, intraoperative blood loss, preoperative and postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores, postoperative incidence of dysphagia and degeneration rate of adjacent joint.
RESULTS AND CONCLUSION:(1) Postoperative symptoms were apparently improved, without severe complications in both groups. (2) Operation time and intraoperative blood loss were better in theZero-P group than in the cage group (P< 0.05). (3) Postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores were significantly improved in both groups (P< 0.05). The recovery rate of Japanese Orthopedic Association scores was similar between the two groups (81%, 81%;P> 0.05). (4) Mild dysphagia was experienced by one case (7%) in theZero-Pgroup, but nine cases (44%) in the cage group. Significant difference in the incidence of dysphagia was detected between the two groups after treatment (P=0.037). However, no significant difference in degeneration rate was detectable between the two groups (P=0.48). (5) These findings verify that in the anteriorcervical discectomy and fusion, the new Zero-Pand titanium plate with cage interbody fixation and fusion system are effective choices for cervical spondylosis. However, theZero-Pinterbody fixation and fusion system showed a low incidence of postoperative dysphagia and better stability.