In this review,concepts concerning etiology and nonoperative and operative treatment methods have been analyzed.This article is based almost exclusively on peer-reviewed studies.The etiology of nontraumatic osteonecrosis of the femoral head may have genetic basis.The interaction between certain risk factors and a genetic predisposition may determine whether this disease will develop in a particular individual.Early diagnosis and intervention prior to collapse of the femoral head is key to a successful outcome of joint-preserving procedures.The rational for use of joint-sparing procedure in the treatment of this disease is based on radiographic measurements and findings with other imaging modalities.The results of joint-preserving procedures are less satisfactory than the results of total hip arthroplasty for femoral head than have already collapsed.New pharmacological measures as well as the use of growth and differentiation factors for the prevention and treatment of this disease may eventually alter our treatment approach,but it is necessary to await results of clinical research with long-term follow-up of these patients.

BACKGROUND:High-incidence early acute reocculision and later restenosis following coronary artery stenting has been widely studied.Biodegradable material metal coated stent carrying paclitaxel,which can effectively inhibit restenosis,is promising for solving this problem.OBJECTIVE:To evaluate the effects of paclitaxel containing degradable material [poly (L-lactide) (PLLA)/polyglyoolide(PGA)]on human umbilical arterial smooth muscle cells.DESIGN,TIME AND SETTING:The present controlled observational cytological experiment was performed at the Laboratory of Toxicity,College of Public Health,Jilin University between July 2003 and July 2005.MATERIALS:Paclitaxel (PLLA/PGA) (PLLA:PGA=9:1) was provided by the Changchun Institute of Applied Chemistry,China.METHODS:The primary human umbilical arterial smooth muscle cells were cultured for passage cells.Thereafter,passage cells were co-cultured with degradable materials containing different concentrations of paclitaxel (1,2,and 3 g).Mental stent and paclitaxel-free PLLA/PGA were used for controls.MAIN OUTCOME MEASURES:At 0,24,48,and 72 hours after culture,effects of degradable materials containing different concentrations of paclitaxel on smooth muscle cell growth were observed under a contrast microscope.RESULTS:Mental stent and paclitaxel-free PLLA/PGA had no influences on smooth muscle cell growth.Paclitaxel(PLLA/PGA) degradable material (1,2,and 3 paclitaxel) inhibited smooth muscle cell growth till 72 hours.There were significant differences between mental stent and paclitaxel-free PLLA/PGA and paxlitaxel(PLLA/PGA) groups (P＜0.01).CONCLUSION:Paclitaxel (PLLA/PGA) degradable material can be used as the intravascular stenting material for inhibiting smooth muscle cell growth.

Phthalate esters (PAEs)are by far the most widely used plasticisers and are categorized as high and low,depending on their molecular weight.Because of their extensive use,humans are most likely exposed to PAEs in the workplace and home environment through direct as well as indirect sources.Injection,inhalation,intravenous injection and skin absorption are potential pathways of expo-sure.With respect to health effects,phthalates are often classified as endocrine disruptors because of their ability to interfere with the endocrine syste m in the body.Furthermore,PAEs possess reproductive toxicity because of their influence on development of the reproductive system in infancy and development and differentiation of germ cells in adults.PAEs promote pathogenesis and development of liver cancer by activating peroxisome proliferator-activated receptor (PPAR)and DNA methylation.In addition, PAEs,which inhibit the i mmune functions of macrophages and pro mote hypersensitive response,pos-sess immunotoxicity.PAEs are also carcinogens that promote pathogenesis and development of cancers including breast,ovarian and so me other cancers.

BACKGROUND: The problem of the high rate of acute restenosis at an early and advanced stage has been a hot spot, while the stent with paclitaxel (poly-L-lactide, PLLA/polyglycolic acid, PGA) degradable material will resolve it. OBJECTIVE: To seek an ideal biologic degradable material used in biologic degradable stent. DESIGN, TIME AND SETTING: The comparative cytological study was performed at the Laboratory of Toxicology, Institute of Public Health, Jilin University (Key Laboratory of Radiobiology of Ministry of Public Health of China, Key Laboratory of Toxicology of Jilin Province) from July 2003 to July 2005. MATERIALS: Paclitaxel degradable material (PLLA/PGA) (PLLA:PGA= 9: l ) were offered by Changchun Applied Chemistry Institute of Chinese Academy of Science). Human umbilical arterial smooth muscle cells (SMCs) were purchased from Boster, Wuhan, China. METHODS: The sixth passage of SMCs were digested by 0.25% Trypsin under ambient temperature for 3 minutes, incubated in 10 mL 10% ox serum BMEM, and made into SMC suspension. The materials kept in hypothermal disinfectant Co60 were heated to 37 ℃ by waterbath after surface treatment, and then placed in a 6-well culture plate. SMC suspension was added into the middle of the materials. The density of cells was about 5×106/cm2. Cell suspension diffused around the materials gradually. At last, 10% ox serum BMEM culture solution was added into it, and cultivated in a 5% CO2 incubator at 37 ℃. The growth of cells in and surrounding the materials was observed by inverted microscope everyday. MAIN OUCOME MEASURES: The materials were obtained after culture for 3, 6, 12, 19, 26, 34 days and vacuum dehydration, and were weighed. The weight loss of materials was compared before and after culture. The average degradable rate of materials was calculated.RESULTS: Degradable material had no influence on the development of SMCs. The average degradation rate ex vivo was 0.45% per day. CONCLUSION: PLLA/PGA with good cellular compatibility could be applied to intravascular stents.

BACKGROUND: A simple use of antibiotic drugs as anti-infection therapy after joint replacement is not enough for subsequent debridement and secondary revision surgeries. Therefore, our team intended to confirm the feasible use of controlled-release microspheres in the local anti-infection treatment.OBJECTIVE: To prepare the Human beta defense 3 (HBD-3)/poly(lactic-co-glycolic acid) (PLGA) micro-spheres and to investigate the microsphere physicochemical properties and drug release profile in vitro.METHODS: With PLGA as a carrier,HBD-3/PLGA controlled-release microspheres were prepared by using double emulsion-solvent evaporation method. Scanning electron microscopy was used to observe its surface morphology.The size of each microsphere was accurately determined using scaleplate. Drug loading capacity and encapsulation efficiency of HBD-3/PLGA controlled-release microspheres were calculated using spectrophotometer. HBD-3/PLGA microsphere controlled-release time was determined in order to analyze the drug release profile of the microsphere. RESULTS AND CONCLUSION: The HBD-3/PLGA controlled-release microsphere possessed smooth surface, uniform distribution and good liquidity.The average particle size was 219.49 nm, the drug loading capacity of HBD-3 was (20.67±0.17)% and the encapsulation efficiency was (54.52±1.31)%. The cumulative release percentage of HBD-3 was(74.12±0.43)%. The HBD-3/PLGA controlled-release microsphere has well controlled-release performance in vitro. In theory, the purpose of antibacterial controlled-release can be achieved,laying a foundation for subsequent animal antibacterial experiments.

Background:Functional dyspepsia(FD)is a commonly seen functional disease which has great impact on patient’s quality of life and mental health,and has got more and more concern by clinicians. Aims:To explore the role of mast cells (MC)and plasma motilin( MTL)in the pathogenesis of FD. Methods:Sixty FD patients including 32 postprandial distress syndrome(PDS)and 28 epigastric pain syndrome(EPS)patients from September 2013 to January 2014 at the Affiliated Hospital of Putian University were enrolled,and 28 healthy volunteers were served as controls(HS group). The number of gastric mucosal MC,plasma MTL level(fasting and 30 minutes after drinking warm water)and gastric emptying time(T1 / 2 )were compared. Results:Compared with HS group,number of gastric mucosal MC was significantly increased (P < 0. 001),plasma MTL level before and after drinking warm water in FD group were significantly decreased( P <0. 001),T1 / 2 was significantly prolonged(P < 0. 001). No significant difference in number of MC was found between PDS subgroup and EPS subgroup(P = 0. 094). Plasma MTL level before and after drinking warm water in PDS subgroup were significantly lower than those in EPS subgroup( P < 0. 001),and T1 / 2 was significantly prolonged( P < 0. 001). Conclusions:Number of gastric mucosal MC is significantly increased in FD patients compared with HS group,suggesting MC may play a role in the pathogenesis of FD. Plasma MTL level is decreased in FD patients,which may be one of the factors involved in the pathogenesis and occurrence of corresponding symptoms of FD.

Objective To investigate the degradation characteristics of the large-scale brain functional networks during aging by functional magnetic resonance imaging measurement and explore its intrinsic mechanism.Methods 40 healthy subjects including 20 elderly persons [mean aged(72.4 ±4.6)years] and 18 young persons [mean aged(23.9± 1.8) years] were enrolled in this study.All subjects underwent functional MRI scanning at blood oxygenation level-dependent contrast resting state.Four canonical resting-state networks,including the default mode network (DMN),dorsal attention network (DAN),executive control network (ECN),salience network,and visual network,were extracted by the seed zone and double regression methods.The functional connectivities in these canonical networks were compared between the young and elderly persons.Results Compared with young persons,the elderly showed the distinct and disruptive alterations in the large-scale aging-related resting brain networks.The impairment of ECN was the most serious,followed by the impairment of DAN.The salience networks and DMN showed relatively limited functional connectivity disruption.The networks associated to higher-order brain functions were impaired,while the visual network,which served as a network related to low-order brain functions,had no significant change.Conclusions The aged brain in healthy subjects is characterized by organized change in networks,and the selective impairments of large-scale brain networks were more significant in the networks associated to higher-order brain functions as compared with the networks related to low-order brain functions.

Objective To discuss the clinical manifestation and treatment of the complications caused by injected polyacrylamde hydro-gel( PAAG) for breast augmentation. Methods This retrospective research was performed among 212 patients who undergoing breast aug-mentation with injected polyacrylamde hydrogel. The clinical manifestation and treatment outcome of the complications were analyzed and summarized,which is aim to search an effective treatment method. Results For the 212 patients,the main complications were breast multi-ple indurations (131 cases),fever (9 cases),infection (14 cases),breast pain (65 cases),PAAG displacement (28 cases) and secondary deformity or asymmetry (25 cases). 152 cases experienced one clinical symptom,the rest patients simultaneously undergone no less than two clinical symptoms. Patients were received open operation with periareolar incision ( surgery group) or vacuum absorption by needle ( aspira-tion group) for dislodging PAAG. No significant difference was found in wound healing,breast shape satisfaction and pain anesis between the two groups. Whilethe surgery group was better than the aspiration group in efficiency for taking out PAAG and the incidence of reoperation, with statistical significance. Conclusion A plenty of complications occurred after breast augmentation with injected polyacrylamde hydrogel, the method of open operation with periareolar incision is a better way for eliminating PAAG and treating the complications.

ObjectiveTo investigate the recent treatment result and the toxic responses of chemoradiotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma. MethodsFrom April 2010 to May 2011, 26 initial treatment patients withadvanced esophageal carcinoma were enrolled. The chemotherapy consisted of paclitaxel (135 mg/m2) on day 1 and lobaplatin (35 mg/m2) on day 2,and one cycle continued 21 days. Radiotherapy started on the second day after the fist cycle of chemotherapy. The median total dose was 60 Gy (2 Gy/Fraction,30 fractions,completed in 6 weeks).ResultsThere were 52 cycles in all and mean 2 cycles per patient.CR occurred in 7 patients (26.9 ％),PR in 17 patients (65.4 ％) and SD in 2 patients (7.7 ％).The total effective rate was 92.3 ％ (CR+PR).The toxic responses mainly represented as following,myelotoxicity principally showed leucopenia at grade Ⅰ - Ⅱ occurred 46.1％ (12/26) and at grade Ⅲ-Ⅳ 46.1％ (12/26),thrombopenia at grade Ⅰ - Ⅱ occurred 30.8 ％ (8/26) and at grade Ⅲ-Ⅳ 7.7 ％ (2/26),hypohemoglobinemia at grade Ⅰ - Ⅱ occurred 42.3 ％ (11/26) and at grade Ⅲ 15.4 ％ (4/26).Baldness occurred 84.6 ％(22/26). Pain of muscles or arthralgia occurred 69.2 ％(18/26). Responses of gastrointestinal tract at grade Ⅰ - Ⅱ occurred 11.5 ％ (3/26).Radiation induced esophagitis occurred 88.5 ％ (23/26) and tracheitis 19.2 ％ (5/26).ConclusionThe toxic responses of concurrent chemoradiaotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma are tolerant, and the recent treatment result is good.Further study is needed.

Objective To explore the time of application of hemoperfusion (HP) for the treatment of acute serious organophosphorus pesticide (ASOPP). Methods One hundred and four patients with ASOPP were randomly divided into two groups, 46 patients accepted traditional treatment(control group), 58 patients were treated with traditional treatment and HP (HP group). The patients in HP group were again divided into three groups according the different time of treatment (time of beginning HP after poisoning), the 4-8 hours group (HP-1 group, 27 patients), the 9-16 hours group (HP-2 group, 19 patients), the 17-32 hours group (HP-3 group, 12 pafients).Tbe coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality and curing among groups were observed. Results The coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality of the HP group were less than those of the control group (P<0.05). Compared with HP-1 group, the eoma period, the dosage of atropine, the time of regaining the vitality of eholinesterase and the time of hospitalization of the HP-2 group and the HP-3 group were higher (P<0.05), but the difference of the rate of fatality and curing between the HP-1 group and the other HP groups was not statistically significant (P>0.05). The difference of all of the above indicators between HP-2 group and HP-3 group was not statistically significant (P>0.05). Conclusion Application of hemoperfusion among 4-32 hours after poisoning for the treatment of ASOPP can improve the efficacy of therapy, and the efficacy of application of hemoperfusion among 4-8 hours is the best.