Objective To detect the initial results of total hip arthroplasty (THA) after failure of internal fixation of femoral neck fractures and investigate the key points in surgical procedures and prosthesis selection.Methods A retrospective analysis was performed on 36 cases who had THA for femoral neck fractures due to the initially failed internal fixation between January 2007 and December 2012.There were 21 males and 15 females,with age ranging from 46 to 72 years (mean,58.6 years).After internal fixation,13 cases were complicated by femoral head necrosis,eight fracture nonunion,and 15 fracture nonunion combined with femoral head necrosis.All the 36 cases had cementless THA,including proximally fixed stem in 25 cases and distally fixed stem in 11 cases.Harris hip score was assessed before operation and at follow-up.Results All the cases received a follow-up of 26-52 months (mean,32.5 months).Mean Harris hip score improved from 26.3 to 83.6,including excellent results in 12 cases,good in 22,and fair in two,with excellence-good rate of 94％.Conclusion With respect to the failed internal fixation of femoral neck fractures,THA is an effective remedial method to improve hip function and quality of life of the patients.

[Objective] To evaluate the results of open reduction with bone autografting and calcaneus reconstruction with internal fixation in treatment of intra-articular calcaneus fracture. [Methods]From January 2005 to May 2007, 17 cases/19 feet of intra-articular calcaneus fractures received treatment of reconstruction plate and bone autografting, with 15 male/18 feet, 2 female/ 2 feet. Patients’ age ranged from 19 to 67 years (mean, 37.5 years). Fracture occurred in left side in 9 cases, right in 6 cases, both sides in 2 cases. All patients received treatment of open reduction with bone autografting and calcaneus reconstruction with internal fixation.[Results]All the patients achieved bone union. One stage union was achieved in 15 feet. Poor blood-supply was found in 3 feet and bone union was achieved after systematic treatment. Wound exudation was found in 1 feet, and bone union was achieved after dressing change treatment. All patients were followed up for an average of 19.7 months (10-38 months). The average union time was 2.5 months, without infection found.X-ray and CT were used to measure Bhler angle, width and axial length, all the indexed showed significant difference (P

Objective To explore the effect and mechanism of the bone morphologenetic protein 4 (BMP4)/Smad signaling pathway on the apoptosis of mouse primordial follicle oocytes .Methods Three-day-old Kunming mouse ovarine tissues were digested by the two-step enzymatic method to extract and purify oocytes .The cultured oocytes were divided into three groups: the normal culture medium (Con group), the medium with BMP4 (BMP4 group), and the medium with BMP4 and BMP4 inhibitor ( BMP4+inhibitor group ) .TUNEL was used to examine the effects of BMP 4 on the survival of the primordial follicle oocyte;Immunohistochemical staining and Real-time quantitative PCR were performed to investigate the expressions of p-Smad1/5/8, sohlh2, c-kit and foxo3a;siRNA interference, sohlh2 plasmid transfection and LY294002 treatments were performed to explore the mechanism of the BMP 4/Smad signaling pathway on the apoptosis of oocytes . Results TUNEL results demonstrated that the ratio of apoptotic oocytes in BMP 4 group was significantly lower than that in the Con group ( P <0.05 ) and the BMP4 +inhibitor group ( P <0.05 ); BMP4 significantly promoted the nuclear translocation of Smad and inhibited the nuclear translocation of foxo 3a, the mRNA and protein levels of sohlh2 and c-kit remarkably increased in BMP4 group.The effect of BMP4 on the oocyte survival was significantly repressed after sohlh 2 siRNA transfection.Sohlh2 overexpression up-regulated the expression of p-foxo3a, and this activity was abolished by LY 294002.Conclusion BMP4/Smad signaling pathway may inhibit primordial follicle oocyte apoptosis , via up-regulation of the expression of sohlh2 and c-kit, and then down-regulation of the nuclear translocation of foxo 3a.

Objective:To evaluate the relationship between breast reconstruction and postoperative complications by meta-analysis.Methods:Through a defined search strategy, related literature was collected in databases from PubMed, MEDLINE, EMBASE, Cochrane, CNKI, Wanfang Database and VIP Database, from January 1990 to November 2017. Data were extracted and each merged data was analyzed using RevMan 5.3 software. The postoperative complications between transverse rectus abdominis musculocutaneous-flap (TRAM) and deep inferior epigastric perforatorflap (DIEP), TRAM and latissimus dorsiflap (LDF), LDF and LDF+ prosthesis, LDF+ prosthesis and simple prosthesis implantation were compared.Results:Twenty-nine papers met inclusion criteria of our study. The Meta-analysis results showed that the risk of local flap necrosis, seroma, infection, fat liquefaction, abdominal wall hernia and abdominal bulging in TRAM group were higher than those in DIEP group, and the differences were significant. There was no significant difference in total flap necrosis, wound dehiscence, venous congestion between the two groups; the risk of total flap necrosis, wound dehiscence and infection in TRAM group were higher than those in LDF group, and the differences were significant. The risk of seroma in TRAM group was lower than that in LDF group, and the differences were significant. There was no significant difference in fat liquefaction between the two groups; there was no significant difference in the postoperative complications between LDF group and LDF+ prosthesis group; the risk of seroma in LDF+ prosthetic group was higher than that in prosthetic group, and the differences was significant. The risk of prosthetic capsular contracture and prosthesis displacement in LDF+ prosthetic group were lower than those in prosthetic group, and the differences were significant. There was no significant difference in prosthesis exposure and infection between the two groups.Conclusions:DIEP has most of the advantages of TRAM and fewer complications. It plays an important role in breast reconstruction in the future. We should make a choice of breast reconstruction methods according to the patient＇s conditions as far as possible in clinical practice.

Objective To establish human choriocarcinoma JeG-3 cell line resistant to floxuridine (FUDR)and describe the characteristics of this FUDR-resistant subline.The thymidylate synthase (TS) expression level in FUDR-resistant subline was also discussed.Methods The FUDR-resistant sub-line JeG-3/FUDRA was established by intermitted exposure to grads increased FUDR.Reversed microscope was used to observe the morphological changes in FUDR-resistant sub-line.Population doubling time was calculated and compared based on the growth curve of these two cell lines,cell cycles and chromosomal ploidy were assayed with flow cytometry methods.The chemo-luminescence assay was used to detect the hormone secretion by two kinds of cell lines.The resistant index (RI) was measured by cell counting kit-8 (CCK-8)assay.Quantitative RT-PCR was used to detect the mRNA expression level of TS and we also detected the TS mRNA expression level in different doses exposed subline.Results The RI of JeG-3/FUDRA was 31.62.Compared with the JeG-3 cell,the FUDR-resistant cell line had gross changes in morphological,cell growth,cell cycles and chromosomal numbers.The ability of human chorionic gonadotrop(hCG) and progesterone secretion was lower in JeG-3/FUDRA subline.The trend of TS mRNA expression was:while exposed to low concentration of FUDR,the TS mRNA expression level was downregulated,then followed the increasing dose of the drug,the expression level of TS mRNA ascended gradually.When the terminal concentration was reached,the expression level of TS mRNA in JeG-3/FUDRA subline was higher than that of JeG-3 cell line (P＜0.05).Conclusions We established the FUDR-resistant subline of JeG-3 successfully.The TS mRNA expression level is stage-related to the different concentration and different phase in FUDR exposure.Our data suggested that TS mRNA expression level may not be used as a biomarker to predict the chemosensitivity in FUDR-based chemotherapy.

In this study ,we intended to prepare anti‐Toxoplasma gondii aquaporin (TgAQP) peptide antibody which was used to the application in the detection of the aquaporin expression and its subcellular localization of Toxop lasma gondii (T .gondii) ME49 strain .The B cell peptide antigen was designed based on the TgAQP amino acids sequence .After the pep‐tide antigen was conjugated to the KLH ,the fusion antigen was injected into New Zealand rabbits to prepare polyclonal anti‐body ,followed by identification of ELISA ,Western‐blotting and immunofluorescence assays .The ELISA showed that the titer of anti‐TgAQP antibody was about 1∶40 000 .Western blotting revealed the specific affinity of the antigen to polyclonal anti‐body at 29 .9 kDa protein T .gondii .The protein detected by the indirect immunofluorescence assays was distributed in the cy‐toplasm of the parasite .Thus far ,the anti‐TgAQP polyclonal antibody was successfully prepared ,providing a useful tool for further study of biological function and metabolic characteristics of TgAQP .

Objective To investigate the feasibility of using CT texture analysis to differentiate among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.Methods 66 lipid-poor adrenal adenoma,98 pheochromocytoma and 101 adrenal metastases lesions were analyzed retrospectively.All the patients had abdominal non-enhanced CT and adrenal enhanced CT scans.We used TexRAD software to analyze the textural features of CT images and compared the differences in each texture parameter among three adrenal lesions.Results On non-enhanced CT images,there were significant differences in Mean and Kurtosis at all the texture scales(SSF 0-6) among the three types of adrenal lesions (P<0.05),as well as SD at fine and coarse texture scale (SSF 2,6)(P<0.05).Entropy (SSF 0-3, 5-6) and MPP (SSF 0-2, 4-6) were significantly lower in lipid-poor adrenal adenoma and adrenal metastases than that in pheochromocytoma (P<0.05).There were significant differences in Skewness (SSF 0-3) among three types of lesions, which was lowest in pheochromocytoma and highest in adrenal metastases.On enhanced CT images, Mean, SD, Entrophy and MPP showed significantly differences among the three types of adrenal lesions at all the texture scales (SSF 0-6) (P<0.05), which were all highest in pheochromocytoma and lowest in adrenal metastases.Skewness (SSF 0) and Kurtosis (SSF 0, 2) were significantly lower in adrenal metastases than that in lipid-poor adrenal adenoma and pheochromocytoma (P<0.05).Conclusion There are significant differences in CT texture analysis parameters among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.CT texture analysis has potential clinical application values in differentiating these three adrenal lesions.

Objective Due to redundant valuations and inaccurate quantities and specifications in processing temporary medical orders, expensive medicines, water and cream medications, program patches of electronic prescriptions included in the nurse work station were designed and developed. Methods Based on the software and hardware platforms of No.1 Military Medical Project, it was developed under Powerbuilder 9.0 without more tables and database expenses. Result Paperless prescription was realized. Conclusion The clinician's workload is reduced. Inaccurate patient expenses and drugs data are stopped.

Objective To retrospectively review the efficacy of large craniotomy with subtemporal decompression in the treatment of severe craniocerebral injury combined with cerebral infarction.Methods Forty-eight patients suffering from severe craniocerebral injury combined with cerebral infarction were randomized into the treatment group (managed by large craniotomy decompression) and the control group (managed by clearance of hematoma by routine craniotomy ).A retrospective analysis was carried out to compare the cerebral infarction size between the two groups before operation and at day 1 and 1 week after operation and the outcomes of the two corresponding groups three months post-operatively.Results The infarction size of the treatment group was insignificant in comparison with that of the control group pre-operatively and at day 1 post-operatively,but was significantly smaller than that of the control group one week post-operatively (P ＜ 0.05 ).The mortality and moderate disability/good rate of the treatment and control groups presented significant differences three months post-operatively (21％,42％ vs 33％,25％ respectively,P ＜ 0.05 ).Conclusion Large craniotomy decompression is effective in treating severe craniocerebral injury combined with cerebral infarction and plays an important role in reducing disability and mortality.

Objective To investigate the interfractional and intrafractional prostate motion during hypofractionated precise radiotherapy for prostate cancer. Methods From 2013 to 2016, twenty?eight patients who received 5 Gy radiotherapy in 9 fractions for prostate cancer were enrolled as subjects. Every patient had three gold fiducials implanted into the prostate by transrectal ultrasound guidance two weeks before computed tomography ( CT) simulation. All patients underwent CT scans in the supine position with full bladders and rectal balloons filled with 60 ml air. The Pinnacle planning system was used to design the treatment plans. Twenty?three patients were treated with a Synergy accelerator. Those patients underwent cone?beam CT ( CBCT) scans prior to treatment. The set?up error was recorded by bone alignment between CBCT images and planning CT images. The prostate displacement was then recorded by gold fiducial alignment. The interfraction prostate displacement was defined by the difference between the above two parameters. The other 5 patients were treated with a Novalis accelerator. Based on gold fiducial alignment,the real?time tracking of gold fiducials was carried out by the ExacTrac system to evaluate the intrafractional prostate displacement. Results A total of 207 measurements of interfractional prostate displacement were made in the 23 patients before treatment. The mean interfractional prostate displacements in the left?right (LR),superior?inferior (SI),and anterior?posterior (AP) directions were (0.05±0?10),(0.20±0?22),and (0.19±0?18) cm,respectively. The displacements larger than 0?3 cm in the above three directions were observed in 1,52,and 49 measurements,respectively,while the displacements larger than 0?5 cm in the three directions were observed in 1,29,and 16 measurements,respectively. A total of 225 measurements of gold fiducial displacement were made in the 5 patients during treatment. The mean intrafractional prostate displacements in LR,SI,and AP directions were (0.61±0?50),(0.68±0?69),and (0.70±0?67) mm, respectively. The displacements larger than 3 mm in the three directions were observed in 0, 1, and 1 measurement, respectively. Conclusions In hypofractionated precise radiotherapy for prostate cancer, the interfractional prostate displacement is significantly larger than the intrafractional prostate displacement. The interfractional prostate displacement must be corrected before radiotherapy. In order to avoid off?target irradiation due to postural changes in patients,the tracking of the intrafractional prostate displacement is still necessary although the displacement is relatively small. The rectal balloon can help immobilize the prostate.