Objective To summarize the early results of total hip replacement with a proximally hydroxyapatite-coated femoral component. Methods From February 2000 to October 2003, 65 cases (70 hips) underwent uncemented total hip replacement with a proximally hydroxyapatite-coated femoral component (U2, United Orthopedic Corporation, Taiwan, China). The diagnosis included femoral neck fractures in 30 cases, osteoarthritis in 15 cases, avascular necrosis of the femoral head in 9 cases, loosening of artificial femoral head in 8 cases, rheumatoid arthritis in 2 cases, and arthrodesis in 1 case. Clinical and radiographic evaluations were performed at 1 week, 3 and 6 months postoperatively, and yearly afterwards. Bone mineral density (BMD) of the proximal femur was measured with dual-energy X-ray Absorptiometry (DEXA) for 44 cases. Results Postoperative X-ray films showed that the initial fixation was excellent or good in all the stems. The follow-ups averaged 3 years (2 to 5.5 years). The mean preoperative Harris hip score was 32 (25 to 52) points, which were improved to 96 points at the latest follow-ups. There was no reported incidence of thigh pain at any time throughout our study. And no case needed revision. By the measurements on the X-ray films taken within 1 year postoperatively, 7 of the 70 stems had subsidence of less than 1.5 mm. No hip experienced extensive proximal end osteolysis, intramedullary osteolysis, or loosening. DEXA showed that the BMD values decreased after operation, and then returned rapidly to the normal or near normal ones 3 to 6 months after operation, especially in zones Ⅱand Ⅵwhere the increase was even more significant than at the control side. All the stems were radiographically stable with evidence of osseous ingrowth typically seen in HA-coated zones, according to the criteria proposed by Engh et al. Conclusions Since HA-coating on femoral implants can enhance the initial fixation of implants, accelerate bone ingrowth and osseous fixation of the femoral component, and seal the interface between the implant and bone to prevent ingress of polyethylene particles, it is helpful in improving clinical results of the cementless total hip replacement.

It explores the disease range of Liuwei Dihuang Pill from formulae source,ancient clinical application,modern study and application angles,combining with modern diseases,to define its multi-system targets,main pharmaceutical function and effective components by seeking for common mechanism.

Since the beginning of 973 plans and major scientific research programs,the ministry of science and technology has organized the implementation of a number of major projects under the principle guidance of top-level design,co-ordinate arrangements,advantage integration and dynamic adjustment.Prominent advance of technology and expansion of innovation capacity has become possible with the success of those major projects.As a dominant force of basic science research,universities took part in the designing and implementing of most of 973 major scientific research programs.In this paper,participating universities,such as Peking University,Tsinghua University,Fudan University,Zhejiang University,Shanghai Jiaotong University,University of Science and Technology of China,Nanjing University,were analyzed in their roles played in those projects,and the questions of how universities should make the adjustment to their planning and management to meet the requirements of future national research programs were discussed.

China ; Humans ; Laparoscopy ; education ; Mentors ; Urology ; education

OBJECTIVE To enhance the positive rate of the blood culture in order to make pathogenic diagnosis actually and quickly and conducting usage of antimicrobial agents in clinic.To value the clinical applied circumstance of BacT/Alert 3D automated blood culture system.METHODS The 3728 blood cultures were detected by BacT/Alert 3D automated blood culture system,and bacterial susceptibility test was conducted on all isolates using Kirby-Bauer methods with CLSI standards.To statistically analyze the examined time,the positive rate and variety and drug resistance for all kinds of pathogens.RESULTS The blood culture positive rate was 6.0% in the 3728 blood cultures with 222 strains of bacteria.The false positive rate was 0.2% and the false negative rate was 0.4%.The positive rate of blood culture was 0.89% in 12 hours,2.01% in 18 hours,and 3.51% in 24 hours.Among all the 222 isolates,29.7% were Enterobacteriaceae,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 13.6%,36.3%,42.4%,and 3.0%,respectively;20.3% were Staphylococcus,the drug resistant rates to erythromycin,levofloxacin,cefoxitin,and vancomycin were 75.6%,33.3%,68.9%,and 0,respectively;11.7% were Enterococcus,the drug resistant rates to errythromycin,levofloxacin,fosfomycin,and vancomycin were 96.2%,80.8%,23.1%,and 0,respectively;11.3% were non-fermented bacilli,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 32.0%,52.0%,32.0%,and 32.0%,respectively;12.6% were fungi.CONCLUSIONS The pathogens in the blood specimens are more wider in distribution and more higher in drug resistance rates than before.BacT/Alert 3D automated blood culture system can be an important tool for the blood culture,it can provide the diagnostic help quickly for the clinic and increase the positive rates in blood culture.It can not only shorten the check-up time,but also be more quick and more exact.

Objective: To prepare and optimize the formulation of intranasal thermo-sensitive gel of Zhi Xiong San and to evaluate its in vitro release mechanism and nasal mucosa permeability. Methods: The formulations of poloxamer thermo-sensitive gel were optimized by a central composite design-response surface method and its in vitro release mechanism and nasal mucosa permeability were evaluated by Franz diffusion chambers. Results: The optimal formulation was Poloxamer 407 (P407) 20% and Poloxamer 188 (P188) 6.5%. Imperatorin was released from the thermo-sensitive gels approximately with a zero-order mechanism, while ferulic acid with a Higuchi model. The formulation demonstrated the enhancement of nasal mucosa permeability. Conclusion: The optimal formulation provides a basis for the development of new administration routes and dosage forms of Zhi Xiong San.

BACKGROUND:Studies have shown that the number of osteoblasts is often decreased after osteoporosis, and osteoblast replacement therapy becomes a new target for the treatment of osteoporosis. OBJECTIVE:To observe the osteogenic differentiation of human bone marrow mesenchymal stem cels cultured in dexamethasone, vitamin C and beta-glycerophosphate. METHODS:Mesenchymal stem cels were isolated and purified from adult bone marrow using human lymphocyte separation medium. The expression of cel surface markers was detected by flow cytometry. Cel ultrastructure was observed by transmission electron microscope. Then, the bone marrow mesenchymal stem cels were cultured in osteogenic induction medium containing dexamethasone, vitamin C andβ-glycerophosphate, and RT-PCR was used to detect the bone morphogenetic protein-2 mRNA expression after osteogenic induction. RESULTS AND CONCLUSION:A large number of adherent cels were visible as fibrous growth at 2 weeks after culture and strongly expressed CD44, CD29, but did not express CD34, CD45. These cels could be induced to differentiate into osteoblasts, and express bone morphogenetic protein-2 mRNA. Alizarin red staining and alkaline phosphatase staining were positive for the cels. These findings suggest that human bone marrow mesenchymal stem cels cultured in dexamethasone, vitamin C and beta-glycerophosphate can differentiate into osteoblasts, and has a potential for the treatment of osteoporosis.

Objective To investigate the causes, diagnosis and surgical treatment of ERCP related duodenal per﹣foration. Methods Clinical data of 6 cases of surgical treatment of ERCP related duodenal perforation were retro﹣spective analyzed. All the 6 perforation patients underwent emergency surgical procedure, including 3 cases trans﹣fered from other hospital after duodenal perforation. 4 cases with a history of abdominal surgery. Preoperative con﹣firmed bravery manager stone 4 cases, 1 case of obstructive jaundice after gallbladder surgery, bile duct expansion in 1 case. Results Perforation causes include duodenum mirror improper operation related in 2 cases, duodenal papilla sphincterotomy related 3 cases (1 case of pre-dissection operation with needle knife), small endoscopic sphincteroto﹣my combined with endoscopic papillary balloon dilation lead to perforation in 1 case.4 cases of intraoperative found right kidney week pneumatosis, 2 cases of postoperative CT found after peritoneal pneumatosis, effusion. All patients with surgery including common bile duct exploration, T tube drainage, duodenal perforation repair, jejunum colostomy, among them 2 cases at the same time line of gastrointestinal anastomosis. 5 cases recovered, 1 case died. Conclusions Inappropriate duodenal papilla sphincter incision indications and Many previous abdominal surgery have higher perforated ration;Found in time, reasonable treatment is the most important;For serious typeⅠand typeⅡperforation, active surgical treatment in time, can effectively reduce serious consequences caused by the ERCP related perforation.

Objective To explore the feasibility,efficacy and safety of endoscopic retrograde cholangio?pancreatography ( ERCP ) drainage during peroperation of hilar cholangiocarcinoma for alleviate jaun?dice. Methods Nineteen cases patients with hilar cholangiocarcinoma who were treated with ERCP in the First Affiliated Hospital of Xi'an Jiao Tong University from January 2013 to December 2013,the drainage way,efficient rate,complication rate,and surgical situation were retrospective analyzed. Results Bilateral endoscopic drain?age was one?time achieved in all 19 patients. Among them,Eendoscopic nasobiliary drainage( ENBD) for unilat?eral bilateral drainage was 4 cases,ENBD and plastic stent for unilateral( left or right) drainage was 9 cases,EN?BD and plastic stent for bilateral drainage was 6 cases. The drainage efficiency rate was 89. 5% ( 17/19) . Serum alanine aminotransferase(ALT),total bilirubin(TBIL),direct bilirubin(DBIL),alkaline phosphatase(ALP) and Prothrombin time (PT) were significantly decreased after 7days post?ERCP((208. 4±47. 7) U/L vs. (90. 3 ±31. 57) U/L,(421. 7±85. 9) μmol/L vs. (150. 1±49. 7) μmol/L,(294. 6±30. 6) μmol/L vs. (95. 4±23. 2)μmol/L,(853. 1±133. 7) U/L vs. (600. 0±116. 4) U/L,(17. 7±1. 8) s vs. (13. 8±1. 0) s;P=0. 000,0. 001, 0. 000,0. 001,0. 004) . There were 6 cases occurred ERCP postoperative complications,including 2 cases of hy?peramylasemia, 1 case of pancreatitis, 3 cases of cholangitis. Seven cases of hilar cholangiocarcinoma patients were received hilar radical surgery by combination caudate lobectomy of the left or right hepatectomy,no postop?erative cholangitis was occurred. Conclusion ERCP biliary drainage is an important means to ensure the perio?perative safety and efficacy of hilar cholangiocarcinoma.

Objective To explore the application value of plastic biliary stent and fully covered self-expandable metallic stent (FCSEMS) in endoscopic retrograde cholangio pancreatography (ERCP) for treatment of benign biliary stricture after liver transplantation.Methods The retrospective cross-sectional study was conducted.The clinical data of 54 patients with benign biliary stricture after liver transplantation undergoing ERCP treatment who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University between January 2010 and August 2016 were collected.Among 54 patients,44 had simple anastomotic stricture and 10 had non-anastomotic stricture.All the patients underwent stent implantation by ERCP.Patients with stricture within 1 month postoperatively initially selected single plastic stent or endoscopic nasobiliary drainage (ENBD),and then changed into multiple plastic stents at the second stent replacement.Patients with stricture after 1 month postoperatively selected multiple plastic stents,multiple plastic stents after balloon dilation or FCSEMS.Observation indicators:ERCP situations,stent implantation,time of stent indwelling,postoperative complications,stent dislocation,treatment outcome and follow-up situations.Patients were followed up by outpatient examination and telephone interview up to November 2016.Clinical symptoms of patients were observed within 1 month postoperatively and liver function and abdominal ultrasound were retested.Liver function and remission degree of biliary stricture were monitored regularly once every 3 months.Measurement data were described as average (range).Results All the patients underwent successful ERCP,of which 53 completed the process of ERCP and 1 rejected treatment due to economic problems.All the 54 patients received 140 times ERCPs with an average of 2.59 times per person,21 times ENBDs,11 times FCSEMSs and 108 times plastic stent implantations (including 35 times single stent implantations,46 times double stents implantations,23 times 3-stents implantations and 4 times 4-stents implantations).All the 54 patients were followed up for 3-143 months,with an average time of 73 months.Of 44 with anastomotic stricture,34 received plastic stent implantation and 98 times ERCPs,with an average number of stent implantation of 2 (range,1-4) and an average time of stent indwelling of 10.7 months (range,9.0-13.0months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 4 persons every time,7 persons every time,10 persons every time and 3 persons every time,respectively;26 patients were cured and 5 were improved,with an effective rate of 91.2％ (31/34);3 patients with noneffective treatment continued to undergo ERCP and 3 patients had recurrence of anastomotic stricture.Among 10 patients with initial FCSEMS implantation,12 times ERCPs were performed,with an average time of stent indwelling of 7.6 months (range,6.0-12.0 months);postoperative biliary infection,hyperamylasemia and stent dislocation were detected in 1 person every time,1 person every time and 1 person every time,respectively;8 patients were cured,with an effective rate of 8/10;of 2 patients with persistent stricture,1 patient received contrast examination after stent removal,showing a comparative stricture in level 1 branch of intrahepatic duct and considering combined ischaemia,and then underwent the second implantation using multiple plastic stents;the other patient had elevated level of jaundice at 3 months after stents removal and received ERCP,showing anastomotic inflammatory polyp,and then underwent FCSEMS implantation again.Ten patients with non-anastomotic stricture received plastic stent implantation and 30 times ERCPs,with an average number of stent implantation of 3 (range,2-4) and an average time of stent indwelling of 11.3 months (range,10.0-14.0 months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 2 persons every time,5 persons every time,2 persons every time and 1 person every time,respectively;3 patients were cured and 3 were improved,with an effective rate of 6/10;of 4 patients with noneffective treatment,2 died of gradually deteriorating liver function and 2 underwent the second liver transplantation.Conclusions Stent implantation in ERCP is safe and effective for treatment of benign biliary stricture after liver transplantation,single plastic stent should be used in the early period (within 1 month) and multiple plastic stents should be used in the later period.Although FCSEMS has a higher displacement rate,it should be recommended due to a better clinical effect,lower incidence of complications and simple operation.For patients with non-anastomotic stricture,plastic stent should be used for extrahepatic biliary stricture,with a good clinical effect,and there is worse effect in stent implantation through ERCP for multiple intrahepatic biliary strictures.