As an important indicator of total hip arthroplasty (THA) the rate and degree of offset reconstruction play an important role in improving the prognosis and life quality of patients. The reconstruction of femoral offset is closely related to reserved length of calcar femorale, the head and neck length of prosthesis, angle degree of neck shaft and whether lower limb is isometric. Reconstruction strategy includes making a meticulous and standard measurement before the surgery, predicting the reserved length of calcar femorale, selecting a prosthesis with approximate anatomical neck-shaft angle and reconstructing offset by adjusting the head and neck length of the prosthetic during the operation. The aim of this article was to introduce the research progress and influence of offset on hip function, prosthetic wear and postoperative complications such as pain, limp and unequal leg length, and to discuss the reconstruction strategy.
Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Femur ; surgery ; Humans ; Reconstructive Surgical Procedures ; adverse effects ; methods

OBJECTIVE:To develop the drug traceability management system in outpatients of medical institutions,and gradu-ally improve its traceability management. METHODS:Based on barcode technology,drug traceability management system in outpa-tients of medical institutions was independently developed,introducing it from system environment,framework design and system function,and the application results were evaluated in terms of differences in dispensing time,deployment error,drug withdrawal treatment and applicability investigation. RESULTS:The system was developed on hospital information system network environ-ment,which was designed by combination of client/server(C/S)network system(B/S)and set function modules as follows as role rights management,data extraction,information control,data acquisition and data query. The system can match with drug electron-ic surveillance code,commodity code and other traceable barcodes,achieve drug tracing from hospitals to users through software interaction,as well as the computer-aided calibration in dispensing to effectively reduce outpatient's dispensing error. The average time for each outpatient prescription prolonged 9 s after using the system;24 dispensing errors and 4 non-normal withdrawals were prevented within 1 month;100% surveyed pharmacists expressed approval for the system's applicability. CONCLUSIONS:The system can achieve the drug suitability management in outpatients,which has shown good applicability and further improved drug safety management and control capabilities in medical institutions.

Objective:To examine the expression of CLC-3 in colorectal tissues and the effect of CLC-3 on the viability and invasion of colorectal cancer (CRC) SW480 and SW620 cells. Methods:The mRNA levels of CLC-3 in CRC cell lines were determined by RT-PCR. CLC-3 expression was inhibited by adding DIDS or NPPB to the CRC cells. Subsequently, cell viability and invasion were assessed by CCK-8 assay and Transwell assay, respectively. In addition, the effects of DIDS and NPPB on the Wnt orβ-catenin signaling pathways were de-termined by Western blot analysis. Results:The mRNA level of CLC-3 was remarkably increased in the CRC tissues compared with that in normal colorectal tissues (P<0.05) and was positively correlated with the T stage of CRC. The blockade of CLC-3 inhibited the viability and invasion of CRC cells (P<0.05). The expression ofβ-catenin, C-myc, cyclin D1, Ki-67, and survivin were evidently reduced by the in-hibition of CLC-3 (P<0.05). Conclusion:The inhibition of CLC-3 decreases the cell viability and invasion of CRC cells by reducing the ex-pression of the proteins related to the Wnt orβ-catenin signaling pathway.

ObjectiveTo explore the relationship among 25-hydroxyvitamin D,serum calcium,calcium-sensing receptor,and breast cancer. Methods The expressions of calcium-sensing receptor (CaSR) in primary breast cancer,breast benign tumors,and normal breast tissue beside tumors were determined by immunohistochemistry S-P method as well as the concentration of serum 25 (OH) D and serum calcium in breast cancer and breast benign tumors by Enzyme-linked immunosorbent assay (ELISA),Tribromoarsenazo Ⅲ method.ResultsSerum 25 (OH) D level of breast cancer was significantly lower than the breast benign tumors [ (34.13 ± 14.14) nmol/L vs (50.29 ± 25.65 ) nmol/L,t =2.870,P =0.001 ].Serum level of 25 ( OH ) D in lymph node metastasis positive patient was lower than that in negative group [ (30.8 ± 9.71 ) nmol/L vs (43.7 ± 23.59) nmol/L,t =2.467,P =0.021 ].The positive expression of CaSR in breast cancer(88.9％ )was higher than breast benign tumors(60％,x2 =6.717,P ＜ 0.01 ) and normal breast tissue beside tumors (60％,x2 =5.628,P ＜ 0.05 ).ConclusionsConcentration of serum 25 (OH)D and expression of calcium-sensing receptor in the tissues may be associated with occurrence,development and prognosis of breast cancer.

The article reviewed the effects of resistance training,aerobic exercise in patients with diabetes and pre-diabetes,based on the metabolic characteristics in patients with pre-diabetes,and aimed at providing theoretical reference for exercise in the prevention and control of diabetes mellitus.

Objective To determine the power-time-ablation scope correlogram of a water-cooled single needle electrode radiofrequency (RF) ablation system and to establish a theoretical basis for its practical application.Methods RF ablations were performed using a water-cooled single needle electrode radiofrequency ablation system developed by the authors using fresh ox liver as well as liver and muscles of healthy adult New Zealand white rabbits.The temperature of the ablation area was monitored using a multichannel thermometric system.The maximum ablation scope was determined by detecting the rim at which the temperature was no less than 50 °C.The specific absorption rate (SAR) of the isolated liver tissue was calculated.Results In the treatment voltage range of 100-130V,the process was smooth and steady.No impedance variation was obvious.The maximum diameter of a single ablation was 51 cm.With the treatment voltage at 140-170 V,a larger ablation area could be reached in less time,but eventually the impedance began to increase while the ablation area was no longer expanded.When the treatment voltage reached the range of 180-200 V the impedance almost always increased rapidly out of limits,and the treatment system stopped automatically.The measured SAR value was consistent with the theoretical value.Pathology confirmed that both liver tissue and muscle tissue manifested typical coagulative necrosis.Conclusions The power amplifier,cooling,thermometric and control sections of the RF ablation system worked stably,and the practical ablation effect met the design and clinical treatment requirements.

Objective To compare the clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 373 patients with gastric cancer who underwent totally laparoscopic or laparoscopy-assisted radical total gastrectomies from the 7 medical centers in China (82 patients in the Affiliated Hospital of Qinghai University,80 in the Traditional Chinese Medicine Hospital of Guangdong Province,60 in the First Affiliated Hospital of Xiamen University,51 in the Hangzhou First People's Hospital,46 in the First Affiliated Hospital of Xi'an Jiaotong University,30 in the Second Affiliated Hospital of Jilin University and 24 in the Xijing Hospital of the Fouth Military Medical University) between January 2015 and December 2016 were collected.Of 373 patients,the 183 and 190 patients were respectively divided into the totally laparoscopic group (undergoing totally laparoscopic radical total gastrectomy) and laparoscopy-assisted group (undergoing laparoscopy-assisted radical total gastrectomy),including 63 and 19 in the Affiliated Hospital of Qinghai University,36 and 44 in the Traditional Chinese Medicine Hospital of Guangdong Province,25 and 35 in the First Affiliated Hospital of Xiamen University,20 and 31 in the Hangzhou First People's Hospital,10 and 36 in the First Affiliated Hospital of Xi'an Jiaotong University,17 and 13 in the Second Affiliated Hospital of Jilin University,12 and 12 in the Xijing Hospital of the Fouth Military Medical University.Routine five-port method was applied for laparoscopic radical total gastrectomy and D2 lymphadenectomy.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy-assisted group.Observation indicators:(1) operation and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as x±s.Comparison between the groups was analyzed by the t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Results (1)Operation and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 183 patients in totally laparoscopic group:conventional circular stapler method were performed in 28 patients,anti-puncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 65 patients and peristalsis side-to-side esophagojejunostomy method in 79 patients.Conventional circular stapler method was applied to 190 patients in the laparoscopy-assisted group.Operation time,time of esophagojejunostomy,length of assisted incision,using time of analgesics and expenses of digestive tract reconstruction were (238± 55)minutes,(29±9)minutes,(5.1 ± 1.1)cm,(2.2±l.0)days,(18 332±2 141)yuan in the totally laparoscopic group and (217±39)minutes,(26±7)minutes,(7.8 ±2.0)cm,(2.7± 0.9)days,(16 237 ± 1 923)yuan in the laparoscopy-assisted group,respectively,with statistically significant differences between the 2 groups (t =4.324,3.455,-16.835,-5.561,9.949,P＜0.05).The cases with postoperative overall complications,anastomosis leakage,anastomosis stricture,anastomosis bleeding and expenses of esophagojejunostomy were respectively 24,9,7,5,(9 668±2 814)yuan in the totally laparoscopic group and 24,8,9,6,(9 331 ±2 067)yuan in the laparoscopy-assisted group,with no statistically significant difference between the 2 groups (x2 =0.036,0.107,0.189,0.059,t=1.322,P＞0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Follow-up and survival situations:of 373 patients,336 were followed up for 4-26 months,with a median time of 13 months,including 166 in the totally laparoscopic group and 170 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tunor metastasis were respectively 150,10,16 in the totally laparoscopic group and 154,9,16 in the laparoscopy-assisted group (10 and 9 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between the 2 groups (x2 =0.075,0.010,P＞0.05).Conclusions Total laparoscopic and laparoscopyassisted radical total gastrectomies are safe and feasible,with equivalent overall outcomes and effects of esophagojejunostomy.Compared with laparoscopy-assisted radical total gastrectomy,the postoperative pain time of patients in total laparoscopic radical total gastrectomy is less,but there are longer time of esophagojejunostomy and higher expenses of digestive tract reconstruction.

Objective To investigate CT findings of concealed rupture of intestine following abdominal trauma.Methods CT findings of 11 cases with concealed rupture of intestine following abdominal trauma proved by surgery were identified retrospectively.Results The main special signs included:(1)Free air in 4 cases,mainly around injured small bowel or under the diaphragnl,or in the retroperhoneal space or and in the lump.(2)High density hematoma between the intestines or in the bowel wall(4 cases).(3)Bowel wall injury sign,demonstrated as low density of the injured intestinal wall,anenuated locally but relatively enhanced in neiighbor wall on enhanced CT.(4)Lump around the injured bowel wall with obvious ring.shaped enhancement(4 cases).Other signs included:(1)Free fluid in the abdominal cavity or between the intestines with blurred borders.(2)Bowel obstruction.Conclusion CT is valuable in diagnosing concealed rupture of intestine following abdominal trauma.

Objective To investigate enhancement appearance of hepatic focal nodular hyperplasia(FNH) at real-time gray-scale contrast enhanced ultrasonography(CEUS),and evaluate the value of CEUS in the diagnosis of FNH. Methods Thirty-four patients (36 lesions) with histologically proved FNH were examined by ultrasonography. Appearance on conventional ultrasonography and the enhancement pattern on CEUS were investigated. Results Thirty-six lesions were mostly hypoechoic.39% (14/36) of lesions had peripheral hypoechogenic circle. Color Doppler flow imaging showed a asteroid-like or spoke-and-wheel pattern in 65% (20/ 31) of lesions.Three enhancement patterns were observed in the early arterial phase: whole-enhancement pattern (28%, 10/36), gushing-spring enhancement pattern (44%, 16/36), and spoke-and-wheel enhancement pattern (28%,10/36).The frequency of central scar on CEUS was 17% (6/36), and detection rate of central scar by CEUS compared with pathology was 40% (6/15).Regarding one of the features (gushing-spring enhancement, spoke-and-wheel enhancement and scar) as standard of FNH, the coincidence of CEUS in this group was 78% (28/ 36) ,which was significantly higher than that of conventional ultrasonography 28% (10/36).Conclusions CEUS can be as a important method for diagnosing FNH.

Objective To explore the expressions and correlation of RWD containing sumoylation enhancer (RSUME),small ubiquitin-like modifier (SUMO-1),hypoxia inducible factor-1α(HIF-1α)and vascular endothelial growth factor (VEGF)in gliomas of different pathologic grade.Methods We investigated the expression levels of RSUME mRNA,HIF-1α mRNA and VEGF mRNA with reverse transcription-polymerase chain reaction (RT-PCR),and investigated the immunohistochemical staining to determine the expressions of SUMO-1,HIF-1α and VEGF in 63 cases of human gliomas of different pathologic grade and 9 cases of normal brain tissues.We studied its correlation with the pathologic grade and the relationship between the expression of RSUME promoter sumoylation and HIF-1α/VEGF pathway in gliomas.Results There were significant differences (P <0.01)in the expressions of RSUME mRNA,HIF-1αmRNA and VEGF mRNA in glioma tissues.With the increasing degree of pathologic grade in tumor specimens,the expression levels of RSUME mRNA,HIF-1α mRNA and VEGF mRNA increased markedly (P <0.01 ).There was a positive correlation of the expression levels of RSUME mRNA with HIF-1αmRNA and VEGF mRNA.There were significant differences (P <0.01 )in the expressions of SUMO-1,HIF-1αand VEGF in glioma tissues by immunohistochemical staining.With the ascending of pathologic grade of tumor specimens,the expression levels of SUMO-1,HIF-1α and VEGF increased markedly (P < 0.01 ).There was a positive correlation between the expression level of SUMO-1 and HIF-1α(r =0.857,P <0.01).The Kaplan-Meier analysis and Log-rank test showed significant differences in progress free survival (PFS)between the RSUME high-expression and low-expression groups (χ2 =36.032,P <0.01).Conclusion RSUME may enhance HIF-1α/VEGF pathway through sumoylation in gliomas.It implicates that RSUME is related to angiogenesis in gliomas and can promote tumor invasion and progression,indicating that RSUME can be a novel target in gliomas treatment.