[Objective]To analyze the causes of perioperative periprothetic fracture with hip arthroplasty and discuss the prevention and treatment of the fracture.[Method]18 of 640 THR cases occurred femoral fracture from July 1995 to August 2006,11 with intraoperative fracture and 7 with postoperative fracture,12 were and 6 female,the mean age 68 years(range:51 to 79 years).According to AAOS'standard,18 cases were divided into 6 types:1 of I type,6 of II type,4 of III type,4 of IVa type,2 of IVb type,1 of V type and 2 of VI type.10 of 11 cases of intraoprative fracture were operated immediately with internal fixation,and one of II type was treated with conservative method.4 of 7 cases of postoperative fracture were operated with open reduction and internal fixation in two weeks,2 cases with loosen stem were operated by revision hip,and one of V type was treated with conservative method because of other disease.[Result]The mean followed up perioid were 15.2 months(rang:6 to 42 months),15 fractures united,2 delayed united and 1 dead after 8 months postoperatively.The average scores were 80 according to Harris'standard(range:67 to 92).[Conclusion]Violence、abnormal of femur cannal、osteoprosis and bigger prothesis are the main causes of intraoperatively peri-prothetic femur fracture after THA,and loosening、 osteoperosis and outside injury are the main causes of postoperatively periprothetic femoral fracture,different treatment should be used according to the different types.

[Objective]To study the reason of loosening prothesis by observing the interface membranes harvested during the hip revision operation.[Method]Thirty eight specimens of interface membranes around the loosening prothesis were harvested from thirty eight patients who underwent the revision of total hip replacement.All the specimens were underwent outer observation,light and scanning electronic microscopic observation.[Result]All the gap of the loosening prothesis were filled with interface membranes with different thickness.A large number of the foreign pelletand bone pieces were found under scanning electronic microscope.[Conclusion]Interface membranes growed and filled in the gap between the loosening prothesis and bone(or bone cement).The wear debris stimulated the interface membrane to release bone resorption factors which caused the prothesis loosening,and the more loosening,the more large gap appeared,and the more resorption factors released from the interface membranes due to the debris stimulating,which formed vicious circle.Cutting the link of the circle could decrease the loosening rates.

0.05),but the integrated arthoplasty group had significant differences from the other two groups(P

It is an essential educational goal to strength experimental teaching and improving the practical skill of medical postgraduate students in medical colleges and universities.We made anexploration and practice on how to improve the practical skill and innovative ability of postgraduate students in medical immunology experimental teaching.The article points out that optimizing the design of experimental course,innovating the teaching methods,standard appraised of experiment and improving the quality of teacher are the efficient ways to enhance the practical skill of postgraduate students.

Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.

Objective To investigate the X-ray and clinic manifestations of hereditary multiple osteochondroma(HMO).Methods Five patients with HMO clinically and pathologically confirmed and 63 persons in their pedigree were studied.Results Of 63 cases inquired in this study,there were 21 patients with hereditary multiple exostosis,including 16 men and 5 women.In 5 cases confirmed pathologically,4 patients had hereditary history of pedigree and the members of three generation in 1 patient with HMO had no the history of pedigree.Conclusion HMO has the remarkable sex difference and the typical inherited trend including the location of exostosis.HMO has inherited character of skipping generation.

Immunology teaching course includes both basic immunology and clinical im-munology.This paper points out the problems of teaching and knowledge integration between the basic immunology and clinical immunology and suggests that teaching team should include the basic immunology and clinical immunology related content clinical experts to promote teaching quality.

ObjectiveTo explore the expression of MRP1 and CD34 in colorectal carcinoma tissue and the relationship with clinicopathological factors.MethodsImmunohistochemical streptavidin-perosidase method was used to examine the expression of MRP1 and CD34 in 53 cases with colorectal carcinoma and normal colorectal tissue.The correlation between the levels of MRP1and CD34 expression and clinicopathological factors were analyzed.ResultsThe positive expression rates of MRP1 in the carcinoma group and normal colorectal tissue group were 49.1％ and 15.1％ respectively,and there was a significant difference of the positive expression between the two groups( x2 =14.029,P ＜ 0.01 ).The expression of MRP1 had no correlation with the degree of differentiation,the depth of invasion,the metastasis of lymph node and all the other clinicopathological factors ( P ＞ 0.05 ).CD34 value in the carcinoma group and normal colorectal tissue group were ( 35.63 ± 12.23 ) MVD/HP and ( 6.12 ± 0.97) MVD/HP,respectively,and there was a significant difference between the two groups (t =17.565,P ＜ 0.01 ).CD34 was not correlated with age,sex,tumor size,localization of the primary tumor ( P ＞ 0.05 ),but correlated with Dukes staging,lymph node metastasis,differentiation of the tumor,depth of invasion( all P ＜ 0.05).ConclusionThe overexpression of MRP1 and CD34 protein may involve in colorectal carcinogenesis;MRP1 may involve in the primary multidrug resistance in colorectal carcinoma.; CD34 may involve in the colorectal carcinoma invasion and metastasis.Investigating the expression of MRP1 and CD34 in colorectal carcinoma simultaneously can provide new referential indexes for the treatment and prognosis of colorectal carcinoma.

Infection is a catastrophiccomplication in total knee arthroplasty.Reported a case of Nocardiafarcinica infection which appeared after application of cemented total knee replacement.A 64-year-old male patient was admitted to hospital 1 months after knee surgery,with a 2-week history of pain,swelling,and restricted mobility.As no improvement could be a-chieved after synovectomy and antibiotherapy,the prosthesis were removed from him.Although improvement could not be a-chieved in the knee of the patient at the end of 10-month therapy,the case has still being followed-up.

Objective To provide structure and function applied anatomical of nasal sub-units for plastic and reconstruction. Methods Twelve cases fresh nose from adult head specimen,to dissect the skin,muscle fascia system, cartilage and bone,to observe and digiital measure nerve, blood vessel and ligament between cartilage. Results The thinnest skin in the point of bone and cartilage junction,the thickest parts in the nasion and the supratip breakpoint.Nose contours include of the skin,cartilage,bones and vascular muscle fascia system;Nasal subunit can be divided into nasion area,nasal dorsum area, nasal tip area,nasal ala area and nasal columella area;Nasal valve was a important anatomic part of bremh.The nasal lateral osteotomy of maxilla can change 2 mm height and width of the nasal bone;Lower lateral cartilage and upper nasal cartilage connection can be separated 6~8 mm. Curvature changes in the crura intermedium of alar cartilage Can raise nasal tip 2 mm. Extent of septal cartilage was 15 mm×20 mm,thickness was 1 mm.The mainly blood supply come from facial artery and ophthalmic artery. Vein accompanying with the same name.Lymphatic flow in the area of superficial muscle fascia. Concision Nasal bone lateral osteotomy can raise up bridge of the nose.To lengthen and highten nasal tip based on the complete strip technique of lower lateral cartilage and upper lateral,and to change angel of medial crus and middle crus of lower lateral cartilage by suture rotation.Nasal skin is rich in artery and vein,so much as four networks.Because the syndrome of nasal contraction deformation occurred more and more recently we must to avoid the vascular network injury when operation, and the anatomical level should be give more noted.