OBJECTIVETo evaluate the chemical composition of the modified surface of fluoride ion-implanted titanium and assess the effect on the formation of focal adhesion plaque in vitro.

METHODSPure commercial titanium discs were treated with fluoride ion implantation by plasma immersion ion implantation technique (PIII) and chemical composition and value of the surface modification layer were characterized by X-ray photoelectron spectrometer (XPS). In order to investigate the formation of focal adhesion plaque, MG-63 cells were seeded onto the surfaces of the modified Ti discs and quantified by morphometric analysis using an immunofluorescence microscope.

RESULTSThe full range XPS spectra and fitting results indicated that the surface of fluoride ion-implanted titanium was the mixture of titanium dioxide and titanium trifluoride. Meanwhile, the quantity of focal adhesion plaque on fluoride ion-implanted titanium was more than that on the non-implanted titanium after 6 hours' cell culture.

CONCLUSIONThe XPS data revealed that the modified surface layer of fluoride ion-implanted titanium contained titanium dioxide and titanium trifluoride, which could enhance the formation of focal adhesion plaque.

Fluorides ; Focal Adhesions ; In Vitro Techniques ; Prostheses and Implants ; Surface Properties ; Titanium

OBJECTIVETo make multi-central clinical evaluation of the massage for supplementing qi and removing obstruction in the Governor Vessel for treatment of infantile diarrhea due to spleen deficiency.

METHODSBy using multi-central, randomized and controlled method, 275 cases were randomly divided into an observation group (n = 137) and a control group (n = 138). The observation group were treated by the massage for supplementing qi and removing obstruction in the Governor Vessel, and the control group by routine massage therapy in Tuina Science, a teaching material for college and school of TCM. After treatment for 7 days, their therapeutic effects were compared.

RESULTSThe cured rate was 83.2% in the observation group and 69.6% in the control group with a signifi cant difference between the two groups (P < 0.05), the former being better than the latter. The mean cured time was (3.22 +/- 1.04) days in the observation group and (4.20 +/- 1.11) days in the control group with a significant difference between the two groups (P < 0.05), the former being shorter than the latter.

CONCLUSIONThe massage for supplementing qi and removing obstruction in the Governor Vessel has a definite therapeutic effect on infantile diarrhea due to spleen deficiency, with rapid effect.

Combined Modality Therapy ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male ; Massage ; Qi ; Splenic Diseases ; therapy

BACKGROUNDEndometriosis (EM) is a benign gynecologic disease predominantly found in women of reproductive age. However, its pathogenesis is still poorly understood. Our experiment was designed to establish a stable and reliable cultural environment for coculture of endometrium and peritoneum, so as to observe the adhesion/invasion ability of endometrium from patients with or without EM.

METHODSEndometria of secretory phase and peritoneum were sampled from 6 women with endometriois during laparoscopy. Six with ovarian teratoma or simple ovarian cyst were taken as control. We cocultured endometrium and peritoneum into four groups (endometrium from EM cultured with peritoneum from EM, endometrium from control cultured with peritoneum from control, endometrium from EM cultured with peritoneum from non-EM and the endometrium from control cultured with peritoneum from EM) to observe the adhesion/invasion process in gas-liquid surface culture and in-medium culture. Specimens were collected at 1 hour, 6 hours, 12 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days and 7 days for histology, immunofluorescence and immunohistochemical analysis on cytokeratin 8 (CK8) and CD10.

RESULTSThe gas-liquid surface culture was superior to in-medium culture for the maintenance of tissue morphology and survival of endometrium. CK8 immunoflurescence demonstrated no remarkable difference in adhesion process between patients with and without EM. CD10 immunochemistry manifested frequent invasion of endometrial stromal cells from EM patients into peritoneum of up to 3 days culture, while the endometriotic cells from non-EM patients did not invade into peritoneum.

CONCLUSIONSGas-liquid surface culture is a suitable model for observing the early events in EM lesion formation. Endometrium from patients with EM showed increased invasion capacity during coculture, which might help to explain the etiology of endometriosis.

Cell Adhesion ; physiology ; Endometriosis ; pathology ; Endometrium ; cytology ; Female ; Humans ; Tissue Culture Techniques ; methods

OBJECTIVE: To investigate the effect of tibial coronal curvature on the alignment of tibial prosthesis in patients undergoing total knee arthroplasty (TKA). METHODS: From July 2019 to April 2021, 100 patients with knee osteoarthritis were treated with total knee arthroplasty. Before operation, the full-length films of lower limbs were taken and the tibial bowing angle(TBA) was measured. TBA more than 2° was tibial bending, which was divided into tibial bending group and non bending group. There were 40 cases in tibial bending group, 9 males and 31 females, aged 56 to 84 years old with an average of (69.22±7.10) years. There were 60 cases in the non bending group, 19 males and 41 females, aged from 51 to 87 years old with an average of (70.80±7.21) years. The preoperative tibial length (TL) and medial proximal tibial angle (MPTA) were measured and compared between the two groups. The full-length X-rays of the lower limbs were taken again 3 days to 1 week after operation. The medial angle of the tibial component coronal aligement angle (TCCA) and the outilier rate of force line of the tibial prosthesis were measured and compared between the two groups. Pearson method was used to analyze the correlation between TCCA and age, TCCA and height, TCCA and weight, TCCA and BMI, TCCA and TBA, TCCA and TL, TCCA and MPTA; Spearman method was used to analyze the correlation between TCCA and gender, TCCA and Kellgren-Lawrence(K-L) grade. RESULTS: All 100 patients successfully completed the operation and obtained satisfactory full-length X-rays in standing position. There was no significant difference in TL, MPTA and TCCA between bending group and non bending group(P>0.05). The outilier rate of force line in tibial bending group was 22.5%, and that in non bending group was 6.67%, the difference was statistically significant(P<0.05). The correlation study found that TCCA was strongly correlated with TBA(r=-0.702, P<0.01), weakly correlated with MPTA(r=0.311, P<0.01), and had no correlation with other parameters(P>0.05). CONCLUSION In patients with knee osteoarthritis undergoing total knee arthroplasty, tibial bending will lead to poor force line of tibial prosthesis. During operation, attention should be paid to osteotomy of proximal tibial vertical tibial mechanical axis and correct installation of prosthesis to avoid poor alignment of prosthesis.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects* ; Female ; Humans ; Knee Joint/surgery* ; Knee Prosthesis/adverse effects* ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery* ; Retrospective Studies ; Tibia/surgery*

OBJECTIVETo investigate the clinical outcomes of C-arm X-ray fluoroscopy before incision to make assistant lines and insert the guide wire of PFNA and PFNA blade.

METHODSFrom January 1st 2012 to January 1st 2015, 132 intertrochanteric fracture patients of type 31A1 and 31A2 according to AO-classification, were retrospectively analyzed. Among them, 62 patients(14 males and 48 females) aged from 52 to 95 years with a mean age of(69.58±8.55) years in traditional group were operated by traditional procedure, while 70 patients in the skin marking group included 15 males and 55 females aged from 61 to 88 years with a mean age of(71.94±7.64) years, on the basis of the traditional operation method, the assistant line of the body surface and the C-arm X-ray was increased, and the guide pin positioning of the proximal femoral nail and the spiral blade was guided by the auxiliary line in the operation. Operative time, frequency of C-arm fluoroscopy, Harris hip score of the third months after surgery and the complications in both groups were queried for statistical analysis.

RESULTSIn addition to skin making group 1 patients had superficial wound infection complications, all patients were stage I wound healing. All patients were followed up for 3 to 18 months with an average of (6.81±3.07) months. The operative time was significantly reduced in skin marking group (56.16±6.36) minutes compared to traditional group (59.06±9.19) minutes (>=0.035). And the frequency of C-arm fluoroscopy of skin marking group was(25.89±5.81) times which was also significantly reduced compared to traditional group(31.32±9.81) times (<0.001). There was no statistical difference in Harris hip score at 3 months after operation and the complication rate between the two groups(>0.05).

CONCLUSIONSIn this study, a simple and easy method of assistant line marking can shorten the operation time and reduce the number of times of operation.

OBJECTIVETo explore occurrence and risk factors of sarcopenia in patients with hip facture.

METHODSFrom May 2013 to January 2017, 187 patients with hip fractures were collected, including 99 males and 88 females aged from 50 to 95 years old with an average age of (77.40±10.58) years old. General conditions, appendicular skeletal muscle index (ASMI), total fat mass, bone mineral content (BMC), body mass index (BMI), grip strength, preoperative blood vitamin D (VITD), albumin, American Society of Anesthesiologists(ASA) classification and new mobility scores(NMS) were observed and analyzed. According to grip strength and ASMI, patients were divided into sarcopina group and non-sarcopina group, univariate and multivariate statistical methods were used to analyzed.

RESULTSNinty-nine patients(52.9%) were diagnosed as sarcopenia. Compared with non-sarcopenia group, occurrence of sarcopenia was associated with advanced age, high ASA, low total fat mass, low bone mineral content, low BMI, low albumin, and low NMS. Subsequent binary logistic regression analysis showed that advanced age (OR=1.804, =0.048), high ASA score (OR=3.052, =0.001), low fat content (OR=0.843, =0.006), low bone mineral salt(OR=0.203, =0.026) were risk factors of hip fracture patient with sarcopenia.

CONCLUSIONSOld age, high ASA score, low fat content, low bone mineral content may be related risk factors for sarcopenia in hip fracture patients.

OBJECTIVETo determine the association of sarcopenia with short-term postoperative function after hip replacement for femoral neck fractures.

METHODSA prospective study of 181 consecutive patients with femoral neck fractures who underwent hip replacement from May 2014 to January 2017 were performed, including 58 males and 123 females aging from 53 to 92 years old. The general conditions were collected before surgery, skeletal muscle index(ASMI), handgrip strength were measured. Clinical outcomes were followed up including postoperative complications, time of on-site, Harris score (postoperative 2 weeks, 3, 6 months), hospitalization costs, and hospital stay. According to handgrip strength and ASMI, the patients were divided into the sarcopina group and the non-sarcopina group; according to the Harris score at the 6-month follow-up, the patients were divided into good prognosis group and poor prognosis group. Univariate analysis and binary logistic regression analysis were used to investigate whether sarcopenia was a risk factor for poor postoperative hip joint surgery.

RESULTSAll patients were followed up at 2 weeks, 3 and 6 months, postoperative early complication included wound infection in 16 cases, thrombus of lower extremity veins in 14 cases, no dislocation, prosthetic loosening and prosthesis related infections occurred. Sarcopenia was present in 82 of 181 patients(45%), Compared with non-sarcopenic patients, sarcopenic patients had a higher risk of postoperative complications, longer postoperative hospital stay, more hospital costs and lower harris scores. In Binary logistic analysis revealed that sarcopenia(=0.08), hemiarthroplasty(<0.001), diabetes(=0.016) and infection(=0.018) were important predictors of unsatisfactory postoperative function.

CONCLUSIONSSarcopenia is an important predictor of poor postoperative prognosis in patients with femoral neck fractures after hip replacement. The treatment for sarcopenia maybe an important way to protect patients with femoral neck fractures from poor prognosis after hip replacement.