[Objective]To discuss the effect of femoral head diameter on risk of dislocation after primary total hip arthroplasty,in order to choose the reasonable diameter of femoral head for preventing the postoperative dislocation. [Methods]From March 1990 to August 2008,primary total hip arthroplasties with various head sizes were performed in 706 patients(762 hips).There were 301 males and 405 females.The average age of the 706 patients in this series were 57 years(range 21～78 years).The preoperative diagnosis for each of the patients were osteonecrosis in 203,congenital dysplasia in 129(the Crowe IV in 15),femoral neck fracture in 190,osteoarthritis in 112,rheumatoid arthritis and ankylosing spondylitis in 58 and the other diagnosis in 14.The femoral head diameter was 22mm in 220 of the procedures,26mm in 83,and 28mm in 459.Among the 762 cases,a modified Harding approach was preferred in 95%,and a posterolateral approach was preferred in 5%.Patients routinely were followed at definite intervals and were specifically queried about dislocation.[Results]All the patients were followed up for at least six months.Of the 762 cases,there were 28 dislocations;the dislocation rate was 3.7%.In the subgroups,there were 7.3%(16/220) for 22mm heads,4.8%(4/83) for 26mm heads,and 1.7%(8/459) for 28mm heads,the difference were statistically significant(x2=13.193,P=0.001;R=0.131,P=0﹤0.01).[Conclusion]The femoral head diameter has a positive effect on risk of dislocation,using a larger femoral head could reduce the risk of dislocation after total hip arthroplasty.A larger femoral head could be selected for preventing the postoperative dislocation and 22mm femoral heads should be avoided.

To investigate the significance and age characteristics of CVB infections among common diseases of children.CVB Ag and CVB IgM were detected from the sera in 967 children in hospital. Positive rates of CVB Ag and CVB IgM in the upper respiratory tract infection group, the lower respiratory tract infection group, the myocarditis group, the asthma group, the ITP group and the anaphylactoid purpura group were higher than the control group.Most of the children with positive CVB were in the 0～1 year age group and 1～3 years age group had respiratory tract infection. With increasing age,the number of the children with respiratory tract infection gradually decreased,while number of the children with myocarditis,asthma,ITP and anaphylactoid purpura increased in those children with positive CVB. It suggests that, beside respiratory tract infection,CVB plays an important role in pathogenesis of myocarditis,asthma,ITP and allergic purpura in children.

Study the immunological adjuvant function of biodegradable microspheres for DNA immunization. Empty poly(D,L-lactide-co-glycolic acid) microspheres were prepared using the water-inoil-in-water(w-o-w)technique; A plasmid DNA pRc-CMV encoding hepatitis B virus S antigen was constructed;The mixture of the microspheres and the plasmid DNA was prepared by incubation method. The mixture was administered to Balb/c mice by intramuscular injection. Result: The high antibody titer (1:1600) of intramuscular injection of the mixture of microspheres and the plasmid DNA was obtained, similar to that of intramuscular injection of the mixture of AL(OH)3 and hepatitis B virus S antigen; while intramuscular injection the plasmid DNA elicited no serum antibody respones. Conclusion: biodegradable microspheres may be used as an good adjuvant for DNA immunization.

Objective To observe the effect of ultrashortwave therapy on the expression of BMP-2 in steroid-induced avascular necrosis of the femoral head(SANFH). Methods Thirty New-Zealand white rabbits were randomly divided into two groups:a normal group(4 rabbits)and an intervention group(26 rabbits).An animal model of steroid-induced avascular necrosis of the femoral head was induced through the intravenous injection of horse blood serum and the intraperitoneal injection of methylprednisolone in the intervention group.X-ray examination confirmed the successful induction of SANFH in 20 of the rabbits,who were then subdivided at random into an uhrashortwave therapy group(1 0 rabbits)and a model group(1 0 rabbits).The rabbits in the ultrashortwave group were treated with ultrashortwave therapy in two 1 5-day courses,with a 5-day interval between them. Non-thermal ultrashortwave therapy was given in the first course,then mild thermal uhrashortwave therapy was given in the second.Those in the model group were reared without ultrashortwave therapy.All the animals were sacrificed immediately after the end of the last treatment,and their femoral heads were sampled to observe the expression of BMP-2 using real time fluorescent quantitative PCR. Results The expression of BMP-2 mRNA in the intervention group was only one fifth of that observed in the normal group.It was 2.7 to 10 times that observed in the model group.Both differences were significant at the 1% confidence level. Conclusion Ultrashortwave therapy can promote the expression of BMP-2 and improve reactivation in avascular necrosis of the femoral head.

Objective To investigate parenteral nutrition and enteral nutrition therapy for esophageal cancer patients nutritional status improvement.Methods Totally 63 patients with esophageal cancer were chosen,preoperative Nutritional Risk Screening 2002 (NRS2002) nutritional screening through joint after parenteral nutrition and enteral nutrition therapy.Patients with intestinal tolerability and complications after surgery on days 1 and 7 days nutrition indicators were observed,including total serum protein,albumin,prealbumin,hemoglobin,and lymphocyte count.Results Preoperative risk malnutrition occurred in 39 patients.Compared to patients on day 1 after the first 7 days,serum levels had no significant difference in total protein.Albumin,prealbumin,hemoglobin,and lymphocyte counts were significantly different statistical significance (P ＜ 0.05).Conclusions NRS2002 for nutritional screening patients at risk of malnutrition can be determined,and the combined parenteral and enteral nutrition therapies can improve nutritional status of patients with esophageal cancer.

Objective To analyze the potential association between the single ucleotide polymorphisms(SNP) of the vascular endothelial growth factor(VEGF) gene with the risk of endometriosis by meta-analysis.Methods Published case-control studies about the influence of VEGF polymorphisms on endometriosis were searched and screened in Medline,the Cochrane library,China National Knowledge Internet(CNKI),Chinese Biological Medicine Disk ( CBM ),data base of Wanfang and Foreign Medical Journal Full-Text Serv ice(FMJS).RevMan 5.0 software was used for meta-analysis.Results Finally,there were 9 literatures including 1610 endometrisis patients and 1643 controls cases,which were eligible for the criteria to investigating the VEGF SNP about - 460C/T,+ 405C/G and + 936C/T.The results of metaanalysis showed that there was no evidence for association between endometriosis and the VEGF -460C/T SNP in the genotype or allele frequencies distribution ( P ＞ 0.05 ).Significant differences were found between the frequencies distribution of VEGF + 405CC genotype( P =0.009,OR =1.45,95％ CI:1.10 - 1.91 ) and + 405 C allele ( P =0.020,OR =1.19,95 ％ CI:1.03 - 1.38 ),also between the + 936CC genotype ( P =0.050,OR=0.81,95％CI:0.66-1.00) and +936T allele (P=0.040,OR=1.20,95％CI:1.01 -1.43).Conclusions The VEGF + 405C/G and + 936C/T SNP may be associated with the risk of endometriosis.Women carrying the + 405C or the + 936T allele could significantly increase the risk of developing endometriosis.

BACKGROUND:Ribbed anatomic femoral stem meets the biomechanical features of the femur, and has achieved satisfactory clinical efficacy with good initial stability, rapid bone growth and low stress shielding.
OBJECTIVE:To evaluate the design features and clinical results of the cementless anatomic Ribbed femoral stem (Ribbed stem) in total hip arthroplasty.
METHODWe retrospectively analyzed 52 patients (52 hips) with hip joint disease who were treated with Ribbed stem in total hip arthroplasty between March 2010 and March 2012. There were 20 males and 32 females. The mean age was 59 years (range 22-78 years). The mean fol ow-up was 3.1 years (range 2-4 years). The preoperative and postoperative Harris hip scores, the rate of postoperative thigh pain, the incidence of intraoperative femoral fracture, wound healing, dislocation and revision were recorded. Radiographic evaluation was used to evaluate the rate of stem fil , subsidence of femoral stem, periprosthetic radiolucent line, bone ingrowth, stress shielding, and osteolysis.
RESULTS AND CONCLUSION:The incidence of intraoperative femoral fracture was 6%. Al incisions were healed. There were no cases of hip dislocation and revision;the rate of thigh pain was 6%, no patient had thigh pain after 1 year postoperatively. The mean preoperative Harris hip score was 48 points, which improved to a mean of 96 points at the final fol ow-up. Postoperative X-ray showed that al patients had a satisfactory femoral fil in both planes and al of the femoral stems were wel-fixed at the final fol ow-up. The average fil ing rate was 91%, 88%and 86%by normotopia imaging, while 88%, 85%and 81%by lateral imaging, at the metaphysic, middle and distal ends respectively. At the final fol ow-up, 49 hips (92%) showed stable bone ingrowth, 3 hips showed stable fiber ingrowth. No osteolysis around the components at the femur or acetabulum was observed. 5 (10%) hips appeared the subsidence of femoral stems, which were<2 mm. The stress shielding phenomenon occurred in al patients, including first-degree in 31 hips, second-degree in 19 hips, third-degree in 2 hips, and fourth-degree in no case. Experimental findings indicate that, Ribbed stem with a rational design can achieve satisfactory clinical outcomes with good initial stability, rapid bone growth and low stress shielding.

The relatively independence and separation in the teaching of clinical medicine and basic medicine limits the ability training of students,and the combination of basic and clinic medicine in teaching has become the core issues and trends in medical teaching reform.So the conventional teaching patterns were reformed in pathophysiology by applying combination of basic and clinic medicine in teaching.In order to accelerate medical students to early exposure to clinical medicine Bengbu medical college changed the teachers' teaching ideas,promoted the local integration of the courses of basic and clinical medicine and the combination of basic and clinic medicine teachers in teaching,reformed mechanisms in teaching management and teaching operation.We also tested the preliminary reform effects by way of students' evaluation of the teaching and examination,and discussed the unfavorable factors affecting the educational reform and thought out some countermeasures.

Objective To elevate the achievement rate of kidney biopsy puncture through the analysis of puncture angle choice of ultrasound guided automatic kidney biopsy in 518 patients. Methods Under the guidance of color Doppler ultrasound,using the 3.5MHz probe with probe holder,we performed kidney biopsy in the degrees of 40°(group X),45°(group Y),60°(group Z) and 70°(group P) with the horizontal plane. Resnlts The total achievement ratio is 100 %. The one time success rate in group Y and group Z is 100 % (group Y, 164/164 ; group Z, 186/186) ;group X is 4.8% (22/46) ;group P is 84.4% (103/122).Conclusion The automatic kidney biopsy an- gle under the guidance of ultrasound should be between 45° and 60° with the horizontal plane which is safe and has higher achievement ratio. In the meantime, complications can be avoided.

Objective To evaluate the mid-and long-term clinic results of ceramic-on-ceramic joint in total hip arthroplasty (THA) in younger patients.Methods A retrospective review was made on 72 younger patients who had THA with ceramic-on-ceramic bearings due to femoral head necrosis or inborn hip dysplasia between March 2001 and March 2011.There were 32 females and 40 males,at a mean age of (35.2 ± 7.6)years (range,17-45 years).Patients were evaluated with Harris hip score and University of California,Los Angeles (UCLA) activity score.Radiological findings were recorded including component loosening,ostelysis,and ceramic bearing related complications.Results Duration of followup was (8.5 ±2.4) years (range,5-12 months).At the final follow-up,Harris hip score was increased to (93.8 ±4.3)points (range,85-100 points) compared to preoperative (46.1 ± 12.3) points (range,27-70 points) and UCLA activity score was increased to (7.1 ± 1.4)points (range,4-10 points) compared to preoperative (4.0 ± 1.2) points (range,2-6 points) (P ＜ 0.05).At the final follow-up,no osteolysis or prosthesis loosening occurred,but there were ceramic sandwich liner fractures in two patients (two hips),dislocation in one patient (one hip) and squeaking in one patient (one hip).After revision due to the ceramics break,the 8-year survival rate was 97％ (95％ CI91.9-100.0).Conclusion Ceramicon-ceramic joint in THA satisfies the activity demand in younger patients,with excellent mid-and longterm clinical results.