High-energy fractures are known to result in a long healing proce ss and a high incidence of nonunion. In the traditional treatment of high-energ y fractures, bone grafting or bone substitute grafting is applied only after the delayed union or nonunion has already been confirmed. Secondary interventions t o treat nonunion are associated with a high morbidity of complications and a lon g time recovery. Charnley (1961) first recommended prophylactic bone grafting in treatment of high-energy fractures to reduce total time of fracture healing. H owever, autogenous bone graft has certain drawbacks, such as limited harvest ava ilable and serious complications at the donor site. In order to overcome these p roblems, various bone graft substitutes, such as growth factors, bioceramics and composite grafts, have been developed as early grafting materials.

This study was aimed to analyze the dynamic accumulation of active ingredients of Echinacea purpurea. Contents of cichoric acid and total polyphenols in different parts through the whole growth process were determined by HPLC and colorimetry. The results showed that the content of total polyphenol changed little in annual plant. There were differences in content of cichoric acid of different parts in different periods. And the content reached the maximum at flowering stage. It was concluded that the harvest stage depended on the content of cichoric acid. The results provided theoretical basis for induced plant in Shandong province.

Objective To identify the relationship of the femoral morphology with the sex and age, analyze and compare the two methods of defining the morphology of marrow cavity.Methods AP and lateral radiography of the hip joint was made in 45 patiens who accepted total hip arthroplasty.The anatomic parameters of the proximal femur were measured on those radiography.The femoral morphology was analyzed using Dorr criteria and Noble class respectively.Results (1)The anatomic parameters of the proximal femur were not correlated with the age in male.(2)The inner diameter of canal 10 em distal to the lesser trochanter, isthmus width and canal to calar isthmus rate were positively correlated with age in female.(3)The medial cortical and lateral cortical thickness 10 cm distal to the lesser trochanter,cortical index and canal-flare index were negatively correlated with age in female.(4)According to Dorr criteria,13 femora were classified as type A,20 as type B,and 12 as type C.According to Noble class,4 femora were classified as champagne type,34 as normal type,and 7 as stove pipe type.Conclusions The femoral morphology don't change with age in male.The width of femoral canal increase with age in female.Type C of Dorr criteria contains all of stove pipe type and a portion of normal type.

Drug Therapy, Combination ; Echinocandins ; administration & dosage ; therapeutic use ; Humans ; Invasive Pulmonary Aspergillosis ; complications ; drug therapy ; Lipopeptides ; Liver Failure ; complications ; drug therapy ; microbiology ; Male ; Middle Aged ; Voriconazole ; administration & dosage ; therapeutic use

[Objective]To develop a new femoral prosthesis that can integrate with femur compactly and increase proximal femoral stress transfer,and further improves the long-term curative effect of total hip arthroplasty.[Method]Five pairs of human cadaver femora were divided equally into two groups one of which received a cobalt-chrome molybdemum alloy(CoCrMo) implant and the other a carbon fiber reinforced polyetheretherketone composite(CF/PEEK) implant.Six strain-gauge rosettes were attached to the external surface of each implant and proximal femora.The loading conditions simulated single-limb stance and the strains were recorded first with the femora intact and then with the femoral components of two different designs implant inserted.[Result]After the insertion of a femoral component,the normal pattern of a progressive proximal-to-distal increase in strains was similar to that in the intact femur and the strain was maximum near the tip of the prosthesis.On the medial and lateral aspects of the proximal femur,thc strains were reduced after implantation of both types of implant.The pattern and magnitude of the strains,however,were closer to those in the intact femur after insertion of the CF/PEEK stem than that of CoCrMo stem.[Conclusion]Our findings suggest that the CF/PEEK stem can provide immediate postoperative stability,better proximal loading transfer in the metaphysis and further reduce stress shielding,bone resorption and osteanabrosis,thus prevent the implant from failuri.

BACKGROUND: Greatly higher elastic modulus of traditional metal prosthesis than bone elastic modulus is mechanical factor for aseptic loosening of artificial joint, resulting in stress shielding, bone resorption and bone atrophy.OBJECTIVE: To measure femoral stress after prosthetic replacement made of carbon fiber reinforced poly-ether-ether-ketone (CF/PEEK), and compare with domestic AML prosthesis, so as to explore the application prospect of compound material in total hip femoral head prosthesis. DESIGN, TIME AND SETTING: Comparative analysis was performed at Orthopedics Laboratory, First Hospital of Soochow University and Institute of Biomechanical Engineering of Shanghai University from September 2002 to March 2004.MATERIALS: CF/PEEK prosthesis was designed by the authors, composed of long CF/PEEK compound material as inner layer, 100 Gpa and short CF/PEEK compound material as outer layer, 20 Gpa; the layer intensity at stress center was strengthened, and the appearance and size of the CF/PEEK prosthesis simulated domestic AML cobalt alloy prosthesis (Beijing Huajiehao Company). Five pairs (10 femurs) of femurs were from fresh adult cadavers. METHODS: Five pairs of human cadaveric femora were divided equally into left and right groups: one group received a cobalt-chrome molybdenum alloy (CoCrMo) implant and the other received CF/PEEK implant. Strain-gauge rosettes were attached to external surface of each implant and proximal femora. The loading condition simulated single-limb stance. MAIN OUTCOME MEASURES: strains distribution on the normal femur and femoral surface after replacement with two kinds of prostheses; shearing strain at femur-prosthesis interface of two groups.RESULTS: Following prosthesis implantation, the strains exhibited a progressive proximal-to-distal increase, which was similar to that in the intact femur, and the strain was maximum near the distal prosthesis. The strains on the medial and lateral surface of the femur were reduced after implantation of both types of implants. The pattern and magnitude of the strains, however, were closer to those in the intact femur after insertion of CF/PEEK prosthesis than in the CoCrMo one. CONCLUSION: Mechanical performance of CF/PEEK compound prosthesis is similar to bone tissue, and can provide similar strain under loading condition. Therefore, it can provide immediate postoperative stability and proximal loading transfer.

Objective To explore the initial stability of a carbon fiber reinforced polyetheretherketone composite (CF/PEEK) stem in human femurs after total hip replacement. Methods 8 pairs of human cadaveric femurs were used to test the CF/PEEK prosthesis versus a conventional cementless stem of cobalt-chrome molybdemum alloy(CoCrMo). The bone-femoral prosthesis interface motion was measured in vitro using displacement transducers. Combined axial and torsional loads and simulated single-leg stance loading were applied. Subsidence, rotation and interface motion were measured with load cycles up to 1 000 N. Results The extent of the micro-motion in the proximal femoral region was larger than that in the distal femoral region. The CF/PEEK composite prosthesis showed less dynamic micro-motion in the proximal region compared with the CoCrMo alloy prosthesis stem, with the average difference being 42%. The extent of the distal micro-motion in the 2 groups was small but the difference was significant (P

[Objective]To summarize results of treating complex proximal tibia fractures with less invasive stabilization system(LISS),and to explore the concept and technology of LISS.[Method]From January 2004 to March 2006,39 cases of complex proximal tibia fractures were treated with less invasive stabilization system,including 26 male and 13 female.The mean age of the patients was 34.8 years(range 22 to 54 years).According to the AO/OTA fracture classification,there were 19 cases in type 41-A3,12 cases in type 41-C2,4 cases in type 41-C3,4 cases in proximal type 42.Seven cases were open fractures and were classified as 3 grade Ⅰ,4 grade Ⅱ open fracture according to the system of Gustilo.Eleven patients were multitraumatic patients.[Result]All the cases were followed up for averaging 15.6 months(10～21 months).The mean operation time was 75 min(60～130 min).All fractures healed,the averaging healing time was 13 weeks(11～16weeks).The averaging blood lost was 300 ml(170～500 ml).The postoperative alignment of 33 fractures was satisfactory,5 cases had 6?～ 8 ?valgus auglation,one case had 5?varus auglation in coronal plane.The mean time of weight bearing was 14.2 weeks(11～18 weeks).The range of movement was 100?～120?.All the cases had no infection,breakage of screws and plates,failed fixation and so on.According to HSS scores system,there were 26 excellent cases,7 good cases,5 fair cases,1 poor case,the excellent and good rate was 84.6%.[Conclusion]Less invasive stabilization system,providing stable fixation and optimizing early bone union and functional rehabilitation,is a realistic therapy in treatment of complex proximal tibia fractures.Exact comprehension of LISS concept and procedure,adjustment according to cases,are very important to assure satisfactory results.

[Objective]To investigate the therapeutic results of grafting with bioactive glass and autologous bone marrow for simple bone cyst in teenagers. [Method]From April 2005 to October 2007,16 teenagers with simple bone cyst were reported.There were ten males and six females with a mean age of 18.5 years(range 12 to 30 years).Eight cysts were in the proximal humerus,five in the proximal femur,two in the proximal tibial and one in the distal end of radius.Lining of cavity was removed thoroughly with a curet.The cyst cavity was filled with the mixtures of 45s bioactive glass and autogenous red bone marrow.Five cases of pathologic fracture were fixed with steel plate or intramedullary nail.[Result]All 16 cases of cysts were ossified radiolo gically within six months,with an average time to syst healing of 18 week.A follow-up of 6 to 32 months(mean 18 months) showed satisfactory healing without complications.[Conclusion]The combined grafting with bioactive glass and autologous bone marrow appears to be an effective and simple treatment for simple bone cyst in teenagers.

[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.