Objective To evaluate the clinical effects in treating periprosthetic femoral fractures classified Vancouver B2 with a cementless modular revision femoral prosthesis.Methods Twenty-six patients (7 males and 19 females with mean age of 66.5 years,range 60-69 years) who suffered from periprosthetic femoral fractures classified Vancouver B2 were treated with a cementless modular revision femoral prosthesis in hip revision and open reduction and internal fixation with cables or plates from March 2007 to February 2014.The previous femoral prostheses included 21 cementless and 5 cemented hip stems.The period from former procedures to fractures was 16 months,range from 7 to 32 months.Harris hip scores and numerical rating scales were analyzed statistically.Time of leaving bed,discharging,fracture union postoperative complications and radiographic imaging were also recorded.Results The operation duration were 143 (range 105-165) minutes.Blood loss volume was 450 (range 270-780) ml.Blood transfusion volume were 330 (range 0-800) ml.All patients were followed up at least two years,averagely 3.5 years after surgeries.All fractures healed at 6.5 (range 3-12) months averagely after surgeries.Harris hip scores improved significantly from 11.8±2.5 before surgeries to 80.3±5.3 one month and to 91.4±7.3 six months after surgeries separately (F=0.715,P=0.001).Numerical rating scales were 9.6±0.3,9.4±0.4 and 9.1±0.7 points averagely in aspect of information acquisition,postoperative pain control and function recovery respectively one month after surgeries.Average time of leaving bed and discharging from surgeries was 68.3 (range 51-75) hours and 6.5 (range 5-9) days respectively.No postoperative complications was found except dislocation in 1 hip,lower limb discrepancy in 1 hip,DVT in 1 hip,and heterotopic ossification in 3 hips.Conclusion Due to achieving prosthetic stability and fracture union,periprosthetic femoral fractures classified Vancouver B2 treated with a cementless modular revision femoral prosthesis combined with open reduction and internal fixation with cables or plates can reach good clinical outcomes.

Objective To investigate how vascular endothelial growth factor(VEGF) up-regulates intercellular adhesion molecule-1 via protein kinase C(PKC)/ nitric oxide(NO) pathway in the retina of diabetic rats.Methods All the rats were divided into 4 groups: normal,diabetes,diabetes+PKCI and control groups.Diabetes was induced by an intraperitoneal injection of STZ.PKC inhibitor GF109203X was injected intravitreally after 5 months of streptozotocin induced diabetes.NO was determined by nitrate reductase method.VEGF and intercellular adhesion molecule-1(ICAM-1) were measured by Western blot.Results VEGF and NO expressions increased obviously in the retina of diabetic rats compared with those in the normal group(P

Objective To explore the appropriate treatment according to the grading system of adolescent idiopathic cervical kyphosis.Methods A retrospective study was performed in 115 adolescent patients with idiopathic cervical kyphosis.The patients were divided into 4 groups according to the magnitude of kyphosis.The initial Cobb angle of 4 groups were 12.7°±1.4° 25.4°±4.8°,47.2°±4.4° and 62.6°±5.7° respectively.The patients in group I were treated with the collar support for 4-8 weeks.The patients in group Ⅱ were treated with skull traction (3-5 kg) and then fixed by cranio-cervical-thoracic plaster.According to the angles between the tangents of posterior vertebral body at each level on lateral cervical radiograph in extension,the anterior fusion levels of the group Ⅲ and angles and range of osteotomy in the group Ⅳ were decided.In group Ⅳ,the patients were treated by two steps.The anterior release and posterior osteotomy were performed firstly.Then skull traction (1/10 body weight) was maintained in order to correct the deformity for 7-10 days,fusion and anterior fusion with autologous bone graft and internal fixation was completed.Results Post-operative radiograph showed that Cobb angle were -5.5°±2.0°,-8.2°±6.1°,-4.5°±6.6° and -2.9°±7.9° in Ⅰ-Ⅳ group after treatment.The deformed appearance of the patients improved significantly.A improvement neck pain and neurologic function were found in all patients.Post-operative MRI showed that physiological curve of the cervical spine was restored,and the cerebrospinal fluid line was clear in the previous kyphosis area.Conclusion Adolescent idiopathic cervical kyphosis has specific characteristics.Surgical strategy is determined by the severity of deformity.

Objective To investigate the role of CCL2 in pain facilitation and spinal mechanisms in the rat model of bone cancer pain.Methods The bone cancer pain model was developed by inoculating.Walker 256 mammary gland carcinoma cells into the rat tibia medullary cavity.SD female rats were divided into 5 groups randomly ( n =8):sham group( group Ⅰ),sham + CCL2 antibody group( group Ⅱ),BCP group( group Ⅲ),BCP +control lgG group ( group Ⅳ),BCP + CCL2 antibody group ( group Ⅴ ).VonFrey threshold was measured one day before operation and 1 st,3 rd,5th,7th,10th,14th,21 st after operation.CCL2 antibody or control lgG was injected intrathecally from 10th to 12th day.The expression of the spinal Iba-1 ( microglial marker) in rat lumbar4-5 was detected by immunohistochemistry assay.Results From the 10th to 21st day after operation,the PMWT of group Ⅲ rats were ( 1.78 ±0.38)g,( 1.70 ±0.17)g,( 1.35 ±0.07 )g;group Ⅳ rats were (2.99 ±0.67)g,(2.52 ±0.75)g,(1.13±0.07)g ; and group Ⅴ rats were (5.88±0.66)g,(7.81 ±0.75)g,(6.19±0.53)g.Compared with group Ⅲ,the PMWT of group Ⅴ was remarkly higher (P＜0.01) ; group Ⅳ had no obvious statistical significance (P＞0.05).At the 14th day after operation,the MOD of group Ⅲ,Ⅳ and Ⅴ rats were (151.3 ±10.8 ),( 149.2 ± 10.6),(74.5 ± 5.0),Compared with group Ⅲ,the MOD of group Ⅴ was significantly increased (P＜0.01 ),group Ⅳ had no obvious statistical significance (P ＞ 0.05 ).Conclusion Intrathecal injection of CCL2 antibody can remarkly attenuate established pain facilitation of tibial bone cancer pain rats,and significantly suppress the expression of Iba-1.It suggests that CCL2 is involved in the bone cancer pain via activation of spinal microglia.

Objective To investigate incidence and related factors of dysphagia after fusion with an anterior cervical plate plus cage or a stand-alone cage (Zero-p cage) following anterior cervical discectomy procedure for treating multilevel cervical spondylotic myelopathy (MCSM).Methods From September 2008to September 2011,226 patients with MCSM underwent anterior cervical discectomy and fusion using an anterior cervical plate plus cage (118 patients,P&C group) or a stand-alone cage (108 patients,Zero-p group).Neurological function was evaluated by Japan orthopedic association (JOA) scores before and after operation.Cervical X-rays were taken to assess the graft fusion,internal fixation related complications and the thickness of the prevertebral soft tissue.The Bazaz dysphagia score and Swallowing Quality of Life questionnaire were used to assess the incidence and degree of dysphagia.Results The average follow-up time was 2.4years (range,1.0 to 3.5 years).The incidence of dysphagia was 41.53％ in P&C group,while 33.33％ in Zero-p group at 2 days after operation.The thickness of the prevertebral soft tissue in P&C group was significantly thicker than that in Zero-p group at 2 days and 2 months after surgery.In Zero-p group,the incidence of dysphagia was 43.1％ in patients who underwent operation from C3 to C6,while 22％ in patients who underwent operation from C4 to C7.Conclusion Dysphagia is common after multilevel anterior cervical discectomy and fusion.The choice of implants and the extent of operation are important influencing factors of postoperative dysphagia.The use of stand-alone cage can decrease the incidence of dysphagia.The operation at higher levels has a higher incidence of dysphagia.

BACKGROUND:Pathophysiological mechanisms after spinal cord injury are very complex, so there is no compressive and in-depth understanding on it.
OBJECTIVE:To study the effect of dura mater spinalis integrity on cytokine levels in the cerebrospinal fluid of animal models of spinal cord injury.
METHODS:The white rabbit models of spinal cord injury were established using clamp compression method, and then the models were randomly divided into four groups:no dura mater spinalis defect group, dura mater spinalis defect group, dura mater spinalis defect composite with membrane repairing group and dura mater spinalis defect composite with autologous fascia repair group. Enzyme-linked immunosorbent assay was
performed to detect the changes of levels of cytokines (interleukin-6, interleukin-10 and tumor necrosis factorα) in the cerebrospinal fluid at 30 minutes, 1, 3, 6, 12 and 36 hours after surgery.
RESULTS AND CONCLUSION:The levels of interleukin-6, interleukin-10 and tumor necrosis factorαin the
cerebrospinal fluid of the dura mater spinalis defect group, dura mater spinalis defect composite with membrane repairing group and dura mater spinalis defect composite with autologous fascia repair group were significantly lower than those of the no dura mater spinalis defect group at 6 hours after surgery (P<0.05). There were no significant differences in the levels of interleukin-6, interleukin-10 and tumor necrosis factorαat other time points between groups (P>0.05). The results indicate that maintaining the integrity of dura mater spinalis of the spinal cord injury model can affect the levels of interleukin-6, interleukin-10 and tumor necrosis factorαin the
cerebrospinal fluid, thus inhibiting the inflammatory response.

Objective To investigate the anti-apoptotic effect of gene A20 in treatment of trau-matic brain injury (TBI). Methods Thirty-five Sprague-Dawley rats were made severe TBI models and assigned randomly to experimental group and control group (35 rats in each group). After severe TBI, the rats in experimental group were injected with liposome-pcDNA3.1-A20 and those in control group injected with liposome pcDNA3.1-A20 at 30 minutes after severe TBI. The animals in both groups were sacrificed to remove the brain of five rats from each group at 12, 24, 48, 72 and 168 hours for sec-tioning. The expression of A20 and neurocyte apoptosis were defined by immunohistological method and TUNEL accordingly. The other ten rats were testified for neurological function at 1,2, 3 and 4 weeks af-ter TBI. Results The expression of A20 in experimental group was higher than that in control group, with statistical differences (P < 0. 01). The peak neurocyte apoptosis was found at 72 hours after TBI. The number of apoptosis cells in experimental group was lower than that in control group at 12, 24, 48 and 72 hours afte TBI (P < 0.01 or 0.05). At the 4th week after TBI, the neurological function in exper-imental group was better than that in control group (P < 0.05). Conclusion Gene therapy with A20 may have anti-apoptosis effect and exert neuroprotective effect on severe TBI.

Objective:To explore the propaganda methods and propagation path of advertising media cosmetology publicity in accordance with public demand and ethical principles,through understanding college students' acceptance level for advertising media cosmetology publicity and its influence on their choice forcosmetic ways.Methods:With the method of stratified cluster sampling,an anonymous questionnaire survey was conducted among 210 college students in a university in Shaanxi province.Results:The Internet has become the main way for college students to acquire cosmetology knowledge.A total of 44.7 ％ of the students thought most of the media cosmetology publicity was unbelievable,46.5％ of the students thought that advertising media publicity mainly considered the interests of the beauty institution,72.9％ of the students would not consider the beauty institution the media recommended,62.4％ of the students would choose regular public hospitals,56.3％ of the students would give up the idea of cosmetology due to the news of cosmetic failure,42.2％ of the students could accept minimally invasive plastic surgery,and 68.5 ％ of the students expected to acquire the cosmetology knowledge through expert consultation.Concltusion:At current,the credibility of media cosmetology publicity is not optimistic enough.It should further strengthen the supervision for media cosmetology publicity.Cosmetology advertising media should construct the publicity mode based on ethics,law,governance,occupation,public welfare and social responsibility.

Objective: To explore the influencing factors of slow blood flow phenomenon after emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: Clinical and PCI angiographic data of 488 patients, who were diagnosed as AMI and received primary PCI in our hospital from Jan 2010 to Jun 2011, were retrospectively analyzed. Patients were divided into slow blood flow group (n=51, TIMI flow ≤ grade 2) and normal flow group (n=437, TIMI flow= grade 3). Their clinical characteristics between two groups were compared. Results: Compared with normal flow group, there were significant reductions in percentages of thrombus aspiration (75.3% vs. 60.8%) and application of platelet glycoprotein IIb/IIIa receptor antagonist (81.7% vs. 68.6%) during PCI, and significant rise in total length of implanted stents [(31.8±12.2) mm vs. (35.7±12.0) mm] in slow blood flow group, P<0.05 all. Multi-factor Logistic regression analysis indicated that percentages of thrombus aspiration during PCI and total length of stents were independent influencing factors for slow blood flow (P<0.05 both). Conclusion: Percentages of thrombus aspiration and total length of stents during PCI are independent influencing factors for slow blood flow.

Objective To analyse the causes of perinatal death and explore the preventive measures to reduce the perinatal mortality.Methods The cases with perinatal death in this hospital from January 2005 to December 2006 were reviewed to analyse the causes of death by categorization and sum-up.Results There were 166 cases with perinatal death and the mortality rate was 27.08‰,including 126 cases with fatal death,which accounted for 75.90%.In the analysis of dead causes,the first one was birth defects,which suffered 69 cases,41.57% of all,and mostly were with fetus edema syndrome.The cord factors had been elevated to the second cause,which suffered 51 cases,30.72% of all.Conclusion Improving the consciousness of gestational monitoring and self-care,strengthening the prenatal diagnosis and genetic counseling,controlling the perinatal birth defects,monitoring mother and fetus by poly-parameter and stopping the pregnancy in time can reduce perinatal death effectively.