Incidence of knee periprosthetic fractures after total knee arthropoasty is increased,and is a challenging clinical problem. Treatment options include conservative and operative methods. Only the doctor have sufficient and systematic understanding of periprosthetic fractures and consider both advantages and dis-advantages before deciding the appropriate treatment, the satisfying treatment outcome will be got. we re-viewde the type, treatment methods and outcomes of periprosthetie fractures of total knee arthroplasty repor-ted in recent years.

AIM: To investigate the effects and mechanisms of atorvastatin on myocardial fibrosis induced by aldosterone in SD rats. METHODS: Forty male uninephrectomized SD rats were limited to drink 1% NaCl water for 4 weeks and assigned to the follow groups: vehicle control rats (CON group);aldosterone treated rats (ALD group);spironolactone + aldosterone treated rats(SPI+ALD group);atorvastatin + aldosterone treated rats (ATO+ALD group). Blood pressure was measured by catheterization. Expression of platelet-derived growth factor (PDGF-A, PDGF-B), platelet-derived growth factor receptor (PDGFR-α, PDGFR-β) and ectodermal dysplasia-1 (ED-1) were analyzed by immunohistochemistry. Collagen volume fraction (CVF) and perivascular collagen area (PVCA) were analyzed by Sirius-Red staining. Myocardium osteopontin protein was detected by Western blotting analysis. RESULTS: Mean arterial blood pressure in ALD group, SPI+ALD group and ATO+ALD group was elevated, and significant difference was observed between the three groups and vehicle control group (P<0.01 or P<0.05). Myocardial fibrosis was observed in ALD group. Compared to other three groups, the index of CVF and PVCA was increased significantly (P<0.01 or P<0.05). No significant difference of the index of CVF and PVCA between ATO+ALD group and SPI+ALD group was observed (P>0.05). Compared to other groups, the levels of PDGF-A, PDGF-B, PDGFR-α, ED-1 and OPN in ALD group were significantly increased (P<0.01 or P<0.05). The levels of PDGF-A, PDGF-B, PDGFR-α and OPN were no significant difference between ATO+ALD group and SPI+ALD group (P<0.01 or P<0.05). However, the level of ED-1 in ATO+ALD group was significantly decreased compared to SPI+ALD group (P<0.05). No significant difference of PDGFR-β level among four groups was found (P>0.05). CONCLUSION: These results suggest that atorvastatin may attenuate myocardial fibrosis induced by aldosterone. The mechanisms concern with reduction of macrophage infiltration, expression of inflammatory cytokines OPN, partially inhibition of platelet-derived growth factor and its receptor expression.

Objective To investigate effect of alendronate on OPG and RANKL in periprosthetic osdeolysis induced by polyethylene particles.Methods Twelve rabbits which had been implanted a titanium plug in femur by intercondylar notch were divided into two groups randomly,polyethylene particles were injected into the left knee joint,one received alendronate,and the other placebo as control.After 12 weeks,all rabbits were sacrificed.Periprosthetic tissues were observed by ELISA.Results The concentration of OPG in the experimental group was not higher than that of the control (P ＞0.05 ).But the concentration of RANKL in the experimental group was lower(P ＜0.01 ).And specific value of OPG/RANKL was higher in the experimental group ( P ＜ 0.05 ).Conclusion The therapy of alendronate can change the concentration of RANKL and specific value of OPG/RANKL in periprosthetic osdeolysis induced by polyethylene particles,inhibit aseptic loosening of prosthesis in rabbits.

Objective To investigate the efficacy and safety of laparoscopic splenectomy (LS) in the treatment of immune throm-bocytopenia(ITP) .Methods 230 cases of ITP were collected in this hospital from December 2011 to December 2012 and randomly divided into two groups with 115 cases in each group .Among them ,the control group was treated by the conventional treatment of open splenectomy(OS) ,while the observation group was treated by LS .The differences of the operative time ,hospitalization dura-tion ,intraoperative blood loss and platelet count ,clinical effects and the occurrence situation of adverse reactions were compared be-tween the two kinds of operation method .Results The operative time and the length of hospital stay in the observation group were significantly shortened compared with the control group (t=14 .706 ,t=13 .625 ,P<0 .05);intraoperative blood loss was significant-ly decreased(t=18 .238 ,P<0 .05) and the platelet count was significantly increased (t=17 .248 ,P<0 .05);the total effective rate of the observation group was 96 .52% ,which was significantly higher than 86 .09% of the control group ,(χ2 =9 .35 ,P<0 .05);the adverse reaction rate and the recurrence rate in the observation group were 6 .09% and 6 .96% respectively ,which were significantly lower than 10 .43% and 19 .13% in the control group(χ2 =8 .35 ,χ2 =8 .75 ,P<0 .05) .Conclusion LS for treating immune throm-bocytopenia has definite efficacy with high effective rate ,low adverse reactions and low recurrence rate .

Objective To assess these in a consecutive series of patients with ICC treated surgically. Methods A retrospective study was conducted on 189 ICC patients undergoing surgery.Surgical results and survival were evaluated and compared among different subgroups of patients.Univariate and multivariate analyses were performed to identify prognostic factors.Results R0,R1,R2 resection and exploratory laparotomy were obtained in 63,84,31 and 11 patients,respectively.The overall 5 -year survival rates for the entire cohort were 16.8%,with corresponding rates of 26.3% for patients with R0 resection;14.3% for patients with R1 resection;6.8% for patients with R2 resection;and 0.0% for patients with an exploratory laparotomy.Independent factors for poor survival included positive resection margin,multiple tumors,beta - catenin nuclear expression and lymph node metastasis. Conclusion R0 resection offers the best possibility of long -term survival,but the chance of a R0 resection is low when surgery is performed for potential resectable ICC.Patients with characteristics of beta -catenin nuclear expres-sion,multiple tumors and lymph node metastasis are indicated to surgery which is needed to be further studied.

OBJECTIVE: To investigate the effects of combined inhibition of signal transducer and activator of transcription 3 (STAT3) and hypoxia-inducible factor-1α (HIF-1α) in the enhancement of chemosensitivity of the model of human laryngeal squamous cacinoma in nude mice. METHOD: Model nude mice were divided into six groups randomly: control group(A) , cisplatin group(B) , cisplatin and AG490 group(C) , cisplatin and HIF-1α⁻/⁻ group (D), cisplatin combined AG490 and HIF-1α⁻/⁻ group (E), HIF-1α⁻/⁻ group (F) (only in calculating tumor inhibition rate). 3mg/kg cisplatin was administered by peritoneal injection for 3 days. Then cisplatin and 10 mg/kg AG490 were administered every other day for 12 days. The expression of Ki67 and HIF-1α was detected by immunocytochemical method. Western blot was used to detect the expression of p-STAT3. RESULT: The expression of HIF-1α in group C and group D were lower than that in group B, and there were significant difference respectively (t₁ = 2.782, t₂ = 3.873, P < 0.05); The expression of HIF-1α in group E was lower than that in group C and group D respectively, and there were significant difference respectively (t₁ = 6.140, t₂ = 3.667, P < 0.01). The expression level of p-STAT3 in group C was markedly lower compared with that in group B, and there were significant difference between them (t = 17.840, P < 0.01); There were no difference between the expression level of p-STAT3 in group D and that in group B (t = 0.038, P > 0.05); The expression level of p-STAT3 in group E was significantly lower compared with that in group C and group D respectively (P < 0.01). Tumor inhibition rate of group E was higher than that in group B, group C , as well as group D respectively and there were significant difference respectively (t₁ = 5.509, P < 0.01; t₂ = 3.422, P < 0.05; t₃ = 2.718, P < 0.05 ). Ki67 index of group E was lower than that in group B, group C as well as group D respectively and there were significant difference respectively(t₁ = 8.307, P < 0.01; t₂ = 3.736, P < 0.05; t₃ = 4.524, P < 0.01). CONCLUSION Combined inhibition of STAT3 and HIF-1α could enhance chemo-sensitivity in the model of human laryngeal squamous cacinoma in nude mice.
Animals ; Antineoplastic Agents ; pharmacology ; Carcinoma, Squamous Cell ; drug therapy ; metabolism ; Cisplatin ; pharmacology ; Drug Resistance, Neoplasm ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Ki-67 Antigen ; metabolism ; Laryngeal Neoplasms ; drug therapy ; metabolism ; Mice ; Mice, Nude ; Neoplasms, Experimental ; drug therapy ; metabolism ; STAT3 Transcription Factor ; genetics ; metabolism ; Tyrphostins ; pharmacology

Objective To describe the self-management behaviors and self-efficacy in patients with chronic low back pain (CLBP) and to explore the relationship between them. Methods The Chronic Disease Self-Management Study Measures and the Chronic Disease Self-Efficacy Scale were used to investigate a total of 113 patients with chronic low back pain. Results The average score of self-management behavior of CLBP patients was 21.42 ± 8.11. The average time for exercise was (168.72 ± 148.97) min/week;the average level of cognitive symptoms management practice and communication with physicians were 1.70 ± 0.74 and 2.10 ± 1.05 respectively. The self-efficacy was achieved the average level of 7.10 ± 1.88. There was a positive and significant correlation between the self-management behaviors and self-efficacy (P<0.05 or 0.01). Conclusions The self-management behaviors among patients with chronic low back pain was poor and was related with self-efficacy. Individualized health education was needed for improving self-efficacy, which would be benefit for self-management behaviors.

Objective To develop a non-invasive means that monitoring surface electromyography (sEMG) of abdominal muscles for bladder function. Methods SEMG of abdominal muscles from 10 healthy subjects were collected, and the parameters were analyzed in time domain and frequency domain quantificationally based on MATLAB. Results and Conclusion The sEMG of abdominal muscles are related with the process of storing and expelling urine.

Objective To evaluate the value of the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and P-POSSUM in predicting the risks of orthopedic surgeries for senile patients with femoral neck fracture.Methods A total of 108 patients with femoral neck fractures who underwent hip joint replacement were retrospectively studied using POSSUM and P-POSSUM scoring system to predict their mortality and complication rate.The difference between predictive value and observed value was analyzed by chi-square test.Meanwhile,the patients were divided into two groups based on their POSSUM scores.The differences between two groups were analyzed.Results According to POSSUM scores,47 patients were predicted to have complications(the mean rate was 43.52％),but only 37 did actually (the rate was 34.26％).There was no significant difference between predicted values and observed values (P =0.238).The predicted death toll was 11 cases (the mean rate was 10.19％),but actually only 2 patients died (the rate was 1.85％).Predicted value was higher than observed value.In terms of complications,death toll agreed well with the predicted values calculated by P-POSSUM (predicted death of 4 cases' the mean mortality being 3.70％ ; actual death of 2 cases' the mortality was 1.85％) without significant difference (P =0.625).We divided the patients into two groups with the POSSUM scores 40,and there was no significant difference between predicted values and observed values (P =0.527,P =0.285).Conclusions POSSUM has better predictive ability of morbidity,but overestimates mortality.P-POSSUM more accurately predicts mortality than POSSUM.The predicted results of POSSUM and P-POSSUM scoring systems are satisfactory in the high risk group.

Objective To investigate the prothetic effect of free grafting of microvascular anastomotic peroneal artery perforator flap when used to repair the donor tissue defects of wrap-around flap of toe.Methods From January 2008 to March 2013,twenty-six cases thumb avulsion at proximal and distal phalanx level with skin and nail bed defect caused by trauma were admitted to our hospital.After incising wrap-around flap of toe to repair the thumb defects,microvascular anastomotic peroneal artery perforator flap was transplanted freely to repair the donor site of it.Results The skin flaps of 26 cases all successfully survived.After a followed-up of 3 months to 4 years,the length of donor toes were the same as before.The appearance of skin flaps were no fat and clumsy and the abradability of their skin were well.Algesia,thalposis and thigmesthesia were partially recovery.Two point discrimination reached to 5-10 mm.There were no obvious uncomfortableness in donor feet when standing and walking except wearing flip-flops.Conclusion Free grafting of peroneal artery perforator flap is a good method to repair the donor defect caused by incising wrap-around flap of toe.