Objective To find out the optimal operative methods for the patients with osteonecrosis of the femoral head according to age and the staging. Methods The current study assessed 202 patients(242 hips)from 1998 to 2008 with an average follow-up of 6.3years (range,1 -10 years), who were operated according to age and staging by Ficat or Catterall. The mean age of the patients was 35.3 years(range,4 -81 years). All patients were evaluated with both clinical and radiographical criterion. Results The postoperative excellent and good rate were 87.2% ,88.8% and 85.7% in each group respectively. The mean Hariss score increased (P <0.05) and the mean VAS score decreased (P < 0.05) in youth group and old group. Conclusions Children who were younger than six years of age and with Catter-all Ⅱ-Ⅲ involvement should be treated by ascularized iliac or greater trochanter bone periosteal flaps. Patients who were less than forty years of age, with Ficat Ⅱ-Ⅲ should be treated by ascularized iliac or greater trochanter bone flaps. For patients with age older than 50 years or younger than 50 years but with severe forms, hybrid or cememtless total hip arthroplasty may be the optimal operation.

Objective Compare the HPV infection characters between women in different geographic area of Ankang (south of Shaanxi) and Yanan (north of Shaanxi),to provide evidence based reference for cervical cancer control.Methods PCR amplification in vitro combined reverse dot-blot hybridization assay were used to analyze HPV genotypes of 7 912 cases from Ankang City Center Hospital,and 3 543 cases from Yanan Affiliated Hospital of Yanan Medical University from June 2012 to July 2016,and compared HPV infection rate,age and hypotype distribution of the cases.Results The HPV infection rate of Ankang area was 21.75％ (1 721/7 912),and Yanan area was 41.41％ (1 402/1 721).The percentage of HPV positive women with high-risk hypotype was 81.46％ (1 402 1 721) in Ankang and 86.16％ (1 264/1 467) in Yanan,with low-risk hypotype was 11.04％ (190/1 721) in Ankang and 7.23％ (106/1 467) in Yanan,with high and low risk hypotype was 7.50％ (129 147) in Ankang and 6.61％ (97/1 467) in Yanan.The women more than 60 year old were higher HPV prevalence age group.The HPV infection rate of this age group was 30.41％ (104/342) in Ankang,and 50.00 ％ (60/120) in Yanan.Yanan's HPV infection rate was obviously higher than Ankang.The popular HPV hypotypes in Yanan were same with that in Ankang.The most popular high-risk hypotypes were HPV16,58 and 52,the most popular low-risk hypotypes were 6,11 and 81.Conclusion The HPV infection rate were rather high in all age group.The most popular HPV hypotypes were same between Ankang and Yanan area.But Yanan's HPV infection rate was obviously higher than Ankang (P＜ 0.01).The causes need further explore.

BACKGROUND:Pain after hip replacement is a difficulty for orthopedic surgeons,and revision surgery might result in severe wound for patients undergoing hip replacement.Extracorporeal shock wave(ESWT) is certificated effective for relieving pain.OBJECTIVE:To evaluate the effects of ESWT on the pain after hip replacement.DESIGN,TIME AND SETTING:Case self-control,double-blind evaluation.The experiment was performed at the Department of Orthopaedics,Zhongnan Hospital,Wuhan University between June 2004 and February 2008.PARTICIPANTS:Fifty-one cases(61 hips) undergoing total hip replacement with pain were selected,including prosthetic loosening(cemented:16 cases,20 hips;non-cement:12 cases,16 hips),ectopic ossification(8 cases,10 hips),acute infection(4 cases,4 hips),chronic infection(5 cases,5 hips),soft tissue aseprtic inflammation(4 cases,4 hips) and acetabulum dislocation(2 cases,2 hips).METHODS:These patients received sessions of ESWT(4 000 shocks,3 times/s),with an energy ranging from 0.54 to 1.06 MJ/mm2,once a week for 8-12 weeks.MAIN OUTCOME MEASURES:Visual analog scale(VAS),Harris hip scores,diversity of the sclerotin surrounding the prosthesis(X-ray).RESULTS:The 51 patients were followed up for 18-64 months(4.1years in average),and 2 died during this period.The scores of VAS in non-cement,chronic infection,ectopic ossification and soft tissue aseprtic inflammation groups were significantly decreased than before treatment(P

OBJECTIVE: To investigate the possible role of Caspase 3 and Bcl - 2 in arsenic trioxide(As2 O3) - induced apoptosis of Namalwa cell line .METHODS: Cell apoptosis was assessed through agarose gel elecrophroresis and the double staining of Annexin V and propidium iodide(PI), of which fluorescent intensities were measured on flow cytometer.Namalwa cells were treated with As2 O3 and DEVD - CHO, a selective inhibitor of Caspase 3,and the changes of expression of Caspase 3 and Bcl - 2 were observed .RESULTS: As2 O3 up - regulated Caspase 3 protein and down - regulated Bcl - 2 protein. DEVD-CHO inhibited the apoptosis induced by As2O3. but it had no effect on down - regulation of Bcl - 2 protein induced by As2O3.CONCLUSION:The activation of Caspase 3 may play a role in mediating apoptosis induced by As2O3 in Namalwa cells.

BACKGROUND:Femoral head avascular necrosis is common in children and elderly. Though, there are many methods can be used for the treatment, it has been inconclusive in the treatment according to the age and stage of the patients. OBJECTIVE:To treat the femoral head avascular necrosis with different methods according to the age and stage, and to retrospectively analyze the fol ow-up results. METHODS:Total y 202 patients (242 hips) with femoral head avascular necrosis were included from October 1998 to October 2008. The patients were divided into groups according to age, included child group (4-14 years old, n=45, 47 hips);youth group (15-45 years old, n=100, 125 hips);and elderly group (46-81 years old, n=57, 70 hips). The patients in the child group were treated with vascularized greater trochanter or iliac periosteal flap displacement, the patients in the youth group were treated with vascularized greater trochanter or iliac periosteal flap displacement, and the patients in the elderly group were treated with hybrid or cementless total hip arthroplasty. RESULTS AND CONCLUSION:Al the 202 patients were fol owed-up for 6 months to 10 years, average 6.3 years. The excellent and good rate of the child group, youth group and elderly group were 87%, 89%and 86%respectively, and al the patients obtained the satisfactory clinical effect;the Harris score of the youth group was increased to (88.1±0.9) points, and the visual analog scale score was decreased to (0.9±0.4) points;the Harris score of the elderly group was increased to (91.5±1.0) points, and the visual analog scale score was decreased to (0.60±0.07) points. The results indicate that vascularized greater trochanter or iliac periosteal flap displacement is suitable for the children and the youths with femoral head avascular necrosis, especial y the patients with the age of 15-45 years in Ficat Ⅱ and Ⅲstage;hybrid or cementless total hip arthroplasty is suitable for the elder patients with femoral head avascular necrosis, as wel as the patients with failure femoral head retention treatment.

This study aimed to evaluate the cost-effectiveness of Chaiyin Granules compared with Oseltamivir Phosphate Capsules in the treatment of influenza(exogenous wind-heat syndrome). Based on a randomized, double-blind, positive drug parallel control clinical trial, this study evaluated the pharmacoeconomics of Chaiyin Granules with cost-effectiveness analysis method. A total of 116 patients with influenza from eight hospitals(grade Ⅱ level A above) in 6 cities were selected in this study, including 78 cases in the experimental group with Chaiyin Granules and Oseltamivir Phosphate Capsules placebo, and 38 cases in the control group with Oseltamivir Phosphate Capsules and Chaiyin Granules placebo. The total cost of this study included direct medical cost, direct non-medical cost, and indirect cost. The remission time of clinical symptoms, cure time/cure rate, antipyretic onset time/complete antipyretic time, viral nucleic acid negative rate, and traditional Chinese medicine(TCM) syndrome curative effect were selected as the effect indicators for cost-effectiveness analysis. Four-quadrant diagram was used to estimate the incremental cost-effectiveness ratio. The results showed that Chaiyin Granules were not inferior to Oseltamivir Phosphate Capsules in the remission time of clinical symptoms of influenza(3.1 d vs 2.9 d, P=0.360, non-inferiority margin was 0.5 d). Compared with Oseltamivir Phosphate Capsules, Chaiyin Granules would delay the remission time of clinic symptoms of influenza for 1 d, but could save 213.9 yuan. 1 d delay in cure time could save 149.3 yuan; 1% reduction in the cure rate could save 8.2 yuan; 1 d delay in antipyretic onset time could save 295.4 yuan; 1 d delay in complete antipyretic time could save 114.3 yuan; 1% reduction in the 5-day cure rate of TCM syndrome could save 19.2 yuan. Different from other indicators, there was no statistically significant difference between two groups in the effect of negative conversion rate of viral nucleic acid, but the cost was lower and the effect was superior, and the pharmacoeconomics was not different from that of Oseltamivir Phosphate Capsules in the field of influenza treatment.
Humans ; Antipyretics/therapeutic use* ; Antiviral Agents/therapeutic use* ; Cost-Effectiveness Analysis ; Influenza, Human/drug therapy* ; Nucleic Acids/therapeutic use* ; Oseltamivir/therapeutic use* ; Phosphates/therapeutic use* ; Treatment Outcome ; Double-Blind Method