[Objective]To investigate the outcomes of cementless metasul metal-on-metal total hip arthroplasty.[Method]Metasul metal-on-metal total hip arthroplasty of 30 hips in 25 patients was performed from August 2003 to December 2005.There were 11 males and 14 females with an average age of 47 years(28-72 years).Harris hip scores were determined before surgery and at the last follow-up examination.Standardized radiographs were obtained to evaluate component conditions.Blood samples were taken to determine serum chromium levels with use of atomic absorption spectrometry.[Result]Twenty-three patients(28 hips)were followed up with a mean period of 3.6 years(2.5-4.8 years).The mean Harris hip score improved from 49.5(17-78)points preoperatively to 93.4(55-99)points at the time of final follow-up.Twenty-two hips(85%)had an excellent result.Radiolucent lines were found in 3 hips.Focal femoral osteolysis was seen only in one patient.Sciatic nerve was injured in one case,which showed rehabilitation after 2.5 years.One hip had periprothetic infection because of diabetes 4 years after operation.There was no measurable wear by X-rays.No dislocation or fracture was found.The median serum chromium concentration was 0.082 ?g/mL(0.020～0.140 ?g/mL).No patient was diagnosed with renal insufficiency or hematologic malignancy during the study period.[Conclusion]The outcomes of Metasul metal-on-metal total hip arthroplasty are satisfactory.However,additional follow-up is necessary to determine any possible long-term deleterious effects.

[Objective]To discuss the cementless revision for postoperative infection after hip arthroplasty.[Methods]From November 1997 to December 2006,7 patients(7 hips) with infection after hip arthroplasty were treated,including 3 males and 4 females,with a mean age of 58 years(36～73 years).In the 7 hips,4 hips underwent a revision of total hip arthroplasty,2 hips only received new acetabular components and 1 hip underwent stem revision.One-stage revision was performed in 4 cases,two-stage revision was performed in 3 cases.Consecutive radiographs were compared to evaluate component conditions.Harris hip scores were determined before surgery and at the final follow-up examination.The erythrocyte sedimentation rate and C-reactive protein were detected.[Results]All patients were followed up with a mean period of 3.6 years(1.5～10.6 years).The mean Harris hip score improved from 35(18-63) points preoperatively to 89(60～99) points at the time of final follow-up.No re-infection was found.Femoral component exsertion was found in 1 patient but without any symptom.Pain of hip joint disappeared in 5 cases,and 2 patients had mild pain when walking long distance.At the time of final follow-up,5 patients still had slight limp.Heterotopic ossification developed in 1 hip.The mean polyethylene liner wear was 0.08 mm per year at final follow-up.Deep vein phlebothrombosis and nerve injury were not found.[Conclusion]It is possible to have satisfactory clinical outcome by one-stage or two-stage revision using cementless prothesis for postoperative infection after total hip arthroplasty.Whether the original prothesis can be saved when fixed tightly with femur or acetabular bone needs more experiences to confirm.

[Objective]To evaluate the clinical and radiographic results of revision hip arthroplasty with cementless prothesis.[Method]Revision hip arthroplasty of 41 hips in 36 patients was performed from November 1997 to August 2007 using cementless prothesis.In the 41 hips,29 hips underwent a revision total hip arthroplasty,8 hips underwent new acetabular components,and 4 hips underwent stem revision.Consecutive radiographs were compared to evaluate component conditions.The value of AAOS and Paprosky classification was used.Harris hip scores(HHSs)were determined before surgery and at the most recent follow-up examination.The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Result]Twenty-two patients(26 hips)were available for complete clinical and radiographic analysis.The mean follow-up period was 4.6 years(range,1-11 years).The mean preoperative Harris hip score of 38(range,11-76)points improved to 88(range,60-99)points at the time of final follow-up.The pain and function socre improved from 16.9 and 17.3 points to 40.4 and 39.9 points,respectively.All patients had moderate to severe limp before revision.At the time of final follow-up,8 patients still had slight limp and 4 patients had moderate limp.Twenty-one hips(75%)had an excellent result.A 1mm width radiolucent line was found in 1 femoral component without any symptom.Osteolysis and migration were seen in 4 hips(3 in acetabular and 1 in femoral component),which needed re-revision(12.5% failure).Heterotopic ossification developed in 8 hips(31%).The mean polyethylene liner wear was 0.27 mm(range,0.02-0.87 mm)in all and 0.08 mm(range,0-0.25 mm)per year.The wear rate was only correlated with changes of abduction angle of the acetabulum.The coincidence of bone defect classification in AAOS is better than Paprosky.Kaplan-Meier survivorship at 4.6 years was 89% with repeat revision for any reason as the end point and 81% with repeat revision or radiographic loosening as the end point.[Conclusion]Cementless prothesis appears to be a good alternative to other revision systems in revision total hip arthroplasty.Careful intraoperative evaluation of bone deficiency are needed to choose an appropriate prothesis in order to obtain a good outcome.

[Objective]To evaluate the midterm clinical and radiographic results of revision hip arthroplasty by acetabular reinforcement ring (ARR) with impaction bone grafting. [Methods]Revision hip arthroplasty by ARR with impaction bone grafting of 8 hips was performed from May 2001 to December 2006. There were 5 males and 3 females with an average age of 53 years (range, 36~70 years).The mean BMI was 20 (range, 15~28). The mean interval between the primary arthroplasty and revision was 5 to 20 years (mean 6.7 years). The causes for revision were infective loosing in 2 and aseptic loosening in 6. In the 8 hips, 6 hips underwent a revision total hip arthroplasty, 2 hips received replacement of the acetabular component. Consecutive radiographs were compared to evaluate component conditions and the influence of bone deficiency to fix the prothesis was analyzed. Harris hip scores (HHSs) were determined before surgery and at the most recent follow-up examination. The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Results]Seven hips were available for complete clinical and radiographic analysis. One patient died for myocardial infarction. The mean follow-up period was 4.5 years (range, 1.5~7.1 years).The mean preoperative Harris hip score of 30(range, 20~64) points improved to 88 (range, 74~94) points at the time of final follow-up, the pain and function socre improved from 13.8 and 11.5 to 40.3 and 39.9 respectively. All patients had severe limp before revision. At the time of final follow-up, 5 patients still had slight limp and 1 patients had moderate limp.Five hips had an excellent result. Infective osteolysis and migration were seen in 2 hips, which need re-revision. Heterotopic ossification developed in 2 hips . Kaplan-Meier survivorship at 4.5 years was 63% with repeat revision or radiographic loosening.[Conclusion]ARR with impaction bone grafting is an effective approach to treat massive acetabular bone defect in revision hip arthroplasty, the midterm result is acceptable, but any possible reason for infection must be monitored.

Objective To observe the inhibitory effect of tumstatin related peptide T3 mediated by short peptide to osteosarcoma vascular. Methods Through MTS assay, wound healing assay, the inhibitory effect of targeting-T3 peptide and T3 peptide on the human umbilical veil endothelial cell was studied in vitro. After the preparation of 50 nude mice model bearing osteosarcoma, the nude mice bearing too large or too small tumors were eliminated and the left ones were divided into 4 groups (6 animals for each group: T3 peptide, targeting-T3 peptide, CTX, PBS) randomly. Through weight of tumor, histopathologicol slice and immunohistochemical methods. The inhibitory action of targeting-T3 peptide and T3 peptide on the neoge-netic vascular of osteosarcoma implanted in nude mouse was studied. Results In vitro, both T3 peptide and targeting-T3 peptide effectively inhibited the proliferation of human umbilical veil endothelial cell. In the experiment of vivo, the average weight of tumor of targeting-T3 peptide group was (1.104?.247) g, the average weight of the T3 peptide group was (1.484?.369) g. There was the statistical difference in tumor inhibition on the osteosarcoma betweent the targeting-T3 group and T3 group (F=16.353, P=0.000). The positive rate of vascular endothelial growth factor and metastasis in the lung in the targeting-T3 peptide group all descended than the T3 peptide group. Conclusion Because of the short peptide to osteosarcoma vascular, targeting-T3 peptide could significantly restrain the development of osteosarcoma. Coupling short peptide to T3 peptide increase the selective binding of T3 peptide to osteosarcoma vascular.

OBJECTIVETo obtain the peptide that specifically binds to human osteosarcoma MG-63 cells from Ph. D. 7TM phage display peptide library.

METHODSHuman osteosarcoma MG-63 cells were used as the target cells with human embryonic kidney 293T cells as the control for screening the peptide from Ph. D. 7TM phage display peptide library. The enriched specially binding peptides were verified by cell enzyme-linked immunosorbent assay (ELISA). The location of the peptide in MG-63 cells was investigated using cell fluorescence staining, and targeting of the peptide was tested by organ immunohistochemistry with Osteosarcoma model.

RESULTSThe specifically binding peptides were enriched after 4 rounds of screening. The sequence SLTNLSK was confirmed as the most frequent peptide by DNA sequencing and showed strong specificity verified by cell ELISA, fluorescent staining and organ immunohistochemistry.

CONCLUSIONA peptide that specifically binds to MG-63 cells has been screened from Ph. D. 7TM phage display peptide library to serve as a potential candidate for osteosarcoma-targeting therapy.

Amino Acid Sequence ; Animals ; Bone Neoplasms ; drug therapy ; Cell Line, Tumor ; Drug Screening Assays, Antitumor ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Osteosarcoma ; drug therapy ; Peptide Library ; Peptides ; analysis ; Protein Binding

Objective: To explore the role of a customized 3D printing guide in total hip arthroplasty (THA). Methods: A retrospective analysis was performed of the 60 patients who had been treated by THA for avascular necrosis of the femoral head at Department of Orthopaedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine from January 2018 to May 2019. Half of them used the personalized 3D printing guide in THA and half did not. In the guide group there were 17 men and 13 women with an age of 53.4±8.9 years while in the conventional group 19 men and 11 women with an age of 54.7±9.4 years. The acetabular cups were orientated at an abduction angle of 40° and an anteversion angle of 15°. The intraoperative blood loss, operation time and acetabular abduction angle were compared between the 2 groups. Results: The 2 groups were comparable due to insignificant differences between them in gender, age, body mass, cause of disease or staging of avascular necrosis of the femoral head (P>0.05). The guide group had significantly less intraoperative blood loss (286.7±150.8 mL) and operation time (90.5±34.4 min) than the conventional group did (438.3±292.6 mL and 115.6±58.6 min) (P< 0.05). The acetabular cup abduction was 38.9°±4.2° in the guide group and 37.2°±5.5° in the conventional group, showing no significant difference(t=1.315, P=0.194). Conclusion Use of a personalized 3D printing guide in THA can shorten the time for installation of an acetabular prosthesis and reduce the amount of intraoperative blood loss, but it leads to insignificant difference in the postoperative acetabular cup abduction compared with no use of the guide.

Objective To evaluate the clinical outcomes of partial lateral patellar facetectomy ( PLPF ) combined with lateral retinaculum release ( LRR ) for treatment of patellofemoral osteoarthritis ( PFOA ). Methods From June 2017 to March 2018, 30 PFOA patients underwent PLPF combined with LRR at Department of Orthopedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine. They were 7 men and 23 women with an average age of 56.4 ± 9.7 years. Their patellar position, patellofemoral joint function, overall knee function, and quality of life were assessed by comparing preoperation and last follow-up in patellofemoral congruence angle ( PFCA ) , lateral patellofemoral angle ( LPFA ) , modified Kujala score, The Western Ontario and Mcmaster Universities Osteoarthritis Index ( WOMAC ) , and SF-12 quality of life scale. Results All the patients were followed up for an average of 7.6 ± 3.4 months ( from 4 to 13 months ). The PFCA was improved from preoperative 22.9°± 7.6°to 12.4°± 4.2°at the last follow-up, the LPFA from preoperative 3.2°± 3.7° to 12.9°± 6.0° at the last follow-up, the modified Kujala score from preoperative 17.1 ± 9.8 to 34.3 ± 5.7 at the last follow-up, the WOMAC from preoperative 14.1 ± 5.2 to 5.9 ± 1.7 at the last follow-up, the stiffness index from preoperative 5.5 ± 3.2 to 2.7 ± 1.2 at the last fol-low-up, daily functional index from preoperative 43.9 ± 9.0 to 25.2 ± 5.4 at the last follow-up, and the SF-12 scores from preoperative 31.3 ± 5.2 to 55.7 ± 6.0 at the last follow-up. All the above comparisons showed a significant difference ( P ＜0.05 ) . Conclusion PLPF combined with LRR is a minimally invasive, easy-to-master and effective knee joint preserving procedure for PFOA as it can significantly relieve joint pain and maximally keep patellar functions.

OBJECTIVESTo summarize the results of liver transplantation for various end-stage liver diseases at the Sun Yat-Sen University of Medical Sciences (SUMS), define the role of liver transplantation in the treatment of hepatocellular carcinoma and fulminant hepatitis B, and assess the efficiency of lamivudine on preventing HBV recurrence.

METHODSSeventy liver transplants performed at the SUMS between April 1993 and December 2000 were retrospectively analyzed. The main indications for liver transplant were hepatocellular carcinoma (26 cases), liver cirrhosis (21 cases), fulminant hepatitis B (12 cases), sclerosing cholangitis (4 cases) and other terminal liver diseases (7 cases). Lamivudine was used in twelve patients suffering from fulminant hepatitis B. Logistic multivariate regression analysis was applied to determine the risk factors predicting liver transplantation outcomes.

RESULTSFifty-four patients survived for more than one month, and 16 patients died within 30 days after orthotopic liver transplantation (OLT). The overall hospital survival rate was 77.1%. The hospital survival rates in the Child's A and B patients were 87.5% and 83.3%, respectively. Those rates were superior to those of the Child's C patients (P < 0.05). The outcome of patients with small hepatocellular carcinoma (HCC) was superior to that of patients with large HCC. Preoperative APACE III scores, the severity of ascites and serum creatine level had independent influence on outcome. Of the patients with fulminant HBV infection, 9 recipients survived for a follow-up period of 2 - 24 months. Treatment with lamivudine monotherapy was both well tolerated and efficacious in patients with fulminant hepatitis B.

CONCLUSIONSThe results indicate that orthotopic liver transplantation could provide long-term cure and palliation for patients with HCC, and that patient selection is extremely important in predicting outcome. The results support the continued application of liver transplantation as a therapeutic modality for various end-stage liver diseases and that lamivudine is an effective and safe monotherapy in OLT for patients with HBV infection.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; mortality ; surgery ; Child ; Child, Preschool ; China ; Cholangitis, Sclerosing ; mortality ; surgery ; Female ; Follow-Up Studies ; Hepatitis B ; mortality ; surgery ; Humans ; Infant ; Liver ; pathology ; surgery ; Liver Cirrhosis ; mortality ; surgery ; Liver Neoplasms ; mortality ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Schools, Medical ; Survival Rate ; Treatment Outcome