Chitosan microsphere containing fluoroquinolones is a kind of novel sustained-released antibacterial agent that possesses the antibacterial and bacteriostatic property of chitosan as well as bactericidal properties of fluoroquinolones. Loading fluoroquinolones in the chitosan microsphere can greatly enhance its antibacterial, bactericidal, anti-inflammation and anti-infection characteristics. This paper reviewes the recent study on different preparation methods of chitosan mierosphere containing fluoroqninolones and discusses its applications.

[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 detect the expressions of p53, vascular endothelial growth factor (VEGF) and microvessel density (MVD) in breast cancer and tumor adjacent tissues to explore their relationship and roles in the pathogenesis of breat cancer. Methods The expression levels of p53,VEGF and MVD were assessed in 110 cases of breast cancer and tumor adjacent tissues with SP immunohistochemical method. Results The positive expression rate of VEGF and p53 was 90.0%(99/110) and 42.7%(47/110) in the breast cancer tissues, and 35.5%(39/110) and 4.5%(5/110) in the tumor adjacent tissues, respectively, which had highly significant difference between two groups (P

Objective The amount of neuroglobin(Ngb) in cerebral cortex after different post-traumatic time intervals were studied in order to find out the value of Ngb in estimating the survival time after trauma.Methods Moderate brain contusions in rats were made using free-falling-body impact device,The area and gray values of Ngb immunoreactive products(Ngb-IR)in the core of injury in cerebral cortex and penumbra and the contra lateral cerebral cortex at different time points after trauma were studied by immunohistochemical method and image analysis.Results The expression of Ngb in the core of injured cerebral cortex declined quickly and reached the nadir by 24 hours and remained at low level for long time.On the contrary,it rose quickly and reached the peak value at 12 hours in the penumbra surrounding the core of injury,then declined gradually and reached normal level at 8d to 16d.Image analysis revealed that the expression of Ngb-IR in the penumbra of injured cortex were stronger than that in the opposite side.Conclusion The amount of Ngb in cerebral cortex at the core and penumbra of injury changed regularly according to different time intervals after trauma.Ngb may play an important role in neuroprotection during acute phase of injury.

BACKGROUND:An appropriate biomaterial can be directly combined with autologous or al ogeneic skin cel s to construct tissue-engineered skin, which can accelerate skin repair after transplantation onto the skin wounds. It is a good idea to solve the deficiency in skin sources. OBJECTIVE:To study the biological characteristics of the complex with bone marrow mesenchymal stem cel s and to investigate the application of this complex in skin defect repair. METHODS:Twenty-eight Sprague-Dawley rats, SPF grade, were randomized into two groups (n=14 per group). By adjustment of temperature, time, pressure and area of NC perm instrument, scald models were made in rats. Rats in the treatment group were given the repair using composite bone marrow mesenchymal stem cel s, while those in the control group were given vaseline gauze repair. Repair effects were compared between two groups. RESULTS AND CONCLUSION:(1) After 72 hours of culture, the composite bone marrow mesenchymal stem cel s smal with round shape distributed dispersedly. After 5 days of culture, the cel s began to stretch and the cel morphology became unstable. After three passages, the cel morphology became stable. The results of antigen identification showed the expression of CD44 and CD29 but the low expression of CD45 and CD34 in bone marrow mesenchymal stem cel s. (2) Twenty-eight days after repair, there was no obvious scar on the wound surface of the treatment group, but a little shrinkage and obvious scar stil existed in the control group. Moreover, in the control group, the epidermal layer of the skin was relatively thick, and the connection between the basal layer and the dermis was unsatisfactory. In the treatment group, obvious epidermal cel stratification, neat arrangement, and tight connection between the epidermis and dermis were observed. In summary, bone marrow mesenchymal stem cel s are a special class of cel s that have pluripotent ability and are more readily available. These cel s are the preferred target cel s for skin defect repair to promote early healing of the skin and improve blood circulation defect site, which are confirmed to have high clinical value.

BACKGROUND: In recent years, acel ular human cadaveric dermis has been applied for repairing dermal defects and fil ing soft tissues, but this repair material is expensive and difficult to obtain. OBJECTIVE: To explore the repair effect of tissue-engineered acel ular dermis on wound healing of skin ulcer. METHODS: Sprague-Dawley rats were randomly divided into autologous reticular dermis and acel ular dermis groups. The tissue-engineered acel ular dermis was prepared by hypotonic solution, 2.5 g/L trypsin, 0.5% Triton X-100 and PBS solution, and in the meanwhile, a rat model of skin ulcer was established. Then, autologous skin graft and tissue-engineered acel ular dermis were transplanted into the autologous reticular dermis group and acel ular dermal group, respectively. Subsequently, comparative study about the repair effect and relative mechanism between two groups was performed. RESULTS AND CONCLUSION: The tissue-engineered acel ular dermis showed a white and grainy shape at room temperature. And hematoxylin-eosin staining showed that: the internal structure of tissue-engineered acel ular dermis exhibited a dendritic distribution, and the gap between col agen fiber bundles was relatively large. At 2, 3, 4 and 8 weeks after dermal transplantation, the survival rate of skin graft in the acel ular dermis group was significantly higher than that in the autologous reticular dermis group (P < 0.05). And the wound contraction rate in the acel ular dermis group was significantly higher than that of the autologous reticular dermis group at 3, 4 and 8 weeks after dermal transplantation (P < 0.05). In addition, the average diameter and clearance rate of col agen fibers in the normal skin around wound in the acel ular dermis group were significantly higher than those of autologous reticular dermis group (P < 0.05). To conclude, it is relatively simple to prepare tissue-engineered acel ular dermis under mild conditions, and the prepared tissue-engineered acel ular dermis presents a regular shape. Moreover, this acel ular dermis achieves desired outcomes in repairing dermal defects, which can promote wound healing by reducing the intradermal DNA residual and significantly improving some biomechanical properties in vivo.

Objective To observe the preemptive analgesia effects of katamine and elonidine, and to find out the influence of preemptive on stress responses. Methods 36 patients with hysteromyoma undergone hysteromyomec-tomy were randomly assigned to three groups (n = 12 each group) :group Ⅰ , control group, without preemptive analge-sia,the patients in control group were given continous epidural analgesia with 2% lidoeaine 12 - 14ml. Group Ⅱ ,the patients were injected 0. 6mg/kg katamine into epidural analgesia 30 minutes before operation. Group Ⅲ,the patients were injected 0. 6mg/kg katamine and 1.5μg/kg clonidine into epidural analgesia 30 minutes before operation. The patients in three groups were recorded VAS score on 2h ,4h ,6h, 12h ,24h after operation, also recorded the change of epinephrine(E) and norepinephrine(NE) and sensation and movement recovery time after operation. The side effects such as dizziness nausea,vomit,and exited talking were observed during the operation. Results The VAS score were significantly different between group Ⅰ ,Ⅱ and Ⅲ. The levels of E and NE in plasma in group Ⅰ were increased more than group Ⅱ and Ⅲ within 24 hours after operation, also there is significant difference in group Ⅱ compared with group Ⅲ in T1 ,T2 ,T3. The time of sensation and movement recovery were remarkably longer in group Ⅲ com-pared with group Ⅰ and Ⅱ, showing significant difference. There were no significant difference in side effects after operation in three groups. Conclusion The preemptive analgesia of kutamine and colnidine can relieve the pain of lower abdominal surgery and stress response after operation,and it do not increase the side effects.