BACKGROUND: Studies have confirmed that Atorvastatin drugs can increase the number of endothelial progenitor cells significantly in vitro, as well as the content of vascular endothelial growth factor(VEGF). OBJECTIVE: To investigate the effect of Atorvastatin on VEGF expression in necrotic femoral heads of rabbits. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Department of Orthopedic Surgery, Renmin Hospital of Wuhan University, from September 2007 to November 2008. MATERIALS: Forty-five male and female healthy New Zealand white rabbits weighing 2.5-3.5 kg were randomly divided into normal control group, model control group and AtorvastaUn group, 15 rabbits in each group. METHODS: Nitrogen refrigeration was used to develop femoral head necrosis models of rabbits in the model control and Atorvastatin groups. Two weeks after modeling, the animals in the Atorvastatin group were administered intragastically with Atorvastatin, normal control and model control group were treated with the same volume of normal saline. MAIN OUTCOME MEASURES: Each five rabbits were sacrificed at the 4th, 8th, and 12th weeks respectively for general observation, X-ray and histological observation. VEGF protein expression was assessed by immunohistochemistry method and VEGF mRNA level was assessed by reverse transcription - polymerase chain reaction method. RESULTS: The VEGF protein and mRNA levels in the model control and Atorvastatin groups were obviously lower than those in the normal control group, while the VEGF protein and mRNA levels in the Atorvastatin group were much higher than those in the model control group at the 8th and 12th weeks alter the treatment with Atorvastatin (P < 0.05). CONCLUSION: Atorvastatin can significantly upregulate the expression of VEGF, which is probably an effective clinical treatment to avascular necrosis of the femoral head.

Clinical data of twenty-six patients with primary tumors involving hip ioint treated surgically in Renmin Hospital of Wuhan University between March 1999 and May 2005 were retrospectively analyzed.The diagnosis of all patients was confirmed by pathohistology.There were 3 cases of chondrosarcomas.6 osteosarcomas,1 synovial sarcoma,14 giant cell tumors and 2 aneurysmal bone cysts.Seventeen cases were treated with custom-made total hip replacement prosthesis,7 with custom-made dipolar femoral head prostheses and 2 with saddle prostheses.They were followed up for 18 months to 6 years with an average of 4 years and 3 monts.Local relapse rate and final limb salvage rate was 40%and 60% in 10 patients with malignant bone tumors:125%and 875%in 16 patients with low-grade malignant bone tumors.According to Enneking(MSTS)evaluation criteria.the average score was 19 with an excellent and good rate of 76.9%.Custom-made artificial hip prosthesis is a satisfactory method in limb salvage operations for patients with malignant or low-grade malignant bone tumors jn hip joint.

Objective: To investigate the feasibility of endoscopic lateral neck dissection via the breast and transoral approaches (ELNDBTOA) for papillary thyroid carcinoma (PTC). Methods: From February 2015 to April 2019, 10 patients with PTC (cN1b) including 1 male and 9 females aged from 22 to 53 years old received ELNDBTOA in the General Surgery Department of Zhongshan Hospital, Xiamen University. Total thyroidectomy, the central lymph node dissection and the selective neck dissection (levels Ⅱ, Ⅲ and Ⅳ) were performed endoscopically via the breast approach, and then the residual lymph nodes were dissected via transoral approach. The medical records, operation time, blood loss, complications and postoperative follow-up outcomes were analyzed retrospectively. SPSS 22.0 software package was used for statistical processing of clinical data of patients. Results: All cases were successfully treated with ELNDBTOA without transfer to open surgery. The average operative time was (362.5±79.7) min, the blood loss was (23.0±14.9) ml, and the postoperative hospital stay was (5.1±1.3) days. The mean number of harvested cervical lymph nodes were (34.2±25.8), and the mean number of positive lymph nodes were (6.5±4.9). Lymph nodes were dissected by the further dissection via oral approach in 6 patients and a total of 9 lateral lymph nodes were havested from 2 of the 6 patients, with 3 positive lymph nodes. Two patients had transient skin numbness in the mandibular area and recovered within two weeks. One patient developed transient hypoparathyroidism and recovered within two months. No secondary bleeding, recurrent laryngeal nerve paralysis, chylous leakage, neck infection, permanent hypoparathyroidism or other complications were observed. The follow-up time was from 16 to 66 months with a median of 42.5 months, no tumor recurrence or metastasis occurred, and also no obvious deformity, abnormal sensation or movement in the chest, neck and mouth was observed. Conclusions: ELNBTOA is safe and feasible, with good cosmetic outcome.
Adult ; Female ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neck Dissection ; Retrospective Studies ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/surgery* ; Thyroidectomy ; Young Adult