BACKGROUND:Primary dislocation after total hip arthroplasty is a major complication, besides prosthesis loosening. It is controversial whether joint capsule and external rotators should be repaired during total hip arthroplasty through posterolateral approach.
OBJECTIVE:To explore the clinical significance of joint capsule and external rotator repair on preventing hip dislocation after primary total hip arthroplasty through posterolateral approach.
METHODClinical data of patients with primary or secondary hip osteoarthritis after primary total hip arthroplasty through posterolateral approach were retrospectively analyzed. They were assigned to two groups according to different strategies of soft tissue repair. Control group did not receive posterior soft tissue repair. Combined repair group received the repair of joint capsule and short external rotators. Al patients were fol owed up for more than 1 year. Early dislocation was defined as the dislocation occurred within 1 year after operation. The effects of different repair methods on early dislocation rate were compared.
RESULTS AND CONCLUSION:There were 362 patients. Total y 390 case-times of primary total hip arthroplasty were included. Early dislocation occurred in 7 cases, of which 6 case-times in the control group (2.2%, 6/268), and 1 case-time in the repair group (0.8%, 1/122). There were significant differences in the incidence rate of early dislocation between the repair group and control group (P=0.012). These findings confirmed that the combined repair of posterior joint capsule and short external rotators could decrease the rate of early dislocation after primary total hip arthroplasty through posterolateral approach.

Objective To study the relationship between chromosomal abnormality and Y chromosome microdeletions and male infertility. Methods Lymphocytes were cultured from peripheral blood of 1975 male infertility patients and stained with Giemsa. The chromosomes were analyzed under microscope. Y chromosome specific sequence tags (STS) were selected, then the Y chromosome microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in azoospermia and oligozoospermia patients. Results There were 305 cases of detected chromosomal abnormalities (15.44%) in the 1975 cases. There were 101 cases (5.11 %) with autosome abnormalities which clinically manifested as oligozoospermia and teratospermia. There were 204 cases (10. 33%) of sexual chromosome abnormalities and the patients were mainly characterized with Klinefelter's syndrome. Y chromosome microdeletions were detected in 109 (14.97 %) of the 728 cases of azoospermia or oligozoospermia. The most common microdeletion of Y chromosome was AZFc (62.39%) and these patients were characterized with azoospermia and oligozoospermia. Five patients (4. 59%) who suffered Y chromosome microdeletion in AZFa region and AZFb region were characterized with azoospermia. Fifteen cases (13.76%) with microdeletion in AZFb region and AZFc region were mainly characterized with azoospermia. There were 6 cases (5. 50 % ) of microdeletion in AZFa, AZFb and AZFc regions,these patients were all characterized with azoospermia. Conclusions Both Chromosome abnormalities and Y chromosome microdeletions are important causes for male infertility.

Magnesium stents have gained increasing interest as an ideal stent of future intervention. In order to study the deformation behavior of magnesium alloy stents in the interventional treatment, the finite element method was used to analysis the effects of different crimp and expansion dimensions on the mechanical properties (maximum stress, radial recoil rate, longitudinal shortening rate and radial strength). The results showed that crimping and expanding have a minimal influence on the stent radial strength. When the expansion size is same, the maximum equivalent stress and recoil rate decrease with the crimp size. When the crimp size is same, in contrast with the radial recoil rate, the maximum equivalent stress and longitudinal shortening rate increase with the expansion size. In addition the paper verified the radial strength-radial displacement curve obtained by FEM. Results are basically consistent, indicating the finite element method can efficiently provide researchers with reliable, high-quality design.
Alloys ; Finite Element Analysis ; Magnesium ; Stents

The finite element method was used for simulating the mechanical performance and fatigue safety of three different structures of Nitinol stent. According to the actual situation, after proposing reasonable assumptions and simplification, the geometry model and finite element model establishment, material mode selection and boundary condition setting are completed. The strain and fatigue life of different stent edges wide (omega) or strut angle (theta) are computed. The result can provide a valuable reference for the optimal design of stent.
Alloys ; Finite Element Analysis ; Prosthesis Design ; Stents

Objective To investigate the clinical value of transient elastography in adult after liver transplantation,by means of evaluating the correlation of liver stiffness measured by FibroScan with liver/renal functions.Method Forty-three patients received orthotopic liver transplant in our hospital during Dec.10,2013 and Mar.19,2014 were included in this study.Liver stiffness measurement (LSM) was performed after transplantation.Clinical data and laboratory tests including liver function and renal function were collected and analyzed.Result Bivariate correlation showed that body mass index (BMI),MELD score,graft-to-recipient weight ratio (GRWR) and warm ischemia time had no correlation with LSM.LSM at the 1st day after transplantation (LSM-1) showed no correlation with cold ischemia time,but LSM at the 7th day after transplantation (LSM-7) did,with R =0.335,P =0.028.LSM-1 showed positive correlation with the ICU time (R =0.488,P =0.001),but LSM-7 didn't.There was significantly positive correlation between LSM and aspartate aminotransferase,bile acid and creatinine,but no significant correlations were found between LSM and alanine arninotransferase,alkaline phosphatase,cholinesterase,gamma-glutamyl transferase,total bilirubin,direct bilirubin,indirect bilirubin,urea nitrogen and uric acid.The group with higher LSM-1 had longer ICU time than the lower group (9 d vs,7 d,P =0.013),and so was the hospital stay (34 d vs.23 d,P =0.023).For the LSM-7,there was no significant difference in ICU time and hospital stay between the two groups.The group with higher LSM-1 had higher serious complication incidence than the lower group (78.57％ vs.27.59％,P =0.002),but the two groups in LSM-7 showed no significant difference in serious complication incidence.Conclusion The LSM partially correlates with the liver function and renal function of liver transplantation recipient,and may have its clinical value for assessing the early prognosis after liver transplantation.

Objective To investigate the effect of concurrent exercise intervention in metabolic endotoxemia induced by high-fat diet in rats,and further understand the damage of liver mitochondrial ultramicrostructure.Methods Eighteen SD rats with the weight of 100g were randomly divided into 3 groups:group A (standard diet group),group B(high-fat diet group) and group C (treadmill-trained group with high-fat diet).Training (1 hour/d) initiated at the same time as the HF diet was fed.After being raised for 6 weeks,the rats was euthanized and weighed up.Blood samples were taken and the levels of serum lipid were detected.The levels of serum endotoxin were detected by enzyme-linked immunoadsorbent assay.The membrane potentials of isolated mitochondrion were detected by flow cytometry instrument and the morphologic changes in mitochondria in liver were observed by electronic microscopy.Results In group B,the levels of endotoxin increased significantly(2.916 ± 0.761 rs 5.454 ± 1.254,t =-4.236,P ＜ 0.05),and the liver mitochondrial density and membrane potential also increased significantly compared with group A after 6 weeks (4.330 ±0.501 vs 3.507 ±0.532,t =2.759,P ＜0.05;l.660 ±0.202 vs 0.473 ±0.064,t =13.712,P ＜0.05).But there was no markedly different in serum endotoxin between group B and group C (4.972 ± 1.757 vs 5.454 ± 1.254,t =-0.547,P ＞ 0.05).Compared with group B,the liver mitochondrial density of group C decreased significantly (4.330±0.501 vs 3.581 ±0.188,t =3.426,P ＜ 0.05).The mitochondrial ultrastructurctural changes in each group were not obvious.Conclusions The rats fed with high-fat diet for 6 weeks can reach the state of metabolic endotoxemia.The increasing levels of the liver mitochondrial membrane potential caused by metabolic endotoxin may affect the happening and development of other diseases in the future.Concurrent exercise can not decrease the level of endotoxin.It also shows that metabolic disease caused by high-fat diet should be prevented by moderation in eating and drinking.

Gastrointestinal neoplasms is the most common digestive tract neoplasms, and its incidence rate is increasing year by year. Compared with other solid tumors, the application of immune checkpoint inhibitors in gastrointestinal neoplasms is still in the stage of continuous exploration. This paper intends to review the relevant research and latest progress of immune checkpoint inhibitors in advanced gastric cancer, mismatch repair function defect/microsatellite high instability and mismatch repair function integrity/microsatellite stability or microsatellite low instability, and further evaluate the effectiveness and safety of immunotherapy combined with relevant studies.

Objective:To explore the relationship between the level of C-reactive protein/serum albumin ratio (CAR) and early postoperative anastomotic leakage in patients with colorectal cancer.Methods:From September 2016 to September 2019, all colorectal cancer patients who were treated in gastrointestinal surgery of Jinjiang hospital in Fujian Province were collected for retrospective analysis. The baseline data of the patients were collected. The blood C-reactive protein (CRP), procalcitonin (PCT) and serum albumin (ALB) were monitored on the first, third, fifth and seventh days after operation, and the results were statistically analyzed.Results:There was no significant difference in baseline data such as age, body mass index (BMI), operation time and intraoperative hemorrhage between the anastomotic leakage group and the non anastomotic leakage group ( P>0.05), but the hospitalization time of the anastomotic leakage group was longer than that of the non anastomotic leakage group ( P<0.05). The CRP level on the 3rd and PCT level on the 5th day after operation in the anastomotic leakage group were higher than those in the non anastomotic leakage group, with significant difference ( P<0.05). The CAR value on the 3rd and 5th day after operation in the anastomotic leakage group was higher than those in the non anastomotic leakage group with significant difference ( P<0.05). Conclusions:CAR can predict early anastomotic leakage in patients with colorectal cancer.

Objective:To explore the value and advantages of perioperative nutritional support in enhanced recovery after surgery (ERAS).Methods:The clinical data of patients admitted to Jinjiang City Hospital for acute abdomen and undergoing surgery from April 2018 to January 2021 were collected. They were divided into two groups: the enhanced recovery after surgery group (ERAS group, 78 cases) and the traditional perioperative management group (CPM group, 75 cases). The nutritional risk assessment of NRS2002 was performed on admission to the two groups. The postoperative inflammatory indexes, nutrition and rehabilitation related indexes were compared between the two groups.Results:There was no significant difference in preoperative NRS 2002 score, operation method, operation time and blood loss between ERAS group and CPM group ( P>0.05). There was no significant difference in C-reactive protein (CRP), albumin (Alb) and prealbumin (PA) between ERAS group and CPM group before operation ( P>0.05). The ALb and PA of the two groups on the first day after operation were significantly lower than those before operation, and the CRP levels on the first, third, fifth and seventh day after operation were higher than those before operation( P<0.05), with significant difference. The CRP level of ERAS group was lower than that of CPM group on the third day after operation, with significant difference ( P<0.05). On the 7th day after operation, the levels of Alb and PA in ERAS group were higher than those in CPM group ( P<0.05). The recovery time of gastrointestinal function and hospitalization days in ERAS group were significantly reduced, and the total cost of hospitalization was significantly less than that in CPM group ( P<0.05). Conclusions:Perioperative effective nutritional support is helpful to accelerate the recovery of patients with acute abdomen. The application of enhanced recovery after surgery can effectively improve the nutritional status of patients with acute abdomen, reduce the incidence of complications and improve the clinical outcome of patients.

Objective:To compare the clinical efficacy and quality of life of patients between Billroth Ⅱ+ Braun anastomosis and simple Billroth Ⅱ anastomosis in digestive tract reconstruction after laparoscopic distal gastric cancer radical resection.Methods:A retrospective analysis was performed on clinical data of 68 patients who underwent laparoscopic distal gastric cancer radical resection in Jinjiang Municipal Hospital from January 2019 to January 2022. Forty patients who underwent Billroth Ⅱ+ Braun anastomosis were included in the observation group, and 28 patients who underwent simple Billroth Ⅱ anastomosis were included in the control group. Perioperative indicators and postoperative indicators one year after surgery were collected to observe the safety and efficacy of patients after surgery.Results:There were no significant differences in operation time, intraoperative bleeding volume, postoperative exhaust time, time to remove gastric tube and drainage tube, and postoperative hospital stay between the two groups (all P>0.05). There were also no significant differences in postoperative complications between the two groups ( P>0.05). One year after surgery, the incidence of food retention and residual gastritis in the observation group were lower than those in the control group (all P<0.05), while there were no significant differences in the incidence of bile reflux and reflux esophagitis between the two groups (all P>0.05). One year after surgery, nutritional evaluation showed that the total protein decline and prognostic nutritional index (PNI) in the observation group were lower than those in the control group, with significant differences (all P<0.05). The incidence of bloating and reflux symptoms in the observation group one year after surgery was lower than that in the control group, with significant differences (all P<0.05). Conclusions:Billroth Ⅱ+ Braun anastomosis is a safe method for digestive tract reconstruction after laparoscopic distal gastric cancer resection, which can improve patients′ quality of life after surgery.