Objective To determine the biomechanical variation in full-length femoral stress pat-tern and periprosthetic femoral stress distribution after implantation either with Charnley Elite cemented prostlesis or Summit proximal porous cementless femoral prosthesis. Methods Three-dimensional finite element models of intact femur, Charnley Elite and Summit femoral prostheses were developed. The stress distributions on the femur and the implants were measured. Applied with hip joint loading and related muscles strength, the stress changes of an intact femur and those implanted with either Charnley Elite or Summit protheses, especially changes in proximal femur, were respectively quantitatively analysed. Results Com-pared with intact femur, there was no change of the full-length femur stress pattern in implantation of both implants, the areas of peak values were all presented at middle and lower regions of the femur, and femoral stress value levels were decreased with both implants. Both prostheses induced significant decrease of stress in the periprosthetic bone tissue, the most serious loss of stresses all appeared at femoral calcar, the stress-shielding rates of Elite and Summit prostheses were 90.8% and 95.3% respectively. The distributions of stress shielding of both prostheses were consistent each other, the Summit proximal porous cementless pros-thesis had more serious stress decrease than the Charnley Elite cemented prosthesis. Conclusion Implan-tation of both implants may cause significant stress shielding in the proximal femur. This may be related with periprosthetic bone loss and aseptic loosening of stems, and can be used to explain the mechanism of post-operative femoral fracture and thigh pain. Both implants designs need further improvement to reduce stress changes in proximal femur.

The methyl tertiary butyl ether(MTBE),as an addictive in gasoline,is used widely since the leaded gasoline has been prohibited.By some ways,MTBE can be transferred into water.Since the degradation of MTBE is very slow naturally,the pollution of MTBE in water is attracting more and more attentions.How to remove the MTBE economically and effectively has become a hot spot in common concern.In this paper,the species of photocatalytic degradation technique and the methods were reviewed including UV-Fenton,UV-H2O2,UV-O3,UV-TiO2 and visible-light photocatalytic decomposition with TiO2 were used to degradation of MTBE in water.

Objective To explore relationship between anterior knee pain after total knee arthroplasty and patella resurfacing and prosthesis design,and to evaluate which femoral prosthesis is more friendly with patella:Genesis Ⅱ or PFC knee prostheses.Methods Data of 145 patients (145 knees) who had undergone primary total knee arthroplasty for treating osteoarthritis were retrospectively analyzed.Posterior-cruciate-substituting total knee prostheses were used in all patients.Among 74 patients who had undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 32 patients and PFC knee prosthesis in 42 patients.Among 71 patients who had not undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 38 patients and PFC knee prosthesis in 33 patients.The Hospital for Special Surgery(HSS) score,patella score,patellar function score,range of motion of knee,anterior knee pain scale,and patient satisfaction were used to evaluate clinical outcomes.At the same time,the imaging results were evaluated by X-rays.Results 144 patients were successfully followed up for 21 to 43 months (average,33 months).There was no significant difference in incidence of anterior knee pain between the group with patella resurfacing and the group without patella resurfacing,while a significant difference was found between patients receiving Genesis Ⅱ knee prosthesis and those receiving PFC knee prosthesis.Four patients who had undergone total knee arthroplasty using PFC prosthesis underwent reoperation.There were no significant differences in postoperative HSS score,range of motion of knee and patient satisfaction between the Genesis Ⅱ group and the PFC group,while there were significant differences in patella score and patellar function score between them.Conclusion Postoperative anterior knee pain was related to the prosthesis design,rather than to the patella resurfacing.Genesis Ⅱ knee prosthesis was more friendly with patella than PFC knee prosthesis.

Objective To explore the effect and factors of patellofemoral arthroplasty (PFA) for isolated patellofemoral osteoarthritis.Methods Data of 18 patients (3 males,15 females) with isolated patellofemoral osteoarthritis underwent PFA from March 2006 to December 2014 were retrospectively analyzed.There were 3 males and 15 females with a mean age of 54 years (range,46-74 years).It was strict to grasp the surgical indications according to the clinical symptoms,signs and imaging data preoperatively.11 patients were operated with AVON patellofemoral prosthesis (Stryker Inc.) and the other 7 patients were operated with the Gender Solutions patellofemoral prosthesis (Zimmer Inc.).Active and passive functional rehabilitation exercise was encouraged at the early stage after operation.Visual analogue scale (VAS) was 5.33±0.99 (range,4-7) and hospital for special surgery knee score (HSS) was 53.28±5.71 (range,44-63) before operation.Results The mean duration of follow-up was 63.98 months (range,6-104 months).VAS after operation for 1 and 3 months were 1.17±0.79 (range,0-3) and 0.72±0.67 (range,0-2),and the pain was almost relieved after 9 months.HSS after operation for 1,3,9 months were 70.06±6.33 (range,61-80),86.06±5.12 (range,77-95) and 91.39±4.83 (range,82-97).HSS score of the latest follow-up was 92.06±4.05 (range,84-97),which was improved obviously from the preoperative ones.The excellent and good rate was 100％ (excellent 15 cases,good 3 cases).The satisfactory rate was 94.4％ (17/18).Only one case got slightly knee pain when walking up and down the stairs after 2 years,and the pain was relieved after being administered with NSAIDs and rest.No incision infection,rupture,prosthesis supported bone fracture,prosthesis loosening and other complication was occurred during the follow-up period in the other patients.Conclusion The clinical outcomes of PFA are strictly related to surgical indications,implant design and appropriate surgical technique.Therefore,based on the appropriate PFA implants,strict surgical indications,appropriate patients,excellent operation skills and actively functional rehabilitation exercise,PFA could treat the isolated patellofemoral osteoarthritis effectively.

Objective To investigate the diagnostic value of knee skin temperature and serum soluble intercellular adhesion molecule-1 (sICAM-1) level in peri-prosthetic infection after total knee arthroplasty (TKA).Methods Thirty patients (11 males and 19 females,aged 59.3±9.5 years old) underwent primary TKA during November 2012 and October 2015.Ten patients with peri-prosthetic infection (3 males and 7 females,aged 60.9±8.2 years old) underwent two-stage revision TKA from November 2012 to October 2015.The interleukin-6 (IL-6),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),sICAM-1 in serum and the skin temperature in knee joint were recorded preoperatively (revision patients on diagnosis),at days 1,7 and at 1,3,6,12 months post-operatively.Results All of the 40 patients were followed up for 12 months.The serum CRP,IL-6 and ESR levels in the primary TKA group were normal preoperatively and increased after operation,reaching their peaks at 1-7 days postoperatively.These indexes then returned slowly to the normal levels within 3 months.The serum sICAM-1 level in the primary TKA group did not change significantly during the follow up.The serum levels of CRP,IL-6,ESR,and sICAM-1 in the revision group were significantly higher than that in the primary TKA group preoperatively (P＜0.05),IL-6,CRP,ESR returned slowly to the normal levels within 3 months after the second-stage revision,while the level of sICAM-1 returned to normal within 3 months after the first-stage revision.During whole follow-up after the second-stage revision,the level of sICAM-1 didn't change significantly.The preoperative mean differential temperature (MDT) in the primary TKA group was 0.73±0.62 ℃ preoperatively and elevated to 4.37±1.06 ℃ at 7 days postoperatively,which returned to the baseline within 6 months after primary TKA.The preoperative MDT in the revision group was 5.03±0.81 ℃,which was significantly higher than that in the primary TKA group (P＜0.05).The MDT returned to the normal level within 6 months after the second-stage revision TKA.Conclusion The change of MDT is in accordance with serum CRP,IL-6,and ESR,which together may predict the occurrence of infection.Serum sICAM-1 level may also be valuable in the diagnosis of peri-prosthetic infection.

AIM: To establish a new kinetic model of hydrating swelling and to make experiments of Radix et Rhizoma Rhei (Rhubarb) designed to validate this model. METHODS: The model was set up according to kinetics, residul water analysis was adopted to measure Rhubarb's sakage, and then obtained the fittin curve and kinetic parameters, its goodness of fit was evaluated by analysis of variance. RESULTS: Hydrating swelling model of the vegetable herb had a form of multivariate first order linear differential equation. Rhubarb comformed to three compartment model with ? = 0.3241min -1 , ? = 0.0185min -1 , ?=5.659?10 -3 min -1 , V ∞ T =1.726mL?g -1 , V ∞ 1 =1.008mL?g -1 , V ∞ 2 =0.2814mL?g -1 V ∞ 3 =0.4366mL?g -1 ,K= 0.2186min -1 ,K 12 =0.02426min -1 ,K 21 =0.07422min -1 ,K 13 =6.402?10 -3 min -3 ,K 31 =0.02481min -1 . CONCLUSION: The kinetic model of hydrating swelling has been in accordance with quantitative changes with multivariate first order linear mammary.

Objective To investigate the risk factors related to the survival time of anti-protrusion cage in acetabular revision.Methods Data of 40 patients who had received acetabular revision using antiprotrusion cages between January 2002 and June 2010 were retrospectively analyzed.There were 16 males and 24 females,aged from 22 to 77 years (average,60.3 years).All patients were followed up for 12 to 82 months (average,39.2 months).According to the AAOS classification,there were 29 cases of type C and 11 cases of type D； while according to the Paprosky classification,there were 29 cases of type ⅢA and 11 cases of type Ⅲ B.The multiple regression analysis was utilized to investigate the relationships between different factors and anti-protrusion cage failure.The corresponding factors included gender,age,bone loss classification,superior or lateral migration of acetabular center of rotation,abduction angle,fixation manners (simple flange fixation or flange fixation plus transacetabular screw fixation),bone grafting techniques and cup type.Results At final follow-up,the average Harris score was 74.5±15.4.Two patients received rerevision due to prosthetic loosening.Obvious radiological loosening of prosthesis combined with pain was found in 2 cases.The statistical analysis indicated that superior migration of acetabular center of rotation,abduction angle and fixation manners were correlated with cup failure,especially when the superior migration was more than 8.5 mm or the abduction angle was larger than 53.5°.Flange fixation plus transacetabular screw fixation could reduce risk of cup failure.Conclusion There is a higher cup failure risk in acetabular revision using an anti-protrusion cage for patients with serious bone defect.However,implanting cup at the level of the true acetabulum as far as possible,decreasing abduction angle properly and using flange fixation plus transacetabular screw fixation can reduce cup failure risk.

Objective: To investigate the clinical effects of primary revision after artificial hip replacement and causes of revision surgery. Methods: A total of 344 patients who underwent revision surgery after total hip arthroplasty (THA) and artificial femoral head replacement from January 2010 to December 2016 were retrospectively analyzed. There were 141 males and 203 fe-males, with a mean age 65.64±10.81 years (28-87 years). A total of 351 hip revisions were performed in 344 patients with 7 pa-tients in bilateral revisions. All patients were followed up for 60.38±22.75 months (24-105 months). All patients with periprosthet-ic infection underwent two-stage revision after prosthesis placement, and all others underwent one-stage revision. The clinical out-comes of revision surgery were assessed with the Harris hip score and the survival rate of the revision prosthesis. According to the duration from artificial hip replacement to revision surgery, all patients were divided into early revision (less than 5 years) and late revision (more than 5 years) groups. They were also divided into two groups according to the age of the patient in revision sur-gery: >55-year-old and ≤55-year-old groups. The causes of revision, hip reoperation and re-revision were recorded. Results: In the 351 hip revisions, a total of 238 (67.8%) had aseptic loosening, 41 (11.7%) periprosthetic fractures, 30 (8.5%) periprosthetic infection, 23 (6.6%) recurrent dislocation and 19 (5.4%) the eccentric liner wear. The infection rate was significantly higher in the early revision group (21.1%) than that in the late revision group (4.2%) (χ²=24.443, P<0.001). The aseptic loosening rate was sig-nificantly higher in the late revision group (72.4%) than that in the early revision group (54.4%) (χ²=9.899, P=0.002). Sixteen pa-tients underwent hip surgery after revision, including 6 recurrent dislocations, 4 aseptic loosening, 3 periprosthetic fractures, and 3 periprosthetic infections. Eight of them underwent revision surgery, including 4 cases of aseptic loosening, 2 cases of periprosthet-ic fractures, and 2 cases of recurrent dislocation. The duration from the primary revision to the second revision was 22.1±10.0 months (1-75 months). The 5-year and 8-year survival rates of the revision prostheses were 99.3%[95%CI(98.3%, 100.3%)] and 92.6% [95%CI(87.1%, 98.1%)], respectively. The proportions of prosthetic infection and eccentric liner wear in the ≤55-year-old group were significantly higher than those in the >55-year-old group (χ²=3.981, P=0.046; χ²=5.226, P=0.022), while the propor-tion of aseptic loosening in the >55-year-old group was significantly higher than that in the ≤55-year-old group (χ²=5.254, P=0.022). The 8-year survival rates of the revision prostheses of ≤55-year-old group and >55-year-old group were 76.8% [95%CI(50.5%, 103.1%)] and 95.4% [95%CI(91.1%, 99.7%)], respectively. Conclusion Young patients have a higher risk of re-revi-sion after revision THA.

Objective:To explore the effects of fast-track surgery (FTS) combined with acupuncture at Neiguan acupoint on stress indicators and recovery quality in patients during anesthesia of craniocerebral surgery.Methods:According to block randomization method, 120 patients with craniocerebral trauma meeting inclusion criteria in the hospital were divided into three groups between January 2018 and December 2020, 40 in each group. The control group was given routine awakening intervention, intervention 1 group was given routine awakening intervention and acupuncture at Neiguan acupoint, and intervention 2 group was given FTS and treatment of intervention 1 group. At 10 min after entering the room, immediately after tracheal intubation and immediately after extubation, level of serum cortisol (COR) was detected by electrochemical luminescence apparatus. The level of serum dopamine was detected by ELISA. The blood pressure and heart rates were recorded. The recovery quality during anesthesia was compared, including recovery time, recovery time of spontaneous breathing, extubation time and recovery time of orientation. The cognitive function of patients was evaluated by Neurobehavioral Cognitive Status Examination (NSCE). The incidence of intestinal paralysis, nausea and vomiting, and hospitalization time were observed and recorded during treatment.Results:Immediately after tracheal intubation and extubation, systolic blood pressure in intervention 2 group, intervention 1 group and control group were significantly decreased ( F=12.03, 13.96), levels of serum COR ( F=91.40, 53.76), and dopamine ( F=29.72, 69.39) were significantly decreased ( P<0.01). The recovery time of orientation during anesthesia [(39.09±3.12)min vs. (41.57±3.54)min, (43.84±3.28)min, F=34.65] in intervention 2 group was significantly shorter than that of the intervention 1 group and control group ( P<0.01), and hospitalization time [(9.36±1.78)d vs. (10.92±1.81)d, (12.10±1.95)d, F=1.44] was significantly shorter than that of the intervention 1 group and control group ( P<0.05). Conclusion:The FTS combined with acupuncture at Neiguan acupoint can reduce stress level during anesthesia, improve recovery quality and relieve postoperative cognitive dysfunction in patients undergoing craniocerebral surgery.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.