OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

Objective To investigate the correlation between serum level of gamma-glutamyl transferase (GGT) and coronary heart disease (CHD) in military pilots. Methods Sixty male military pilots hospitalized in Airforce General Hospital having coronary angiography examination(CAG) from March 2005 to May 2015 were involved then were divided into CHD group (n = 24) and control group (n = 36) according to the results of coronary angiography (CAG). The patients with CHD were divided into low score group (Gensini score ≤ 20) and high score group (Gensini score > 20) according to Gensini score. Results There were significant increase of the level of TG, GGT and decrease of the level of HDL-C in CHD group than those in control group(P<0.05);there was no significant difference with the level of GTT between high score group and low score group (P > 0.05); logistic regression analysis showed that serum GGT was an independent risk factor of CHD in military pilots (OR = 1.168, P < 0.01). Conclusion Serum GGT is associated with CHD in military pilots and is the independent risk factor of CHD in the pilots.

In this paper the background and advances of stem cell technique in stomatology were reviewed, especially the lately research of repair of maxillofacial defects with bone marrow stem cells, repair or reconstitution of teeth with dental pulp stem cells and repair of other tissues such as parotid with embryonic stem cell. Stem cell technique provides a new choice and extensive prospect of application for stomatology, therefore, deserves further research.
Oral Medicine ; Stem Cell Transplantation ; methods ; Stem Cells ; cytology

Objective To evaluate the value of human epididymis secretory protein 4(HE4)and CAl25 in the diagnosis of ovariall malignancy.Methods HF4 and CA125 in the serum specimens of malignant ovarian tumor group(30 cases),benign ovarian diseases(110 cases;45 benign ovarian tumor,57endometriotic diseases and 8 pelvic inflammation were included) and healthy women group( 137 cases)were assayed double blindly . The levels and the diagnosis efficiency of the HE4 and CA125 were analyzed.Results (1) The median levels of HE4 and CA125 were significantly higher in malignant ovarian tumor group (244 pmoi/L and 601 kU/L respectively) than those of the benign ovarian diseases group( 32 pmol/L and 22 kU/L respectively)and healthy women group (32 pmoi/L and 11 kU/L respectively) (P =0. 000-0. 029). The median levels of CA125 were also higher in endometriotic diseases and pelvic inflammation groups(53 and 41 kU/L respectively) than those of benign ovarian tumor group and healthy women group (12 and 11 kU/L respectively;P = 0. 000-0. 031 ). (2) The positive rate of HE4 was lower than that of CA12s in malignant ovarian tumor group ( P = 0. 036 ). HE4 was negative in benign diseases and healthy women groups. But the positive rates of CA125 were 56. 1% and 5/8 respectively in endometriotic diseases and pelvic inflammation groups and there were significant differences compared with HE4( P =0. 000). (3)The HE4 assay had advantage over the CA125 assay in receiver operating characteristic-area under the curve (ROC-AUC) and sensitivity with a specificity of 100% when ovarian malignancy was compared with controls having benign diseases and healthy women, benign tumor or benign diseases groups respectively. The CA125 assay had advantage over the HE4 assay in ROC-AUC and sensitivity with the same specificity when ovarian cancers were compared with controls having healthy women group. (4) Combined assay of HE4 and CA125was better than CA125 alone when ovarian malignancy was compared with controls having any group. (5)Combined assay was better than HE4 alone in ROC-AUC and sensitivity with the same specificity when ovarian cancers were compared with controls having benign diseases and healthy women or healthy women groups. And combined assay was lower in the ROC-AUC and the sensitivity with specificity of 100% than HE4 when ovarian cancers were compared with controls having benign tumors or benign diseases groups respectively. (6) The diagnosis efficiency of the HE4 assay at the level 86 pmol/L determined in ROC curve with controls having benign diseases and healthy women group and at the 95% reference level 50 pmol/L of healthy women or 150 pmol/L recommended by the kit respectively was compared. The sensitivity of 50 pmol/L was 73% higher than 150 pmol/L and 86 pmoi/L, while the specificity and positive predictive value were lower ( P = 0. 002, P = 0. 000 ). The specificity, accuracy and positive predictive value of HE4 assay at the set point of 150 pmol/L and 86 pmol/L were 100%, 96% and 96%. The set point of 86 pmol/L had advantage over 150 pmol/L at the sensitivity of diagnosis, 70% and 63% respectively. But the positive predictive value was 95% lower than 150 pmol/L, being 100%. There was no significant difference( P =0. 883, P = 0. 883 ). Conclusions The specificity of HF4 assay is higher than CA125 assay in the diagnosis of ovarian cancer and HE4 combined with CA125 assay can improve the diagnoses. The set point of 150 pmol/L is advantageous for the accurate diagnosis, while the set point of 86 pmol/L is advantageous for the screening of malignant ovarian cancer.

OBJECTIVETo study the cell biocompatibility of porous biphasic calcium phosphate nanocomposite in vitro.

METHODSBone marrow mesenchymal cell (BMSCs) obtained from SD rat bone marrow were in vitro induced and proliferated. Afler their osteoblast phenotypes were verified, BMSCs were seeded onto prepared porous biphasic calcium phosphate nanocomposite (Experiment group) and common porous hydroxyapatite (Control group). The cell adhesion was evaluated by scanning electron microscope. Synthesis of alkaline phosphatase enzyme (ALP) and osteocalcin were detected and cell cycle was detected by flow cytometry.

RESULTSBMSCs could fully attach to and extend on the material in experiment and control group, Moreover, experiment group were superior to control group in adhesion, proliferative abilities and osteogenic activity.

CONCLUSIONBMSCs can differentiate to osteoblast phenotype; the porous biphasic calcium phosphate nanocomposite as bone tissue engineering scaffold has good cell biocompatibility.

Alkaline Phosphatase ; Animals ; Bone Marrow Cells ; Bone and Bones ; Cell Adhesion ; Durapatite ; Hydroxyapatites ; Materials Testing ; Nanocomposites ; Osteoblasts ; Osteocalcin ; Rats ; Tissue Engineering ; Tissue Scaffolds

OBJECTIVETo investigate the results of hip arthroplasty for the treatment of severe comminuted proximal femoral fracture with ipsilateral acetabulum fracture.

METHODSFrom June 2007 to September 2013, 8 patients (8 hips) with severe comminuted proximal femoral fracture combined with ipsilateral acetabulum fracture were treated with hip arthroplasty. All patients were male and using biological prosthesis. Aged from 33 to 64 years old with an average of 41.9 years. According to Harris score in aspect of pain, function, range of motion to evaluate clinical effects.

RESULTSThere was no untoward reaction in 8 patients. And bed rest at 3 months after operation, waiting for acetabulum fracture healed to out-of-bed activity. There was no complications such as pneumonia, bedsore and so on in the patients. Follow-up time was from 9 to 72 months with an average of 35.8 months, the wound healed, there was no the subsidence and loosening of prosthesis, no dislocation and infection. The mean of Harris score was 87.5 points after operation.

CONCLUSIONThe effect of the hip replacement in treating severe comminuted proximal femoral fracture with ipsilateral acetabulum fracture is confirmed. It can restore motor function and reduce traumatic complication, may serve as a substitute for internal fixation of difficult operation. The long-term efficacy is necessary to further observe.

Acetabulum ; injuries ; surgery ; Adult ; Arthroplasty, Replacement, Hip ; methods ; Femoral Fractures ; physiopathology ; surgery ; Fractures, Comminuted ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular

Objective: To determine incidence rates of uterine clear cell carcinoma among non-White US subpopulations. Methods: Data from the United States Cancer Statistics and National Cancer Database from 2004 to 2016 were analyzed using descriptive statistics. Results: A total of 488,811 women were diagnosed with uterine cancer from 2004–2016.Of these, 73.3% were endometrioid, 6.6% were serous, 5.3% were carcinosarcoma, 1.4% were clear cell, and 13.4% were other. Blacks had the highest incidence rate of uterine clear cell compared with Whites, Asian/Pacific Islanders, and American Indian/Alaska Natives (0.59 vs. 0.31, 0.29, and 0.24, respectively). Overall mean age at diagnosis was 68.6 years, with the youngest age in Asian/Pacific Islanders compared to Whites, Blacks, and American Indian/Alaska Natives (65.9 vs. 68.7, 68.6, and 66.3 years, respectively). Analysis of the Asian subpopulation revealed significantly younger age at diagnosis in Vietnamese women (55.8 years) compared with 72.4 years in Japanese, 68.6 years in Pacific Islander, 66.6 years in Indian/Pakistani, 65.9 years in Filipino, 65.8 years in Chinese, 65.2 years in Korean, and 63.7 years in other Asians. Conclusions Black women are two times more likely to be diagnosed with uterine clear cell carcinoma compared with other races. Asians present at younger ages, with Vietnamese women most likely to be diagnosed at the youngest age.

BACKGROUNDThe role of B-cell remains an enigma in the pathogenesis of ankylosing spondylitis (AS). This study aimed to investigate the distributions of B-cells and subsets in peripheral blood of AS patients and observe their changes in etanercept-treated AS patents.

METHODSWe detected the proportions of CD19(+) B-cell, naive B-cell (CD19(+)CD27-), memory B-cell (CD19(+)CD27dim) and plasmablast (CD19(+)CD27high) in peripheral blood of 66 patients with AS (39 at active stage, 27 at stable stage; 35 patients with peripheral joint involvement, 31 patients with axial involvement alone), 30 patients with rheumatoid arthritis (RA) and 30 healthy volunteers using flow cytometry. And then we observed the changes of the above indexes of 39 active AS patients treated with etanercept in a randomized, double-blind, placebo-controlled trial.

RESULTS(1) Percentages of CD19(+) B-cells in active or peripheral joint involvement AS patients increased more obviously than those in stable or axial involvement alone AS patients (both P = 0.001), and percentage of CD19(+)CD27high B-cells in AS patients with peripheral joint involvement was significantly higher than that in cases with axial involvement alone or healthy volunteers (P = 0.005 and 0.006, respectively); (2) The percentage of CD19(+) B-cells in AS patients was positively correlated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, Patient's Global Assessment (PGA) scores, total back pain scores and nocturnal back pain scores (r = 0.270, 0.255, 0.251 and 0.266, P = 0.029, 0.039, 0.042 and 0.031, respectively); (3) At week 6 and week 12, there were no statistical differences of the percentages of B-cells and subsets between etanercept group and placebo group of AS patients (P > 0.05); the percentage of CD19(+) B-cells in etanercept group was higher than that in healthy volunteers at week 12 (t = 3.320, P = 0.003).

CONCLUSIONSMisbalance is present in B-cells and some subsets in peripheral blood of active AS patients with peripheral joint involved. B-cells might play an important role in the pathogenesis of AS patients. The high percentage of CD19(+) B-cells in active AS patients cannot be down-regulated after 12-week etanercept treatment.

Adolescent ; Adult ; Antigens, CD19 ; immunology ; B-Lymphocytes ; drug effects ; immunology ; Etanercept ; Female ; Flow Cytometry ; Humans ; Immunoglobulin G ; pharmacology ; therapeutic use ; Immunosuppressive Agents ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Spondylitis, Ankylosing ; drug therapy ; immunology ; Tumor Necrosis Factor Receptor Superfamily, Member 7 ; immunology ; Young Adult

Animals ; Hydrogen Sulfide ; metabolism ; Hypertension, Portal ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley

Objective To observe the therapeutic effect of ketogenic diet therapy for children with intractable epilepsy and its safety.Methods Fifteen patients with intractable epilepsy were treated with ketogenic diet that was modified specifically for Chinese people.The compliance,seizure frequency and side effects were followed up.Results Twelve patients maintained on the treatment for 1 month.Among them,the reduction of seizure frequency in 10 patients exceed 50%.Ten patients maintained on the treatment for 3 months.Among them,the reduction of seizure frequency in 8 patients exceed 50%.Five patients maintained on the treatment for more than 6 months.The reduction of seizure frequency all exceed 50%.The reduction of seizure frequency in 4 patients exceed 90%.The seizures of 3 patients were controlled completely.Ten patients among all cases had various adverse effect,such as nausea,vomiting,diarrhea,constipation,hypoglycemia(nonsymptomatic),hyperlipemia and damage of liver function and so on,which could eliminate by anti-symptomatic treatment.Conclusions Ketogenic diet is effective and safe in Chinese children with intractable epilepsy with modified methods specifically for Chinese.The effect is unrelated with seizure types obviously.