A broken metal handle accompanied by femoral trunk fracture, which would shorten service life of handles. Therefore, it is necessary to judge whether the notch is the main reason for handle broken. Some literatures thought that the pores of sintered porous coated anatomic (PCA) porous layer produce the notch on the handle surface and the notches lead to the handle broken being incorrect. The Apex of the pore is taken for the bottom of the notch, expanding into a crack, and it should also not grow to the base-alloy, accordingly, the above conclusion is wrong. Some reports pointed out the notch, apex of the pore, will expand into the crack, but it is not associated with the broken handle. Under the sintering temperature, the grain boundary apertures be generated on the base metal surface, the aperture is expanded into the crack, which leads to handle broken in the forced area. However, neither theoretical basis, nor a case of corroboration, can prove exist of notch. Actually, the broken handle is caused by the sintering technology. The high temperature of sintering joining results in grain boundary aperture, when encounter the largest forced area and expand into crack, it will break the handle.

INTRODUCTION: General joining techniques are at low level, which produces some potential problems in porous layer of porous coated anatomic (PCA).LIMITATIONS: The problems in general joining techniques are caused by limitations of each technique, which could not be solved using advanced measures.APPLICATION: The activated diffusion brazing technology is an effective way. Its many advanced processes can solve those potential problems.CONCLUSION: The stress-shielding problem caused by PCA porous layer can be solved by using small metal balls in the same diameter in combination with the advanced activated diffusion brazing technology. Moreover, the high performance brazing metals by activated diffusion brazing technology is harmless for humans.

OBJECTIVE: Sintering of porous coated anatomic porous layer bonding technology remains controversial because of poor understanding to its essence.ESSENCE: Sintering is a technology that the bonding temperature exceeds 5 ℃ or higher than the base-alloy solids temperature of 1 230 ℃, resulting in base-alloy produce a series of serious problems, such as grain boundary racks, handle broken and so on.HAZARDS: In sintering temperature, the low melting point eutectlc phase and the brittle metal compounds flow out of the grain boundary to bond the small metal balls and the handle, which greatly reduces the fatigue strength. The grain boundary cracks formed and expanded ultimately leading to handle broken.DISCUSSION: The cause of a handle broken is neither notch nor metallurgical defects but sintering process, because high sintering temperature results in grain-boundary lacunas.CONCLUSION: Sintering is not suitable for connecting the force components. High sintering temperature produces grain-boundary lacunas which can expand into cracks and ultimately result in handle broken under some condition.

Neutrophil ( PMN) is the main immune effect cell of killing candida yeast cells .It can recognize different cellular components of candida through a variety of surface and intracellular pattern recognition receptors , phagocytose and/or form extracellular traps to capture candida yeast and mycelia , then kill them with oxidation or non-oxidation mechanism .It can also adjust innate immunity and adaptive immune response in candida infection by interaction with other immune cells .This article reviews recent progress of the multiple subsets of neutrophil , the mechanism of its recognizing and killing candida , and the interaction with other immune cells , to provide new perspectives for clinical therapy of candida infections .

Objective To detect circulating autoantibodies to melanocytes in patients with vitiligo and its relationship to disease activity and subtypes. Methods IgG autoantibodies to melanocyte surface antigens were measured in sera from 334 patients with vitiligo and 50 normal individuals using a live cell enzyme linked immunoabsorbent assay. Results Anti melanocyte IgG antibody was present in 67％ of patients(165/250) with active non segmental vitiligo, 30.3％ of patients(10/33) with inactive non segmental vitiligo, 40.54％ of patients(23/51) with active segmental vitiligo and 21.42％ of patients with inactive segmental vitiligo (3/14). The autoantibody levels were significantly higher in patients with active non segmental vitiligo and active segmental vitiligo than those with inactive disease or normal individuals. Conclusion Autoimmune mechanism may play an important role in both non segmental and segmental vitiligo.

0.05),while there was significant difference among other groups(P

[Objective]To study the effects of titanium cable system used as a treatment alternative for comminuted patella fractures.[Method]Fifty-seven cases of comminuted patella fractures were treated from November 2004 to August 2007.The patients were divided into three groups:the group of titanium cables,AO modified tension band and nickel titanium-patella catcher respectively,according to the choice of internal fixation.The operation time,the amount of blood loss,the first knee exercise time after operation,length of hospitalisation,medical expenses,time off for employees,complication and long-term knee function were studied.All the data were analyzed and compared by statistical ways.[Result]The 57 patients were followed up for 11 to 48months(means,22.4 m).Patients who were fixed with titanium cables could start most early extending and flexing the knee(5.6 d after operation),but most expense in medical usages(9500 RMB).The good or excellence rate was 95.1% in patients treated with titanium cables cerclage,which was better than that of the other two groups.[Conclusion]Titanium cables cerclage can cure comminuted patella fractures.The method had advantage of better long-term curative effect and less complication,and so on.It's worthy to be recommended for the therapy of comminuted patella fracture.

Objective To investigate melanocyte membrane antigen associated with vitiligo,for further purification and cloning.Methods Sera from patients with vitiligo were screened by using a live cell enzyme-linked immunoabsorbent assay,98strongly positive sera were obtrained.Melanocyte antigens were immunoblotted after splitting of cultured normal human melanocytes.Thirty strong positive vitiligo sera were detected.Results There were positive bands in all screened sera as shown by immunoblotting.Whereas,positive band was seen in only one normal human sera.The antibody bound many antigens with different molecular weights(150kd,90kd,75kd,50kd,40~45kd).Positive rates for individual antigens were70%,60%,83%,16%and23%,respectively.Conclusions Antibody directed to melanocyte membrane antigens of melanocytes are present in the sera of patients with vitiligo.The molecular weights of the antigens are mainly150kd,90kd and75kd,the antigens with small molecules discovered previously maybe the degradation products of big molecules.

Objective To understand the prophylactic use of antimicrobial agents in the patients undergoing I incision surgery from 2011 to 2013 in a tumor hospital,to explore the the effects of intervention management measure for antibacterial agents using in the perioperative period.Methods The cases of tumor surgical patients of 2011-2013 were selected and divided into the three intervention groups and non-intervention group.The data of medication after three-stage continuous integrated intervention were collected and compared.Results The percentage of antibiotics use was much lower,from 61.73%pre-intervention to 47.03%,26.78%and 24.85%after three stage intervention. The course of preventive medication treatment was significantly decreased from 81h to 53h,33h,21h,respeetively.The reasons of their rationally utilizing antibiotics were significantly improved after intervention management.Conclusion Rational antibiotics utilization can be improved by intervention management during perioperative period of typeⅠinci-sion operations,which can achieve the goal of health department.

Objective To investigate perioperative nursing of respiratory system in severe scoliosis patients.Methods 26 severe scoliosis patients with respiratory function training before operation were retrospected.All of them tested pulmonary function before and after training,postoperative respiratory system nursing were also taken to maintain airway unobstructed,including respiratory rate and oxygen saturation monitoring,effective pain management and respiratory complications controlling.Results The average forced vital capacity(FVC)was 45.9%and 52.1%before and after breathing exercises,the mean forced expiratory volume in one second(FEV1)was 43.8%and 48.8%before and after breathing exercises,with lung function improvement in 69.2%patients. There were two hemopneumothorax and three mild or moderate pleural effusion occurred within 10 days after surgery,but all recovered after effective treatment and nursing.Conclusions Perioperative systematic and effective training in respiratory function and airway management can improve lung function and surgical safety,reduce the incidence of postoperative pulmonary complications,and promote early rehabilitation .