BACKGROUND:The regional gene therapy of bone defect is to transfer genes capable of accelerating bone healing into target cells, which will transcript the genes into mRNA and translate them into proteins, then the target cells will be stimulated to differentiate under the role of protein, and finally reach the purpose of accelerating bone healing by means of autocrine or paracrine. With the development of cell recombination technique, more and more genes of growth factors involved in the bone repairing have been successfully cloned, which make it possible to treat bone defect with gene therapy. The present status for the regional gene therapy of bone defect is summarized.DATA SOURCES: An online search in Pubmed database was undertaken to identify articles about the regional gene therapy of bone defect published in English from January 1965 to January 2006 by using keywords of "gene therapy,bone defect". Meanwhile, Chinese relevant articles published from January 2000 to January 2006 were searched in Wanfang database by using the same keywords in Chinese.STUDY SELECTION: The data were primarily checked, and the references of each article were looked up. Inclusive criteria: related to the regional gene therapy of bone defect. Exclusive criteria: repetitive study or Meta analysis.DATA EXTRACTrON: Totally 237 articles were collected, 32 of them were in accordance with the inclusive criteria, and the other 205 were old or repetitive ones. Of the 32 articles, 4 were about the selection of destination genes, 3 about the selection of target cells, 7 about the selection of gene expression vector, 3 about the methods of gene transfer, 4 about gene therapy combined with tissue engineering in treating bone defect, 5 about polygenes in treating bone defects, and 2 about the problems and prospects in the gene therapy of bone defect.DATA SYNTHESIS: The regional gene therapy of bone defect is a new technique developed base on the basic theoretical cognition of bone regeneration and gene recombination technique, and provides ideal solving program for the treatment of bone defect caused by various reasons. The basic problems mainly include the selection of destination genes, selection of target cells, selection of gene expression vectors and the selection of the methods of gene transfer.The studies about the selection of target cells and methods of gene transfer become mature day by day, bone marrow stromal cells have become the target cells should be selected firstly, and it has been generally acknowledged that ex vivo gene transfer has more obvious advantages than in vivo one. The key problem at present is how to further explain the natural process of the repair of bone defect, and select the most effective component from the signal molecules involved in the process to apply in the gene therapy of bone defect, and further improve the gene expression vector, so as to ensure the safety of gene therapy. It is believed that with the continuously deepened theoretical cognition of bone regeneration and the continuous perfection of gene recombinant technique, the gene therapy of bone defect will finally go out of laboratory, and really serve the patients with bone defect.CONCLUSION: The regional gene therapy of bone defect can effectively activate the activity of bone regeneration at the site of bone defect, also can avoid the problems of immunologic rejection and systematic toxicity caused by the direct application of cytokines, and has good prospects of clinical application. At present, this technique is not completely perfect, and there are many problems to be deeply investigated in destination genes, gene vectors and transfection technique, etc.

BACKGROUND: Metal on metal (MoM) hip prosthesis has been used for more than 30 years. With the increasing number of young patients who used it, the metal ions cumulative in the body may cause the biological effects, such as cell toxicity, genetic toxicity, carcinogenicity and metal allergy, etc, which have received attention and concern. OBJECTIVE: To describe what influences the production of metal ions, and how metal ions distribute in human tissue after MoM hip prosthesis implantation. In particular the change of the metal ions serum level and the MoM hip prosthesis biological effects of the pathological manifestations were investigated. This paper also focused on the factors influencing metal ions serum level and the mechanism of metal ions biological effects. RETRIEVAL STRATEGY: A computer-based search of Pubmed database was undertaken to identify the articles between January 2004 and November 2007, with the key items of "metals, total hip replacement" and language was limited to English. Meanwhile the China Journal Full-text Database was retrieved for the related articles published from January 2000 to November 2007, with the words of "joint replacement, metal ions" in Chinese. Totally 267 articles were screened out, and checked primarily. Inclusion criteria: ①prosthesis interface described the articles for MoM;②procedure described in the articles for hip replacement;③ articles focused on biological effects of metal ions. Exclusion criteria: ①non-MoM interface of the prosthesis;②non-hip arthroplasty;③articles described the metallurgy;④reproducibility study. LITERATURE EVALUATION: Both titles and abstracts were screened preliminarily, excluding 194 articles of unrelated objectives, 58 articles of repeated contents and 0 Meta analysis. Finally 30 articles were taken into further analysis, including 6 reviews and other basic or clinical trials. DATA SYNTHESIS: MoM prosthesis releases metal ions in the body through electrochemical process (corrosion) and enhanced machinery plus electrochemical process (wear-corrosion). It spreads to various body tissues by body fluid, and raises a number of biological effects. Human body shows a reaction of metal ions in a dose-dependent manner, and metal ions serum level decides the biological effects. Generally we consider the serum concentration of metal ions is influenced by ①ion excretion factors. ② mechanical factors. ③individual factors. ④others. At present, the biological effects of metal ions include ①inflammatory response, ②oxidative damage, ③apoptosis, ④osteoporosis and extracellular matrix dissolution, ⑤carcinogenesis, ⑥host response. Its mechanism is related with corrosion, macrophage activation, reactive oxygen generation, osteoblast function inhibition, osteoclast activation, metal-protein complex formation, and so on. The consequence is a series of pathological changes: ①foreign body granuloma synovitis, ②draining lymph node lesions, ③chromium calmly disease, ④malignant lesions, ⑤metal allergy. CONCLUSION: There is no better product to replace MoM hip prosthesis. Through the study of their biological effects, people gradually concern about two issues. First: What is a safe wear rate? Second: What is harmful serum level of metal ions?

The technology of bone tissue engineering has got rid from autologous bone implant and allograft bone. With the development in recent 20 years,the basic pattern of tissue engineered bone has already been constructed,consisting of related molecules to bone regeneration,active cells for osteogenesis and scaffold materials. The related molecule to bone regeneration is the dominant factor to determine the bio-activity of tissue engineered bone,and also is the key researches in the field of bone tissue engineering. As the molecule bio-mechanism of bone regeneration has been elucidated and molecule bio-techniques have been combined with bone tissue engineering,many achievements regarding the related molecules to bone regeneration are observed in bone induction mechanism,vector,gene therapy technology and the combined use,which all improve the effect of tissue engineered bone on repairing the bone defects.

SOCS3 has significant regulation effects in cell signal transduction pathways, which can be induced by many kinds of cytokines and proinflammatory factors. After being studied for years, the effect of SOCS3 has become clear in maintaining physiological functions and affecting histopathologic changes in human tissues. This review presents the role of SOCS3 in the occurrence, development, diagnosis and treatment of human diseases, such as inflammation, virus infection, obesity and tumor. As abnormal levels or impaired function of SOCS3 were reported in the onset and development of disease, SOCS3 can be considered as a bio-marker to diagnose and predict prognosis of some disorders, and as a therapeutic target for certain diseases.

BACKGROUND: Currently, total hip arthroplasty is a recognized and preferred method for treatment of adult congenital acetabular dysplasia, however, there were lack of ideal evaluation methods to precisely solve acetabular reconstruction in the process of treatment. OBJECTIVE: To investigate the evaluating effects and biological properties of computer aided technology in adult acetabular dysplasia after total hip arthroplasty.METHODS: The clinical data from 80 patients with adult congenital acetabular dysplasia who received the treatment at Department of Bone and Joint Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA from January 2015 to August 2015 were selected and analyzed. Al the enrol ed patients underwent total hip arthroplasty. Al the patients were randomly divided into control and computer-aided technology groups. CT scanning was conducted in these two groups before replacement. Three-dimensional reconstruction measuring and surgical rehearsal on the acetabular site were conducted using M3D visualization software in the computer-aided technology group. The effects and biological properties of total hip arthroplasty were compared between these two groups. RESULTS AND CONCLUSION: Patients in these two groups primarily healed after replacement. The excel ent and good rate, Harris score after treatment, acetabular component, valgus angle and anteversion in the computer-aided technology group were significantly higher than those in the control group (P < 0.05). The acetabular cup abduction angle offset degrees, acetabular cup anteversion offset degrees, and the incidences of complications after replacement were significantly decreased compared with those in the control group (P < 0.05). These results suggest that the effect of computer-aided evaluation in adult acetabular dysplasia after total hip arthroplasty is ideal, and can accurately grasp the true acetabular anatomical characteristics and the corresponding relationship with the prosthesis, so as to help patients to choose the proper acetabulum and acetabular prosthesis and reconstruction ways and improve the biological performance of acetabulum after replacement, with a high clinical value.

OBJECTIVE:To observe the therapeutic effect of compound glycyrrhizin injection on herpes zoster METHOD_S:50 cases of herpes zoster received compound glycyrrhizin injection 60ml q d intravenous drip for 5 days RESULTS:Curative rate was 22% and improving rate 64% with a total effective rate of 86% CONCLUSION:Compound glycyrrhizin has corticosteroid-like action,which could regulate immunologic function and inhibit virus

[Objective]The best treatment method for cemented acetabular component loosening during revision hip replacement has not been established.The purpose of this study is to determine the initial results obtained with a unique implant the modular porous tantalum cup,designed as an alternative treatment for aseptic prosthesis loosening following total hip arthroplasty.[Method]From Apr. 2006 to Nov.2006,porous tantalum cups were implanted during sixteen revision total hip replacements in nine women and seven men who had an average age of 69.2 years at the time of the procedure.Harris score and UCLA activity score were measured before,at 1,2 years and after arthroplasty.Radiographic follow-up was performed simultaneously.All patients were followed-up clinically and radiographically.[Result]The mean follow-up period was 24 month (range18-25months).The mean preoperative Harris hip score(HHS) was 21-54 (32.6) compared with the postoperative HHS of 56-90 (87.5).The mean preoperative UCLA score was 2-5(3.8) compared with the postoperative score of 6-9 (8.2).Radiographic evaluation of the revised components demonstrated no evidence of loosening or subsidence,and all showed radiographic evidence of bone ingrowth.[Conclusion]At the time of short-term follow-up,the porous tantalum cup effectively provided structural stability for acetabular component failure of cemented primary fixation.The potential for long-term biologic fixation may provide durability for porous tantalum cup.Long-term follow-up and comparison with alternative revision techniques will be required to evaluate the true effectiveness of this treatment approach.

Objective:To explore the application of fetal multi-organ hemodynamics in the detection and evaluation of oxygen supply and blood supply for fetus in the third trimester of pregnancy. Methods: 42 pregnant women with gestational diabetes mellitus and 42 healthy pregnant women were divided into observation group and control group, respectively. All of the fetuses of pregnant women received Doppler ultrasound examination, and the pulsatility index(PI), resistance index(RI) and systolic/diastolic(S/D) ratio of umbilical artery (UA)and middle cerebral artery (MCA) of every fetus in the two groups were observed. Besides, the number of fetal distress was recorded and the relationship between fetal distress rate and gestational diabetes mellitus were calculated.Results:The PI, RI and S/D of MCA of fetuses of pregnant women with gestational diabetes mellitus was significantly higher than that of healthy pregnant women (t=7.52,t=6.04, t=8.69,P<0.05). And the PI, RI and S/D of UA of fetuses of pregnant women with gestational diabetes mellitus also was significantly higher than that of health pregnant women (t=11.95,t=9.78,t=8.95, P<0.05). Besides, the fetal distress rate of observation group was significantly higher than that of control group (x2=19.56,P<0.05).Conclusion: The fetal blood flow information which obtained from Doppler ultrasound has very importantly value in the diagnosis of gestational diabetes mellitus, and it verifies the relationship between fetal distress rate and gestational diabetes mellitus. It provides beneficial basis for the prevention and treatment of the gestational diabetes mellitus in the clinical practice.

Objective To compare the effect of anti-spin intramedullary nail and dynamic hip screw fixation in the treatment of elderly intertrochanteric fractures ,in order to investigate the clinical value of anti-spin intramedul-lary nail in elderly intertrochanteric fractures .Methods 160 elderly patients with intertrochanteric fractures were divided into the observation group and control group according to the random number table .The observation group received anti-spin intramedullary nail fixation , the control group received dynamic hip screw fixation .The fracture healing and hip function of two groups were compared .Results The operative time of the observation group was shor-ter than that of the control group ,and blood loss was less than the control group ,the differences were statistically sig-nificant(t=4.635,3.643,all P<0.05).The function,pain,deformity,range of motion and total scores of the obser-vation group were significantly higher than those of the control group ( t=4.433,4.364,4.865,3.876,3.645,all P<0.05).The postoperative hip function excellent rate of the observation group was 90.0%,which was significantly higher than 72.5%of the control group (χ2 =5.153,P<0.05).Conclusion Proximal femur intramedullary nail anti-rotation fixation in the treatment of elderly intertrochanteric femoral fractures has shorter operative time ,less blood loss,and postoperative hip function recovery is good ,it is worthy of promotion .

BACKGROUND: Biological fixation refers to the treatment of coarse or porous prosthetic surface. It is favorable to "bone ingrowth" prosthesis to achieve long-term stability. Porous tantalum is the latest scientific product that appears suitable to prosthetic surface owing to its porous feature and has been attracting a great deal attention.OBJECTIVE: To investigate the therapeutic efficacy of a porous tantalum uncemented acetabular cup in acetabular revision arthroplasty.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA between April and November 2006.PARTICIPANTS/MATERIALS: Sixteen patients (16 hips), 7 males and 9 females, aged 54-81 years old, who received treatment at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA were included in this study. Of these patients, 2 suffered from femoral neck fracture, 6 from aseptic femoral head necrosis, and 8 from osteoarthritis. Trabecular metal cup (Zimmer, Warsaw, Indiana) provided a titanium alloy bottom layer and porous tantalum-coated surface, which was realized by technical combination of bone trabecular tantalum and titanium alloy. The prosthesis contained an ultrahigh modulus polyethylene lining.METHODS: All patients underwent acetabular revision with modular porous tantalum uncemented acetabular cup. Prior to replacement, acetabular defects and femoral prosthesis were evaluated. A posterolateral approach of hip joint was made. Following acatabular prosthesis removal, bone cement was cleared with osteotome, simultaneously scar tissue, granulation tissue, and fibrous limiting membrane in the acetabular fossa were erased with curette to avoid further damage to sclerotin. Bacteriological examination and susceptibility test with respect to intraarticular tissue fluid confirmed aseptic loosening. Antibiotics were used in each patient to prevent infection. Antibiotics and low molecular heparin were used afterwards to prevent infection and thromboembolism, respectively. Patients could not load within 4 weeks but could walk with the aid of two canes within subsequent 6 weeks. One week after surgery, plain X-ray films were taken in the lateral plane.MAIN OUTCOME MEASURES: Prior to and 6, 12, and 24 months after surgery, Harris hip score and University of California Los Angeles (UCLA) activity score were assessed. The position of acetabular prosthesis was observed through an anteropostedor pelvic radiograph.RESULTS: The average follow-up time was 24 months (range 18-25 months). Harris hip score significantly increased from 32.6 points (range 21-54 points) prior to revision to 87.5 points (range 56-90 points) after revision (P < 0.05). UCLA activity score significantly increased from 3.8 points (2-5 points) prior to revision to 8.2 points (range 6-9 points) after revision (P<0.05). The anteropostedor pelvic radiographs taken in the last follow-up displayed no phenomena regarding non-stability including prosthesis aversion and subsidence and revealed that the in-growth of sclerotin surrounding the bone trabecular tantalum acetabular cup. Postoperative complications were found in none of 16 patients. By the last follow-up, there had been 14 cases who did not complain of pains while walking and 2 cases that had slight pain and slight limp while walking. Deep venous thrombosis or nerve injury did not appear afterwards. No cases needed another acetabular revision arthroplasty.CONCLUSION: For cases of failed primary fixation of artificial acetabular cup, application of porous tantalum uncemented acetabular cup can produces favorable results in acetabular revision if no bone defects exist.