OBJECTIVETo investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky type III severe acetabulum bone defect.

METHODSTwelve patients (12 hips) with Paprosky type III severe acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty, were retrospectively analyzed from March 2009 to December 2012. Among the patients, there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old; the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky, all patients were Paprosky type III acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty, and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared, Harris score were used to evaluate clinical effects.

RESULTSEleven patients ( 11 hips) were followed up from 9 to 36 months with an average of 25 months, 1 case was lost to follow-up for dying in car accident. The incisions were healed at stage I . Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis, periprosthetic femoral fracture and infection, sciatic nerve injury occurred after operation. Harris score were improved from (46.25 ± 8.99) before operation to (83.75 ± 6.76) after operation. There was significant difference in Harris score before and after operation (t = 3.14, P = 0.00 < 0.05), and 7 cases got excellent results, 2 good and 2 moderate. CONCLUCSION: Tantalum metal block is suitable for revision of Paprosky III acetabulum bone defect, could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft, induce bone growth pressured between metal block and metal cup, provide a new further choose for the treatment of Paprosky type III severe acetabulum bone defect.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tantalum

Objective There is still a concern that epidural labor analgesia could affect uterinecontraction.The purpose of this study was to investigate the effect of epidural labor analgesia on uterinecontraction.Methods Forty ASA Ⅰ-Ⅱ primiparous women aged 20-30 yr at full term in normal uncomplicateddelivery were enrolled in this study.They were taller than 1.5 m and weighed less than 100 kg.The amnioticmembrane was artificially ruptured at 3 cm cervical dilation and a catheter was inserted into uterine cavity beyondthe head of the fetus and connected to a maternal-fetal monitor.The patients were randomly divided into 2 groupswith 20 patients in each group:Ⅰ control group received no analgesia and Ⅱ epidural group received continuousepidural analgesia(PCEA).An epidural catheter was placed at L_2-3.After a loading dose of 8-10 ml of the PCEAsolution(0.1% ropivacaine+1 ?g?ml~(-1) fentanyl)PCEA was started(bolus 3 ml,lockout interval 15 min andback ground infusion 6-8 ml?h~(-1)).The height of block was controlled below T_10.Blood samples were taken frommaternal vein at 3 cm cervical dilation(T_1),1h later(T_2)and at delivery(T_3)and from umbilical vein andamniotic fluid was aiso collected for determination of cortisol,PGE_2 and pitocin levels.VAS scores,intrauterinepressure,the frequency and duration of uterine contraction,the use of pitocin(%),incidence of cesareansection,the length of labor and neonatal Apgar scores were recorded.Results The maternal blood eortisolconcentration was significantly lower during PCEA(T_2,T_3)in group Ⅱ than in control group(P

AIM:To observe the efficacy of intravitreal conbercept injection for chronic central serous chorioretinopathy (CSC).METHODS: Nine eyes of 9 patients diagnosed as chronic CSC between October 2015 to May 2016 were treated with an intravitreal injection of conbercept (0.5mg/0.05mL) (six patients were given the same does of intravitreal injection again at 1mo after the first injection).Follow-up observation was at 1, 2, and 6mo after injection.Observed indicators included best-corrected visual acuity (BCVA), intraocular pressure, optical coherence tomography (OCT), fundus fluorescein angiography (FFA), choroidal indocyanine green angiography (ICGA), macular fovea thickness (CMT), subfoveal choroidal thickness (SFCT).RESULTS:Seven of the 9 patients responded significantly to the drug, while 2 patients had no response.The CMT was 373.12±72.43μm at baseline, which decreased significantly to 332.05±67.13μm, 282.24±62.30μm and 225.56±71.08μm at 1, 2 and 6mo after the intravitreal injection.The mean thickness of SFCT was 422.11±64.82μm before treatment.The choroidal thickness of non-responsive patients before treatment was below average, respectively 353μm and 365μm.The SFCT of 1, 2, and 6mo after treatment was 391.45±75.24μm, 365.53±63.07μm, 355.40±66.65μm.Before treatment and 1mo after, there was no significant difference (P=0.074), but there was statistically significant (P<0.01) between those of before and 2mo and 6mo after.The mean BCVA of the prior treatment was 0.53±0.32, the after treatment was 0.65±0.20, there was no different between the two(P>0.05).CONCLUSION: Intravitreal conbercept injection in chronic CSC may have some effect in accelerating subertinal fluid resolution and decreasing the CMT.The SFCT within 6mo after treatment was significantly lower than pretreatment.The SFCT may be an indicator of whether patients respond.

Partial nature of "promoting blood circulation and dieresis" of Salvia Miltiorrhizain was initially demonstrated by investigating the regulation effect of AQP2 expression in kidney of trauma blood stasis model rats with the Salvia Miltiorrhizain so as to provide guidance for its clinical deployment of administration. Random allocation was taken to averagely divide 30 SD rats into two groups: 10 rats in normal group and 20 rats in blood stasis syndrome group. Trauma blood stasis rat model was established by quantitatively beating. Then the rat model group was divided into model group and salvia group. After 7 days of treatment, the rat kidney AQP2 expression was detected, the content of urine AQP2 was compared and the damaged local muscle and kidney pathological changes were observed by immunohistochemical method and western blot method. Compared with that of the normal group, rats in model group had inflammatory cells infiltration, blood stasis and edema of the injured local muscles and up-regulated AQP2 expression, decreasing urinary output, and kidney tissues blood stasis and edema (P < 0.05). On the other hand, compared with that of the model group, those parameters of rats in salvia group were all decreasing except urine output (P < 0.05). Such result indicated that Salvia Miltiorrhiza can reduce trauma blood stasis rat content of urine AQP2 and down-regulated AQP2 expression in kidney tissue, so as to reduce the reabsorption of water by renal tubular and increase urine output. The promoting blood circulation effect of Salvia Miltiorrhizain can alleviate the degree of the damaged tissue edema and encourage urine drainage. This therapy is closely related to the effect of regulating AQP2 in kidney by salvia, so the purpose of this study by verifying "promoting blood circulation and diuresis" as the mechanism for the regulation effect of the salvia on AQP2 expression.
Animals ; Aquaporin 2 ; genetics ; metabolism ; Blood Circulation ; drug effects ; Diuresis ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Kidney ; blood supply ; drug effects ; metabolism ; physiopathology ; Kidney Diseases ; drug therapy ; genetics ; metabolism ; physiopathology ; Male ; Rats ; Salvia miltiorrhiza ; chemistry

Objective To explore the effective method in treatment of traumatic intracranial hematoma.Methods The measures and effects of traumatic intracranial hematoma treated by combined treatment of traditional Chinese medicine and western medicine were retorspectively analyzed. 62 cases with traumatic intracranial hematoma were taken controlled methods of clinical research: the control group had 30 patients ( received Western medicine),and experimental group had 32 cases ( received Western medicine treatment combined with Chinese medicine Qingkailing or/and Ligustrazine at the same time ), therapeutic effect evaluation was mede after 28 days.Results Clinical results of the experimental group was superior than the control group ( P ＜ 0.05 ); and complications were fewer (P ＜ 0.05). Conclusion Integration of Chinese and western medicine could improve the efficacy of traumatic intracranial hematoma.

OBJECTIVETo evaluate in vivo pharmacokinetics of Ophiopogonis Radix polysaccharide MDG-1 oily suspension injection prepared with different prescriptions in rats, and explore the feasibility of the long-acting drug delivery of MDG-1 Injection by using the oily suspension drug release system.

METHODMDG-1 microparticles were prepared by the anti-solvent precipitation method. Their size and size distribution were characterized. Castor oil with a high viscosity or aluminum stearate were added into soybean oil with a low viscosity, in order to prepare oily media with different viscosities, detect their rheological properties and screen out superior prescriptions for in vivo evaluation.

RESULTThe average size of microparticles was 21.81 microm, and the span between them was 2.63. The in vivo evaluation was conducted for prescriptions of mixed oil (soybean oil/castor oil, 2: 3) and soybean oils gelled by 2% and 4% aluminium stearate. Among them, the prescription of soybean gelled by 4% aluminium stearate could significantly reduce C(max) and prolong the apparent t1/2, with the MDG-1 release time of several days.

CONCLUSIONIt is feasible to achieve the long-acting MDG-1 drug delivery by using oily media with a high viscosity.

Animals ; Chemistry, Pharmaceutical ; methods ; Drug Delivery Systems ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; pharmacokinetics ; Male ; Ophiopogon ; chemistry ; Plant Oils ; chemistry ; Polysaccharides ; administration & dosage ; chemistry ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Viscosity

Epithelial-to-mesenchymal transition (EMT) plays a critical role in cancer metastasis,and is relevant to the inflammatory microenvironment.Lipopolysaccharide (LPS),a cell wall constituent of gram-negative bacteria,has been reported to induce EMT of cancer cells through TLR4 signal.We previously reported that LPS promoted metastasis of mesenchymallike breast cancer cells with high expression of cyclin D 1 b.However,the role of cyclin D1b in LPS-induced EMT has not been fully elucidated.In the present study,we described that cyclin D1b augmented EMT induced by LPS in MCF-7 breast cancer cells.Cyclin D1b markedly amplified integrin αvβ3 expression,which was further up-regulated under LPS stimulation.Our results showed ectopic expression of cyclin D1b promoted invasiveness of epithelial-like MCF-7 cells under LPS stimulation.Additionally,LPS-induced metastasis and EMT in MCF-7-D1b cells might depend on αvβ3 expression.Further exploration indicated that cyclin D1b cooperated with HoxD3,a transcription factor promoting αvβ3 expression,to promote LPS-induced EMT.Knockout of HoxD3 repressed LPS-induced EMT and αvβ3 over-expression in MCF-7 cells with high expression of cyclin D1b.Specifically,all these effects were in a cyclin D1a independent manner.Taken all together,LPS up-regulated integrin αvβ3 expression in MCF-7 cells with high expression of cyclin D 1b and induced EMT in breast cancer cells,which highlights that cyclin D1b may act as an endogenous pathway participating in exogenous signal inducing EMT in breast cancer cells.

Objective:To explore the clinical efficacy of sinew-regulating and bone-setting manipulation combined with functional exercise to treat mild to moderate rotator cuff injury (RCI).Methods:Forty patients with mild to moderate RCI were randomly divided into a treatment group and a control group,with 20 cases in each group.The treatment group was given sinew-regulating and bone-setting manipulation combined with functional exercise,and the control group was given the same manipulation as the treatment group.The therapeutic effect on the functional improvement was assessed after treatment according to pain threshold,shoulder range of motion (ROM) including flexion,abduction,internal rotation and external rotation,and the University of California at Los Angeles (UCLA) shoulder rating score.Results:Compared with the same group before treatment,the pain threshold,shoulder flexion,abduction,internal and external rotations increased after the treatment in the two groups (all P＜0.05).The UCLA shoulder rating score increased (both P＜0.05).The improvement in the treatment group is significantly better than that in the control group with a statistical significance (P＜0.05).The total effective rate was 95.0％ in the treatment group,was higher than 65.0％ in the control group (P＜0.05).Conclusion:The sinew-regulating and bone-setting manipulation combined with functional exercise relieve the pain of patients with mild to moderate RCI,increase the motion of shoulder joints,and improve the quality of life of patients.The curative effect is better than the treatment of simple sinew-regulating and bone-setting manipulation.

Objective To evaluate the efficacy,adverse events of gemcitabine vs.5-FU with radiotherapy for locally advanced pancreatic carcinomas.Methods Between January 2007 and January 2011,a total of 56 patients with locally advanced pancreatic carcinomas was included and clinical data were retrospectively analyzed.All patients received 3-DCRT radiotherapy with individual dose of 1.8 ～ 2 Gy,5 times per week,and total dose of 45 ～ 50.4 Gy for 25 ～ 28 fractions,and received concurrent chemotherapy (5-FU or gemcitabine).The patients (n =30) in gemcitabine group were treated with gemcitabine (500 rng/m2 at the 1st,8th,15th,22nd day,at 10 mg · (m2)-1 · min-1,through micro-pump) during radiotherapy; 3 weeks after radiotherapy the patients received gemcitabine infusion at a dose of 800 mg · (m2)-1 · d-1,one time per week,for 3 or 4 cycles.The patients (n =26) in 5-FU group were treated with 5-FU (500 mg/m2 at the 1 ～ 5th day per week,IV),the cycle was repeated every 2 weeks during radiotherapy; 3 weeks later the patients received 5-FU infusion at a dose of 800 mg · (m2)-1 · d-1,the 1st ～5th day per week,the cycle was repeated every 2 weeks ; with a total of 3 or 4 cycles.The efficacy and adverse events were observed,and the patients were followed until June 2013,and the median survival,1 year and 2 year survival was calculated.Results Of the 56 patients,the overall response (CR + PR) rate was 73.2％,and it was 65.3％ in radiotherapy with 5-FU group,80.0％ in radiotherapy with gemcitabine group (P ＜ 0.05).The overall one and two year survival rate was 48.2％ and 14.3％,while median survival was 15.2 months,and the corresponding values were 42.3％,11.5％,13.3 months in radiotherapy with 5-FU group,and 53.3％,16.7％,16.6 months in radiotherapy with gemcitabine group,and the survival difference between the two groups was not statistically significant (P =0.071).At the end of treatment,the pain-relief rate (VAS score ＜4) of the 56 patients was 83.3％,it was 75.0％ in 5-FU group and 90.0％ in gemcitabine group.In radiotherapy with gemcitabine group,the incidence of 3～ 4 grade myelosuppression was significantly higher than that in radiotherapy with 5-FU group,and the difference between the two groups was statistically significant (20.0％ vs 7.6％,P ＜ 0.05).Conclusions For the locally advanced pancreatic carcinomas,radiotherapy with gemcitabine can improve pain-relief and prolong survival compared with radiotherapy with 5-FU,but the incidence of adverse event of myelosuppression is higher.

Objective To investigate the relevant risk factors for fungal infection following operation of the gastrointestinal neo- plasm and offer supporting data for the prevention of fungal infection.Methods Medical records from 116 patients who under- went the operation of gastrointestinal neoplasm in the special group of this hospital from January 2006 to June 2006 were retro- spectively reviewed on the relevant risk factors by univariate and multivariate Logistic regression analysis.Results Of the 116 patients reviewed, 18 had fungal infection.Forty-six samples were positive for fungal pathogen.The most frequently isolated fungal strain was Candida albicans (15/20) and the most common infection site was gastrointestinal tract (14/18).Fungal in- fection after the operation of gastrointestinal neoplasm was significantly relevant with the duration of antibiotic use, duration of post-operative fasting, low serum albumin, high blood glucose and complication of bacterial infection.The duration of antibiotic use was a significantly independent risk factor.Conclusions Reasonable antibiotic use, nutritional support, early enteral nutri- tion and control of blood glucose should be taken into account after the operation of gastrointestinal neoplasm in order to prevent fungal infections.