108 patients with femoral neck fractures were treated with bipolar hemiarthroplasty in Qinhuangdao First Hospital from January 2002 to June 2008.All patients were followed up.The length of stay and operation,and the quantity of bleeding during operation were retrospectively analyzed;the results of X-ray before and after operation and the Harris hip scores after operation were assessed during follow-up to assess the clinical outcome.All patients were followed-up for 6 months to 5 years(average 3.4 years).According to the Harris hip score,42 cases rated as excellent,with mean score of 96.4;50 as good,with mean score of 85.7;10 as fair,with mean score of 74.5;6 as poor;the excellent and good rate was 85.2%.No prosthetic loosening or subsidence occurred according to X-ray results.Bipolar hemiarthroplasty for femoral neck fractures can reduce operation time,risk and blood loss during operation,and effectively improve quality of life,which is a satisfactory therapy for femoral neck fractures.

Objective To prepare poriferous ?-tricalcium phosphate(?-TCP) particles and investigate the possibility of these particles to serve as bone graft and bone tissue engineering scaffold.Methods Poriferous anorganic bone particles were prepared with healthy bovine cancellous bone by removal of cells,defat and double calcination,finally with ?-TCP remained as the main ingredient.A bone defect was made in rabbit's femur,and it was repaired with poriferous ?-TCP bone graft.The results were observed by X-ray,molybdenum target films,fluorescence label and histology at the 4th,8th and 12th week after operation.Results The nature of cancellous bone structure was still maintained in the poriferous ?-TCP bone graft,even retaining its contour after it was transplanted in the bone defect.At the 4th week after operation,the graft was integrated with neighboring tissues,and the new bone gradually grew in the ?-TCP bone graft pores,with delineation of bone defect remaining clear.There was no obvious absorption of the graft,neither growth of soft tissues or bone tissue into the central part.At the 8th week after operation,the soft tissue further grew into the inside of the ?-TCP bone graft,and little bone tissue grew in the central part.At the 12th week after operation,the graft was firmly surrounded with new bone tissue,the demarcation between the graft and new bone becoming obscure,and the graft was partially absorbed,with thickening of bone trabeculae,which extended into the center of ?-TCP bone.However,the speed and quantity of the new bone formation were deteriorated.Histologic examination also found that the ?-TCP bone graft degenerated slowly with passage of time.Conclusion The poriferous ?-TCP bone graft possesses excellent osteogenesis for repairing a bone defect,and may be used as bone tissue engineering scaffold,though its degradation speed should be ameliorated.

BACKGROUND:Ceramic-on-ceramic total hip arthroplasty can be applied to young patients requiring frequent activity and high quality of life.
OBJECTIVE:To explore the short-term efficiency of ceramic-on-ceramic total hip arthroplasty in young and middle-aged patients of femoral neck fractures.
METHODS:Fifty-one young and middle-aged patients under 50 years old with ceramic-on-ceramic total hip arthroplasty were selected to analyze the function of hip joints and the complication after operation.
RESULTS AND CONCLUSION:Al the patients were fol owed up for 6 months to 44 months. At the last fol ow-up, the average Harris score was 92.0±3.4 points with an excellent and good rate of 94.1%. No dislocation was observed and three cases exhibited mild limping. Imaging examination showed that, no prosthesis loosing, broken, sinking or radiolucent line around prosthesis was observed. Ceramic-on-ceramic total hip arthroplasty in young patients with femoral neck fractures can effectively decrease the osteolysis, prosthesis loosing and sinking caused by the debris of wearing, prolong the working life of the prosthesis, and improve the patient’s quality of life.

Background and purpose:Previous researches have shown that intravenous amino acid infusion during general anaesthesia prevents the decreases in core temperature. This study aimed to investigate the effect of amino acid infusion on postoperative liver and renal function in elderly patients undergoing gastrointestinal surgery. Methods:Forty ASAⅠ orⅡ patients (33 males, 7 females) aged 65-75 years undergoing elective gastrointestinal can-cer operation under epidural block combined with general anesthesia were randomly divided into 2 groups (n=20 each). GroupⅠ received intravenous infusion of mixed amino acids at a rate of 2 mL·(kg·h) -1 from induction of anesthesia to the end of operation (AA group); GroupⅡ received infusion of equal volume of normal saline (NS group). Snuff temperature was monitored for induction of anesthesia immediately, after 90 min and at closed abdomen. Renal and hepatic function was performed regularly before operation and on the 1st and 7th postoperative day.Results:The naso-pharyngeal temperatures at 90 min after the beginning of surgery and the time when the peritoneum was closed in AA group were signiifcantly higher than those in NS group (P<0.05). Hepatic and renal function indices were within the normal range in the AA and NS groups. There were signiifcant increases in TBIL, DBIL, ALT, and AST (P<0.05) after operation, whereas TP, ALB, BUN, Scr and UA decreased signiifcantly (P<0.05). There were no signiifcant differences in hepatic and renal function indices between the AA and NS groups (P>0.05).Conclusion:Intraoperative amino acid infusion has no signiifcant effects on the renal or hepatic function in elderly patients undergoing gastrointestinal surgery.

Background and purpose:Perioperative hypothermia will affect the prognosis of cancer patients. Amino acid infusion can increase the core temperature by endogenous thermogenesis. And the forced-air warming system has gained high acceptance as a measure for rewarming. This study aimed to find out whether amino acid infusion was effective to treat postoperative hypothermia and how well the treatment effect was when compared with the forced-air warming system.Methods:Fifty-seven ASAⅠ orⅡ patients aged 18-60 years undergoing elective esophageal or gastric cancer operation under epidural-general anesthesia and whose core temperature were below 36℃. When admitted to the recovery room wererandomly divided into 3 groups (n=19): GroupⅠ received intravenous infusion of mixed amino acid at a rate of 2 mL·kg-1·h-1 (A); GroupⅡ received a forced-air system (B); groupⅢreceived no therapy (C). Rectal temperature and thermal comfort were recorded per 5 min during the ifrst 1 h and oral temperature and thermal comfort were recorded at the 2, 6 and 24 h. ABG was recorded when patients were admitted to the recovery room and at the ifrst hour.Results:At the ifrst hour, the rectal temperature and thermal comfort of groups A and B were higher when compared with group C (P<0.05), and there was no difference between groups A and B (P>0.05). At the second and sixthhour, the temperature and thermal comfort of group A were higher when compared with group B and C (P<0.05), and there was no difference between groups B and C (P>0.05). At the 24th hour, there were no statistically signiifcant differences in the temperature and thermal comfort among the three groups (P>0.05).
Conclusion:The rewarming effect of infusion of mixed amino acid is better than that of the forced-air warming system. It is the more effective and convenient method to rewarm the postoperative hypothermia.