[Objective]To study the effect of femoral offset and hip joint center on joint function after total hip replacement,radiographic measurements were taken postoperation.[Method]A series of 92 hip joints(87 patients)were followed up.The average follow up priod was 25 monthes.The femoral offset and the position of the prothesis head center were measured in the orthophoric hip joint X-ray photograph and were compared with anatomic Fo and HJC.H arris evaluation system was used to evaluate joint function in four groups.The results were statistically analyzed,with Fisher' exact probability and P value less than 0.05 indicating significant difference.[Result]The coincidence rate of group A(both FO and HJC,27 hips)was 29.35%,group B(only Fo,23 hips)25.00%,group C(only HJC,31 hips)33.70%,group D(neither FO nor HJC,11 hips)11.96%.93.0% patients got the Harris score more than 80 for group A,73.19%(group B),74.19%(group C),27.27%(group D).The difference of Harris evaluation between A and B,A and C,A and D was significant statistically.[Conclusion]Based on the results of the study,the recovery of femoral offset and hip joint center should be considered to contribute to the healing effect after total hip replacement directly.

[Objective]To explore the effect of hip joint center on the stability of hip joint,the radiographic measurements were compared between preoperation and postoperation.[Method]A total of 155 hips from 120 patients with primary total hip replacement from resent years were studied,the hip joint center difference through radiographic measurements between preoperation and postoperation were compared.[Result]The coincident rate and the incoincident rate were 63.23%(group A,98 hips) and 36.77%(group B,57 hips) respectively.For loose,dislocation or low back pain,the rate of revision in group A and group B were 6.12% and 29.82% respectively.[Conclusion]The comeback of hip joint center was essential for stability of hip joint.

Background Treatment of corneal ulceration by transplanting drug-loaded amniotic membrane has been used widespreadly abroad,however,seldom study is found in China up to now.Objective This study was to explore the sustained release property and the efficacy of the drug-loaded amniotic membrane.Methods The bacteriostatic area of amniotic membrane fragments immersed with different concentrations (5,20,30 g/L) of levofloxacin for different time points (5,15,30,60 minutes) was evaluated by in vitro test.Bacterial corneal ulceration models were established in 20 rabbits by injected 0.7 MCF staphylococcus aureus suspension (0.1 ml) into the central corneal stroma to form the cloudy area of 4.0-6.0 mm.Then the rabbits were randomized into two groups.Regular amniotic membrane transplantation was performed laterally and 0.5％ levofloxacin drops was topically administered after operation in the amnion+levofloxacin drops group,and drug-loading amnion transplantation was used in the drug-loading amnion group.Aqueous humor of 0.1 ml was collected in 30 minutes,1 hour,2,3.5,5.5 hours after levofloxacin was administered and 1 day,3,7,10,14,21 days after operation for the detect of levofloxacin level with high-performance liquid chromatography.The corneal symptom was scored based on McNeill's criteria in 1 week,2 weeks and 4 weeks and the ulceration area was assessed under the slit lamp in the first week.The pathological examination was carried out in the fourth week after surgery.Results The mean bacteriostatic area was bigger with the increase of levofloxacin concentration,and bacteriostatic area in amnion immersed for 15 minutes was bigger than that of 5 minutes (P＜0.01).The levofloxacin concentration of aqueous humor after transplantation was decreased by extending the time,and that in 30 minutes and 5.5 hours after operation was (0.873±0.264) mg/L and (0.106±0.027) mg/L,respectively,in the amnion+levofloxacin drops group,and that in day 1,3,7 after surgery in the drug-loading amnion group was higher than at 30 minutes in the amnion+levofloxacin drops group,showing all significant differences (all P =0.00).In the first,second and fourth week after operation,the corneal symptom score was 1.7±0.6,1.3±0.5,0.2±0.4 in the drug-loading amnion group and 2.2±0.8,2.0±0.6,1.5±0.8 in the amnion+ levofloxacin drops group,with the significant differences among the different groups and time points (Fgroup =9.49,P =0.01 ;Ftime =22.96,P=0.01).The corneal ulceration area was (1.6±0.6) mm2 in the drug-loading amnion group and (3.2±0.8) mm2 in the amnion+levofloxacin drops group 1 week after operation,showing a significant difference between them (t =3.98,P =0.00).Histopathological revealed that the various layers of cornea tissue appeared irregular arrangement in the amnion + levofloxacin drops group 4 weeks after operation with 1-2 layers of new squamous epithelium.Disorder hypothallus structure,more inflammatory cells and residual vascular cavity were visible.However,new squamous epithelium of 4-5 layers was seen in the drug-loading amnion group,and inflammatory cells and residual vascular cavity were less than the amnion+levofloxacin drops group 4 weeks after operation.Conclusions Levofloxacin-loaded amniotic membrane can sustained release levofloxacin and maintain an effective drug concentration in aqueous humor,which improves the treating efficacy for staphylococcus aureus corneal ulceration.

Adult ; Agriculture ; Female ; Humans ; Lung ; physiology ; Male ; Middle Aged ; Plastics ; Respiratory Function Tests ; Surveys and Questionnaires

OBJECTIVETo compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis.

METHODSFrom January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening.

CONCLUSIONThe early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.

Aged ; Arthritis, Rheumatoid ; physiopathology ; surgery ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Deformities, Acquired ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular ; Retrospective Studies

The aerolysin genes (aerA) of BZ and NK isolates were cloned and sequenced. The sequence analysis showed that the partial aerA of BZ and NK isolates consisted of 1393 bp, encoding a protein of 464 amino acids. The similarity of nucleotide and amino acid sequences of aerA between BZ and NK isolates was 97.6% and 98.3% respectively. The nucleotide sequence of aerA of BZ strain exhibited 71.6% to 97.5% homology with other Aeromonas isolates, and the amino acid sequence exhibited 68.0% to 98.9% homology. The phylogenetic tree based on aerA nucleotide sequences from Aeromonas isolates was constructed with neighbor-joining method. It showed that there were three branches of aerolysin genes, and a close relation- ship among Aeromonas hydrophila isolates which were clustered into the same branch.

Objective The variation of serum thyroid hormones within the euthyroid range may be associated with insulin sensitivity.The study was to investigate whether the variation of thyroid hormones within the euthyroid range could influence insulin sensitivity in elderly patients with type 2 diabetes mellitus (T2DM). Methods 200 elderly inpatients and outpatients with type 2 diabetes were collected from September 2013 to May 2014 in our hospital for T2DM group.150 normal controls with normal glucose metabolism were taken as the control group.Blood samples were collected after 75g oral glucose tolerance test(OGTT) on all the re-search objects.Questionaire survey, physical examination and related metabolic index test were also done on them .Chemilumines-cence method were applied to detect their insulin, thyroid stimulating hormone(TSH), FT3 and FT4. Results FT3 levels were significantly lower in T2DM group than in control group[(4.05 ±0.27 )pmol/L vs (4.61 ±0.5)pmol/L), P<0.05].TSH levels were significantly higher in T2DM group than in control group[(2.75 ±1.07) IU/mL vs (2.28 ±0.89) IU/mL, P<0.05], while there was no significant difference as to FT4 levels between these two groups.All subjects were divided into three groups according to the tertiles of FT3 level, Matsuda index of high FT3 level group were significantly higher in comparison to middle and low FT3 level groups, while there was no significant difference as to HOMA-IR in the three groups.FT3 levels were negatively correlated with HO-MA-IR and positively correlated with Matsuda index .After stepwise regression analysis, there was significant positive association be-tween FT3 and Matsuda index. Conclusion Thyroid hormone especially FT3 is significantly associated with insulin resistance .FT3 may participate in the development of type 2 diabetes, which pro-vides a new treatment for T2DM.

Objective To compare the clinical effectiveness of external fixation,expert tibial nail (ETN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of AO type 43A tibial fractures.Methods The clinical data of 102 patients with AO type 43A tibial fracture were retrospectively analyzed who had been treated from June 2010 to June 2014.They were 68 men and 34 women,from 18 to 71 years of age (average,36 years).By AO classification,there were 36 cases of type A1,45 ones of type A2,and 21 ones of type A3.External fixation was used in 30 cases,MIPPO in 42,and ETN in 30.The 3 groups were compared in terms of operation time,blood loss,fracture healing time,complications and functional evaluation according to American Orthopaedic Foot and Ankle Society (AOFAS) criteria for middle and fore foot.Results The operation time in external fixation group (72.7 ± 16.1 min) was significantly less than in MIPPO group (101.5±15.1 min) and ETN group (115.0±11.2 min) (P ＜0.05).The blood loss and fracture healing time in external fixation group were (320.6 ±40.8 mL) and (160.6 ± 25.0 days),significantly greater than in MIPPO group (125.5 ± 27.3 mL and 120.3 ± 20.2 days)and ETN group (124.2±25.4mL and 125.5±25.6 days) (P ＜0.05).The total complication rate in external fixation group (53.3％,16/30) was significantly higher than in MIPPO group (9.5％,4/42) and ETN group (10.0％,3/30) (P ＜ 0.05).The total AOFAS excellent to good rate in external fixation group (66.7％,20/30) was significantly lower than in MIPPO group (88.1％,37/42) and ETN group (90.0％,27/30) (P ＜ 0.05).However,there were no significant differences between MIPPO and ETN groups concerning all the above outcome indicators (P ＞ 0.05).Conclusions For AO type 43A tibial fractures,internal fixation should be the first choice.Both MIPPO and ETN can lead to good clinical efficacy.However,in cases where internal fixation is not suitable,external fixation with distal lateral tibial nails at the Chaput tuberosity can obtain satisfactory ankle function.

BACKGROUND:Ethyl linoleate has been proved to attenuate the inflammatory-cytokines release induced by lipopolysaccharide, but whether it can inhibit titanium-induced osteolysis and the underlying mechanism remain unclear. OBJECTIVE:To observe the effect of ethyl linoleate on the expression of inflammatory-related factors induced by titanium particles and explore its mechanism. METHODS:Forty-eight Kunming mice were randomly divided into blank control, titanium, dimethylsulfoxide (DMSO) and experimental groups. The back air pouch Inflammatory models were established in the mice of the titanium, DMSO and experimental groups, in which the 200 μL menstruum of DMSO (0.5%) and 200 μL ethyl linoleate (0.5%) were respectively administered into the pouch of the mice at 12 hours. Mice in the blank control group received no intervention. Fourteen days later, the inflammatory cel infiltration in the skin was examined through hematoxylin-eosin staining;the expression levels of inhibitorκB-α, nuclear factor-κB, inducible nitric oxide synthase, cyclooxygenase-2, tumor necrosis factor-αand interleukin-6 as wel as ERK, p-ERK, JNK, p-JNK, p38 and p-p38 in MAPK signaling pathways were evaluated by western blot assay. RESULTS AND CONCLUSION:In the titanium group and DMSO group, there were numerous inflammatory cel s and vacuole-like necrotic tissues in the hair fol icle lacuna of dermis and loose connective tissues of hypodermis. The experiment group showed significant reduction in inflammatory cel infiltration and vacuole-like necrosis. Compared with the blank control group, the expression levels of inducible nitric oxide synthase, cyclooxygenase-2, nuclear factor-κB, tumor necrosis factor-α, interleukin-6, ERK, JNK and p38 in the DMSO and titanium groups were significantly increased, while inhibitorκB-αsignificantly decreased (P<0.05). Compared with the DMSO and titanium groups, there were significantly down-regulated levels of inducible nitric oxide synthase, cyclooxygenase-2, nuclear factor-κB, tumor necrosis factor-α, interleukin-6, ERK, JNK and p38, and up-regulated inhibitorκB-αlevel in the experimental group (P<0.05). In conclusion, ethyl linoleate can remarkably suppress the expressions of titanium-induced inflammatory factors associated with the inhibition of nuclear factor-κB and MAPK signaling pathway activation.