Objective To evaluate the clinical results of free vascularized fibular grafting (FVFG) for the treatment of osteonecrosis of the femoral head (ONFH).Methods From July,2009 to January,2013,85 cases (120 hips) of ONFH were treated with free vascularized fibular grafting.These cases included 61 males (87 hips) and 24 females (33 hips) with an average age of 36.5 years (22-51 years);7 hips (Ⅰ A 2 hips,Ⅰ B 3 hips,Ⅰ C 2 hips) were at stage Ⅰ,98 hips (Ⅱ A 24 hips,ⅡB 39 hips,ⅡC 35 hips) at stage Ⅱ and 15 hips (ⅢA 9 hips,ⅢB 4 hips,Ⅱ C 2 hips) at stage]Ⅲ according to the classification system of Association Research Circulation Osseous (ARCO).The mean preoperative Harris hip score was (60.21±6.85) points (42-71 points),The follow-up items included the X-ray examination,the Harris scores of the hip,and the evaluation of the complications.Results Eighty-three cases (117 hips) were followed up.The average duration of follow-up was 25 months (range from 12 months to 42 months).The mean postoperative Harris hip score was increased to (81.26±5.84) points (67-91 points) by the end of the follow-up,compared with the preoperation,the score improved significantly,the difference was statistically significant (P＜0.05).Comparing with postoperative X-ray,101 hips (86.3％) were improved,12 hips (10.3％) had no significant changes and deterioration occurred in 4 hips (3.4％).Conclusion The free vascularized fibular grafting is an effective method for treating osteonecrosis of and preventing the collapse of the femoral head.

Objective To establish three-dimensional (3D) simulation model of acetabular fracture based on Letournel-Judet classification and analyze its significance. Methods Pelvis of one healthy female volunteer was scanned with 16 slice spiral CT. Dicom format data were processed by software Mimics 10.01 to reconstruct 3D model of hip bone. Different fracture types were simulated based on Letournel-Judet classification of acetabular fracture. The fracture fragments were displayed with different color. Screen-captures of fracture model from different directions were saved and video mode of fracture model was exported. Five orthopedic doctors and 10 medical students were employed to compare 3D fracture model with two-dimensional planar schematic diagram and made preliminary evaluation. Results The 3D simulation model of acetabular fracture had realistic form and stereoscopic sense, with satisfactory visual effect. The fracture could be observed and charted from optional direction and angle. Fracture model could rotate for 360° in the corresponding video mode. Four orthopedic doctors and nine medical students considered that 3D simulation model of acetabular fracture was helpful for understanding fracture classification. Conclusion The 3D simulation model of acetabular fracture is intuitive, realistic and dynamic and is helpful for clinical work and medical teaching.

Poor ovarian response (POR) is a pathological condition in which the ovary responds poorly to gonadotropins,and is a major constraint on the unsatisfactory outcome of in vitro fertilization-embryo transfer (IVF-ET). Follicular growth,development,maturation,and expulsion are all affected by the yin-yang balance between heart and kidney,as well as the elevation exchange. If the heart and kidney essence and blood are insufficient,water and fire are out of harmony,and qi movement is not smooth,fewer high-quality follicles will be recruited and acquired during the ovarian stimulation cycle,resulting in a low transferable embryo rate and unacceptable pregnancy result. Sympathetic treatment of heart and kidney should be based on the following principles at different stages of the IVF-ET cycle:replenishing the heart,kidney,essence,and blood before entering the cycle,in order to nourish the essence and assist in the growth of the follicles;nourishing renal water,and clearing heart fire during the pituitary down-regulation period,in order to lessen the negative effects of the down-regulation medicinals;regulating the depression of the heart,liver,spleen,and kidney meridians during the follicle's retrieval period,in order to encourage the smooth release of the ova;and warming heart and kidney fire to improve endometrial tolerance during the implantation period. The application of the theory of intercourse of heart and kidney to elucidate the pathogenesis of POR is critical to the development of clinical strategies for fertility enhancement,as well as providing new ideas for the clinical application of traditional Chinese medicine in the field of reproduction.

Objective: To investigate the effect of magnetic-induced cell targeted transplantation (MagIC-TT) on repair of bone defects in mice using therapeutic fluorescent gene labeled cells into bone tissue and its mechanism. Methods: The proliferation, apoptosis and targeted migration ability were compared between magnetized and unmagnetized murine bone marrow stromal cells labeled with green fluorescent protein (GFP-BMSCs) (n=3). GFP-BMSCs were loaded into tissue engineering bone (TEB) by MagIC-TT in the experimental group (n=5) before the TEB was transplanted into the large femur defects in the model of red fluorescent protein (RFP) transgenic mice. In the control group (n=5) TEB was not loaded with GFP-BMSCs while in the blank group (n=3) the large femur defects were only fixated with intramedullary nails. The effects and mechanism of bone repair were explored 3 months after surgery using X-ray, micro-CT, semi-solid decalcification (SSD) and histology, respectively Results: There were no significant differences between magnetized and non-magnetized GFP-BMSCs in proliferation (0.760±0.029 versus 0.733±0.033) or in survival rate (87.9%±1.0% versus 87.4%±2.0%) (P>0.05), but the mobility of magnetized GFP-BMSCs was significantly higher than that of non-magnetized GFP-BMSCs (P<0.05). The X-ray 3 months after surgery showed that the scaffolds in the experimental group were degraded and that the proximal and distal ends of the femoral defects were connected by new bone tissue. No new bone formation was found in the blank group while a small amount of bone formation was observed in the control group. The Micro-CT showed that stable new bone tissue formed in the femur defects after removal of intramedullary nails in the experimental group. The SSD showed that GFP-MSCs were densely distributed in the scaffolds with red fluorescent protein (RFP) recipient cells penetrating them, indicating involvement of both donor and recipient cells in the formation of new bone. Conclusions MagIC-TT can be used to promote introduction of therapeutic cells into bone tissue to achieve a fine effect on repairing bone defects. Dual fluorescence gene marking combined with SSD shows that both donor and recipient cells may take part in the bone repairing.

Myopia is becoming more and more common all over the world, and the incidence of myopia is gradually increasing. Many treatments have been used to prevent and control myopia, including optics, drugs, environment or behavior, but the results are different and lack standardization. At present, many experiments have proved that peripheral defocus technology has a certain effect on myopia control. Based on this technology, three kinds of framed eyeglass lenses with peripheral defocus design, namely defocus incorporated multiple segments(DIMS), highly aspherical lenslets(HAL)and cylindrical annular reactive elements(CARE), are commonly used in medical and optometry institutions in China. These lenses provide not only clear vision in the central area, but also a certain amount of myopic defocus in the periphery to control the progression of myopia. This paper aims to focus on the design principle and myopia prevention and control effect of the above three peripheral defocus lenses, and evaluate their effectiveness in clinical practice.