BACKGROUNDTotal hip arthroplasty (THA) in developmental dysplasia of the hip (DDH) is more complex than the normal hip, with large replacement risks and many complications. Although nonosteotomy THA is convenient to perform, femoral osteotomy shortening can avoid blood vessel and nerve traction injuries. This study aimed to compare osteotomy THA with nonosteotomy to determine reasonable options for operative management of DDH.

METHODSData on 48 DDH patients who underwent THA were analyzed retrospectively. The patients were divided into two groups: Group A 29 cases (nonosteotomy), and group B 19 cases (osteotomy). Harris and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, limb length discrepancy (LLD), radiological data on the hip, and claudication were evaluated. Data were analyzed by using paired-sample Student's t-test, independent-sample Student's t-test, and Pearson's Chi-square test; the test level was α =0.05.

RESULTSPostoperative Harris (90.7 ± 5.1) and WOMAC scores (88.0 ± 10.6) were significantly improved compared with preoperative Harris (44.8 ± 5.7) and WOMAC scores (42.0 ± 5.3) in group A (P < 0.05). Postoperative Harris (90.4 ± 2.8) and WOMAC scores (88.2 ± 5.9) were significantly improved compared with preoperative Harris (44.4 ± 4.2) and WOMAC scores (43.2 ± 4.3) in group B (P < 0.05). One case of dislocation occurred in group A; after closed reduction, dislocation did not recur. In group A, 2 patients developed cutaneous branch injury of the femoral nerve, which spontaneously recovered without treatment. Postoperative LLD >2 cm was seen in one case in group A and five cases in group B. Postoperative claudication showed no significant difference between the two groups (P > 0.05). No patients developed infection; postoperative X-rays showed that the location of the prosthesis was satisfactory, and the surrounding bone was not dissolved.

CONCLUSIONSTHA is effective and safe for DDH. For unilateral high dislocation DDH patients with limb lengthening ≤4 cm and good tissue conditions, THA without femoral osteotomy may be considered.

Adult ; Arthroplasty, Replacement, Hip ; methods ; Female ; Hip Dislocation, Congenital ; surgery ; Humans ; Male ; Middle Aged ; Osteotomy ; methods ; Postoperative Period ; Range of Motion, Articular ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the pathological expression and significance of VEGF in patients with active ankylosing spondylitis.

METHODSThe expression of VEGF in the synovial tissues of cacroiliac joint of patients with active AS was detected by using in situ hybridization and the results were compared with those in the patients with pelvic fracture using image analysis system.

RESULTSThe positive expressions of VEGF in the synovial tissues of cacroiliac joint of patients with active AS were stronger than those in the control group (P<0.01).

CONCLUSIONVEGF are important factors in patients with active AS. They are tightly correlated with the process of osteoclasia and pathological new bone formation in the cacroiliac joint of patients with active AS. If we can reduce the expressions of VEGF in the patients with active AS, the process of osteoclasia and pathological new bone formation will be interrupted and this provides a new strategy for the treatment of ankylosing spondylitis.

Adult ; Case-Control Studies ; Female ; Gene Expression Regulation ; Humans ; Male ; RNA, Messenger ; genetics ; metabolism ; Spondylitis, Ankylosing ; genetics ; Synovial Fluid ; cytology ; metabolism ; Vascular Endothelial Growth Factor A ; genetics

Objective To understand the epidemiological characteristics of common respiratory viruses among influenza-like illness (ILI) and severe acute respiratory infections (SARI) in Pudong New Area, Shanghai , so as to help estimate the disease burden and conduct the valuable control strategies . Methods Respiratory specimen ( throat swab or sputum ) from cases older than 65 years old with ILI/SARI were collected from outpatient and inpatient settings in four sentinel hospitals in Pudong New Area . Each specimen was tested by multiplex PCR for eight target viral etiologies , including influenza virus , human rhinoviruses ( HRV ) , human para-influenza virus ( PIV ) , adenoviruses ( ADV ) , respiratory syncytial virus ( RSV ) , human metapneumovirus ( hMPV ) , human coronavirus ( hCoV ) and human bocavirus ( hBoV) .Chi-square tests or Fisher's Exact Test were used to compare and analyze . Results From January 1st, 2014 to June 30st, 2016, a total of 363 elderly cases with ILI/SARI were enrolled, with 202 (55.65%) male and a median age of 70 years old.142(39.12%) patients were detected posi-tive for any one of the eight viruses.Influenza was the predominant virus (20.94%, 76/363), with the positive proportion of ( 29 .83%) among ILI cases and ( 12 .09%) among SARI cases .The Influenza infection presented two seasonal peaks in winter ( December to February ) and summer ( July to September ) . Conclusion Influenza is identified as the leading viral pathogen both among ILI and SARI cases older than 65 years old, and two seasonal epidemic peaks areobserved in Shanghai .Influenza vacci-nation strategy should be advocated for the elderly population in Shanghai .

Adult ; Diagnosis, Differential ; Humans ; Lung ; pathology ; Lung Diseases, Interstitial ; diagnosis ; drug therapy ; pathology ; Male ; Middle Aged

OBJECTIVESTo study the surgical techniques and clinical outcomes of the revision surgery to treat recurrent dislocation after total hip arthroplasty.

METHODSFrom March 1997 to November 2010, 12 patients (12 hips) with revision total hip arthroplasty for recurrent dislocation were reviewed. There were 5 male and 7 female, aged from 20 to 73 years (mean age 52.7 years), whose body mass index (BMI) were 14.8-30.0 kg/m2 (mean 23.6 kg/m2). The Harris score and WOMAC score were registered and analyzed before surgery and at the time of latest follow-up. Any episode of dislocation and other complications such as deep infection, deep vein thrombosis and pulmonary embolism (DVT-PE) events, periprosthetic fracture, or early aseptic loosening were recorded.

RESULTSTwelve patients were successfully followed for 1.0-12.7 years (mean 4.0 years). No further dislocation episodes reported and all the hips were stable at the time of follow-up. No one complicated as deep infection, DVT-PE events, periprosthetic fracture, or early aseptic loosening. The Harris score was greatly improved from 38±21 before surgery to 81±9 at the time of last follow-up with statistic significance (t=-8.616, P<0.05) accompany with the WOMAC score elevation from 54±21 to 82±12 significantly (t=-6.200, P<0.05).

CONCLUSIONWith a reasonable algorithmic approach, the recurrent dislocated total hip arthroplasty can be treated with a relatively high success rate.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Hip Dislocation ; surgery ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Recurrence ; Reoperation ; Retrospective Studies ; Young Adult

Acupuncture anesthesia (AA) appeared in 1950s. It originates with Chinese TCM researchers and is one of important achievements of modern medicine. AA was developed vigorously and applied widely between 1960s-1970s. Due to the objective and subjective reasons, clinical application and research of AA in recent 20 years have developed very little. The paper reviews the formation and development processes of AA, analyzes the advantages and mechanisms of AA and its problems, then provides the feasible advice for the development of AA.
Acupuncture Analgesia ; Humans

OBJECTIVETo assess the value of European system for cardiac operative risk evaluation (EuroSCORE) in predicting quality of life in patients post coronary artery bypass graft surgery (CABG).

METHODSA total of 387 patients underwent CABG in our institute from December of 2002 to December of 2007 were assessed by EuroSCORE before operation. Health-related quality of life (QoL) was estimated postoperatively with Seattle angina questionnaire (SAQ), Nottingham healthy profile (NHP) and Duke activity status index (DASI) in order to evaluate the value of EuroSCORE for predicting quality of life in patients post CABG.

RESULTSThere were statistically significant but weak correlations between postoperative QoL score and preoperative EuroSCORE score (r: 0.010 - 0.276). Emotional and psychological experience subgroup analysis showed better predictive value of EuroSCORE score on postoperative QoL score in improved physical functioning subgroups (r > 0.2). Linear regression analysis showed that EuroSCORE score was significant but weakly (r(2) < 0.1) correlated with postoperative QoL score (P < 0.05).

CONCLUSIONPreoperative EuroSCORE score is weakly correlated with postoperative QoL score in patients post CABG.

Aged ; Coronary Artery Bypass ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Risk Assessment ; Severity of Illness Index

OBJECTIVETo detect breast cancer specific gene 1 (BCSG1) expression in different breast tissue, analysis its correlation with clinical parameters and evaluate the prognosis of breast cancer.

METHODSThe expression of BCSG1 was detected by reverse transcription-polymerase chain reaction (RT-PCR) in surgical specimens from 84 cases of breast disease patients selected randomly at XinHua Hospital affiliated with Shanghai Second Medical University from September 1999 to December 2002. Of 84 cases, 72 case were breast cancer. Statistic analysis BCSG1 gene expression correlation with clinical parameters of breast cancer. 72 breast cancers were followed up (4 - 43 months) to set up independent prognosis factor by survival analysis.

RESULTSBCSG1 was undetectable in all benign breast lesions, while was detectable in 36.1% of all breast cancer samples (26/72), in which 79.2% of stage III/IV cases were positive (19/24). The expression of BCSG1 was tightly correlated with the stage (P = 0.000) and the size of tumor (P = 0.007). Both ER (P = 0.027) and BCSG1 (P = 0.001) were the independent prognosis factor of breast cancer.

CONCLUSIONBCSG1 is one of independent tumor marker of breast cancer, the expression of BCSG1 is closely correlated to the stage of breast cancer and the tumor size. Maybe, BCSG1 is a new prognosis factor of breast cancer.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; diagnosis ; genetics ; pathology ; Female ; Gene Expression ; Humans ; Middle Aged ; Neoplasm Proteins ; genetics ; Neoplasm Staging ; Prognosis ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; gamma-Synuclein ; genetics

OBJECTIVETo investigate the meaning of pedicle exposure technique for screw fixation on atlas with the vertebral groove height less than 4 mm by using reconstructive computed tomography.

METHODSFrom April 2015 to June 2015, 84 pedicles of 51 patients with groove heights less than 4 mm were studied by digital reconstruction respectively. Parameters of atlas pedicle screw fixation were measured.

RESULTSAmong the 51 cases, the vertebral groove height was (3.28±0.51) mm. Lateral mass heights, lateral mass widths and the transition area heights between lateral mass and posterior arch were fit for 3.5 mm screw implanting. Ideal pedicle screw trajectory lengths from 0° to 15° (0°, 5°, 10°, 15°) were (27.36±1.81), (27.01±1.68), (27.07±1.75), (27.48±1.72) mm, exposed trajectory lengths from 0° to 15°(0°, 5°, 10°, 15°) were(23.44±1.79), (23.87±1.84), (24.58±1.89), (25.56±2.01) mm, trajectory length of lateral mass was (20.78±2.05) mm. The mean CT values on 5 sections through pedicle trajectory and lateral mass trajectory were (701.89±141.48) HU and (599.11±137.33) HU, respectively. There were no significant differences between ideal pedicle trajectory lengths from 0° to 15°(>0.05). Exposed trajectory lengths was significantly increased accompanying with medial angles increasing (<0.05), and was longer than trajectory lengths of lateral mass (<0.05). CT value of pedicle screws was higher than CT value of lateral mass screws significantly (<0.01).

CONCLUSIONSScrews can be implanted in atlas with vertebral groove height less than 4 mm by using pedicle exposure technique. Few trajectory lengths will be sacrificed with favorable pull out strength due to adequate bone mass purchased.

Toxoplasma gondii is an obligate intracellular parasite that stimulates production of high levels of proinflammatory cytokines, which are important for innate immunity. NLRs, i.e., nucleotide-binding oligomerization domain (NOD)-like receptors, play a crucial role as innate immune sensors and form multiprotein complexes called inflammasomes, which mediate caspase-1-dependent processing of pro-IL-1β. To elucidate the role of inflammasome components in T. gondii-infected THP-1 macrophages, we examined inflammasome-related gene expression and mechanisms of inflammasome-regulated cytokine IL-1β secretion. The results revealed a significant upregulation of IL-1β after T. gondii infection. T. gondii infection also upregulated the expression of inflammasome sensors, including NLRP1, NLRP3, NLRC4, NLRP6, NLRP8, NLRP13, AIM2, and NAIP, in a time-dependent manner. The infection also upregulated inflammasome adaptor protein ASC and caspase-1 mRNA levels. From this study, we newly found that T. gondii infection regulates NLRC4, NLRP6, NLRP8, NLRP13, AIM2, and neuronal apoptosis inhibitor protein (NAIP) gene expressions in THP-1 macrophages and that the role of the inflammasome-related genes may be critical for mediating the innate immune responses to T. gondii infection.
Apoptosis ; Cytokines ; Gene Expression ; Immunity, Innate ; Inflammasomes* ; Macrophages* ; Multiprotein Complexes ; Negotiating ; Neurons ; Parasites ; RNA, Messenger ; Toxoplasma* ; Up-Regulation