Recent years,the rapid development of manufacturing process for ceramic materials improves wear performance,biocompatibility,scratch resistance,no ion release property,wettability,and reduces friction.This makes ceramics become one of the most significant achievements in total hip arthroplasty.Ceramic-on-ceramic prosthesis seems to be one of the best choices for young and active patients.

[Objective] To investigate the effect of one-stage bilateral hip replacement in the treatment of late stage of hip joint ankylosis.[Methods]Ninteen patients(38 hips)with hip ankylosis were taken as research samples.Patients underwent biologically total hip replacement with posterolateral incision and acetabular plastic repair after second osteotomy.The ankle between acetabulum and femoral body was modulated according to the pre-operative deformation.A larger artificial prosthesis was installed.Early functional exercises were taken after operation.[Results]All cases were given a mean follow-up of 5.5 years(1~8 yrs).Dislocation was found in 2 cases and recovered after manual reduction.Slight fissure fractures were found in 2 hips and no special management was given.Slight heterotopic ossification was found in 6 hips,with grade Ⅰ in 3 hips,grade Ⅱ in 3 hips according to Brooker Classification.No obvious functional influence was found.The flexion-extension range increased from 0? pre-operation to average 81?(65?~115?)and the mean moving range reached 160?(110?~230?).[Conclusion]Bilateral hip replacement is a good method to reconstruct the hip function,promote the living standard.Artificial joint damage in the traditional two stage operations was avoided.It also has advantages of less medical expenses for patients and less pain after surgery.Functional exercises could be started earlier.It is a satisfactory method for the treatment of hip joint ankylosis.

[Objective] To evaluate the treatment with total hip arthroplasty(THA)using Zweym?ller system for short females with Crowe-Ⅲ and Ⅳ developmental dysplasia hip(DDH).[Method]From January 2004 to December 2006,thirteen THA procedures were performed in 12 female patients with 13 hips.The age of the patients was from 28 to 62 years old(average 51 years).The height was from 1.48 to 1.55 meters.Based on Crowe classification,8 patients with 9 hips were type-Ⅲ,and 4 patients with 4 hips were type-Ⅳ.before surgery,the discrepancy of lower limbs was from 3 cm to 5 cm.All patieds had severe hip pain and dysfunction.The Harris hip score ranged from 35 to 64 points with 40 points on the average.In all procedures the soft tissue was released entirely,the acetabular component was placed in the true acetabulum without femoral osteotomy.[Result]After operation,the legs lengthened from 2 to 5 cm.During the follow-up of 12 to 36 months(average 24 months),no femoral fracture,femoral or sciatic nerve palsy or loosening was detected except one dislocation according to clinical outcomes and X-ray findings.The Harris score was improved from 60 to 95.There was significant difference between before and after operation(P

[Objective]To describe a new way of arthroscopic posterior cruciate ligament reconstruction and evaluate the early stage of follow up results.[Method]Twenty four consecutive cases of isolated and combined posterior cruciate ligament deficiency were studied.Quadriceps tendon patellar bone was used for preparation of "Y" shaped autograft.Double-tunnel of femur were drilled and tibia was inlayed at their anatomical footprint.[Result]All cases were followed up for 24 months to 30months,averaging 24.5 months.Lysholm rating scales were used to make clinical subjective evaluations.Lysholm scores raised from 49.20?1.44 before operation to 87.91?1.52 after operation.Finial Lysholm evaluation showed 7 patients were excellent,16 good,and 1 poor.The good to excellent rate was 95.8%.Anteroposterior translation as clinical objective evaluations was measured with KT-1000.KT1000 arthrometer measurement showed that the average posterior translation improved from 12.85?1.10mm preoperatively to 3.98?1.99mm postoperatively.One patient was graded as failure.[Conclusion]Arthrosopy assisted prodedure of double bundle posterior cruciate ligament reconsruction using quadriceps tendon patellar bone autograft by double-tunnel of femur and inlaying of tibia is effective and reproducible.The short follow up clinical results are encouraging.

[Objective]To evaluate the clinical effect of the plastic splint on treatment of Colles fracture.[Method]A total of 105 patients with Colles fracture were collected between September 2002 and August 2008.All patients were perfromed using the plastic splint afrer diaplasis.According to Gartland and Werley scoring syste,the function of wrist was evaluated after 3 months.[Result]There are only 2 cases losing during treatment,103 cases were finished.The average excellent to good case was 90.3%,including 80 cases of being excellent,13 of being good,7 of being fair and 3 of being poor.[Conclusion]The plastic splint is exactly effective to treatment Colles fracture,especially,it could effectively relieve swelling and improve the contour of the wrists.Theses all rely on reasonable biomechanics design.

Objective To evaluate the inhibitory effect of rofecoxib in human gastric carcinoma tissues established in nude mice by orthotopic transplantation through the expressions of vascular endothelial growth factor (VEGF) and inducible nitric oxide synthase (iNOS). Methods After the models of human gastric carcinoma in nude mice by orthotopic transplantation were established, rofecoxib was administered intragastrically. The expressions of VEGF and iNOS were evaluated in the local tumors by Envision immunohistochemical method. Results The expression of VEGF protein in isotonic saline group, rofecoxib group and combination group were 81.25%, 61.25%, and 35.00% respectively.There was significant difference between rofecoxib group and isotonic saline group, and so was rofecoxib group and combination group (P

Objective To investigate the effects of hedysarum polybotys saccharide (HPS) on lipid metabolism and the expression of stearoyl-CoA desaturase-1(SCD-1) gene in rats with non-alcoholic fatty liver disease (NAFLD). To discuss the interfering effects of HPS on NAFLD. Methods The SD rats were randomly divided into the blank control group and the experiment group. Rats in the experiment group were fed with lipid rich food for 8 weeks to establish model and were randomly divided into model group, drug positive group and HPS group. After 8 weeks of drug intervention, the level of ALT, AST, TC, TG, HDL-c and LDL-c were measured with automatic chemistry analyzer, and expression of SCD-1 gene was measured by semi-quantitative polymerase chain reaction.Results Compared with blank control group, serum ALT, AST and TC, TG, LDL-c of model group were higher (P<0.05,P<0.01), the level of HDL-c of model group and the expression of SCD-1 gene were lower (P<0.01). Compared with model group, HPS was useful to decrease serum ALT, AST, LDL-c, TC and TG (P<0.05,P<0.01), and increase the level of HDL-c (P<0.01) and the expression of SCD-1 gene (P<0.01).ConclusionHPS had a positive effect on regulating lipid metabolic disturbance of NAFLD rats and promoting the expression of regulatory gene SCD-1.

Objective To evaluate the uncertainty of the small bowel dose?volume and the normal tissue complication probability (NTCP) during intensity?modulated radiotherapy (IMRT) for rectal cancer, and to provide a reference for the dose limit and protection of the small bowel during IMRT for rectal cancer. Methods A total of 20 patients with rectal cancer who received postoperative adjuvant radiotherapy from March 2014 to August 2015 were enrolled in this study, including 10 patients receiving CT scan in the supine position and 10 patients in the prone position. All patients received computed tomography ( CT) scan before the treatment and at weeks 1, 2, 3, and 4 of treatment, and they were defined as Plan, 1W, 2W, 3W, and 4W CT groups, respectively. The small bowel loop ( BL ) and peritoneal space ( PS ) were delineated on the images. The IMRT plan based on the Plan CT was copied to the 1W, 2W, 3W, and 4W CT groups, and then the small bowel dose?volume and NTCP were assessed for all CT groups. The paired t?test was used for comparison between groups. The Pearson method was used to analyze the correlation between NTCPC(chronic NTCP) and dose?volume. Results A total of 89 CT images of 20 patients were obtained. In all the patients, the volumes of BL and PS were 25121 cm3 and 132416 cm3 , respectively, and the shift% was 2315% and 1134%, respectively. The V15 of BL and PS was 18486 cm3 and 79245 cm3 , respectively, and the shift% was 3169% and 370%, respectively. The V30 of BL and PS was 8801 cm3 and 64573 cm3 , respectively, and the shift% was 3766% and 1049%, respectively. The V15 of BL in 35% of patients and V15 of PS in 20% of patients, the Dmax of BL in 50% of patients, and the NTCP of 15% of patients in the course of treatment exceeded the safety limits. The 1?4W CT groups had a significantly higher NTCPC than the Plan CT group (402% vs. 320%, P=0104), and their SD% was 4168%. There was a significant correlation between NTCPC and V30?V50 of BL (R>0400, P=0000). The NTCPA ( acute NTCP ) and NTCP C in the supine position were significantly higher than those in the prone position ( 6230% vs. 5674%, P=0061;488% vs. 322%, P=0145 ) . Conclusions Small bowel motility leads to an uncertainty of the adverse event assessment during IMRT for rectal cancer. The change in BL is significantly larger than that in PS and the change in BL and PS in the supine position is significantly larger than that in the prone position. Using the prone position and minimizing V15 and V30 when designing the treatment plan can reduce the NTCP A and NTCP C in the small bowel.

Objective To compare the dose volume and normal tissue complication probability (NTCP) of small intestine between intensity-modulated radiotherapy (IMRT) with dose constraints to the peritoneal space (PS) and the bowel loop (BL) in the treatment of rectal cancer,and to investigate the feasibility of placing a dose constraint to the PS instead of the BL in protection of the small intestine.Methods A total of 24 patients with rectal cancer undergoing postoperative adjuvant radiotherapy were enrolled as subjects.In the 24 patients,12 were treated in supine position an.d 12 in prone position.The weekly computed tomography (CT) scans from pre-treatment to weeks 1-4 of treatment were defined as Plan,1 W,2 W,3 W,and 4 W.Contours of PS and BL were delineated on all CT images.Based on the Plan CT images,two IMRT plans,PPS and PBL,were designed with dose constraints to the PS and BL,respectively.The method was applied to 1-4 W CT images.For each CT scan,the dose volume and NTCP of the small intestine were evaluated in PPs and PBL.Results A total of 109 sets of CT images were acquired from 24 patients,and 218 plans were designed and copied.The median volume of the PS and BL was 1339.28 and 250.27 cm3,respectively.For the Plan CT scans,V15 values of the PS in PPs plan and the BL in PBL plan were 918.96 and 199.57 em3,respectively.For all CT scans,the dose volume of the small intestine in PPs,in most cases,was lower than that in PBL,while V15 values in Ps and PBL were 170.07 and 178.58 cm3 (P=0.000).The dose volume of the small intestine was correlated with V15 (P=0.000).PPs had significantly lower NTCP of chronic and acute adverse reactions than PBL(2.80％ vs.3.00％,P=0.018;57.32％ vs.58.64％,P=0.000).In patients with prone and supine treatment positions,most of the dose volume and NTCP of the small intestine in Ps were significantly lower than those in PBL(P＜0.05 for V10,V15,V30,and NTCP of acute adverse reactions).Conclusions It is feasible to place a dose constraint to the PS instead of the BL for protection of the small intestine during IMRT for rectal cancer.V15＜830 cm3 can be referred to as the objective function of dose restraint.

BACKGROUND:Pedicle screw implantation is a common method to repair many kinds of diseases of the lower cervical spine. Three-dimensional (3D) reconstruction visualization system can be used in order to improve the accuracy of the implant and improve the prognosis.
OBJECTIVE:To investigate the effect of 3D reconstruction visualization system on the accuracy of cervical pedicle screw implantation.
METHODS: The clinical data of 89 patients with cervical spine dislocation, who underwent cervical pedicle screw implantation, were analyzed retrospectively. Patients were divided into control group (46 cases) and observation group (43 cases) according to the navigation method. Patients in the control group underwent C arm X ray two dimensional navigation. Patients in the observation group underwent three-dimensional reconstruction visualization system navigation. Intraoperative placement time was observed, and the accuracy of screw placement was assessed in both groups. The cases were folowed up for 12 months, and the adverse events were recorded and compared.
RESULTS AND CONCLUSION: (1) Intraoperative implantation time was shorter in the observation group than in the control group, but no significant difference was found (P> 0.05). (2) Accuracy rate: There were no three types of nail cases in the observation group, and the accuracy rate was 93% (40/43). In the control group, two cases affected three types of nailing, and the accuracy rate was 81% (37/46). The accuracy rate was significantly higher in the observation group than in the control group (P < 0.05). (3) Postoperative folow-up: None suffered from nerve tissue injury to vertebral artery, blood vessel and spinal cord. The screws of the two groups were in stable condition, without screw breakage or loosening. (4) Results suggested that in lower cervical pedicle nail implantation, 3D reconstruction navigation system can effectively improve the accuracy of screw placement, and does not increase nailing time or lead to adverse events. It is a safe and effective navigation mode.