How to remove the well fixed cement or cementless prosthesis and get a completely distal cement removal in the rTHR are critical to the outcome of revision. Because of higher rate of union, excellent intraoperative exposure, and adjustment of abductor tension, ETO has been widely applied to rTHR and complicated primary THR by foreign scholars. Furthermore, this technology has wide indications, very few contraindications, high cure rates,and low complications rate. ETO turns out to be a safe and effective revision technology. In the article, the indication, contraindication, complications and advantages of this technique were reviewed.
Arthroplasty, Replacement, Hip ; methods ; Humans ; Osteotomy ; adverse effects ; methods

Objective To investigate the effectiveness of organ dose modulation (ODM) technology with respect to dose reduction and image quality of the sensitive organs during CTA of craniocervical arteries. Methods Ninety one patients suspected of arterial vascular disease and evaluated by CTA of craniocervical arterires were enrolled in this study. Patients were divided into group A (n=46) and group B (n=45) according to the order of examination. All patients hadCTA examination of craniocervical arteries. The ODM technique was used only in plain phase in group A and was used both in the plain phase and enhanced phase in group B. The tube current in the four direction (anterior,posterior,left,right) of thyroid and orbital area and radiation dose were recorded. The image quality of group A and group B was evaluated by objective indicators [CT attenuation values and contrast-to-noise ratio (CNR) of vessels in the thyroid area and orbital region ]and the subjective score. The independent samples t test was used for the statistical analysis of the objective indicators and nonparametric rank sum Mann-Whitney U test were used for subjective score. Results For A group, There were significant differences for the tube current at all directions of the thyroid gland and orbital area between the plain phase and the enhanced phase except the current at the posterior of the thyroid gland area(P value all<0.05),and the current in plain phase lower than that in enhanced phase. The mean current of thyroid gland and the orbital area were (604±43) mA and (656± 22) mA in the plain phase and (341±54) mA and (409±63) mA in enhanced phase. The differences were significant (t values were -10.909 and -38.454,P<0.01).CTDIvol and ED were (15.6±1.4) mGy and (1.44± 0.17) mSv in the plain phase and (17.4 ± 1.4) mGy and (1.60 ± 0.18) mSv in the enhanced phase, the differences were significant (t values were - 42.008 and - 32.130, P<0.01) . There was no significant differences for the objective indicators and the subjective score between group A and group B(P>0.05). Conclusion ODM technique can provide protective effect on the sensitive organs during craniocervical CTA examination without compromising the image quality.

Objective To investigate the clinical application value of the critical value electric reporting system .Methods The critical value data from Aug .1 ,2015 to Jan .31 ,2016 were inquired through the electronic hospital information system (eHIS) .The incidence rate of critical values ,items distribution and department distribution were analyzed .Results A total of 3 405 items of crit‐ical value were reported .The occurrence rate of critical values was 0 .45% .The top 5 of critical values numbers were chlorine (25 .76% ) ,myocardial‐specific isoenzyme of creatine kinase (19 .97% ) ,serum sodium (9 .43% ) ,platelet count (9 .05% ) and partial pressure of carbon dioxide (6 .40% ) .The top 5 departments of critical values reported number were the cardiology department (18 .94% ) ,followed by neurological intensive care unit (12 .04% ) ,intensive care unit (9 .52% ) ,second wards of neurosurgery (5 .11% ) and neurovascular wards (5 .02% ) .The median time of critical value report was reduced by 33 .33% and the quartile range time weas reduced by 40 .00% .Conclusion The application of critical value electric reporting system reduces the elapsed time of critical value report ,increases the promptness and accuracy of critical value report ,and has an important significance to guarantee the medical quality .

This study aimed at the molecular mechanism of Cordyceps sinensis polysaccharide-A(CPS-A) on angiotensin (Ang Ⅱ)-induced injury of L02 cells.The effect of AngⅡ and CPS-A on the proliferation of L02 cells was analyzed by MTT assay.PCR,Real-Time PCR and Western blot were also employed to determine the expression of IL-1β,AT1R,AT2R,NF-κB p65,TNFα and other inflammatory factors at mRNA and protein levels.The results showed that Ang Ⅱ and CPS-A could inhibit the proliferation of L02 cells by 1 × 10-5 mol/L and 200 μg/ mL,respectively.PCR,Real-Time PCR and Western blot showed that CPS-A could significantly down-regulate IL-1 β,TNF-α,NF-κB and AT1R.CPS-A has a good protective effect on AngⅡ-induced L02 cell injury.

This article reported a case of a male patient with primary hyperparathyroidism(PHPT) caused by an ectopic parathyroid adenoma in the anterior superior mediastinal. Hospital routine examinations indicated hyperlipidemia, hyperuricemia, type 2 diabetes with nephropathy, chronic kidney disease in stage Ⅳ, elevated PTH, hypercalcemia, hypophosphatemia, clinically highly suspected hyperparathyroidism. There was no obvious abnormality of parathyroid ultrasound, while 18F-FDG systemic metabolic imaging and 99mTc-MIBI dual-phase parathyroid imaging suggested that an ectopic parathyroid gland in the anterior superior mediastinal which was hyperactive. Evaluations of anterior pituitary function, pancreas, and endocrine-related hormones showed no obvious abnormalities, and thus we ruled out the possibility of multiple endocrine adenomas, combined with the patient′s symptoms and previous medical history, and ruled out the possibility of tertiary hyperparathyroidism, the patient was diagnosed as PHPT caused by the anterior superior mediastinal ectopic parathyroid adenoma. To restore the blood calcium to normal, the patient was treated with intravenous rehydration, diuresis, calcitonin to promote urinary calcium excretion, and zoledronic acid to inhibit bone resorption. Further thoracoscopic mediastinal tumor resection was performed, and the diagnosis of parathyroid adenoma was confirmed by pathology. All the indicators were normal and no recurrence of hyperparathyroidism was found during the follow-up. Integration of the patient′s clinical manifestations, biochemical indicators, and imaging examinations are necessary to diagnose PHPT qualitatively and location-specifically. In particular, it is necessary to pay attention to whether there is the possibilities of ectopic adenoma and multiple endocrine adenomas, to reduce the rates of missed diagnosis and recurrence.

Objective To study the diagnosis, treatment and prognosis of the rupture of breast implant. Methods Physical examination, X-ray fluoroscopy, high frequency and color the Doppler ultrasonography were helpful to make a clear diagnosis, in exploring and removing the fiber envelope by inframammary or periareolar incision, repairing the anatomy structure of the breasts and performing augmentation mammaplasty again. Results In 32 patients, the breast shape was basically symmetrical, most of the incisions were healed by first intention except 2 cases with complication of subcutaneous fluid collection. A satisfactory therapeautic result could be achieved by taking out the breast implant which was rupture, exploring and removing the fiber envelope, and extending the lacuna. Conclusion A satisfactory therapeautic result can be achieved by extending the lacuna.

AIM:To detect the endogenous expression of B-cell leukemia/lymphoma 6 member B (BCL6B) in FHC and LoVo cells, and to investigate the effects of BCL6B on proliferation and migration of LoVo cells for further explo-ring the underlying mechanism .METHODS:The endogenous expression of BCL 6B in the FHC and LoVo cells was detec-ted by RT-PCR and Western blot .The methods of MTT assay , colony formation assay , wound healing assay and Transwell chamber experiment were employed to examine the biological functions of BCL 6B in the LoVo cells.The mRNA and protein levels of BCL6B, cyclin D1 and matrix metalloproteinase-9 ( MMP-9) were determined by RT-PCR and Western blot , re-spectively.The level of phosphorylated protein kinase B (p-AKT) was detected by Western blot.RESULTS:BCL6B ex-pression was notably repressed in the LoVo cells as compared with the FHC cells , which were significantly increased by transfection with pcDNA3.1-BCL6B.The abilities of proliferation and migration of the LoVo cells at 72 h were inhibited by 28.33%(P<0.01) and 36.11%(P<0.05) in BCL6B group.The mRNA levels of cyclin D1 and MMP-9 in the cells of BCL6B group were decreased by 39.90%(P<0.01) and 77.36% (P <0.05), and the protein levels of cyclin D1, MMP-9 and p-AKT were reduced by 44.00%(P<0.05), 47.06%(P<0.01) and 32.88% (P<0.05), respectively. CONCLUSION:BCL6B inhibits proliferation and migration of the LoVo cells , and the PI3K/AKT signaling pathway is in-volved in this process .

OBJECTIVETo investigate the feasibility of bone marrow mesenchymal stem cell (MSC) transplantation with ultrasound-targeted microbubble destruction.

METHODSTwenty-one Wistar rats were divided into MSCs-iv group (MSCs-iv), ultrasound+MSCs-iv group (US+MSCs-iv), ultrasound+microbubble+MSCs-iv group (US+MB+MSCs-iv) with intravenous MSC transfer, ultrasound and microbubble treatment as indicated. The skeletal muscles were obtained from the rats for microscopic examination with HE staining. The hindlimb gracilis and semimembranosus muscles were sampled 7 days after MSC transplantation, and the transplanted MSCs were detected by immunohistochemistry. The vital organs were collected from rats in US+MB+MSCs-iv group for immunohistochemistry.

RESULTSIn US+MB+MSCs-iv group, HE staining demonstrated the presence of red blood cell leakage into the tissue space in the gracilis and semimembranosus muscles, and immunohistochemistry identified large numbers of transplanted MSCs in the the gracilis and semimembranosus muscles and the spleen, whereas no labeled cells were detected in the skeletal muscles in other groups.

CONCLUSIONUltrasound-targeted microbubble destruction provides a useful means for enhancing the efficiency of stem cell transplantation.

Animals ; Bone Marrow Cells ; cytology ; Cell Movement ; radiation effects ; Female ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; Microbubbles ; Muscle, Skeletal ; cytology ; Rats ; Rats, Wistar ; Ultrasonics

OBJECTIVETo investigate the effects of neoadjuvant chemotherapy on the response of surgical stress during perioperative period.

METHODSFrom July 2005 to June 2006, 30 SD rats with the same age were distributed into 3 experimental groups and 1 control group randomly. Each experimental group included 8 rats, and the control group included 6 rats. The rats in experimental groups received intravenous infusion of cyclophosphamide, while the rats in control group received IV infusion of normal sodium. The blood of rats from experimental groups was taken 30 min before and during the stimulation of abdominal surgery which was given at the end of the first, the second and the third week after receiving IV infusion cyclophosphamide. Then the plasma concentration of noradrenaline was measured respectively.

RESULTSThe IV infusion of cyclophosphamide before operation could greatly improve the plasma level of norepinephrine, and it reached peak at the end of the second week. When surgeries were given at that time, the stress response became much more seriously. The response induced by neoadjuvant chemotherapy disappeared 3 weeks later.

CONCLUSIONSNeoadjuvant chemotherapy with cyclophosphamide can induce significant stress response which is characterized by the increase of plasma level of norepinephrine. It indicates that the best time of surgery for patients who have received neoadjuvant chemotherapy with cyclophosphamide is 2 weeks later.

Animals ; Catecholamines ; blood ; Chemotherapy, Adjuvant ; Cyclophosphamide ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Infusions, Intravenous ; Male ; Perioperative Care ; adverse effects ; methods ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological ; etiology

Cognitive impairment and dementia are increasingly considered to be a continuum of overlapping neurological syndrome in the elderly with cerebrovascular disease and neurodegenerative disease.The association between cerebral microbleeds and cognitive impairment have attracted more and more attention.This article reviews the relationship between spatial distribution of cerebal microbleeds and cognitive impairment.