BACKGROUND:In the selection of minimally invasive total hip arthroplasty approaches,there is considerable debate about whether direct anterior and posterior approaches differ in postoperative gait,limb balance,and hip motor capacity,and therefore further investigation is warranted. OBJECTIVE:To assess the gait and hip ambulation ability of direct anterior and posterior approaches for primary unilateral total hip arthroplasty with a prospective randomized controlled study. METHODS:A total of 61 patients with unilateral avascular necrosis of the femoral head in Qingdao Municipal Hospital from January 2019 to June 2020 were included in the study.There were 40 males and 21 females,at a mean age of(64.83±5.52)years.All the patients were randomly divided into a direct anterior approach group(n=28)and a posterior approach group(n=33),and received initial total hip arthroplasty by direct anterior approach and posterior approach,respectively.Gait analysis(gait time-space parameters such as stride length,stride frequency,single-leg support time,and plantar pressure difference)and hip ambulation ability(standing-walking timing test and 2-minute walking test)were performed before and 1,3 and 6 months after operation. RESULTS AND CONCLUSION:(1)With the extension of postoperative time,gait time-space parameters in both groups were gradually improved.The stride length,stride frequency,single-leg support time,and plantar pressure difference in the direct anterior approach group were significantly better than those in the posterior approach group 1 month after surgery(P<0.01).The stride frequency,single-leg support time,and plantar pressure difference in the direct anterior approach group were significantly better than those in the posterior approach group 3 months after surgery(P<0.05).The plantar pressure difference in the direct anterior approach group was significantly better than that in the posterior approach group 6 months after surgery(P<0.01).(2)With the extension of postoperative time,the results of the standing-walking timing test and 2-minute walking test were gradually improved in both groups.The results of the standing-walking timing test and 2-minute walking test 1 and 3 months after operation in the direct anterior approach group were better than those in the posterior approach group(P<0.05).(3)The results have indicated that the recovery of postoperative gait and hip ambulation ability of the two groups is inconsistent.The direct anterior approach group has some advantages in the improvement of postoperative gait and hip ambulation ability compared with the posterior approach group in the early postoperative period.

BACKGROUNDTo study the clinical effects of ¹⁵³Sm-EDTMP plus chemotherapy in the treatment of bone metastasis of lung cancer.

METHODSOne hundred and ten lung cancer patients with one metastasis [male 82 and female 28, aged from 32 to 76 yrs; squamous cell carcinoma 28, adenocarcinoma 27, small cell lung cancer (SCLC) 7, mix type 41, alveolar carcinoma 7] who did not undergo an operation were entered into this study. The patients were divided into 3 groups: ¹⁵³Sm-EDTMP therapy only (37 cases), ¹⁵³Sm-EDTMP plus chemotherapy after 3 days (42 cases), 30 days after chemotherapy plus ¹⁵³Sm-EDTMP (31 cases). The dosages of ¹⁵³Sm-EDTMP ranged from 1 111 to 2 660 MBq. The patients with SCLC were adapted CCNU, MTX and CTX; those with non-small cell lung cancer (NSCLC) were adapted MMC, VCR and DDP. Statistic analysis of the data was performed by Chi-square test.

RESULTSTotal pain relief rate for ¹⁵³Sm-EDTMP only was 89.2% , for ¹⁵³Sm-EDTMP plus chemotherapy was 92.8%, and for chemotherapy plus 153 Sm EDTMP was 90.3% . The foci disappeared in 9 cases with ¹⁵³Sm-EDTMP only, in 12 cases with ¹⁵³Sm-EDTMP plus chemotherapy, and in 9 cases with chemotherapy plus ¹⁵³Sm-EDTMP. The 1 year survival rate was 29.7%(11/37) by 153 Sm only, 40.5%(17/42) by 153 Sm plus chemotherapy, 38.7%(12/31) by chemotherapy plus ¹⁵³Sm-EDTMP.

CONCLUSIONS¹⁵³Sm-EDTMP plus chemotherapy is effective in the treatment of bone metastasis of lung cancer.