Objective To study the effect of icariin on proliferation and phenotype of osteoblasts interfered with titanium particles. Methods Calvarial osteoblasts of newborn rats were cultured in vitro and cell identification was performed by alkaline phosphatase staining. Effect of titanium particles with different concentrations on osteoblasts proliferation was detected by CCK-8 method. Meanwhile , medium lethal concentration of titanium particles was screened out. Under this concentration , icariin with concentrations of 10-5, 10-6, 10-7, 10-8, 10-9 and 10-10 mol/L was added respectively for interference. The effect of icariin on proliferation of osteoblasts interfered with titanium particles was observed so as to obtain optimum drug concentration. Icariin with optimum concentraion was added into osteoblasts interfered with titanium particles. ALP activity of each group was detected by ELISA and calcified nodules were stained by alizarin S red to observe the effect of icariin on phenotype of osteoblasts. Results Titanium particles with different concentrations can inhibit proliferation of osteoblasts (P < 0.05), 0.5 mg/mL is its medium lethal concentration. Icariin can promote proliferation of osteoblasts interfered with particles (P < 0.05), the optimum drug concentration is 10-9 mol/L. With this concentration, icariin can significantly improve ALP activities of osteoblasts (P<0.05) and calcified nodules formation. Conclusion Icariin can promote proliferation and phenotypic expression of osteoblasts interfered with titanium particles. It may probably become an effective medicine for preventing aseptic joint prosthesis loosening.

Objective To compare the effectiveness and safety of continuous and intermittent ice compression therapy following total knee arthroplasty surgery. Methods Eighty patients were divided into two groups receiving continuous or intermittent 30 minutes every 2 two hours within 48 hours after the operation. The subjective pain (VAS score), additional pain-killer use, swelling of extremity, drainage, range of motion were observed and compared. Results Patients in the observation group had less pain than those in the control group (Z values in the first 3 postoperative day was-2.722,-3.359,-2.039, respectively, P<0.05). Less pain-killers were required in the experimental group (Z=-2.559, P<0.05). The postoperative swelling by the thigh circumferences in the first day in the observation group was (1.84 ± 1.11) cm, which was milder than the (3.30 ± 1.69) cm of the control group (t=4.565, P<0.01). So was it in the calf circumferences, (0.94 ± 0.89 ) cm vs. (1.46 ± 0.91) cm (t=2.627, P=0.01). Within the first 3 days after the operation, this mildness still existed in aspect of thigh circumferences, which was (3.09±1.39) cm in the observation group vs the (4.09 ± 1.71) cm in the control group, t=2.869, P < 0.01. Conclusions Continuous ice compression therapy has better effects than intermittent 48 hours after total knee replacement, with functional training and exercise not disturbed. It is considered safe and assured, and is therefore recommended.

[Objective]To explore the advantages and disadvantages of minimal incision surgery(MIS) for total hip replacement.[Methods]Thirty-two patients(37 hips) who had undergone a MIS were compared with 32 patients(37hips) who had undergone conventional incision surgery with similar condictions.The length of incision,operation time,intraoperative blood loss,postoperative drainage,hospitalized days and complications were observed.[Results]The average incision length was 7.7 cm for MIS group and 11.5 cm for conventional incision group(P0.05).In MIS group,greater trochanter fracture occured in 1 patient during operation.Dislocation occurred in another patient with anterolateral approach 3 days postoperatively because of malposition of the cup,the cup was then adjusted to proper position by re-operation with extended incision length.In conventional incision group,no complication occured during or after operations.[Conclusion]Total hip replacement with the incision length of 6～8.5 cm is a very demanding technique.There were no much advantages of MIS for total hip replacement concerning surgical time,blood loss or trauma compare with a conventional incision surgery.The incision length for total hip replacement should not be stressed.The most important thing for total hip replacement is not the length of the incision and the length of incision should not be reduced at the price of more soft tissue injury.

[Objective]To investigate the outcomes of cementless metasul metal-on-metal total hip arthroplasty.[Method]Metasul metal-on-metal total hip arthroplasty of 30 hips in 25 patients was performed from August 2003 to December 2005.There were 11 males and 14 females with an average age of 47 years(28-72 years).Harris hip scores were determined before surgery and at the last follow-up examination.Standardized radiographs were obtained to evaluate component conditions.Blood samples were taken to determine serum chromium levels with use of atomic absorption spectrometry.[Result]Twenty-three patients(28 hips)were followed up with a mean period of 3.6 years(2.5-4.8 years).The mean Harris hip score improved from 49.5(17-78)points preoperatively to 93.4(55-99)points at the time of final follow-up.Twenty-two hips(85%)had an excellent result.Radiolucent lines were found in 3 hips.Focal femoral osteolysis was seen only in one patient.Sciatic nerve was injured in one case,which showed rehabilitation after 2.5 years.One hip had periprothetic infection because of diabetes 4 years after operation.There was no measurable wear by X-rays.No dislocation or fracture was found.The median serum chromium concentration was 0.082 ?g/mL(0.020～0.140 ?g/mL).No patient was diagnosed with renal insufficiency or hematologic malignancy during the study period.[Conclusion]The outcomes of Metasul metal-on-metal total hip arthroplasty are satisfactory.However,additional follow-up is necessary to determine any possible long-term deleterious effects.

[Objective]To discuss the cementless revision for postoperative infection after hip arthroplasty.[Methods]From November 1997 to December 2006,7 patients(7 hips) with infection after hip arthroplasty were treated,including 3 males and 4 females,with a mean age of 58 years(36～73 years).In the 7 hips,4 hips underwent a revision of total hip arthroplasty,2 hips only received new acetabular components and 1 hip underwent stem revision.One-stage revision was performed in 4 cases,two-stage revision was performed in 3 cases.Consecutive radiographs were compared to evaluate component conditions.Harris hip scores were determined before surgery and at the final follow-up examination.The erythrocyte sedimentation rate and C-reactive protein were detected.[Results]All patients were followed up with a mean period of 3.6 years(1.5～10.6 years).The mean Harris hip score improved from 35(18-63) points preoperatively to 89(60～99) points at the time of final follow-up.No re-infection was found.Femoral component exsertion was found in 1 patient but without any symptom.Pain of hip joint disappeared in 5 cases,and 2 patients had mild pain when walking long distance.At the time of final follow-up,5 patients still had slight limp.Heterotopic ossification developed in 1 hip.The mean polyethylene liner wear was 0.08 mm per year at final follow-up.Deep vein phlebothrombosis and nerve injury were not found.[Conclusion]It is possible to have satisfactory clinical outcome by one-stage or two-stage revision using cementless prothesis for postoperative infection after total hip arthroplasty.Whether the original prothesis can be saved when fixed tightly with femur or acetabular bone needs more experiences to confirm.

[Objective]To evaluate the clinical and radiographic results of revision hip arthroplasty with cementless prothesis.[Method]Revision hip arthroplasty of 41 hips in 36 patients was performed from November 1997 to August 2007 using cementless prothesis.In the 41 hips,29 hips underwent a revision total hip arthroplasty,8 hips underwent new acetabular components,and 4 hips underwent stem revision.Consecutive radiographs were compared to evaluate component conditions.The value of AAOS and Paprosky classification was used.Harris hip scores(HHSs)were determined before surgery and at the most recent follow-up examination.The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Result]Twenty-two patients(26 hips)were available for complete clinical and radiographic analysis.The mean follow-up period was 4.6 years(range,1-11 years).The mean preoperative Harris hip score of 38(range,11-76)points improved to 88(range,60-99)points at the time of final follow-up.The pain and function socre improved from 16.9 and 17.3 points to 40.4 and 39.9 points,respectively.All patients had moderate to severe limp before revision.At the time of final follow-up,8 patients still had slight limp and 4 patients had moderate limp.Twenty-one hips(75%)had an excellent result.A 1mm width radiolucent line was found in 1 femoral component without any symptom.Osteolysis and migration were seen in 4 hips(3 in acetabular and 1 in femoral component),which needed re-revision(12.5% failure).Heterotopic ossification developed in 8 hips(31%).The mean polyethylene liner wear was 0.27 mm(range,0.02-0.87 mm)in all and 0.08 mm(range,0-0.25 mm)per year.The wear rate was only correlated with changes of abduction angle of the acetabulum.The coincidence of bone defect classification in AAOS is better than Paprosky.Kaplan-Meier survivorship at 4.6 years was 89% with repeat revision for any reason as the end point and 81% with repeat revision or radiographic loosening as the end point.[Conclusion]Cementless prothesis appears to be a good alternative to other revision systems in revision total hip arthroplasty.Careful intraoperative evaluation of bone deficiency are needed to choose an appropriate prothesis in order to obtain a good outcome.

[Objective]To evaluate the midterm clinical and radiographic results of revision hip arthroplasty by acetabular reinforcement ring (ARR) with impaction bone grafting. [Methods]Revision hip arthroplasty by ARR with impaction bone grafting of 8 hips was performed from May 2001 to December 2006. There were 5 males and 3 females with an average age of 53 years (range, 36~70 years).The mean BMI was 20 (range, 15~28). The mean interval between the primary arthroplasty and revision was 5 to 20 years (mean 6.7 years). The causes for revision were infective loosing in 2 and aseptic loosening in 6. In the 8 hips, 6 hips underwent a revision total hip arthroplasty, 2 hips received replacement of the acetabular component. Consecutive radiographs were compared to evaluate component conditions and the influence of bone deficiency to fix the prothesis was analyzed. Harris hip scores (HHSs) were determined before surgery and at the most recent follow-up examination. The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Results]Seven hips were available for complete clinical and radiographic analysis. One patient died for myocardial infarction. The mean follow-up period was 4.5 years (range, 1.5~7.1 years).The mean preoperative Harris hip score of 30(range, 20~64) points improved to 88 (range, 74~94) points at the time of final follow-up, the pain and function socre improved from 13.8 and 11.5 to 40.3 and 39.9 respectively. All patients had severe limp before revision. At the time of final follow-up, 5 patients still had slight limp and 1 patients had moderate limp.Five hips had an excellent result. Infective osteolysis and migration were seen in 2 hips, which need re-revision. Heterotopic ossification developed in 2 hips . Kaplan-Meier survivorship at 4.5 years was 63% with repeat revision or radiographic loosening.[Conclusion]ARR with impaction bone grafting is an effective approach to treat massive acetabular bone defect in revision hip arthroplasty, the midterm result is acceptable, but any possible reason for infection must be monitored.

BACKGROUND:The outcomes of SL-Plus? stem in primary total hip arthroplasty have been proved good, but whether SLR-Plus? revision stem can obtain a good outcome in revision hip arthroplasty needs more studies. OBJECTIVE:To observe the clinical results of revision hip arthroplasty with Zweymül er SLR-plus ? stem. METHODS:Revision hip arthroplasty of 41 hips in 39 patients was performed from November 1997 to May 2013 using SLR-plus ? stem. There were 26 hips (male) and 15 hips (female). They were at the age of 34-73 years old, 53 on average. In the 41 hips, 36 cemented and 5 uncemented femoral prostheses were used. Prosthetic changes on radiographs were observed. In accordance with Brooker classification, heterotopic ossification was classified to record the region and incidence of heterotopic ossification. Hip joint function was evaluated using Harris Hip Score, and survival rate of the prosthesis was analyzed. RESULTS AND CONCLUSION:A total of 31 patients (33 hips) were fol owed up for 1 to 16 years. The mean preoperative Harris hip score of 34 (range, 13-64) points improved to 85 (range, 55-94) points at the time of final fol ow-up. 32 hips (97%) had an excellent result. A 1 mm width radiolucent line was found in 1 femoral component without any symptom. Osteolysis and migration were seen in 1 hip, which needed re-revision. Heterotopic ossification developed in 9 hips, including 2 hips of Brooker grade 1, 4 hips of grade 2 and 3 hips of grade 3. No re-infection was found. Kaplan-Meier survivorship was 92%with radiographic loosening as the end point. Results demonstrated that the SLR-Plus? stem has sufficient immediate and long-term stability, which is reliable for patients undergoing hip revision surgery.

OBJECTIVE:To detect the expressions of five gastric cancer cell metastasis associated genes induced by arsenic trioxide METHODS:The expressions of CD44,P53,nm23,H-ras,PCNA induced by arsenic trioxide were examined by immunohistochemistry method RESULTS:Arsenic trioxide induced the decrease of the expressions of CD44,P53,PCNA in gastric cancer cells;the expressions of nm23 and H-ras were not changed by As2 O 3 CONCLUSION:It is tentatively proved that the antineoplastic action of As2 O 3 may be related to the down-regulation of CD44,P53 and PCNA

The paper analyzes the status of trauma rescue and treatment informatization in Xinjiang,states the thoughts of construction of intelligent trauma medical center in southern Xinjiang (including the telemedicine system based on regional medical network,orthopedics trauma and disease diagnosis and treatment platform,etc.).It also provides the application examples and discusses the social economic benefits.