Objective To review the pathogenesis of osteoarthritis ( OA) and microsphere delivery systems advances in the field of osteoarthritis treatment, and provide theoretical support for clinical research and osteoarthritis therapy.Methods The literatures on osteoarthritis have been reviewed in recent years, and pathogenesis and osteoarthritis therapy were summarized.ResuIts At present, the therapy of OA was gradually from symptoms relief to pathogenesis, and further revealed the inner regularity of osteoarthritis treatment.However, a variety of western medicines had its own limitations. ConcIusion In recent years, intra-articular injection therapy because of its unique advantages in clinical treatments,attracts widespread attention, and particularly the microsphere injection with superior prospects is researched more in the field of new formulations.

BACKGROUND:Recent advances in polylactic acid-polyethylene glycol (PLA-PEG) block copolymer and hydroxyapatite surface-grafted with poly(l-lactide) (HA-g-PLLA), including their synthesis and preparation, have been approved for application in bone tissue engineering. But they have stil many disadvantages. Combination of HA-g-PLLA and PEG-PLA could show a great potential for development in bone tissue engineering. OBJECTIVE:To investigate the effect of PLA-PEG/HA-g-PLLA composite fibrous material with different content of HA-g-PLLA on adhesion, multiplication and cellviability of osteoblasts. METHODS:Four fibrous materials of 5%PLA-PEG, 5%PLA-PEG/5%HA-g-PLLA, 5%PLA-PEG/10%HA-g-PLLA, 5%PLA-PEG/15%HA-g-PLLA were prepared using electrospinning technique and divided into four experimental groups. Mouse osteoblasts were inoculated on the materials. A statistical analysis was done based on results from celldyeing and alkaline phosphatase detection at certain time points to evaluate the effect of new materials on osteoblast adhesion, proliferation and viability. RESULTS AND CONCLUSION:In the experiment of cellmultiplication and the test of alkaline phosphatase activity, both absorbance values and activity of alkaline phosphatase from high to low were 5%PLA-PEG/10%HA-g-PLLA>5%PLA-PEG/15%HA-g-PLLA>5%PLA-PEG/5%HA-g-PLLA>5%HA-g-PLLA (P<0.05). The absorbance value of PLA-PEG/HA-g-PLLA roughly presented a waveform with the increasing addition of HA-g-PLLA. The effect of PLA-PEG/HA-g-PLLA composite fibrous material on adhesion, multiplication and osteogensis of osteoblasts increases with addition of HA-g-PLLA in a certain range.

Objective To understand the progress of paclitaxel carriers, to provide theoretical support for research of paclitaxel carriers and clinical use of paclitaxel.Methods To study literatures on paclitaxel carriers recently and understand the research direction of paclitaxel carriers.Subsequently, the advantages and disadvantages of various paclitaxel carriers were analyzed and summarized.Results Paclitaxel as an effective anti-tumor chemotherapy drugs, had poorly water-soluble, serious toxicity and side effects, which limited the wide application of paclitaxel to some degree.Development of liposomes, micelles, microspheres, nanoparticles and other new dosage forms had broken these restrictions, which had vital significance.Conclusion Paclitaxel carriers can improve the solubility of the drug, reduce side effects, and develop toward multi-functional and finely targeted.

BACKGROUND:Bone graft for acetabular reconstruction includes morselized bone graft, structural bone graft and hybrid bone graft, and the morselized bone has been widely used because of the advantages of simple
production and short healing time.
OBJECTIVE:To explore the key technologies and clinical effect of impaction bone grafting with morselized bone in total hip revision for AAOS Ⅲ acetabular deficiency.
METHODS:Sixteen cases of AAOS Ⅲ acetabular deficiency were treated with impaction bone grafting with morselized bone combined with metal devicesor constructive bone grafting. The hip Harris scores and
radiographic data were compared before and after treatment. The effect of impaction bone grafting with morselized bone on acetabular deficiency was assessed.
RESULTS AND CONCLUSION:Al the patients were fol owed-up at 3, 6, 12 months after surgery and every half a year successively. The pain of hip joints after operation was relieved significantly and the walking function was
restored. The hip Harris score was improved from 48.00 points before surgery to 84.94 points after surgery (P<0.01). Five cases were graded as excel ent, eight cases as good, two cases as average, and one case as poor. The excel ent and good rate was 81%, and the satisfying rate of the patients was 94%. The post-operative X-ray films of al the 16 patients showed that the acetabular rotation centers were recovered (near) to normal and the acetabular cups were covered wel by bone. The grafting bone particles got radiological osseointegration and the
acetabular cup prosthesis did not displaced, and no displacement and breakage happened to the metal devices.
Impaction bone grafting with morselized bone in total hip revision for AAOS Ⅲ acetabular deficiency can effectively reconstruct the acetabular bone structure, retain and restore the acetabular bone mass, and it has good technical advantages and good clinical effects.

Objective: To explore the clinical effects of retroperitoneal laparoscopic ureterolithotomy (RPLU) and flexible-ureteroscopic holmium laser lithotripsy (f-UHLL) for complicated upper ureteral calculi. Methods: A total of 45 cases of complicated upper ureteral calculi between March 2014 and January 2016 in Department of Urology, Affiliated Jiangyin Hospital of Southeast University Medical College were retrospectively analyzed, there were 32 males and 13 females, ranging from 27 to 45 years with an average age of (34.1±9.5) years. Of the 45 patients, 28 had ureteral distortion and 17 had concurrent ureteral stones in the lower or middle ipsilateral ureter. In those patients, 20 cases underwent f-UHLL, and 25 cases received RPLU. The stone size, operation time, hospital stay, stone clearance rates and postoperative fever rates between the two groups were compared with t test and χ²test. Results: The operation was successfully performed in all patients, no complications with leakage of urine or ureteral perforation occurred, and no significant difference in renal function between the two methods were founded in postoperative period. There was no significant difference in operation time((78.4±8.5) minuetes vs.(73.3±11.3) minuetes, t=0.61, P=0.67), time of double J tube removed ((33.8±3.4)days vs. (37.6±8.9) d, t=2.37, P=0.08) and ipsilateral renal glomerular filtration rates ((41.3±7.6)ml/minuetes vs.(40.5±7.1) ml/min, t=0.78, P=1.27) between the two groups. However, the hospitalization time ((5.9±1.7)days vs. (4.2±1.6) days, t=1.92, P=0.04), postoperative fever rates (4% vs.30%, χ²=5.72, P=0.03) and calculus clearance rates (100% vs. 75%, χ²=7.03, P=0.01) in RPLU were significantly higher than f-UHLL. Besides, 5 patients in the f-UHLL group had postoperative stone residue and were treated with extracorpore shock wave lithotripsy. Conclusions Both RPLU and f-UHLL are safety and validity for complex upper ureteral calculi. RPLU can improve the rate of calculus removal and reduce the rate of postoperative fever.

To systematically evaluate the expression of lymphovascular invasion (LVI) in predicting the clinical prognosis of patients after radical cystectomy.Methods The relevant search strategy,including and excluding criteria for the relevant literature were developed by two independent researchers.The study of tumor prognosis in the patients with LVI following radical cystectomy cancer were searched by computerized PubMed,EMBASE,Web of Science,Cochrane library,China National Knowledge Infrastructure (CNKI),Wanfang and VIP citation database.The search period was setted from the beginning of establishment of library until May 2017,and the search language was English and Chinese.The methodological quality of the included studies was assessed by the NOS.Besides,the relationship between LVI and the clinical outcome in patients following radical cystectomy was calculated by RevMan 5.3 and Stata 12.0 software.Results A total of 18 related clinical studies were included,published from 2008 to 2017.There were 12 354 patients with bladder cancer,of which 4 272 cases of LVI,with a proportion rate 34.6％.The results showed that the patients with LVI in pathological sections had a lower overall survival rate (HR =1.26,95％ CI 1.16-1.38,P ＜0.001),recurrence-free survival (HR =1.27,95％ CI 1.06-1.52,P ＜0.001),cancer-specific survival rate (HR =1.30,95％CI 1.18-1.42,P ＜0.001).Egger's publication bias analysis showed no significant publication bias in terms of overall survival(P =0.636),recurrence-free survival (P =0.077),and cancer-specific survival (P =0.342).Conclusions LVI had a significant poor outcome in patients with radical resection of bladder cancer.It can be used as an independent risk factor to evaluate the postoperative prognosis of those patients,but more randomized controlled studies are still needed to make a further conformity in our completion.

Objective:To explore the clinical effect of using great toe fibular flaps of both feet on reconstruction of pulp defects of two neighbouring digits.Methods:A total of 14 digit pulp defects in 7 cases were repaired in Zhoukou Huaihai Hospital using great toe fibular flaps of both feet from August 2020 to January 2023. Of the 7 cases, there were 4 males and 3 females, with an average of 28 years old, ranging from 19 to 45 years old. Meanwhile, there were 4 cases in left hand and 3 cases in right hand. There were 3 cases of digit pulp defects in index and middle fingers, 2 in middle and ring fingers, and 2 in thumb and index fingers. The area of soft tissue defect in 1.2 cm×1.5 cm-3.0 cm×2.5 cm, and flap was 1.5 cm ×1.8 cm-3.2 cm×2.8 cm. Furthermore, 1 case underwent emergency surgery and 5 were repaired in elective surgery. The donor site of the flap was closed directly, and an intermediate-thickness skin graft was prepared from the medial plantar area for transfer in the case of high suture tension at the wound edge. After surgery, patients received postoperative by outpatient clinic and WeChat to observe the appearance, sensation, functional recovery and flap contracture of digits, as well as the movement of the great toes of both feet.Results:After the surgery, all flaps in the 7 cases survived smoothly and the donor sites healed. All patients entered scheduled follow-ups postoperatively for 6 months to 2 years, with an average of 9 months. The flap showed an aesthetic appearance and excellent sensation, with a TPD of 3-6 mm, and satisfactory digit function. The donor site of the great toe fibular flap left linear scars only, without abnormality in range of motion and gait in walking. In addition, there were 5 in excellent and 2 in good according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Conclusion:Application of great toe fibular flaps of both feet is an ideal option for the simultaneous repair of pulp defects of two neighbouring digits, which can achieve good reconstructive results.