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

BACKGROUND:Clinical physicians should pay attention on how to reduce ankle fracture healing wounds, reduce bleeding, improve operating technique, and improve repair effect, especialy for comminuted fracture. It is necessary to understand how to develop a detailed plan before repair, observe specific circumstances of the fracture from multiple angles, and establish three-dimensional images using two-dimensional X-ray films or CT scan. These raise a chalenge for each physician. OBJECTIVE:To explore the application effect of three-dimensional print, minimaly invasive percutaneous screw and locking plate fixation in the repair of ankle fractures. METHODS: A total of 26 cases of fracture of ankle joint were treated from January 2012 to June 2014. There were 9 cases of double ankle fracture, 12 cases of three ankle fractures, and 5 cases of three ankle fractures involved PILON fracture on the lower tibia. They received spiral CT scanning on the ankle joint, and stored in the format of di.com. After processing with minics software, data were converted into STL format, and then input into the three-dimensional printer. Thus, models of ankle joint were made at the ratio of 1:1. The repair scheme was made. After discharge, X-ray films were checked every month to observe the healing condition of fractures. According to Mazur ankle score standard, ankle joint function was assessed. RESULTS AND CONCLUSION: Al 26 cases were folowed up for 6-12 months. The fractures were healed. The healing time was 4-6 months, averagely 5.5 months. The healing was good, without vascular and nerve damage, or plate breakage. In accordance with the Mazur ankle score standard, there were excelent in 11 cases, good in 13 cases with an excelent and good rate of 92%. The operation time was (64±15) minutes, and intraoperative blood loss was (100±15) mL. The incision was healed in stage one. These findings confirm that the simulation training and operation in fracture models of three-dimensional print have smal injuries to patients with ankle fracture. The bleeding was less, the operation was simple, the healing time was short, and the functional recovery was rapid, especialy for comminuted fracture.

Adult ; Aged ; Disease Outbreaks ; Female ; Humans ; Leptospirosis ; epidemiology ; Male ; Middle Aged

OBJECTIVETo observe therapeutic effects of qi supplementing, yin nourishing, blood stasis dispersing, collateral dredging recipe (QYBCR) on early diabetic nephropathy (DN).

METHODSSeventy-eight early DN patients were randomly assigned to the treatment group (39 cases, treated by QYBCR) and the control group (39 cases, treated by irbesartan). The changes of the therapeutic efficacy, Chinese medicine syndrome scores, urine albumin excretion rate (UAER), serum creatinine (SCr), blood urine nitrogen (BUN), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), and the occurrence of end-point events were observed after one-year treatment.

RESULTSThe total effective rate in treatment group was 83.8% (31/37 cases), which was obviously higher than that in control group (60.5%, 23/38 cases) (P < 0.05). After treatment the Chinese medicine syndrome scores were reduced significantly in the treatment group (P < 0.05, P < 0.01), and showed significant difference when compared with those in the control group (P < 0.05, P < 0.01). Levels of UAER, SCr, BUN, FBG, TC, and TG were (65. 78 +/- 9.67) microg/min, (93.20 +/- 12.99) micromol/L, (5.69 +/- 1.21) mmol/L, (6.14 +/- 1.47) mmol/L, (4. 85 +/- 0. 83) mmol/L, (1.46 +/- 0.81) mmol/L after treatment in treatment group. All of them decreased more significantly than before treatment [(161.03 +/- 20.01) microg/min, (101.11 +/- 14.33) micromol/L, (6.54 +/- 1.12) mmol/L, (9.27 +/- 2.32) mmol/L, (6. 19 +/- 2.13) mmol/L, (2. 70 +/- 1.86) mmol/L] (P < 0.05, P < 0.01). The aforesaid indices were also improved in the control group after treatment (P < 0.05, P < 0.01). The reduction of TC and TG after treatment in the treatment group was more significant [(5.58 +/- 1.57) mmol/L, (1.99 +/- 1.22) mmol/L] (P < 0.05). Besides, the incidence rate of end-point events (5.4%, 2/37) (1 year after the development of clinical DN) of the treatment group was slightly lower than that of the control group (10.5%, 4/38), but with no statistical difference.

CONCLUSIONQYBCR combined with Western medicine-based treatment showed better therapeutic efficacy on early DN.

Adult ; Aged ; Biphenyl Compounds ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Qi ; Tetrazoles ; therapeutic use

OBJECTIVETo observe the clinical effect of combined treatment with safflor yellow powder injection and benazepril in treating patients with diabetic nephropathy (DN).

METHODSSeventy-six patients with DN were randomly assigned to the treatment group (39 cases) and the control group (37 cases). Conventional treatment for lowering blood glucose was given to both groups, but to the control group 10 mg benazepril was given orally once a day additionally, while to those in the treatment group the same dosage of benazepril po. and 150 mg/d of safflor yellow powder injection by adding in 250 mL 0.9% normal saline for intravenous dripping. The therapeutic course for them all was 15 days, and all patients received two courses with an interval of 5 days. Changes of clinical symptoms, urinary albumin excretion rate (UAER), blood and urinary levels of beta2 -microglobulin (beta2 -MG), urinary level of alpha1-microglobulin (alpha1 -MG), D-dimer (D-D) and plasma fibrinogen (FIB) were observed.

RESULTSThe total effective rate in the treatment group was higher than that in the control group (84.62% vs 59.45 %, P < 0.05). The total score of syndrome in the treatment group was lower than that in the control group (P < 0.05). Levels of UAER, 132-MG in serum and in urine, alpha1-MG in urine were decreased significantly after after 2 courses of treatment in both groups, showing significant difference as compared with before treatment (P < 0.05 or P <0.01), and the decrements were more significant in the treatment group than those in the control group (P <0.05); while decrease of FIB, D-D only happened in the treatment group (P <0.01), so the post-treatment data in the treatment group were significantly lower as compared with those in the control group (P <0.01).

CONCLUSIONCombined therapy with safflor yellow injection and benazepril is superior to benazepril alone in reducing urinary albumin, improving renal function and blood hyperviscosity manner for patients with DN, suggesting the combination of the two could play their respective superiorities and act in cooperation for retarding the progression of DN.

Adult ; Albumins ; analysis ; Benzazepines ; administration & dosage ; Blood Glucose ; Diabetic Nephropathies ; drug therapy ; metabolism ; urine ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Kidney Function Tests ; Male ; Middle Aged

Receptor for advanced glycosylation end products (RAGE) has long been a focus in studies of diabetic vascular diseases. Recently, clinical evidence has shown that the expression level of RAGE is high in liver, stomach, pancreas and prostate cancer tissues whereas the expression level of RAGE is lower in chondrosarcoma and lung cancer tissues. The abnormal expression of RAGE is closely associated with tumorgenesis, angiogenesis, tumor invasion and metastasis. This review summarizes the abnormal expression of RAGE in different tumors and its role in carcinogenesis and development of tumor. Copyright© 2011 by TUMOR.

AIMAn in vitro cultured monolayer system of alveolar epithelial cells was used as a model to investigate the transport pathway peptides or proteins, salmon calcitonin (sCT), insulin (INS), recombinant hirudin (rHAV2), and recombinant human growth hormone (rhGH), in pulmonary epithelium in vivo.

METHODSHuman lung adenocarcinoma A549 cells formed continuous monolayers with growing polycarbonate filters of Transwell plate. Transport studies of macromolecules in the monolayer system were carried out after 6 days in culture. The transport of peptides or proteins with MW 3,400 - 22,000 was studied in cultured human lung adenocarcinoma A549 cell monolayers at different conditions.

RESULTSThe results showed that the apparent permeability coefficients (Papp) of these macromolecules across A549 cell monolayers ranged from 2 x 10(-6) to 5 x 10(-6) cm x s(-1) and exhibited good inverse correlation with molecule weight. No concentration, direction and temperature dependence were observed in the permeation of sCT, INS and rHAV2. While the Papp of rhGH in the BA direction (2.25 x 10(-6) cm x s(-1)) was significantly less than that in the reverse direction. The Papp values of rhGH were concentration and temperature independent in the AB direction.

CONCLUSIONThese findings suggest that the hydrophilic peptides and proteins, salmon calcitonin, insulin, recombinant hirudin, and recombinant human growth hormone used in this study, appeared to penetrate the A549 cell monolayers via a paracellular pathway by passive diffusion mechanism.

Adenocarcinoma ; metabolism ; pathology ; Biological Transport ; Calcitonin ; pharmacokinetics ; Cell Line, Tumor ; Epithelial Cells ; metabolism ; Hirudins ; pharmacokinetics ; Human Growth Hormone ; pharmacokinetics ; Humans ; Insulin ; pharmacokinetics ; Lung Neoplasms ; metabolism ; pathology ; Peptides ; pharmacokinetics ; Permeability ; Proteins ; pharmacokinetics ; Pulmonary Alveoli ; metabolism ; pathology

The traditional Chinese medicine of Radix Hedysari plays an important role in invigorating gas for as-cending, benefiting blood for promoting production of fluid, and promoting circulation for removing obstruction in collaterals, which is consistent with the principle of treatment for osteoporosis. This study is designed to investigate the bioactive components on increasing peak bone mass (PBM) by exploring the spectrum-effect relationship between chromatography fingerprints and effect. Multiple indicators are selected to evaluate the pharmacological activity. In fingerprints, 21 common peaks are obtained, five of which are identified. Furthermore, gray relational analysis (GRA) is a quantitative method of gray system theory and is used to describe the correlation degree of common peaks and pharmacological activities with relational value. 21 components are then divided into three different regions, of which ononin and calycosin play an extremely significant role in increasing PBM. In addition, factor analysis and hierarchical cluster analysis (HCA) are used to screen the optimal producing area for Radix Hedysari. This provides a comprehensive and efficient method to improve the quality evaluation of Radix Hedysari, confirming the bioactive components for PBM-enhancement and further develop its medicinal value.

OBJECTIVETo observe therapeutic effect of electrical plum-blossom needle for treatment of juvenile myopia and biological effect on ocular tissue and structures.

METHODSOne hundred and sixty cases with mild myopia (diopter < 3.00D) were randomly divided into two groups, a treatment group and a control group. The treatment group were treated with electrical plum-blossom needle therapy, tapping Jingming (BL 1), Chengqi (ST 1), Taiyang (EX-HN 5) and Neiguan (PC 6), and the control group with Tropicamide eye drops. The changes of vision, diopter, corneal refractive power, ocular-axial length, lens and ciliaris thickness were observed before and after treatment.

RESULTSThe total effective rate was 80.0% in the treatment group and 58.1% in the control group, with a very significant difference between the two groups (P < 0.01); the two therapies could decrease the thickness of lens and ciliaris, and eliminate spasm of ciliary muscle, however the electrical plum-blossom needle therapy had more obvious action (P < 0.05); the two therapies had no effect on the corneal refractive power and ocular-axial length.

CONCLUSIONThe electrical plum-blossom needle therapy is an effective method for increasing vision, correcting ametropia and delaying development of myopia.

Adolescent ; Child ; Electroacupuncture ; methods ; Female ; Humans ; Male ; Myopia ; physiopathology ; therapy ; Refraction, Ocular ; Vision, Ocular

OBJECTIVETo investigate the potential causes and preventive measures for blood loss in laparoscopic liver resection.

METHODSThe candidates for laparoscopic liver resections were 21 patients with liver lesions, including 13 patients with primary liver cancer, 2 patients with liver abscess, 3 patients with liver hemangioma, 1 patient with hepatic cellular adenoma, 1 patient with hepatic focal nodular hyperplasia, and 1 patient with infected liver cyst. They were classified as Child A in 16 and B in 5 patients.

RESULTSTwenty-one patients with liver lesions underwent 23 laparoscopic resections uneventfully. Operating procedures included partial liver resection in 12 patients, segment IV in 1 case and anatomical left liver resections in 8 patients. Operation duration was 80 - 320 (mean 193.8 +/- 78.3) minutes. The blood loss in operation was 100 - 1000 (mean 333.1 +/- 291.4) ml. The postoperative hospital stay averaged 6.3 +/- 1.5 days, which was markedly shortened in comparison to conventional laparotomy liver resections. In addition, there was no complication in this series.

CONCLUSIONSBased on these preliminary results, occlusion of hepatic vessels with clamp is very important for partial liver resection. The key technique is to control the blood loss in operation. We conclude that laparoscopic liver resection is a prospective minimally invasive technique. These experiences suggest that laparoscopic procedures could be employed both in the treatment of benign and malignant tumors in selected cases.

Adult ; Aged ; Blood Loss, Surgical ; prevention & control ; Female ; Hepatectomy ; adverse effects ; methods ; Humans ; Laparoscopy ; adverse effects ; methods ; Liver Diseases ; surgery ; Male ; Middle Aged