OBJECTIVETo evaluate the clinical efficiency of selective cyclo-oxygenase-2 (COX-2) inhibitor compared to traditional nonselective NSAIDs for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA).

METHODSBy searching Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Science Citation Index et al, only randomised controlled studies of selective COX-2 inhibitors VS nonselective COX-1 and COX-2 inhibitors for the prevention of HO after THA were included. The quality assessment of included studies was evaluated according to the standard of the Cochrane Collaboration, and the data were analysised by statistic software Stata 10.0. The HO incidence of both groups in different degrees was compared.

RESULTSFour eligible randomised controlled trials of totally 808 patients were included. Meta-analysis results showed that no statistically significant difference was found in overall incidence of HO (RR = 1.08, 95% CI: 0.71-1.64,P = 0.73), incidence of moderate severe HO (Brooker II and III) (RR = 0.83, 95% CI: 0.48-1.42, P = 0.49) and any grade of Brooker classification between two groups. In all included studies, 16 patients receiving nonselective COX inhibitor (4.4%) discontinued treatment because of gastrointestinal toxicity,whereas 10 patients in the selective COX-2 inhibitor group (2.7%) discontinued for gastrointestinal side effects.

CONCLUSIONThe selective COX-2 inhibitors are as equally effective as nonselective NSAIDs for the prevention of HO after THA. Considering the side effects of nonselective NSAIDs, selective COX-2 inhibitors were recommend for the prevention of HO after THA.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Cyclooxygenase 2 Inhibitors ; adverse effects ; therapeutic use ; Cyclooxygenase Inhibitors ; adverse effects ; therapeutic use ; Humans ; Ossification, Heterotopic ; prevention & control ; Randomized Controlled Trials as Topic

OBJECTIVETo investigate the change of zygomatic and temporal soft tissue after coronal incision.

METHODSA retrospective analysis was performed in 33 patients who received firm fixation for unilateral zygomatic comminuted fracture through semi-coronal incision. All the patients were followed up for more than one year. Craniofacial anthropometric measurement through 3D-CT reconstruction and facial profile was performed. The difference between the operated side and healthy side was analyzed.

RESULTSAt the temporal concave point, the soft tissue thickness at healthy side was (1.60 +/- 0. 97) mm more than that at operated side, showing a significant difference between them (P < 0.01). While the soft tissue thickness was not statistically different between two sides at zygion, malar prominence, zygomaxillare, and temporal convex point (P > 0.05).

CONCLUSIONSThe soft tissue atrophy may happen at temporal fat pad after semi-coronal incision, but not at zygomatic area. Intraoperative precise dissection and less stretch of soft tissue may be helpful to avoid the postoperative facial asymmetry.

Adipose Tissue ; anatomy & histology ; Adult ; Female ; Follow-Up Studies ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Scalp ; surgery ; Young Adult ; Zygomatic Fractures ; surgery

OBJECTIVETo retrospectively study medium-term follow-up outcomes of total hip arthroplasty (THA) for patients with ankylosing spondylitis (AS).

METHODSFrom January 2000 to December 2008, 67 patients (88 hip joints) with AS were treated with all ceramic interface THA. And 55 patients (74 hips) were finally followed up. Among them, there were 30 males and 25 females, with an average age of 32.6 (ranged 19 to 58) years old. Sixty-one hips were treated with biological prosthesis and 13 hips were treated with hybrid prosthesis. Fifty-five patients were followed up at least 5 years, with an average of (75.2 +/- 8.6) months. Clinical symptoms and radiography information were evaluated after follow-up.

RESULTSHarris hip score were significantly improved from 30.8 +/- 7.0 preoperatively to 85.2 +/- 5.5 at the last follow-up (P<0.01). The hip movement range increased from (21.2 +/- 8.5) degrees preoperatively to (142.0 +/- 10.2) degrees postoperatively (P<0.01). The 5-year survival of prosthesis was 95.9%. One patient were renovated because of internal wall broken caused by injury, 1 was renovated for infection, 1 was renovated for fracture arround femoral stem prostheses, and 1 was treated with conservative treatment by dislocation. Three cases with abnormal sound were cured with non-operation. 7 cases with heterotopic ossification were not treated, 2 cases with thigh pain received conservative treatment. Bone dissolve around prosthesis, loose and sink of femur and acetabulum prosthesis were occurred in other cases.

CONCLUSIONTHA for the treatment of AS is a reliable method, which has a satisfied medium-term follow-up outcomes.

Adult ; Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spondylitis, Ankylosing ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo introduce statistical methods of time trend analysis on cancer rates.

METHODSCancer incidence data collected by the Shanghai Cancer Registry during 1991 to 1999 was used in the analysis to calculate the crude and age-adjusted rates, percent changes (PCs) and annual percent changes (APCs). APCs were estimated by a linear regression of the logarithm on the incidence rates during the nine years. It also introduced a method for partitioning a linear trend in age-adjusted rates into site-specific contributions to the overall floating trend. 95% confidence intervals for the APCs and contributions were described in the paper.

RESULTSA decreasing rates were observed for cancers of stomach and esophagus among both men and women in urban Shanghai from 1991 to 1999. The increasing rates among men would include cancers of colon, rectum, gall bladder, pancreas, prostate, urinary bladder, kidney and leukemia. The rates of cancers among women increased for colon, rectum, lung, breast, gall bladder, endometrium, ovary, urinary bladder and kidney. The changes of above cancers over time were statistically significant (P < 0.05 or P < 0.01), but rates for other cancer sites changed little. The APCs (weighted method) and contributions for the cancers of stomach, esophagus, colon, rectum and prostate were -2.99% and -65.72%, -2.90% and -17.07%, 12.30% and 21.46%, 2.94% and 18.62%, and 3.11% and 15.09% among men, and -6.05% and -39.55%, -1.08% and -35.19%, 2.81% and 28.64%, and 3.69% and 15.70% for the cancers of stomach, esophagus, breast and colon in women, respectively.

CONCLUSIONAPC, and related statistics could be used to describe and analyze the time trend of cancer rates rather than PC or/and graphical method alone.

Algorithms ; China ; epidemiology ; Female ; Humans ; Incidence ; Linear Models ; Male ; Neoplasms ; epidemiology ; Time Factors

BACKGROUND:There are many treatment methods for infected bone defects,but there is no first stage treatment method,which has the characteristics of sustained-release,anti-inflammation,osteogenic activity,bone conduction and degradable absorption.OBJECTIVE:To investigate the research progress of bone tissue engineering technique in the treatment of infected bone defects.METHODS:A computer-based retrieval of PubMed,WanFang and CNKI databases was conducted for the articles published from 2000 to 2016,concerning the basic and clinical research on the local application of antibiotics;basic research on infected bone defects with sustained-release of antibiotics;basic studies on the source of seed cells and the osteogenic mechanism;and scaffold materials.A total of 55 eligible articles were included for result analysis.RESULTS AND CONCLUSION:Topical application of antibiotics exhibits different effects in the treatment of osteomyelitis.The development of bone tissue engineering has brought new hope for the treatment of bone defects,and in the meanwhile,selection of excellent seed cells has become a hot and difficult research.A rational combination of antibiotics,seed cells and scaffold materials may provide a new treatment strategy for infected bone defects.

OBJECTIVETo investigate the factors affecting the result and selection of local excision for low rectal cancer.

METHODSThe clinical data of 101 patients with low rectal cancer treated by local excision were retrospectively analyzed. Survival was estimated using the Kaplan-Meier. The factors influencing on the survival were analyzed using univariate (Log rank) and multivariate (Cox model) analysis methods.

RESULTSOf 101 patients in this series, 91 patients underwent transanal excision, 9 had transsacral excision, 1 recieved transvaginal excision. Postopertative complication developed in 6 patients (5.9%). No death occurred within 30 postoperative days. Five T4 patients underwent preoperative radiotherapy, and 34 received postoperative radiotherapy. The overall 5-year survival rate was 91.0% for the whole group, and it was 100%, 92.6%, 77.1%, 83.3% for patients with Tis, T1, T2, and T3/T4 lesion, respectively. The incidence of local recurrence was 15. 8%. Univariate analysis revealed that pathological T stage, tumor size (> 3 cm), lymphovascular invasion, ulcerative lesion, adjuvant radiotherapy and local recurrence were significant factors affecting the survival (P <0.05). However, by multivariate analysis, only tumor size ( > 3 cm) and local recurrence were found to be the significant prognostic predictors.

CONCLUSIONThe important selection criteria for local excision in the treatment of low rectal cancer may include T1 stage, well or moderate differentiation,tumor size < or = 3 cm, no lymphovascular invasion.

Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; pathology ; radiotherapy ; surgery ; Rectum ; pathology ; radiation effects ; surgery ; Retrospective Studies

The two mammalian codon optimized genes, F and G genes of Nipah virus, were generated by assembly PCR, and inserted into mammalian expression vector pCAGGS under chicken beta-actin promoter to construct pCAGG-NiV-F and pCAGG-NiV-G. Syncytium formation was induced in BHK cells by plasmid pCAGG-NiV-F and pCAGG-NiV-G transfection, which indicate recombination proteins F and G were expressed in BHK cell and possessed good biologic activity. Six-week-old female BALB/c mice were intramuscularly primed with 100 microg pCAGG-NiV-F, pCAGG-NiV-G or pCAGG-NiV-F+ pCAGG-NiV-G respectively, and boosted with same dose after 4 weeks. The sera were collected at 3 weeks post second boost. The serum IgG against Nipah virus F and G proteins was detected by indirect ELISA using recombinant Baculovirus expressed Nipah F and G glycoproteins. The results showed that specific antibodies possessed good sensitivity and specificity. Furthermore, the G and F proteins' specific antibodies could neutralize the infectivity of VSVdeltaG* F/G (the NiV F and G envelope glycoproteins psudotyped recombinant vesicular stomatitis virus expressing green fluorescence protein). And, pCAGG-NiV-G also induced higher titer of neutralizing antibody response than pCAGG-NiV-F did. The result indicates that DAN immunization is an efficient vaccine strategy against Nipah virus.
Animals ; Antibodies, Viral ; blood ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Mice ; Mice, Inbred BALB C ; Nipah Virus ; immunology ; Vaccines, DNA ; immunology ; Viral Envelope Proteins ; genetics ; immunology ; Viral Vaccines ; immunology

Objective To investigate the value of a nomogram model based on contrast-enhanced CT radiomics in predicting the histological type of thymoma.Methods A total of 154 patients(101 in low-risk group and 53 in high-risk group)with thymoma confirmed by pathology were retrospectively selected.The cases were randomly divided into training set(n=107)and validation set(n=47)at a ratio of 7∶3.The three-dimensional volume of interest(VOI)of the whole lesion on the image from the arterial phase of contrast-enhanced CT was manually delineated,and the radiomics features were extracted.Based on the selected radiomics features,the radiomics model was constructed and the model Radiomics score(Radscore)was calculated.Clinical risk factors were screened to construct a clinical model,and a nomogram model was constructed by fusing Radscore and clinical risk factors.The receiver operating characteristic(ROC)curve,area under the curve(AUC),accuracy,sensitivity and specificity were compared to analyze the predictive efficacy and difference of different models for high-risk and low-risk thymoma.The decision curve and calibration curve were drawn to evaluate the clinical value and fitting performance of the nomogram model.Results Eleven radiomics features were selected to construct the radiomics model,and five clinical risk factors[myasthenia gravis(MG),morphology,border,surrounding tissue invasion and CT value in arterial phase]were used to construct the clinical model.In the training set,the AUC of the nomogram model(0.88)was higher than that of the radiomics model(0.80)and the clinical model(0.79),and the difference was statistically significant(Z=2.233,2.713,P=0.026,0.007,respectively).In the validation set,the AUC of the nomogram model was higher than that of the radiomics and clinical models,but the difference was not statistically significant.The calibration curve showed that the nomogram model had good fitting performance,and the decision curve showed that the nomogram model had high clinical benefit.Conclusion The nomogram model based on contrast-enhanced CT can effectively predict high-risk and low-risk thymoma,which is helpful to guide clinicians to make relevant decisions.

The study was purposed to explore the role of mesenchymal stem cells (MSCs) in the pathogenesis of bone disease particularly observed in multiple myeloma (MM), the biological features of marrow derived MSCs from patients with MM have been investigated. Marrow aspirates were harvested from 11 newly diagnosed patients with MM and 5 normal adults and MSCs were isolated and culture-expanded by the cell properties of adherence to plastic flasks, The phenotype was analyzed by flow cytometric technique. The proliferation of MSCs was observed by MTT assay and their differentiation capacities into osteoblasts and adipoblasts were assessed with lineage-specific histochemical staining. The concentrations of IL-6 and SCF in the culture supernatant were detected by enzyme-linked immunosorbent assay (ELISA). MSC culture supernatants were collected and MTT assay was performed to evaluate their support on the proliferation of an MM cell line SKO007 cells. The results showed that bone marrow-derived MSCs from MM patients were homogeneously positive for CD29, CD73, CD166 and HLA-ABC and negative for hematopoietic cell marker CD45 and endothelial cell marker CD31, the phenotype of which was similar to that of marrow counterparts from normal adults. MTT assay indicated that MSCs from MM patients or normal adults proliferated at similar rates. MSCs from MM patients occupied in vitro osteogenic and adipogenic capacity as those from normal adults. The levels of IL-6 and SCF in culture supernatant were greatly up-regulated in MM patients by ELISA assay. Furthermore, MSC culture supernatants from MM bone marrow displayed enhanced activity to promote the proliferation of SKO007 cells. It is concluded that marrow-derived MSCs from bone marrow of MM patients are normal in their proliferation and differentiation capacities, and myeloma bone disease may not be ascribed to the differentiation of MSCs while the elevated secretion of IL-6 and SCF may provide necessary cues for the survival of malignant myeloma cells.
Bone Marrow Cells ; pathology ; Cell Differentiation ; Cells, Cultured ; Female ; Humans ; Interleukin-6 ; analysis ; Male ; Mesenchymal Stromal Cells ; metabolism ; pathology ; Middle Aged ; Multiple Myeloma ; pathology ; Osteoblasts ; cytology ; Stem Cell Factor ; analysis

OBJECTIVETo study and analysis prevalence and incidence of target organ injury and the relative factors for isolated systolic hypertension (ISH) in Beijing.

METHODS1002 cases aged 80 to 99 years were investigated in 28 cadre retirement centers in Beijing. Blood pressure was taken for three times with mercurial sphygmomanometer in every person, the mean values were recorded and the relative material was gathered according to questionnaire after the health education. Physical examination form of outpatient department and inpatient case history in fixed hospital were analyzed.

RESULTSIn 1002 very old persons, there were 673 hypertensive patients (67.2%) and 455 ISH (45.4%). Among all hypertensive patients, the rate of ISH was 67.6% and double hypertension was 32.4%. Awareness rate was 87.90% and 97.71%, taking antihypertensive drug rate was 77.58% and 80.73%, control rate was 58.68% and 62.84% in ISH and in double hypertension group, respectively, which were no significant differences between the two groups. There was no significant difference in morbidities of cardiac heart disease, myocardial infarction and chronic renal insufficiency between the two groups. The incidences of heart failure, cerebrovascular disease, disability and dementia were 4.62% and 8.72%, 41.54% and 55.50%, 10.55% and 16.06%, 8.57% and 12.84% in ISH and double hypertension group, respectively, which were significant differences between the two groups (P < 0.01). The susceptible age period for ISH was 70 to 79 years in this study.

CONCLUSIONISH is more common in hypertensive patients in very old persons at 28 cadre retirement centers in Beijing. Morbidity of heart failure, cerebrovascular disease, disability and dementia were higher in double hypertension group compared with those in ISH group. The results showed that increase of both systolic and diastolic blood pressure was more dangerous than that of systolic pressure only for very old persons. The improvement of small arterial plastic and the control of blood pressure to target level (< 140/90 mm Hg) in very old hypertensive patients are very important for decreasing the incidence of target organ injury and increasing their life quality and late survival rate.

Aged, 80 and over ; Cardiovascular Diseases ; epidemiology ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; physiopathology ; Kidney Failure, Chronic ; epidemiology ; Male ; Prevalence ; Systole