Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Objective To explore the expression pattern and effects of hypoxia inducible factor-1? (HIF-1?) in experimental spinal cord injury. Methods The expression of HIF-1? at various time was detected at levels of mRNA and protein by using methods of reverse transcription-polymerase chain reaction (RT-PCR),in situ hybridization (ISH) and immunohistochemistry. Results HIF-1? expressed more significantly at levels of mRNA and protein in all kinds of cells in the injured spinal cord than in the normal spinal cord (P

As one type of primary brain injury, diffuse axonal injury (DAI) has specific traumatic mechanisms. The occurence of DAI is close to the loading property, loading manner, structural characteristics of skull, brain tissue and neck. This article demonstrated how the stress and strain varied in brain tissue effected by the load magnitude, load waveform, load frequency, load duration, linear acceleration, rotational acceleration, compounded linear/rotational acceleration, brain tissue, cerebral falx, cerebellar tentorium, skull and neck, and what are the relationships between these factors and the event of DAI.
Animals ; Biomechanical Phenomena ; Brain ; physiology ; Diffuse Axonal Injury ; physiopathology ; Humans ; Neck ; physiology ; Skull ; physiology ; Stress, Mechanical

OBJECTIVETo investigate the protective effect of pSVPoMcat (myelin basic protein microgene) modifying Schwann cell on injured spinal neurons.

METHODSA model of rat spinal cord injured by hemisection was used. One hundred and twenty healthy SD rats of both sexes weighing 250-300 g were divided into three groups: Group A (n=40, treated with implantation of pSVPoMcat modifying Schwann cell), Group B (n= 40, treated with implantation of Schwann cell only) and Group C (n=400, treated with sham operation as the control). One week after operation the rat functional recovery was observed dynamically by using combined behavioral score (CBS) and cortical somatasensory evoked potentials, the spinal cord sections were stained by Nissl, acid phosphatase enzyme histochemistry and cell apoptosis was examined by methye green, terminal deoxynucleotidyl and the dUTP Nick end labeling technique. Quantitative analysis was done by computer image analysis system.

RESULTSIn Group A the injured neurons recovered well morphologically. The imaging analysis showed a result of Group A

CONCLUSIONSpSVPoMcat modifying Schwann cell implantation has protective effect on injured spinal neurons and promotes recovery of injured spinal cord function in rats.

Acid Phosphatase ; metabolism ; Animals ; Apoptosis ; Cell Transplantation ; Disease Models, Animal ; Evoked Potentials, Somatosensory ; Female ; Gene Transfer Techniques ; Male ; Methyl Green ; Myelin Basic Protein ; genetics ; Nerve Regeneration ; Rats ; Rosaniline Dyes ; Schwann Cells ; metabolism ; transplantation ; Spinal Cord Injuries ; physiopathology ; surgery

OBJECTIVETo observe the repair effect of Schwann cells (SCs) modified by microgene pSVPoMcat on injured spinal cord in rats.

METHODSSemi-transection injury at the level of T(8) of spinal cord was made with cutting method on 120 Sprague Dawley (SD) rats. Then 40 rats implanted with SCs modified by microgene pSVPoMcat were taken as Group A, 40 rats implanted with simple SCs as Group B and the other 40 rats were taken as the control group (Group C). The functional recovery of the rats was observed through combined behavioral score (CBS) and cortical somatosensory evoked potential (CSEP), and the expression of the glial fibrillary acidic protein (GFAP) was measured with in situ hybridization and immunocytochemistry. At 3 months after operation, the rats were examined with magnetic resonance image (MRI), and the neurofilaments (NF) of the axons were stained with immunohistochemical method.

RESULTSGFAP expression in Group A was significantly lower than that of the other 2 groups. MRI showed that the spinal signals in the injured area recovered fundamentally in Group A, didn't recover in Group B and malacia focus was found in Group C, which was same as the results of NF staining. Wave amplitudes in incubation periods in Group A and Group B tended to recover. It recovered to the normal level in Group A, which was similar to the results of CBS.

CONCLUSIONSSCs modified by microgene pSVPoMcat can inhibit GFAP expression, improve the growth of the axons and the functional recovery of neurons after spinal cord injury.

Analysis of Variance ; Animals ; Evoked Potentials, Somatosensory ; Gene Transfer Techniques ; Genetic Therapy ; Glial Fibrillary Acidic Protein ; metabolism ; Immunohistochemistry ; In Situ Hybridization ; Magnetic Resonance Imaging ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; metabolism ; transplantation ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; pathology ; physiopathology ; therapy

OBJECTIVETo study the sequential changes of HIF-1alpha (hypoxia-inducible factor 1 alpha) in experimental spinal cord injury in rats and to analyze its potential effects in SCI.

METHODSA static compression model of SCI was employed in this study. Expressions of HIF-1alpha were measured with immunohistochemical staining, while flow cytometry was used to determine the apoptotic ratio and bcl-2 expressions.

RESULTSHIF-1alpha began to increase 1 day after injury, and reached the peak at 3-7 days. Two weeks later, it declined significantly. The sequential changes of HIF-1alpha coincided well with the alterations of apoptotic ratio and contents of bcl-2.

CONCLUSIONSHIF-1alpha possibly participates in the secondary ischemic and hypoxic procedures after spinal cord injury, and may mediate the traumatic apoptosis. Further understanding of HIF-1alpha may provide new therapeutic regimens for SCI.

Animals ; Apoptosis ; Biomarkers ; analysis ; DNA-Binding Proteins ; analysis ; metabolism ; Disease Models, Animal ; Female ; Flow Cytometry ; Hypoxia-Inducible Factor 1 ; Hypoxia-Inducible Factor 1, alpha Subunit ; Injury Severity Score ; Ischemia ; pathology ; Nuclear Proteins ; analysis ; metabolism ; Probability ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism ; pathology ; Transcription Factors

Objective To supervise military training by application of clinical classification of fatigue fracture so as to decrease the occurrence and development of fatigue fracture. Methods From Feb.1999 to Feb.2002, the knowledge of clinical classification of fatigue fracture was applied in the military training in which it was essential to prevent and treat fatigue fracture. Results From 1999 to 2002, the incidence of fatigue fracture decreased year by year. Types Ⅱand Ⅲof fatigue fracture decreased significantly. Conclusion Clinical classification plays an important role in decreasing the occurrence and development of fatigue fracture.

Objective To study the protective effects of the intracord transplantation of microgene pSVPoMcat－ genetically－ modified Schwann cells (MSCs)on spinal cord injury (SCI).Method Rats with semi－ division(SD) of the spinal cord was divided into 4 groups.Group S consisted of the rats with SD treated with the transplantation of MSCs, Group B of the rats with SD treated with the transplantation of SCs without genetic modification,Group C of the rats with SD without treatment and Group D was the normal control. 8 hours after operation,the half of the rats of each group were killed and the injured segment of the spinal cord was resected to be examined with atomic absorption spectrophotometry . Another half of the rats of all the groups were examined with neurological function tests to have a combined behavioral score (CBS).Result There was a significant increase of water content and Na＋ and Ca2＋ ions and a decrease of K＋ and Mg 2＋ ions in the injured cord segment of Group C and a statistically significant recovery was observed in Group A. The intracord transplantation of pSVPoMcat genetically modidied SCs improved the neurological outcome of spinal cord injury.Conclusion Our findings indicate that intracord transplantation of pSVPoMcat－ genetically－ modified－ Schwanncells exerts protective effects on the injured segment of the spinal cord through the improvement of the internal ion environment of the spinal cord.

Objective 　To investigate the treatment of cystic craniopharyngiomas by CT-guided stereotactic neuroendoscopic resection and intratumoral chemotherapy. Methods　16 cases of cystic craniopharyngiomas were partial resected by CT-guided stereotactic neuroendoscopy. Intratumoral chemotherapy with bleomycin were given postoperatively. Results　The clinical symptoms improved promptly after evacuations of cyst in all patients. No death or severe complications occurred. Follow-up (ranged from 2 to 3 years) CT or MRI indicated that the tumor cysts gradually regressed or disappeared. Conclusions　The treatment of CT-guided stereotactic endoscopic resection and intratumoral chemotherapy for cystic craniopharyngioma is safe and effective, which should be a very useful procedure in clinical practice.

Objective In order to observe the role of genetically modified Schwann cell (SC) with pSVPoMcat in the regeneration of injured spinal cord.Method The cells were implanted into the spinal cord.Ninety SD rats were used to establish a model of hemi- transection of spinal cord at the level of T8,and were divided into three groups,randomly, that is,pSVPoMcat modified SC implantation(Group A), SC implantation(Group B),and without cell implantation as control(Group C).After three months the presence of axonal regeneration of the injured spinal cord was examined by means of horseradish peroxidase(HRP)retrograde labeling technique and stereography.Result The results indicated that HRP labeled cells in Group A and B could be found in the superior region of injured spinal cord and the brain stem such as the red nuclei and oculomotor nuclei. The density of ventral horn neurons of the spinal cord and the number of myelinated axons in 100 μ m of the white matter was A >B >C group.Conclusion In brief,the pSVPoMcat modified SC intraspinal implantation could promote regeneration of the injured spinal cord.