At present, total hip arthroplasty (THA) is the primary treatment for hip diseases such as femoral head necrosis and developmental dysplasia of the hip. It has good effects in reducing pain and improving joint function. The appearance of modular hip prosthesis facilitates adjustment of limb length and femoral offset. However, the wear between the interface of hip prosthesis can lead to inflammatory pseudotumor, osteolysis and other adverse reactions. To explore the risk factors of wear between hip prosthesis interface is helpful to improve the design and manufacturing concept of the product, improve the product performance, help surgeons optimize the operation technology and reduce the impact of human factors on the wear of the prosthesis. Many literatures have reported the mechanism of wear between the head-acetabula interface of prosthesis. The mechanism of wear between the interfaces has been described relatively clearly. In addition to the head-acetabula interface, the wear between the head-neck interface is another major cause of unexplained pain around the joint and prosthesis loosening after hip replacement. Many factors affect head-neck wear. The design of prosthesis (such as prosthesis material and prosthesis taper), surgical technology (such as impact strength and prosthesis mismatch) and patient factors (such as age, gender and activity) have important impact on head-neck wear. Adverse reactions caused by head-neck wear have also been widely concerned. However, there is no considerable solution for wear prevention. Thus, we should optimize the design of prosthesis, improve the surgical technology, and guide the rehabilitation of patients to prevent wear. In order to improve the attention of joint surgeons, the present paper reviews the literatures and analyzes the risk factors of head-neck interface wear and the clinical manifestations caused by head-neck wear.

Objective:To observe the effectiveness of bone cement-enhanced proximal femoral nail antirotation (PFNA) in the treatment of severe osteoporotic intertrochanteric fracture.Methods:Between January 2016 and June 2017, 23 patients with severe osteoporotic intertrochanteric fracture were treated with bone cement-enhanced PFNA at Department of Orthopaedics, The Second Affiliated Hospital to Luohe Medical College. They were 9 men and 14 women with an average age of 85.3 years (range, from 80 to 91 years). According to AO/OTA-2018 classification, there were 2 cases of type 31-A1.3, 5 cases of type 31-A2.2, 13 cases of type 31-A2.3 and 3 cases of type 31-A3.3. According to Singh standard grading, 4 cases were rated as level 1, 16 cases as level 2 and 3 cases as level 3. The PFNA fixation was enhanced by bone cement in all. The operation time, amount of intraoperative bleeding, postoperative complications, fracture healing time and hip Harris scores at the last follow-up were recorded.Results:The operation time averaged 56.3 minutes (range, from 47 to 91 minutes) and the amount of intraoperative bleeding 197 mL (range, from 110 to 450 mL). All patients were followed up for 5 to 27 months (mean, 14.7 months). One patient who had been rated as good by the Harris hip score died 5 months after surgery because of acute suppurative obstructive cholangitis. All the 23 fractures achieved bony union. The healing time averaged 11.3 weeks (range, from 8 to 18 weeks). By the Harris scores at the last follow-up, 11 cases were excellent, 10 cases good and 2 cases fair, giving an excellent and good rate of 91.3%.Conclusion:Bone cement-enhanced PFNA can bring about good short-term outcomes for severe osteoporotic intertrochanteric fractures because it can improve the screw control and reduce the risk of internal fixation failure.

Objective To evaluate the effect of ditching for drain on the control of the breed of Oncomelania hupensis snails in beaches of Dongting Lake. Methods From November,2009 to November,2012,an O. hupensis snail infested beach of the Yueyang jail and an O. hupensis snail infested beach of Junshan District were selected as research fields in the eastern Dongting Lake area,and the former,as the intervention field,was performed with the ditching for drain by excavators and the latter,as the control field,was not. Results Before the project implemented,the average soil moisture contents on the beaches in dry seasons of the two fields were both about 35.56%. After the project implemented,in the intervention field,the average soil mois?ture content was 26.53%which was significantly lower than that(35.56%)in the control field(F=6.53,P<0.05). The under?ground water levels in different heights in the intervention field were lower than those in the control field (χ2 = 33.33,P <0.05). Before the project implemented,the natural death rates of the snails were 0.98%and 0.89%in the two research fields re?spectively(P>0.05),and after the project implemented(in 2012),no adult and young snails were found in the interventional field,but in the control field,the average densities of living snails and young snails were 29.37 snails/0.1 m2 and 213±108.45 snails/0.1 m2 respectively. Conclusion The intervention of ditching for drain can decrease the soil moisture contents quickly and change the ecological condition,therefore,can control the breed of O. hupensis snails in the beaches of Dongting Lake.

BACKGROUND:Electrospinning preparation for the tissue engineering scaffold materials is an extremely promising technology.
OBJECTIVE:To review the progress of electrospinning technology in different fields and its main problems in the current application.
METHODS:We searched Medline and CNKI databases for articles published from 2000 to 2013 using the keywords of“electrospinning, tissue engineering”in English and Chinese.
RESULTS AND CONCLUSION:The structure of non-woven cloth materials made by this technology is similar to the extracel ular matrix, which has high surface area and control able mechanical properties. Electrospinning materials have been widely applied in the tissue engineering field, especial y in the biodegradable materials and high biocompatibility molecular polymer synthesis process. Electrospinning has been developed rapidly in tissue engineering applications, especial y in the choice of materials or electrospinning technique combined with different technologies. Different morphological structures and properties of the materials can be wel combined by using electrospinning technology. A series of new polymers were successful y incorporated into a tissue engineering scaffold as the matrix for cel proliferation and regeneration, but there are some important issues to be solved, including how to control the interaction between the scaffold and the biological system that is to achieve the infiltrative growth of cel s, how to control the pore size, mechanical properties and toxicity. This technology clinical y applied in biomedicine stil requires further research, especial y in vivo studies.

Objective To investigate the short-term surgical effect and complications of posterior dislocation of the hip with femoral head fractures.Methods Twenty-two patients with posterior dislocation of the hip with femoral head fractures treated surgically from December 1999 to December 2008 were reviewed retrospectively.All the patients were males aged from 23-52 years (mean 39.2 years).According to Pipkin classification,fractures were type Ⅰ in nine cases (41％),type Ⅱ in seven (32％),type Ⅲ in two (9％) and type Ⅳ in four (18％).Different surgical approaches and treatment methods were employed together with a periodic follow-up.Harris score and Thompson & Epstein score were used as measurement standard in postoperative clinical and radiological follow-up.Postoperative complications were analyzed as well.Results All the patients were followed up for mean 36 months.Clinical outcome as assessed by Harris criteria was excellent in 10 cases,good in seven,fair in two and poor in three,with excellent-good rate of 77％.Complications included femoral head avascular necrosis in four cases and traumatic arthritis in six.Heterotopic ossification of the hip did not occur.One case complicated with idiopathic injury of sciatic nerve was recovered at one year after operation.Conclusions Posterior dislocation of the hip with femoral head fractures should be operated as soon as possible.Operational modalities should depend on the type of fractures for the sake of reducing complications.

ObjectiveTo investigate the relationship between the expression of ER,PR,HER-2,Ki-67 and the effective rate of neoadjuvant chemotherapy (NAC) and to study the influence of NAC on expression of ER,PR,HER-2 and Ki-67 in breast cancer.Methods41 patients of breast cancer were performed 2 to 6 cycles of CAF chemotherapy.The expression of ER,PR,HER-2 and Ki-67 was detected by SP immunohistochemical method before and after NAC.ResultsThe effective rate of NAC was 73.17％ (30/41).The positive and negative efficiency rate was 67.86％ (19/28) vs 84.62％ ( 11/13 ) for ER,64.29％ (9/14) vs 77.78％ (21/27 ) for HER-2,70.00％ (14/20) vs 76.19％ ( 16/21 ) for Ki-67.The difference had no statistical significance (P ＞0.05).The positive and negative efficiency rate was 66.67％ (16/24) vs 82.35％ (14/17) for PR.The difference had statistical significance (P ＜ 0.05 ).The expression of ER,PR,HER-2 and Ki-67 before and after NAC changed in 10,8,3 and 9 cases respectively.The difference had no statistical significance (P ＞ 0.05).ConclusionsNAC has no influence on the expression of ER,PR,HER-2 and Ki-67.Patients with PR negative are more sensitive to NAC.The expression state of PR can be used to predict the curative effect of NAC.The expression state of ER,HER-2 and Ki-67 has no significant correlation with NAC.

OBJECTIVETo investigated the chemical structures and bioactivity of polysaccharides from Isatidis Radix.

METHODPolysaccharides were extracted and purified by column chromatograph and their chemical structures were identified by UV, IR, NMR, periodic acid oxadation and Smith degradation method and their stimulation effects to macrophage were evaluated by using MTT method.

RESULTFive polysaccharides, polysaccharide A , B, C, D and E were gotten and their molecular weights were 2 000, 1 757.1, 1 34 2.7, 955.6, 11.7 kDa, respectively. Polysaccharide A was composed of arabinose, polysaccharide E was composed of arabinose and galactose, polysaccharides B, C, D were composed of glucose and 1 --> 2, 1 --> 3, 1 --> 4, 1 --> 6 linkages existed in polysaccharides A-E, of A, B, C, D, E were alpha-configurations. Polysaccharides B, C and D showed better bioactivity than polysaccharides A and E with stimulation index (SI) of 5.31, 4.76, 5.17.

CONCLUSIONFive polysaccharides are seperated firstly from Isatidis Radix.

BACKGROUND: Bone metabolism disorder happens in diabetic environment, bone defects in which are difficult to repair. Study addressing osteogenic property of adipose-derived stroma cells (ADSCs) in diabetic environment provides theoretical basis for its application in certain environment.OBJECTIVE: To explore the effects of high glucose (HG) and advanced glycation end-products (AGEs) on osteogenic capacity of human ADSCs. METHODS: 100 mg/L AGEs and 27.5 mmol/L HG were used to simulate in vitro diabetic environment and intervened ADSCs osteogenic differentiation. The cells were divided into 4 groups, with 6 samples in each group. The expression of type Ⅰ collagen was examined by fluorescent immunofluorescence at 21 days after osteogenic induction. The number of calcification nodes was counted under contrast phase microscopy at 14, 21 and 28 days. RESULTS AND CONCLUSION: Fluorescent quantitation scan showed that the type Ⅰ collagen amount of the AGEs+HG treated group was 2.76 times lower than that of the control group. AGEs+HG reduced the number of ADSCs calcification nodes compared with the control, HG, and AGEs groups, the differences were statistical significant (P < 0.01). AGEs and HG exposure inhibit the cognate osteogenic differentiation of ADSCs, which suggest that AGEs and HG are unfavorable factors that reduce ADSCs osteogenic ability.

BACKGROUND: Adult acetabular dysplasia in advanced stage combined with hip joint osteoarthritis should undergo total hip replacement. The severity of acetabular lesion is various in different patients, which leads to significantly increased difficulty in reestablishing acetabulum. Acetabular medial wall displacement osteotomy can solve the component of acetabular prosthesis, but the displacement range of the acetabular medial wall following osteotomy is controversial.OBJECTIVE: To look for a suitable displacement range of acetabular medial wall following osteotomy by computer-aided design finite element analysis.METHODS: SolidWorks 2008 software was used to establish three-dimensional models of acetabular dysplasia pelvis. Acetabular medial wall displacement osteotomy was simulated to make acetabular medial wall bone displace from 2 mm bone contact to 7 mm bone contact in the pelvic cavity. One experimental group was set at 1 mm intervals, totally 10 experimental groups. The acetabulum in each group was split into four quadrants. The prosthesis acetabulum-bone interface in each group was analyzed by computer simulation contrast mechanics experiment. The Mises stress and shear stress values were measured between acetabular prosthesis and bone interface.RESULTS AND CONCLUSION: In groups 1, 5, 6, 9 and 10, the Mises stress was unevenly distributed in posterior inferior, anterior superior and anterior inferior quadrants. In groups 2, 3, 4, 7 and 8, the Mises stress was evenly distributed in posterior inferior,anterior superior and anterior inferior quadrants. Of them, the stress was most even in the group 4. In groups 2, 3, 4, 7 and 8, the shear stress was evenly distributed in the above-mentioned three quadrants. The shear stress was lowest in the groups 7 and 8.These indicate that joint force in the acetabulum mainly focused in the posterior superior quadrant. With the displacement of acetabular cup, the contact area of acetabular cup and bone would gradually increase, which finally increased the Mises stress in the contact surface. However, shear stress decreased with displacement of acetabular medial wall. Therefore, the suitable displacement range of acetabular medial wall osteotomy is 1 mm away from the pelvic cavity and 1 mm complete embolism in the pelvic cavity. The optimal position was 1 mm complete embolism in the pelvic cavity.

BACKGROUND: During the hip replacement, selection of prosthesis often depends on patients' bone condition. There has been no gold standard for selection of prosthesis. It will be of scientific significance to select femoral prostheses implanted under different bone densities through three-dimensional finite element analysis and simulated contrast mechanical tests.OBJECTIVE: Three-dimensional finite element analysis was employed to select femoral prostheses according to different bone densities, and simultaneously simulated contrast mechanical tests were performed to determine the age criteria regarding the selection of femoral prosthesis during the hip replacement.DESIGN, TIME AND SETTING: An open experiment was performed at the Second Department of Orthopedics, First Clinical Hospital of Jilin University and Institute of Biomechanics, Jilin University between September 2006 and May 2007.MATERIALS: Freshly adult femoral specimens were harvested from cadavers.METHODS: Three-dimensional finite element models of femur were established using Solidworks software. Following the known formula, the bone density and elastic modulus at different age brackets were calculated and input into the computer. The human one-foot standing condition was simulated and pressure was loaded on the reconstructed femoral models.MAIN OUTCOME MEASURES: Some biomechanical characteristics of uncemented and cemented femoral prostheses, such as the distress distribution and initial micromovement at different bone densities, were measured.RESULTS: Relatively well-distributed whole distress and slight initial micromovement of uncemented femoral prostheses were found in male patients at 30-60 years old and in female patients at 40-55 years old. Symptoms of cemented femoral prostheses the same as the uncemented femoral prostheses were present in male patients at 60-70 years and in female patients older than 55 years old.CONCLUSION: Results of three-dimensional finite element analysis and simulated contrast mechanical tests suggest that uncemented femoral prostheses provide better therapeutic effects in male patients younger than 60 years and in female patients younger than 55 years than cemented femoral prosthesis.