Mid‐ to Long‐Term Outcomes of Cementless Modular,Fluted, Tapered Stem for Massive Femoral Bone Loss in Revision Total Hip Arthroplasty

ObjectiveTo evaluate mid‐ to long‐term results of revision total hip arthroplasty for massive femoral bone loss using a cementless modular, fluted, tapered stem.MethodsThis is a retrospective study performed at a single hospital. During the period of January 2007 to January 2015, 33 patients (34 hips) underwent primary revision surgery with cementless modular, fluted, tapered stems due to femoral bone loss. Sixteen men and 17 women were included in the study, with an average age of 63.9 ± 11.7 years (range, 27 to 88 years). Operative data including operative duration, length of incision, drainage volume and duration, blood loss and transfusion, cases of bone graft and extended trochanteric osteotomy were recorded. Clinical evaluation was performed using Harris hip score (HHS), visual analogue scale (VAS), and patients'' satisfaction. Radiographic data including femoral stem fixation, subsidence, integrin of allograft bone, and leg length discrepancy were assessed. Complications and survivorship were evaluated using Kaplan–Meier survival rate.ResultsThe mean follow‐up was 9.1 ± 2.5 years (range, 5–13 years). The Harris hip score was 43.6 ± 11.5 preoperatively and maintained at 86.5 ± 6.6 at the time of latest follow‐up (P < 0. 05). The X‐ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in three hips (9%), and instability in one hip (3%). The average stem subsidence was 3.9 ± 2.2 mm (range, 1 to 10 mm). The mean difference in leg length in our study was 3.3 ± 2.7 mm (range, 0 to 10 mm), and the leg length discrepancy in 28 (82%) patients was within 5 mm. No case of junction fracture was observed. Seven (21%) intraoperative fractures occurred in our study. Three (9%) cases with infection were observed after revision. Six (18%) patients had lower limb vein thrombosis. The survivorship of prostheses with re‐revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10‐year follow‐up. Three (9%) re‐revisions were needed, including one for aseptic loosening, one for dislocation, and one for infection.ConclusionThe mid‐ to long‐term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stems are encouraging for massive femoral bone loss.     

Osteosarcomatosis

A review of the 690 cases of osteosarcoma in the radiographic file of the Armed Forces Institute of Pathology revealed 29 cases of "osteosarcomatosis" (multiple skeletal sites of osteosarcoma). Fifteen of these patients were 18 years old and under and manifested rapidly appearing, usually symmetric, sclerotic metaphyseal lesions. The remaining 14 patients were more than 18 years old and had fewer, asymmetric sclerotic lesions. In most patients (28 of 29), a radiographically dominant skeletal tumor was seen. Pulmonary metastases occurred in the majority of patients and were detected at the same time as the bone lesions. These 29 patients were studied with regard to demographic data and skeletal distribution and radiographic appearance of their lesions. As a result of the findings, a metastatic origin from a primary dominant osteosarcoma is favored over a multifocal origin as the basis for osteosarcomatosis. Osteosarcomatosis is more commonly encountered in the mature skeleton than has been previously recognized.     

Association of angiotensin Ⅱ type 1 receptor gene polymorphism with essential hypertension

Objective To determine whether the polymorphism A1166C in the angiotensin Ⅱ type 1 receptor (AT1R) gene is associated with essential hypertension.Methods A case-control study was carried out using 125 hypertensive and 103 normotensive subjects. The A→C variant at position 1166 (A1166C) of t he AT1R gene was identified by polymerase chain reaction (PCR) and PCR/ restriction fragment length polymorphism (PCR/RFLP) analysis. The digestion products were separated on 2% agarose gels and visualized with ethid ium bromide under ultraviolet ray.Results The differences in C1166 allele frequency and in the AC genotype dist ribution of the AT1R gene between the hypertensive and normotensive groups were statistically significant (C allele: 0.092 vs 0.034, χ(2) =6.1 86, P&lt;0.05; AC genotype: 0.184 vs 0.068, χ(2) =6.654, P&lt;0.05).Conclusion The AC genotype is associated with essential hypertension, and the C a llele may be a marker for predisposition to hypertension in Chinese H an population.     

微电极记录技术在立体定向手术治疗帕金森病中的应用

目的：提高立体定向手术的定位精确度。方法：32例帕金森患者均采用CT定位。通过微电极描述和记录苍白球腹后内侧部（Gpi)及丘脑腹外侧核（Vim)的电生理信号。从而pi和Vim核的电生理靶点。结果：电生理靶点坐标与原始CT靶点坐标的更换率为64%。总有效率为90%,无永久性并发症,结论：微电极记录技术的应用提高了手术治疗帕金森病的效果。降低了手术并发症。     

急诊冠状动脉内支架植入治疗急性心肌梗死——围术期死亡和近期预后的研究

为评价急性心肌梗死(AMI)患者急诊经皮冠状动脉腔内成形(PTCA)和冠状动脉内支架植入围术期死亡和近期预后的影响因素,通过对74例行急诊冠状动脉内支架植入的AMI,术后6个月内的临床随访和冠状动脉造影随访,进行多因素相关回归分析。结果表明,多支病变患者的糖尿病、高血压和高血脂的合并比例明显高于单支病变患者;总围术期内死亡率为5.4％,剔除合并心源性休克患者后,死亡率为1.4％;12例75岁以上的患者中,2例死于心源性休克,1例死于心脏破裂,5例心源性休克患者死亡3例;术中非致命性合并症的发生率在单支和多支病变组之间差异无显著性(P>0.05);多元回归分析表明血流动力学状态和患者的年龄是决定AMI患者围术期死亡的独立相关因素;多支病变患者术后6个月内心脏事件发生率明显高于单支病变组;术前和术后6个月内的患者左心室射血分数(LVEF)明显改善;而且单支和多支病变组之间术后6个月时的LVEF之间无显著性差异。     

《伤寒杂病论》合方运用探讨

重点阐述了《伤寒杂病论》所创合方的这一方剂变化的特殊形式及其运用。并对合方的源流,涵义,组方原则,作用及意义进行了探讨。认为合方虽源于《内经》,但成形于《伤寒杂病论》。合方具有单方所不具备的优势和疗效,如治疗面广,作用性强,产生新疗效,调整作用功能等。     

日本血吸虫细菌人工染色体文库的初步构建(英文)

初步构建了一个日本血吸虫细菌人工染色体（BAC）文库,该文库已包含1000多个含基因组DNA插入片段的重组pEcBAC1克隆,平均插入片段为120kb。BAC文库将为日本血吸虫基因的结构与功能研究提供新的资源。     

糖尿病多形核白细胞吞噬功能的改变

目的 研究正常人及糖尿病患者多形核白细胞（polymorphonuclear leukocytes,PMNLs)吞噬功能的改变及钙通道阻滞剂对其的影响。方法 应用过氧化氢释放法测定白细胞吞噬功能,同时研究PMNLs细胞外不同浓度糖环境及钙通道阻滞剂对细胞吞噬功能的影响。结果 糖尿病患者的PMNLs吞噬功能较正常人低下。体外培养基葡萄糖浓度增高,吞噬功能越差,硝苯啶可明显改善糖尿病患者PMNLs的吞噬功能。结论 推测葡萄糖可能是通过激活L型钙通道引起细胞内游离钙浓度升高,从而影响吞噬功能,而硝苯啶可阻断该通道,恢复吞噬功能。     

QT Dispersion Level and Its Clinical Significance.in Dilated Cardiomyopathy

［1］Richardson CP, Mckenna RM, Bristow CM, et al.Report of the 1995 Word Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996,93: 841 ［2］Barr CS, Naas A, Freeman M, et al. QT dispersion and sudden unexpected death in chronic heart failure. Lancet, 1994,343:327 ［3］Martin AB, Garson A, Perry JC, et al. Prolonged QT interval in hypertropic and dilated cardiomyopathy in children. Am Heart J, 1994,127(1):64 ［4］Pye M, Quinn AC, Cobble SM. QT dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias?Br Heart J, 1994,71(5):51 ［5］Berger RD, Kasper EK, Baughman KL, et al. Beat to beat QT interval variability: novel evidence for repolarization lability in ischemic and non ischemic dilated cardiomyopathy. Circulation, 1997, 96 (5):1557 ［6］Wolfram G, Ulrike S, Volker M, et al. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol, 1997,78: 458 ［7］Fei L, Goldman JH, Prasal K, et al. QT dispersion and RR variations on 12-lead ECGs in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy. Eur Heart J, 1996,17: 258 ［8］Pan YZ, Guo NS, Xing ZF, et al. The relation between QT dispersion and ventricular arrhythmia of dilated cardiomyopathy. Chin J Inter Medi, 1996,35(11):73 ［9］Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J, 1998,19(7) :1054     

大肠癌新相关基因HSU17714的染色体定位研究

目的确定大肠癌新相关基因ＨＳＵ１７７１４的染色体定位。方法采用强化荧光原位杂交技术（ＦＩＳＨ）,以生物素化酪胺强化荧光原位杂交信号。结果８０．０％（１２８／１６０）的间期细胞和５９．８％（１０４／１７４）的中期分裂相可见到明显集中的ＨＳＵ１７７１４基因的杂交信号,相应荧光Ｒ带分析中,８５．１％（４０／４７）在２２号染色体上１区３带处有杂交信号。结论ＨＳＵ１７７１４基因定位于２２ｑ１３。