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25 November 2012, Volume 16 Issue 48 Previous Issue    Next Issue

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Autoimmune properties of nucleus pulposus in the patients with lumbar disc herniation Zhang Hai-ping, Zhang Feng, Yao Yu 2012, 16 (48):  8931-8937.  doi: 10.3969/j.issn.2095-4344.2012.48.001 Abstract ( 351 )   PDF (701KB) ( 525 )   Save BACKGROUND: Much pathogenesis can cause discogenic low back pain. During the occurrence and development of disc degeneration, the correlation between the expression of vascular endothelial growth factor, T lymphocytes and B lymphocytes and the highlight type and duration is not yet fully clear. OBJECTIVE: To investigate the expression of T lymphocytes, B lymphocytes and vascular endothelial growth factor in the lumbar disc tissue of the patients with different types of lumbar disc herniation, and to analyze the association between their expression and clinical symptoms and signs. METHODS: The lumbar disc specimens were selected from the patients with lumbar disc herniation as the experimental group, it included extrusion group, herniation group and bulge group; the normal lumber discs of the patients with vertebral body fracture were collected as control group. Angiopoiesis and gathering of peripheral lymphocytes of the lumbar disc specimens were observed by hematoxylin-eosin staining. Immunohistochemistry method was used to detect the distribution of CD4, CD8, IgG, IgM and vascular endothelial growth factor. RESULTS AND CONCLUSION: ①Plenty of vascular endothelial cells and neovascularization can be observed in the degenerative nucleus pulpous. Lymphocyte aggregation was found around them. ②Expression of activated T cells CD4+ and CD8+, as well as the IgG and IgM positive B cells and vascular endothelial growth factor were observed by immunohistochemistry staining. The expression level in extrusion group and bulge group was obviously higher than that in herniation group (P < 0.05). Otherwise, there was no positive expression in the control group. Nucleus pulpous can activate T and B cells and cause immune reaction when exposed to autoimmunity system. Vascular endothelial growth factor plays a key role in the neovascularization of degenerative lumbar disc. At the same time, it has synergistic effect on the discogenic low back pain with the autoimmunity reaction caused by T and B cells. Related Articles | Metrics

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Research and application of the software for measuring template before total hip replacement Wang Hong, Yue Rui-hong, Zhou Hai-yu, Wang Shuan-ke, Wang Jing, Ma Jing-lin 2012, 16 (48):  8938-8942.  doi: 10.3969/j.issn.2095-4344.2012.48.002 Abstract ( 693 )   PDF (519KB) ( 1135 )   Save BACKGROUND: The dislocation, loosening, activity of artificial joint associated with the material factors and the surgeon technologies, but also closely related with the choice of prosthesis sizes. OBJECTIVE: To investigate the research of the software for measuring template before total hip replacement and its reliability in initial clinical application. METHODS: 132 patients were divided into two groups, the preoperative measurement of the prosthesis model that actually used in the process of hip replacement was performed with the research and development total hip replacement template measurement software or traditional methods respectively, and finally compared the above results with the practical application at surgery. RESULTS AND CONCLUSION: The coincidence rate of prosthesis model measured by the software was 86.36% while coincidence rate of prosthesis model measured by traditional methods was 71.97%, the difference was statistically significant (χ2=13.794, P < 0.001). There was significant correlation between software predicted preoperative acetabular prosthesis model and intraoperative acetabular prosthesis model (r=1.000 0, P=0.015), and software predicted preoperative femoral prosthesis model was significantly correlated with the intraoperative application of femoral prosthesis (r=0.999 9, P=0.029). The software for preoperative measuring is devised successfully, and the initial clinical application is well. Related Articles | Metrics

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Selection of prosthesis size before total hip arthroplasty Li Jian-long, Li Yi-zhong, Lin Jin-kuang, Yao Xue-dong, Zhuang Hua-feng 2012, 16 (48):  8943-8947.  doi: 10.3969/j.issn.2095-4344.2012.48.003 Abstract ( 473 )   PDF (403KB) ( 549 )   Save BACKGROUND: A good press-fit between the femoral component and the cross-section of medullary cavity of proximal femur is very important. The accuracy of preoperative measurement of prosthesis model by template measurement method was low. It was necessary to search a new method for preoperative prediction of prosthesis model. OBJECTIVE: To measure the minimum medial dimension of medullary cavity of femoral neck and the intramedullary dimension of femoral isthmus by CT in order to predict the size of suitable femoral prosthesis in total hip arthroplasty. METHODS: Clinical data of 52 patients (61 hips) undergoing primary total hip arthroplasty were collected. The size of the femoral stem was accurately measured from preoperative CT film based on the medial dimension of medullary cavity of femoral neck and the intramedullary dimension of femoral isthmus. Conventional preoperative template measurement method was served as control. The feasibility and accuracy of the two methods to predict the size of the prosthesis was analyzed. RESULTS AND CONCLUSION: The medial dimension of medullary cavity of femoral neck and the intramedullary dimension of femoral isthmus were correlated fairly well with sizes of the stems (r=0.97-0.99, P < 0.05). There were 47.5% cases of CT-isthmus measurement method predicted sizes were excellence, and the accuracy of the CT-isthmus measurement method was better than that of the template measurement method, especially in the age below or equal to 65 years. The results of the medial-dimension measurement method of femoral neck predicted sizes were excellent in 52.5%, and the accuracy of the medial-dimension measurement method was better than that of the template measurement method, especially in the age more than 45 years. CT-isthmus measurement method has better clinical value in the patients with the age below or equal to 65 years or in the patients with narrow medullary cavity of the femoral stem, while the medial-dimension measurement method of femoral neck has better accuracy in the prediction of the prosthesis model preoperatively in the patients with the age more than 45 years or in the patients with large medullary cavity of the femoral stem. It suggested that the application of the two methods was feasible for prediction of femoral component in total hip arthroplasty. Related Articles | Metrics

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Comparison of the autologous blood transfusion after hemostasis during total knee arthroplasty Guo Min, Yang Jiang-huai 2012, 16 (48):  8948-8952.  doi: 10.3969/j.issn.2095-4344.2012.48.004 Abstract ( 313 )   PDF (403KB) ( 458 )   Save BACKGROUND: Previous studies often focus on the comparison between the entire tourniquet technology and halfway tourniquet technology which used the tourniquet when the bone cement combined with the prosthesis. OBJECTIVE: To research the influence of clinical symptoms and limb function on postoperative patients between the entire process of tourniquet and tourniquet released electric coagulation and bone wax hemostatic method before the incision is closed, both combined with autologous blood transfusion in total knee arthroplasty. METHODS: Sixty cases of knee osteoarthritis patients who underwent total knee arthroplasty were selected for research. Thirty cases were treated with entire process of tourniquet (tourniquet group) and 30 cases were treated with relax tourniquet before wound closing, and hemostasis using electric coagulation and bone wax respectively (electric coagulation group). After the total knee arthroplasty, the autologous blood transfusion devices were placed in the patients of two groups. The early clinical effect and affected limb function of patients in two groups were evaluated by comparing the amount of bleeding and draining, the American knee society knee score of clinical symptoms and function postoperatively. RESULTS AND CONCLUSION: The intraoperative blood loss of tourniquet group (50±10) mL was lower than that of electric coagulation group (180±120) mL (P < 0.05); the drainage flow of tourniquet group (237±83) mL was lower than that of electric coagulation group (285±215) mL (P < 0.05). There was no significant difference of early American knee society knee score, and the difference of joint hematoma occurring rate and lower extremity venous thrombosis incidence was not significant. In total knee arthroplasty, the intraoperative bleeding and postoperative drainage volume of the hemostatic method before closing the incision is more than that of the entire process of tourniquet, and there is no significant difference of the early postoperative clinical symptoms and limb function. Related Articles | Metrics

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Knee joint movement after fixed-bearing and mobile-bearing total knee arthroplasty Luo Wei, Cheng Ming-hua, Xiao Xun-gang 2012, 16 (48):  8953-8957.  doi: 10.3969/j.issn.2095-4344.2012.48.005 Abstract ( 404 )   PDF (430KB) ( 573 )   Save BACKGROUND: To date, the medium-and long-term functional outcome after total knee replacement and the reoperation rate of using the fixed-bearing total knee arthroplasty is same with that of using mobile-bearing total knee arthroplasty, but there are different opinions for the knee function improvement. OBJECTIVE: To compare the knee joint movement angle after fixed-bearing or mobile-bearing total knee arthroplasty in order to investigate the improvement of joint motion. METHODS: From January 2005 to December 2012, 90 osteoarthritis patients without operation history were treated by fixed-bearing total knee arthroplasty (n=47) or mobile-bearing total knee arthroplasty (n=43). Both the range of motion of the knee joint before replacement and the femoral angle, the tibia angle, knee valgus angle, tibial plateau posterior slope and patellar height after replacement were measured. RESULTS AND CONCLUSION: All the patients were followed-up for 4-36 months, and in the final follow-up, the maximum flexion after replacement in the mobile-bearing group was larger than that in the fixed-bearing group, and the difference was not significant (P < 0.05). There was no significant difference of the femoral angle, the tibia angle, knee valgus angle and tibial plateau posterior slope between two groups in the final follow-up (P > 0.05), and there was no significant difference of patellar height between two groups in the final follow-up (P > 0.05). It indicated that both mobile-bearing and fixed-bearing total knee arthroplasty could improve the knee function, and recently study found that the clinical outcomes of mobile-bearing were better than that of fixed-bearing. Related Articles | Metrics

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Total knee arthroplasty in patients with hemophilic arthritis Hou Bo, Wang Yi, Shen Yu-hui, Feng Jian-min, Liu Zhi-hong, He Chuan 2012, 16 (48):  8958-8962.  doi: 10.3969/j.issn.2095-4344.2012.48.006 Abstract ( 503 )   PDF (439KB) ( 687 )   Save BACKGROUND: The effect of total knee arthroplasty for the treatment of hemophilic arthritis is directly related to the coagulation factor replacement treatment programs and surgical techniques. OBJECTIVE: To summarize the rehabilitation outcome of 12 hemophilic arthritis patients treated with total knee arthroplasty, and to describe the coagulation factor Ⅷ monitoring and alternative treatment program in perioperative period. METHODS: Take the coagulation factor replacement therapy scheme by Ruijin Hospital as a standard, combining with the actual factor level and experienced surgeon, we operated total knee arthroplasty for the 12 male patients (17 knees) with hemophilic arthritis. Function was assessed using the Cleveland score and the Knee Society Rating Scale. RESULTS AND CONCLUSION: Results were excellent in 8 knees, fair in 3 knees and poor in 3 knees according to the Cleveland score, 1 thigh amputees and 2 patients who suffered from joint fusion surgery were not involved in this score. According to KSS score, average knee score increased from (23.6±9.0) preoperatively to (86.7±12.1) postoperatively, average knee function score increased from (25.2±28.4) preoperatively to (65.7±39.8) postoperatively. For the patients with hemophilic arthritis, reasonable alternative treatment program can promote the recovery of joint function, but it has bigger risk, so caution is necessary. Related Articles | Metrics

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Effect of low molecular weight heparin on blood loss after primary total hip arthroplasty and total knee arthroplasty Xu Jie, Ma Ruo-fan, Li Liang-ping, Cai Zhi-qing, Dong Wen-wu 2012, 16 (48):  8963-8967.  doi: 10.3969/j.issn.2095-4344.2012.48.007 Abstract ( 363 )   PDF (447KB) ( 571 )   Save BACKGROUND: Deep vein thrombosis of lower limb is a common complication after total hip arthroplasty and total knee arthroplasty, and the application of low molecular weight heparin has become the general guiding principles after arthroplasty. OBJECTIVE: To explore the clinical impact of low molecular weight heparin on blood loss after total knee arthroplasty and total hip arthroplasty. METHODS: Between January 2006 and June 2011, the clinical data from 529 patients undergoing primary total knee arthroplasty and total hip arthroplasty were retrospectively analyzed. In accordance with using low molecular weight heparin or not, the cases were divided into two groups, the trial group and the control group. In the trial group, the patients received subcutaneous injection of low molecular weight heparin (4 000-6 000 U/day) from 8-12 hours after arthroplasty and lasted for 10-15 days. In the control group, the patients received no anticoagulation drug. The total blood loss, dominant blood loss and hidden blood loss of two groups were compared. RESULTS AND CONCLUSION: There was significant difference of total blood loss between two groups (t =-23.42, P < 0.01). The dominant blood loss was the major part of blood loss for the total knee arthroplasty cases and the hidden blood loss was the major part of blood loss for the total hip arthroplasty cases, there was significant difference of dominant blood loss and hidden blood loss between two groups (t=-23.3, P < 0.01). Application of low molecular weight heparin after arthroplasty can increase the patients’ bleeding volume; the percentage of dominant and hidden blood loss in total hip arthroplasty is different from that in total knee arthroplasty. Calculation of the dominant blood loss, including operating bleeding and postoperative draining was not enough to estimate perioperative blood loss. We should pay more attention on the changes of hemoglobin during anticoagulant therapy. Fully consider the hidden blood loss according to the surgery characteristics and thus result in better preparation of blood during operation. Related Articles | Metrics

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Application of absorbable screw plus absorbable suture tension band and locking plate in bone fracture Zheng Xu-guang, Li Li-geng, Liang Jun-sheng, Zhang Li-feng, An Zhi-gang 2012, 16 (48):  8968-8975.  doi: 10.3969/j.issn.2095-4344.2012.48.008 Abstract ( 393 )   PDF (545KB) ( 639 )   Save BACKGROUND: At present, the treatment of elderly humeral greater tuberosity fracture mainly depends on locking plate internal fixation or tension band internal fixation. OBJECTIVE: To study the clinical effects of absorbable screw plus absorbable suture tension band internal fixation on the treatment of elderly humeral greater tuberosity fracture. METHODS: Sixty-six patients with elderly humeral greater tuberosity fracture were divided into two groups: treatment group (n=34) and control group (n=32). The patients in the treatment group were treated with absorbable screws plus absorbable suture tension band internal fixation, the patients in the control group using locking plate internal fixation. RESULTS AND CONCLUSION: All cases were followed-up for 6 months to 4 years. Shoulder function scores of the patients of the treatment group had the excellent proportion and were significantly higher than that of the control group (P < 0.05). The fracture of all patients was healed, no malunion, no death cases occurred during the treatment. The blood loss, fracture healing time, time of hospitalization, and hospital costs of the treatment group were significantly lower than those of the control group (P < 0.05). The results suggest that absorbable screws plus absorbable suture tension band internal fixation for the treatment of elderly humeral greater tuberosity fracture has good clinical effects. Related Articles | Metrics

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Type of intertrochanteric fracture and choice of internal fixation screw Deng Jian-fu, Zhou Shun, Niu Qing-hai 2012, 16 (48):  8976-8982.  doi: 10.3969/j.issn.2095-4344.2012.48.009 Abstract ( 352 )   PDF (539KB) ( 529 )   Save BACKGROUND: The intramedullary and extramedullary fixations are two main surgical treatment methods for intertrochanteric fractures, each method has the advantages and disadvantages. OBJECTIVE: To investigate the different effect of dynamic hip screw and the new generation of the femur proximal femoral nail (InterTan) in the treatment of different sub-type of intertrochanteric fractures. METHODS: A series of 84 cases of intertrochanteric fractures were fixed by dynamic hip screw and InterTan during July 2010 to December 2011. According to Evans classification, 43 patients of type Ⅰa and type Ⅰb were treated with dynamic hip screw, and 41 patients of type Ⅰc and type Ⅰd were treated with InterTan nails． RESULTS AND CONCLUSION: Eighty-four patients were followed-up for an average of 11.6 months, all patients were fracture healing. There was no significant difference in healing time, get out of bed time and the last follow-up Harris hip score between two groups (P > 0.05). The last follow-up Harris hip score in the dynamic hip screw group was (87.7±9.3) points, and the excellent and good rate was 83.7%; The last follow-up Harris score in the InterTan group was (85.9±8.6) points, the excellent and good rate was 90.2%. There was no significant difference of last follow-up Harris hip score between two groups (P > 0.05). During the choice of internal fixation materials, patients with Evans type Ⅰa and type Ⅰb should be treated with dynamic hip screw, and the patients with Evans type Ⅰc and type Ⅰd should be treated with InterTan nail. Both dynamic hip screw and InterTan have a positive effect and the effect is similar. Related Articles | Metrics

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Physical therapy in the fracture region with metal implants fixation Zhang Han, Xu Yi-ming, Wan Da-qian, Bai Yue-hong 2012, 16 (48):  8983-8987.  doi: 10.3969/j.issn.2095-4344.2012.48.010 Abstract ( 288 )   PDF (493KB) ( 637 )   Save BACKGROUND: After fracture fixation with metal implants, is it able to take physical therapy in promoting the fracture? This exploratory experiment can be the preparation for later discussion. OBJECTIVE: To investigate the feasibility of physical therapy after fracture fixation with metal implants and to observe the effect of physical therapy on the fracture recovery and surrounding tissues. METHODS: Twenty-four adult white rabbits were selected and randomly divided into three groups. The models of the transaction fracture on the middle of left femur were established and fixed with plate. After fixation, the models in the control group received no treatment; the models in the intermediate-frequency group received the intermediate-frequency electro-therapy with intermediate-frequency therapeutic equioment ECM99-IIB at 4 days after fixation and lasted for 30 days; the models in the high-frequency group received the microwave therapy with microwave apparatus PM-800S at 4 days after fixation and lasted for 30 days. RESULTS AND CONCLUSION: General observation showed that the control group had the most fibrous tissue, followed by the intermediate-frequency group, and high-frequency group had the least fibrous tissue. There was no significant difference of nerve conduction velocity among three groups (P > 0.05). Histological observation showed that there was no visible bone matrix in the control group, trabecular bone formation could be seen in the intermediate-frequency group, maturate trabecular bone could be seen in the high-frequency group. Fibrosis of muscle tissue could be seen in the control group, partly fibrosis of muscle tissue could be seen in the intermediate-frequency group and the fibrosis in the high-frequency group was not obvious. Serum biochemical indicators showed that the serum content of Ca2+ and alkaline phosphatase in the intermediate-frequency group and high-frequency group were significantly higher than those in the control group (P < 0.05). Under the experimental conditions, intermediate-frequency electro-therapy and high-frequency electro-therapy could be used after fracture fixation, and had a positive effect on the union of fracture. The effect of the high-frequency electro-therapy was better than that of the intermediate-frequency electro-therapy. Related Articles | Metrics

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Healing effect of electromagnetic treatment plus traditional Chinese medicine hot compress therapy on femoral shaft fracture after internal fixation Yang Bo, Sun Kai, Shi A-jun, Ding Chun-fa, Liu Jian-wen 2012, 16 (48):  8988-8992.  doi: 10.3969/j.issn.2095-4344.2012.48.011 Abstract ( 393 )   PDF (443KB) ( 530 )   Save BACKGROUND: Studies have shown that the electromagnetic treatment and traditional Chinese medicine hot compress therapy can promote the healing of fractures and improve the functional recovery, but the combination of electromagnetic treatment and traditional Chinese medicine hot compress therapy for femoral shaft fracture healing has been reported rarely. OBJECTIVE: To investigate the healing effect of the electromagnetic treatment plus traditional Chinese medicine hot compress therapy on femoral shaft fracture. METHODS: Fifty-seven cases of femoral shaft fractures patients were treated with open reduction and internal fixation surgery, and the patients were randomly divided into three groups according to different rehabilitation therapy: the electromagnetic treatment group, traditional Chinese medicine hot compress group, and combination group, 19 cases in each group. After rehabilitation therapy for 8 weeks, X-ray examination was performed, according to the femoral shaft fracture assessment criteria, the extent of fracture healing of the patients in each group was assessed. RESULTS AND CONCLUSION: The lower limb activity of the patients in combination group was improved significantly, local pain was less or disappeared, X-ray examination showed that the degree of fracture healing in combination group was significantly better than that in the pure electromagnetic treatment group or traditional Chinese medicine hot compress group (P < 0.05), and there was no significant difference between two groups (P > 0.05). The effect of combination therapy of electromagnetic treatment and traditional Chinese medicine hot compress therapy on the healing of femoral shaft fracture is better than that of pure electromagnetic treatment or traditional Chinese medicine hot compress therapy. Related Articles | Metrics

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Finite element analysis on the stress in mandibular first molar short crown restored by post inlay of different cuspal inclination Xiao Yue, Guan Jing-hong, Shi Chong, Wang Jian-ping 2012, 16 (48):  8993-8996.  doi: 10.3969/j.issn.2095-4344.2012.48.012 Abstract ( 395 )   PDF (462KB) ( 651 )   Save BACKGROUND: Clinical research about the post inlay mainly focuses on inlay materials and pile length, while the research on the morphology of the occlusal surface is rare. OBJECTIVE: To analyze the stress magnitude and distribution of remaining dentin and parodontium in mandibular first molar short crown restored with post inlay using three-dimensional finite element method. And then to discuss the rational core design of occlusal surface of mandibular first molar short crown. METHODS: The three-dimensional element models of mandibular first molar short crown restored with post inlay were created by CT scanning, Mimics software and Unigraphics NX6.0 software. Different cuspal inclination of post was used in the modeling, including post inlay, crown, root, periodontal ligament and alveolar bone. A load of 240 N was applied to the occlusal surface in order to analyze the maximum principal stress, Von-mises peak stress and distribution of remaining dentin in mandibular first molar short crown restored with post inlay. RESULTS AND CONCLUSION: The maximum stress on remaining dentin and parodontium increased markedly with the increasing of different cuspal inclination. Cuspal inclination has influence on magnitude and distribution of stress on remaining dentin and parodontium in mandibular first molar short crown restored with post inlay. Related Articles | Metrics

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Curative effects of acromioclavicular fixation versus coracoclavicular fixation for acromioclavicular joint dislocations through Meta-analysis Zhang Wei-wei, Wang Shi-bo, Feng Yan-hua, Luo Yu-chun, Xu Bin, Ji Hang-yu, Fan Rong 2012, 16 (48):  8997-9001.  doi: 10.3969/j.issn.2095-4344.2012.48.013 Abstract ( 294 )   PDF (501KB) ( 504 )   Save BACKGROUND: A lot of reports focus on the treatment of acromioclavicular joint dislocations with many differences on the methods and implants. The methods for treatment of the acromioclavicular joint dislocations which used more often in clinic are acromioclavicular fixation and coracoclavicular fixation. There exists great controversy on which method is better. OBJECTIVE: To compare the curative effects between acromioclavicular fixation and coracoclavicular fixation for acromioclavicular joint dislocations through Meta-analysis. METHODS: Related randomized controlled trials on acromioclavicular fixation and coracoclavicular fixation for acromioclavicular joint dislocations were searched in PubMed database (1950-01/2011-10), EMBASE database (1966-01/2011-10), CNKI database (1979-01/2011-10), Wanfang database (1982-01/2011-10) and VIP database (1989-01/2011-10). The articles were collected according to the inclusion criteria and then compared. Heterogeneity analysis and Meta-analysis were performed using RevMan5.0 software, and then the forest graph was made. RESULTS AND CONCLUSION: Nine articles involving 473 patients and 473 acromioclavicular joints were accepted in our Meta-analysis. There were no significant differences in curative effect score, strength of upper limbs, shoulder movement, re-dislocations rate between acromioclavicular fixation and coracoclavicular fixation. Therefore, the clinical treatment of acromioclavicular joint dislocation can not only use the acromioclavicular fixed or coracoclavicular fixation, doctors should choose the best method according to the patients' condition, hospital conditions and the surgery proficiency of the doctor. Related Articles | Metrics

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Meta analysis on intertrochanteric fractures in adults treated with proximal femoral nail anti-rotation and common intramedullary fixation Lei Guang-hua, Zeng Chao, Wei Jie, Gao Shu-guang, Sun Zhen-qiu, Wang Yi-ren 2012, 16 (48):  9002-9009.  doi: 10.3969/j.issn.2095-4344.2012.48.014 Abstract ( 305 )   PDF (838KB) ( 785 )   Save BACKGROUND: At present, the treatment of intertrochanteric fractures is mainly depending on extramedullary fixation and intramedullary fixation. Theoretically, the intramedullary fixation has the better stability and fewer complications. However, the emergence and existence of a large number of different types of fixtures demonstrate that these internal fixations have certain defects and deficiencies. OBJECTIVE: To compare the efficacy of proximal femoral nail anti-rotation versus other two common intramedullary fixations (proximal femoral nail and Gamma nail) in the treatment of intertrochanteric fractures in adults. METHODS: A computer-based search was performed on Cochrane library, Medline database, Elsevier database, Chinese Biomedical Database and Wanfang database for randomized controlled trials or non-randomized controlled trials on comparison between proximal femoral nail anti-rotation and proximal femoral nail, proximal femoral nail anti-rotation and Gamma nail fixation in the treatment of intertrochanteric fractures which were reported before 5 December 2011. Methodology quality of the trials was critically assessed and relative data were extracted. RESULTS AND CONCLUSION: A total of 5 randomized controlled trials and 13 non-randomized controlled trials involving 2 185 cases were included, 1 013 cases in proximal femoral nail anti-rotation group, 658 cases in proximal femoral nail group and 514 cases in Gamma nail fixation group. The results of meta-analysis showed that proximal femoral nail anti-rotation could significantly decrease the mean duration of surgery and mean intraoperative blood loss compared with proximal femoral nail. However, no insufficient evidence demonstrated that proximal femoral nail anti-rotation was better than proximal femoral nail in the rate of postoperative complication and the excellent and good rate of Harris score. It also showed that proximal femoral nail anti-rotation could significantly decrease the mean duration of surgery and mean intraoperative blood loss when compared with Gamma nail. However, there were no statistic differences in the mean duration of hospital, mean duration of fracture healing, the rate of postoperative complication and the excellent and good rate of Harris score between proximal femoral nail anti-rotation and Gamma nail treatment. Related Articles | Metrics

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Knee function after anterior cruciate ligament reconstruction using artificial ligament and autologous hamstring tendon Li Li-nan, Zhang Wei-guo, Wang Shou-yu 2012, 16 (48):  9010-9014.  doi: 10.3969/j.issn.2095-4344.2012.48.015 Abstract ( 358 )   PDF (459KB) ( 487 )   Save BACKGROUND: Artificial ligament has been focused since utilization with the advantages of without sacrificing of autologous tissue, no potentially infectious disease, short recovery time after the ligament reconstruction. OBJECTIVE: To analyze the contrast experiment of anterior cruciate ligament reconstruction using ligament advanced renforcement system artificial ligament and autologous hamstring tendon in order to evaluate and compare the efficacy and safety of the two methods on the recovery of knee function. METHODS: Primary screening of the literatures was performed by internet and by hand. Control trial studies regarding the anterior cruciate ligament reconstruction using ligament advanced renforcement system artificial ligament and autologous hamstring tendon were screened out from CBM database, CNKI database, VIP database and PubMed (Medline) database. The results were involved in Meta analysis. Experiment group underwent anterior cruciate ligament reconstruction using ligament advanced renforcement system artificial ligament, while control group underwent anterior cruciate ligament reconstruction using autologous hamstring tendon. RESULTS AND CONCLUSION: Five control trial studies were involved. Meta analysis results have showed that 6 months postoperative Lysholm score in experiment group was higher than that in control group, and the difference was significant. There was no significant difference of over 12 months postoperative Lysholm score between the two groups. There was no significant difference of postoperative Tegner measuring between the two groups. Postoperative kt-2000/1000 score had no statistically significant difference between the two groups. Compared with autologous hamstring tendon in anterior cruciate ligament reconstruction, ligament advanced renforcement system artificial ligament has a higher Lysholm score in short time, and difference of long time Lysholm score, Tegner score and kt-2000/1000 measuring difference is not obvious. Related Articles | Metrics

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Meta-analysis on the association between medial tibial plateau slope angle and anterior cruciate ligament injuries Zeng Chao, Wei Jie, Gao Shu-guang, Lei Guang-hua, Zhu He-yuan, Zhang Kai 2012, 16 (48):  9015-9019.  doi: 10.3969/j.issn.2095-4344.2012.48.016 Abstract ( 387 )   PDF (433KB) ( 559 )   Save BACKGROUND: As an anatomy associated risk factors of the anterior cruciate ligament injury, medial tibial plateau slope angle has been attracted much more attention, but as for the correlation between the anterior cruciate ligament injury and medial tibial plateau slope angle presence or absence, the results of the studies are not the same. OBJECTIVE: To determine the association between medial tibial plateau slope angle and anterior cruciate ligament injuries, and to investigate gender differences between anterior cruciate ligaments injured subjects and gender-matched controls. METHODS: The Cochrane library, Medline database, Elsevier database, Chinese Biomedical database and Wanfang database were retrieved by computer and the hand research of relevant literatures was performed. The deadline of all the retrieves was 2011-11-01. We included case-control and sectional studies on the association between medial tibial plateau slope angle and anterior cruciate ligament injury. The STATA11.0 software package was used for data-analysis. RESULTS AND CONCLUSION: Twelve trails with 1 823 objects were included for Meta analysis (888 objects in injury group and 925 objects in control group). For the whole objects in the injury group and control group, the pooled weighted mean difference for medial tibial plateau slope angle was 1.06, 95% confidence interval (CI) (0.36, 1.76), and P < 0.05. Subgroup analysis showed that, for the male objects, the pooled weighted mean difference for medial tibial plateau slope angle in the injury group and the control group was 0.84,95%CI:(-0.03,1.70) and P > 0.05. For the female objects, the pooled weighted mean difference for medial tibial plateau slope angle was 1.62, 95%CI (0.72, 2.52) and P < 0.05. The results of this Meta-analysis suggest that increased medial tibial plateau slope appears to contribute to anterior cruciate ligament injuries in females, but not in males. Related Articles | Metrics

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Application of three-dimensional CT reconstruction in total knee arthroplasty Ding Yu-run, Wang Wei-li 2012, 16 (48):  9020-9024.  doi: 10.3969/j.issn.2095-4344.2012.48.017 Abstract ( 313 )   PDF (421KB) ( 660 )   Save BACKGROUND: Perfect preoperative preparation is essential, extremity X-ray measurement, CT three-dimensional reconstruction of the application, as well as computer aided technology all contribute to the patients for more accurately placed prosthesis. OBJECTIVE: To discuss the value of femur marrow rod insertion point determined by preoperative CT three-dimensional reconstruction on knee function after total knee arthroplasty. METHODS: Thirty-two patients with total knee arthroplasty were collected to review. Among the 32 patients, 18 patients received CT three-dimensional reconstruction preoperatively to locate the femur marrow rod insertion point (CT three-dimensional reconstruction group), and the other patients did not receive the CT three-dimensional reconstruction (control group). All the cases were followed-up at 3 monts, 1 and 2 years after total knee arthroplasty. RESULTS AND CONCLUSION: After 3 months, 1 and 2 years follow-up, the knee function scores overall function and simple knee function of the CT three-dimensional reconstruction group were higher than those of the control group (P < 0.05). It will be much more effective to insert the femur marrow navigation rod and much more accurate to process the distal femur osteotomy and place the knee prosthesis through the CT three-dimensional reconstruction to measure and locate the femur marrow rod inserting points before the total knee arthroplasty. It will also help the patients to recover the force line and the function of the knee. Related Articles | Metrics

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Risk factors for nerve function damage caused by thoracolumbar and lumbar burst fractures Peng Yin-xiao, Quan Zheng-xue, Xiao Bo, Peng Lei, Zhong Wei-yang 2012, 16 (48):  9025-9029.  doi: 10.3969/j.issn.2095-4344.2012.48.018 Abstract ( 394 )   PDF (395KB) ( 590 )   Save BACKGROUND: Nowadays, there are different opinions on risk factors of nerve damage caused by thoracolumbar and lumbar burst fractures. OBJECTIVE: To analyze the relationship between the posterior ligamentous complex integrity, degrees of spinal stenosis and neural function damage after thoracolumbar and lumbar burst fractures. METHODS: A total of 156 patients with thoracolumbar and lumbar burst fractures were included in this retrospective analysis, the patients were collected from the Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University (2002-04/2011-10). The spinal canal sagittal diameter of spine CT cross-sectional was measured, the integrity of posterior ligamentous complex and neural function damage was evaluated, and the statistical analysis was performed. RESULTS AND CONCLUSION: Neural function damage was found in 94 patients. There was a significant correlation between neural function damage and degrees of spinal stenosis. At the T12 level, neural function damage showed the highest correlation with degrees of spinal stenosis (rs=0.87, P < 0.001). At the T11 level, neural function damage showed the lowest correlation with degrees of spinal stenosis (rs =0.59, P < 0.001). The posterior ligamentous complex integrity was significantly correlated with neural function damage (odd ratio=3.82, P < 0.001). The posterior ligamentous complex integrity and degrees of spinal stenosis were significantly correlated with neural function damage in patients with thoracolumbar fractures. Related Articles | Metrics

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Distortion capability of normal and degenerative nucleus pulposus cells Ren Long-tao, Wei Chen-gang, Niu Jian-peng, Lin Shu-zhong 2012, 16 (48):  9030-9033.  doi: 10.3969/j.issn.2095-4344.2012.48.019 Abstract ( 329 )   PDF (421KB) ( 496 )   Save BACKGROUND: The distortion capability of cells can reflect the changes of cell structure and function. To date, the studies on the cell mechanics of nucleus pulposus are rare. OBJECTIVE: To analyze the distortion capability of normal and degenerative nucleus pulposus in vitro. METHODS: The normal and degenerative nucleus pulposus cells were respectively obtained from discarded nucleus pulposus tissue of 3 scoliosis patients and 3 intervertebral disc hernitaion patients. Pancreatin and collagenase type Ⅱwere used to isolate the nucleus pulposus tissue and performed with primary culture. The micropipette aspiration test was used to measure the length of nucleus pulposus cells aspirated into micropipette at 4 seconds under suitable negative pressure, and the statistical analysis was performed. RESULTS AND CONCLUSION: The negative pressure of the normal and degenerative nucleus pulposus cells were (411.31±27.93) Pa and (434.24±46.26) Pa respectively, and the difference was significant (P < 0.05). Within 4 seconds, the lengths of the normal and degenerative nucleus pulposus cells aspirated into micropipette were (2.20±0.92) μm and (2.48±0.71) μm, their differences were not significant (P > 0.05). With the certain time and the same length of the normal and degenerative nucleus pulposus cells aspirated into micropipette, the degenerative nucleus pulposus cells needed greater negative pressure than normal nucleus pulposus cells. It indicates that the distortion capability of degenerative nucleus pulposus cells is worse than that of normal nucleus pulposus cells. Related Articles | Metrics

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Expression of aquaporin 1 and aquaporin 3 in degenerative lumbar intervertebral disc tissue Li Shao-bo, Zhang Yong-tao, Yang Kai-shun 2012, 16 (48):  9034-9038.  doi: 10.3969/j.issn.2095-4344.2012.48.020 Abstract ( 293 )   PDF (464KB) ( 577 )   Save BACKGROUND: Lumbar intervertebral disc degeneration can be induced by many factors, the research on changing regular of aquaporins in the lumbar intervertebral disc degeneration is rarely reported. OBJECTIVE: To compare the expression of aquaporin 1 and aquaporin 3 in normal lumbar intervertebral disc tissue and degenerative lumbar intervertebral disc tissue. METHODS: Fifteen cases of normal lumbar intervertebral disc tissue from surgical intervention for lumbar bursting fracture and 15 patients with lumbar intervertebral disc degeneration were collected from the Department of orthopedics, Affiliated Hospital of Dali University. The expressions of aquaporin 1 and aquaporin 3 were tested by hematoxylin-eosin staining and immunohistochemistry method, and the mean absorbance values of aquaporin 1 and aquaporin 3 were measured. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed the limpid structures of lumbar intervertebral disc tissue and collagen fibrins in control group, the lumbar intervertebral disc tissues were mild edema without mucoid degerenation; in the lumbar intervertebral disc degeneration group, the structure of lumbar intervertebral disc tissue was blear and mussy, hyperplastic collagen fibers, serious inflammatory edema and mucoid degerenation could be seen. Immunohistochemical staining showed mean optical density of aquaporin 1 and aquaporin 3 in lumbar intervertebral disc degeneration group was significantly lower than that in the control group (P < 0.01). The decreasing of aquaporin 1 and aquaporin 3 expression may be the reason of lumbar intervertebral disc degeneration. Related Articles | Metrics

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Distribution and co-expression of neuropeptide Y/calcitonin gene-related peptide in the lumbar intervertebral disc Wang Yong-gang, Zhou Hai-yu, Wang Shuan-ke, Wang Dong-min, Shi Pei-sheng, Wang Jing, Wang Cui-fang, Ma Jing-lin 2012, 16 (48):  9039-9043.  doi: 10.3969/j.issn.2095-4344.2012.48.021 Abstract ( 351 )   PDF (485KB) ( 813 )   Save BACKGROUND: Studies have found the co-existence of neuropeptide Y/calcitonin gene-related peptide in the sympathetic ganglia. OBJECTIVE: To study the distribution of neuropeptide Y/calcitonin gene-related peptide in the normal lumbar disc and the co-expression in herniated lumbar nucleus pulposus tissue. METHODS: Complete lumbar discs were collected from 10 cases of cadaver, and herniated lumbar nucleus pulposus tissues were collected from other 10 cases of cadaver as control. Thirty patients with the symptoms lumbar disc herniation were collected, lumbar nucleus pulposus of L4/5 and L5/S1 were removed and the nucleus pulposus tissues were obtained as control group. RESULTS AND CONCLUSION: ①Positive neuropeptide Y/calcitonin gene-related peptide immunofluorescence double staining of nerve fibers were distributed in the 1/3 outside annulus fibrosus and few in 2/3 inside annulus fibrosus and nucleus pulposus in the normal lumbar intervertebral disc tissue. ②Co-expression of nucleus pulposus and the positive rate of neuropeptide Y/calcitonin gene-related peptide immunofluorescence double staining of nerve fibers in the experimental group were higher than those in the control group (P < 0.05). This study demonstrates that neuropeptide Y/calcitonin gene-related peptide distributes on the 1/3 outside annulus fibrosus in normal lumbar intervertebral disc, but do not distribute on the 2/3 inside of annulus fibrosus and nucleus pulposus. But a large number of neuropeptide Y/calcitonin gene-related peptide co-expressed in the herniated nucleus pulposus. Related Articles | Metrics

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Expression of bone morphogenetic protein-2 and decorin at the fracture ends and the surrounding tissues of bone nonunion Han Xin-guang, Wang Dong-kui, Gao Feng, Liu Ren-hao, Bi Zheng-gang 2012, 16 (48):  9044-9049.  doi: 10.3969/j.issn.2095-4344.2012.48.022 Abstract ( 272 )   PDF (496KB) ( 538 )   Save BACKGROUND: Bone morphogenetic protein-2 and decorin have the potential to promote fracture healing, and many reports have proved that they can promote each other in promoting fracture healing. OBJECTIVE: To detect the expression of bone morphogenetic protein-2 and decorin at the fracture ends and the surrounding tissues of bone nonunion. METHODS: Eleven patients with a delayed union (eight patients) and a nonunion (fifteen patients) were included. The average duration of the delayed union or nonunion was 11 months. Sample tissues were obtained from the fracture end and its surrounding zone, including fracture ends, medullary cavity contents and the surface scar of bone. Immunohistochemical staining and real time PCR were used to detect the expression of bone morphogenetic protein-2 and decorin of these different tissues. RESULTS AND CONCLUSION: The expression of bone morphogenetic protein-2 of the surface scar tissues was higher than that of the fracture ends and medullary cavity contents, and the difference was significant (P < 0.05); the expression of decorin of the fracture ends was higher than that of the medullary cavity contents and surface scar tissues, and the difference was significant (P < 0.05). Visibly, tissues' lower capabilities of anti-fibrosis and osteogenesis of the nonunion district was related to the asynchronous highly expression of bone morphogenetic protein-2 and decorin. Therefore, the joint injection of bone morphogenetic protein, such as bone morphogenetic protein-2 and decorin into the bone nonunion district can not only promote bone induction capabilities, but also can enhance the conversion of obsolete scar, and make the treatment effect of nonunion be better. Related Articles | Metrics

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Expression of osteoprotegerin and vascular endothelial growth factor after local injection of connective tissue growth factor Ding Ming-cong, Wei Pan-deng, Lin Qing2, Du Bin, Tai Hui-ping, Chen Zhi-xin 2012, 16 (48):  9050-9053.  doi: 10.3969/j.issn.2095-4344.2012.48.023 Abstract ( 263 )   PDF (462KB) ( 474 )   Save BACKGROUND: Studies have found that connective tissue growth factor plays an important role in the cartilage development process with a strong angiogenic proliferative effect, but its influence on fracture healing is not clear. OBJECTIVE: To explore the effects of connective tissue growth factor on the expression of osteoprotegerin and vascular endothelial growth factor during fracture healing and its mechanism. METHODS: Forty Sprague Dawley rats were randomly divided into two groups. After the tibial bone fracture model was established, the rats in the experimental group were injected with 0.1 μg/kg connective tissue growth factor at the sites of the bone fracture, rats in the control group were injected with the same volume of normal saline. This was carried once every 2 days. RESULTS AND CONCLUSION: The hematoxylin-eosin staining indicated that more chondrocytes were found at early-stage of callus in experimental group. The immunohistochemistry staining showed that the expression levels of osteoprotegerin and vascular endothelial growth factor in the experimental group were higher than those in the control group at each period (P < 0.05). Compared with the control group, expression peak of both osteoprotegerin and vascular endothelial growth factor have extended in the experimental group. This effectively shortened the time interval of both expression peak. Connective tissue growth factor can improve the expression levels of osteoprotegerin and vascular endothelial growth factor in callus tissue during fracture healing, and it can also promote the fracture healing by changing the expression peak of both osteoprotegerin and vascular endothelial growth facto Related Articles | Metrics

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Research and application of finite element digital model of the knee joint Zhao Hai-bo, Yang Wei-jiang, Long Teng-he, Luo Huan-jiang, Lei Chen-gang 2012, 16 (48):  9054-9058.  doi: 10.3969/j.issn.2095-4344.2012.48.024 Abstract ( 276 )   PDF (596KB) ( 511 )   Save BACKGROUND: The biomechanical properties of the knee joint are determined by the anatomical structure and mechanical characteristics, the finite element analysis of knee biomechanics mechanism and the injury mechanism can effectively guide, prevent and treat the knee disorders. OBJECTIVE: To evaluate the research on the establishment of finite element digital model of the knee joint and its application value. METHODS: A computer-base search was performed on the VIP database and Wanfang database from January 2005 to November 2011 for the articles related to the establishment and application of knee joint model with the key words of “CT, MRI, knee joint, finite element, model establishment”. Repetitive articles or Meta-analysis were eliminated. We focused on nine articles to investigate the application of CT, MRI and finite element model in the research of the knee joint. RESULTS AND CONCLUSION: DICM images collected by CT and MRI have advantages and disadvantages in the establishment of finite element model, reasonable application of the finite element model can provide more comprehensive and reliable imaging data for the knee surgery. Clinicians can design the surgical program and simulate the surgical progress according to the model which can reduce the risk of surgery significantly and reduce the suffering of the patient. Related Articles | Metrics

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Research progress of the wear particles-induced aseptic prosthesis loosening Li Hai-ya, Zha Zhen-gang 2012, 16 (48):  9059-9063.  doi: 10.3969/j.issn.2095-4344.2012.48.025 Abstract ( 286 )   PDF (552KB) ( 654 )   Save BACKGROUND: Studies have shown that the wear particle-induced periprosthesis osteolysis is the main reason leading to aseptic loosening of prosthesis. OBJECTIVE: To review the research progress of the wear particle-induced aseptic prosthesis loosening in molecular biology. METHODS: A computer-based search was performed on the CNKI database and PubMed database from January 1991 to March 2012 for the articles related to the wear particles of prosthesis. The key words of “arthroplasty, wear particles, loosening of the prosthesis” in English and Chinese were used to search the articles in the title and the abstract. Finally, a total of 30 artilces were included to review. RESULTS AND CONCLUSION: Aseptic loosening of the prosthesis is the main reason for the failure of the surgery after artificial joint replacement, and the wear particles play an important role during the process. The synthesis on the research of cytokines and signal transduction pathways provides a theoretical basis for prevention and drug treatment of prosthesis aseptic loosening. However, prosthesis aseptic loosening can be influenced by a variety of factors, prevention should be the overall focused and comprehensive studied which can provide direction for the prevention of prosthesis loosening . Related Articles | Metrics

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Usage of statins for the prevention and treatment of aseptic loosening of artificial joint Wang Jing, Tian Jing 2012, 16 (48):  9064-9068.  doi: 10.3969/j.issn.2095-4344.2012.48.026 Abstract ( 270 )   PDF (540KB) ( 531 )   Save BACKGROUND: The most significant factor that affects the life span of joint prosthesis is the artificial joint aseptic loosening. Statins were found that it can stable artificial jointaseptic loosening. OBJECTIVE: To review from three areas, including pharmacological mechanism, clinical trials and adverse reactions, in order to provide reference for clinical practice of statins on the prevention of artificial joint aseptic loosening. METHODS: A computer-based online search of PubMed database and CNKI database between 2007 and 2011 was performed to search related articles with the key words of “statins, artificial joint, aseptic loosening, prosthesis, osteolysis” in English or Chinese. Literatures related to statins for the prevention of artificial joint aseptic loosening were selected, and for the articles in the same field, we preferred the ones published recently or in authorize journals. A total of 167 literatures were primarily selected, and 33 documents were involved for summary according to inclusion criteria. RESULTS AND CONCLUSION: Statins can promote the formation of new bone around prosthesis, enhance the three-point bending strengths and stabilize the structure of bone around the prosthesis. However, some experiments show that high doses of simvastatin might be harmful in multiple myeloma patients, as it can results a inflammation in certain concentration. As a new drug for preventing artificial jointaseptic loosening, further studies to determine the best drug threshold, administration methods and value of human bone regeneration are very important. Related Articles | Metrics

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Research and mechanism of bacterial biofilm on the surface of orthopedic implants Wang Yong-qing, Bi Hong-bin 2012, 16 (48):  9069-9073.  doi: 10.3969/j.issn.2095-4344.2012.48.027 Abstract ( 401 )   PDF (636KB) ( 548 )   Save BACKGROUND: After the formation of biofilm, drug resistance of bacteria will become strong, but surgical infection, especially the orthopedic implant infection is related to bacterial biofilm on the surface of materials. OBJECTIVE: To review the mechanism and research progress of the formation, structure, influencing factors, drug-resistant mechanisms, prevention and control measures of bacterial biofilm. METHODS: The CNKI database and PubMed database from January 1982 to September 2011 were used to search the articles on prevention treatment of bacterial biofilm and the formation of biofilms after postoperative infection of implants. A total of 34 articles were included to review. RESULTS AND CONCLUSION: The using of antibiotics can effectively remove the bacterial biofilms, and lead to the drug resistance. Changes in the microenvironment of the biofilm, good biocompatibility of implant materials selection and lower bacterial adhesion may be the future direction of anti-infective research. Related Articles | Metrics

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Transpedicular instrumentation of bone graft and vertebral pedicle screw in fractured vertebra for the treatment of thoracolumbar fractures Hu Hai-gang, Wang Qing, Tan Lun 2012, 16 (48):  9074-9078.  doi: 10.3969/j.issn.2095-4344.2012.48.028 Abstract ( 337 )   PDF (641KB) ( 661 )   Save BACKGROUND: The posterior transpedicular instrumentation of bone graft and vertebral pedicle screw in fractured vertebra has been widely used in the treatment for thoracolumbar fractures. Prior to its feasibility, effectiveness, safety and other aspects of biomechanics and clinical research, but there are still more controversial. OBJECTIVE: To summarize the effectiveness and security of thoracolumbar fractures treated with posterior transpedicular instrumentation of bone graft and vertebral pedicle screw in fractured vertebra. METHODS: VIP database and PubMed database (1989-01/2011-09) were used to search the related articles about the treatment of thoracolumbar fractures with posterior transpedicular instrumentation of bone graft and vertebral pedicle screw in fractured vertebra. The key words of “thoracolumbar fractures, injured vertebral, fixation, bone graft” in Chinese and English were put in the title and abstract to search the relate articles. Finally, a total of 33 articles were included to review. RESULTS AND CONCLUSION: The posterior transpedicular instrumentation of bone graft and vertebral pedicle screw in fractured vertebra is a more solid fixation, while helping to fracture reduction and kyphosis correction, and benifit to restore and maintain the vertebral height, reduce the correction rate of loss. However, the surgery reports at present are mainly the retrospective analysis, and there lacks the long-term follow-up, a series of forward-looking analysis and research, as well as the evidence-based medicine, and there is considerable controversy on the indications of nail set on the injured vertebral, security and technical specifications, which need further study and improvement. Related Articles | Metrics

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Traction treatment of cervical spondylosis Fan Hong-yuan, Cao Jun-yan, Xiang Kai-wei, Sun Jun, Zhao Jing 2012, 16 (48):  9079-9082.  doi: 10.3969/j.issn.2095-4344.2012.48.029 Abstract ( 270 )   PDF (626KB) ( 507 )   Save BACKGROUND: Since 1929, cervical vertebra traction, a controlled axial traction method has already been one of the acknowledged methods for the treatment of cervical spondylosis. The curative effect has been recognized by most health workers. OBJECTIVE: To summarize the investigative situation and progression about the quantitative research of cervical vertebra traction at home and abroad. METHODS: The CNKI database and PubMed database (1992-01/2010-10) were used to search the related articles about cervical spondylosis traction. The key words of “cervical spondylosis, treatment, traction” were put in the title and abstract and then some related articles were selected. For the articles in the same fields, those published recently or in the authorized journals were selected. There were 124 articles after the initial survey. According to inclusion criteria, 28 articles related to cervical spondylosis traction were selected for the review. RESULTS AND CONCLUSION: The application of cervical vertebra traction has auxiliary effects in treating cervical spondylosis. The traction time, angles and the weights have been mostly concerned according to quantitative research of cervical vertebra traction. So the cervical vertebra traction will be widely used in clinical treatments. Related Articles | Metrics

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X-ray measurement of frontal lower limb alignment Shi Ze-feng, Wu Hao 2012, 16 (48):  9083-9087.  doi: 10.3969/j.issn.2095-4344.2012.48.030 Abstract ( 529 )   PDF (597KB) ( 854 )   Save BACKGROUND: Accurate and reliable measurement of frontal lower limb alignment on X-ray film is important for diagnosis and treatment of knee disease, while it is still controversial currently. OBJECTIVE: To summarize the clinical and basic research progress related to frontal lower limb alignment measurement on X-ray film. METHODS: A computer-base search was performed by the first author on CNKI database and PubMed database for the relate articles published from January 1985 to December 2011. The Chinese key words were “full length of the lower limb, lower limb alignment, lower limb axis, knee”, and the English key words were “lower limb alignment, knee alignment, lower limb formity, full length, HKA”. Articles related to film capture, measurement technique and its reliability, anatomic landmark and influencing factors of frontal lower limb alignment measurement on X-ray film were extensively reviewed. Finally, a total of 33 articles were included to review. RESULTS AND CONCLUSION: Full length lower limb X-ray film through one exposure combined with computer assisted measurement technique is an effective method for evaluating frontal lower limb alignment. Various influencing factors, such as weight bearing or not, rotation of lower limb, knee flexion and anatomic landmark location, should be considered in measurement. Related Articles | Metrics

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Treatment of fractures around the prosthesis after total hip arthroplasty Hu Ru-yin, Tian Xiao-bin, Sun Li, Han Wei, Tian Jia-liang 2012, 16 (48):  9088-9095.  doi: 10.3969/j.issn.2095-4344.2012.48.031 Abstract ( 281 )   PDF (665KB) ( 741 )   Save BACKGROUND: Fractures around femoral prosthesis are common complications after total hip arthroplasty, and the incidence rate is increased continuously, therefore, the improvement of methods and technology for the treatment of fractures around femoral prosthesis has become a research topic. OBJECTIVE: To explore the therapeutic effect of various internal fixations for treatment of fractures around femoral prosthesis after total hip arthroplasty, and to provide a theoretical reference information for the improvement of treatment technology as well as the improvement of the quality of life in patients. METHODS: The factors and internal fixation of the fractures around prosthesis during and after total hip arthroplasty were analyzed through experimental data analysis, especially the clinical effects of shape memory alloy embracing fixcator and locking plate internal fixation for the treatment of fractures around femoral prosthesis after total hip arthroplasty; and the effects of different internal fixations for the treatment of fractures around femoral prosthesis after total hip arthroplasty were compared. RESULTS AND CONCLUSION: The age, years, type of prosthesis and the stability of the prosthesis were the risk factors of fractures around femoral prosthesis after total hip arthroplasty, such as the fracture risk of uncemented prosthesis was higher than that of the bone cement prosthesis. For the choice of internal fixation method for the treatment of fractures around prosthesis after total hip arthroplasty, shape memory alloy embracing fixcator could not damage the cortical bone around the prosthesis, and has the advantages of fixed solid, simple operation, less invasive and fewer complications, and so on, while the locking compression plate combined with steel cable internal fixation has the advantages of less trauma, little blood interference on the fracture fragments and fixed solid. Two kinds of internal fixation can obtain better clinical therapeutic effect, but the therapeutic effect of locking compression plate internal. fixation is bet ter than that of the shape memory alloy embracing fixcator internal fixation. Related Articles | Metrics

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Impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone Yin Qu-dong, Gu San-jun, Sun Zhen-zhong, Rui Yong-jun, Shou Kui-shui 2012, 16 (48):  9096-9100.  doi: 10.3969/j.issn.2095-4344.2012.48.032 Abstract ( 386 )   PDF (664KB) ( 484 )   Save BACKGROUND: Segmental defect of limb long bone is common in clinic, which has long been a problem in the field of reconstruction and repair of bone. OBJECTIVE: To introduce a new method of impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone, including its experimental research and clinical applications. METHODS: The PubMed database (http://www.ncbi.nlm.nih.gov/PubMed), CNKI database (www.cnki.net/index.htm), VIP database (http//www.cqvip.com/) between 1990 and 2011 were searched by the first author for the articles relate to impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone. The English key words were “segmental bone defect, titanium mesh or titanium cage” and the Chinese key words were “limbs or lone bone, segmental bone defect, titanium mesh or titanium cage”. The repetitive studies, non-limb long bone and Meta-analysis articles were excluded. According to the inclusion and exclusion criteria, a total of 30 literatures were included to review. RESULTS AND CONCLUSION: Impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone have achieved good results for bone formation in both large and small animal experiments, which was superior to free bone graft without titanium mesh and free large cortical bone graft. Autologous bone, allograft bone and artificial bone are feasible materials for bone graft, but autogenous cancellous bone is relatively better and bioactive titanium mesh of the autogenous cancellous bone is better than general titanium mesh. Clinically, it has achieved good therapeutic effect in all parts of long bone segmental bone defects, including long bone defect cases that more than 10 cm. The impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone is a new method, which changed the old view of more than 6 cm long bone defect is only suitable for vascularized bone graft, not suitable for non-vascularized free bone graft. It is relatively simple, safe and effective, and it is an ideal non-vascularized free bone graft for the treatment of segmental long bone defects. Related Articles | Metrics

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Application of magnetic resonance imaging in the location of the body lesions Hou Zong-lai, Qian Dao-zhi, Wen Chang-hui, Dong Guang-sen 2012, 16 (48):  9101-9108.  doi: 10.3969/j.issn.2095-4344.2012.48.033 Abstract ( 364 )   PDF (1101KB) ( 571 )   Save BACKGROUND: Medical imaging means has confined to the lesion, and could not locate the lesion intuitively for the image positioning, qualitative. A positioning equipment needs to be made in order to better help clinicians to accurately locate in the lesion. OBJECTIVE: To investigate body bone and soft tissue lesions positioning methods, analysis of the accuracy of MRI body bone and soft tissue lesions locator. METHODS: A computer online retrieval was performed to search papers regarding the application of magnetic resonance imaging in the location of the body lesions, using key words of “magnetic resonance imaging, location, diagnosis, body lesions, space-occupying lesions, locator, nervous system disease, neurosurgery” in both Chinese and English. RESULTS AND CONCLUSION: MRI scans is fixed to the suspected lesion. A good surface positioning has been done after the scan is complete, and implementation puncture, surgery, radiotherapy. The body lesions locator can quickly locate high accuracy, and avoid the important functional areas of the large blood vessels, nerves, and ligaments. Body bone and soft tissue lesions play an important role in guiding surgery or puncture treatment. MRI body bone and soft tissue lesions locator in the examination of body space-occupying lesions is characterized by accurate positioning, diagnosis and treatment of the lesion. The operation of MRI lesions locator is simple and flexible, convenient and safe to use, reasonable structure, technological innovation, which can determine the precise spatial location of the lesions, and overcome the problem of lesions difficult surgery, finding tiny lesions in a sequence. Related Articles | Metrics

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Reliability and validity evaluation and clinical application of sub-axial injury classification scoring system Geng Da-wei, Wang Li-ming, Wang Da-lin, Xu Jie, Jin Cheng-zhe, Xu Yan 2012, 16 (48):  9109-9113.  doi: 10.3969/j.issn.2095-4344.2012.48.034 Abstract ( 370 )   PDF (402KB) ( 458 )   Save BACKGROUND: Spine injury classification system has an important guiding sense to diagnosis, treatment and prognosis of sub-axial cervical spine injury, but it lacks a widely accepted classification system clinically. OBJECTIVE: To evaluate the reliability and validity of the sub-axial injury classification system and to explore its role in the clinical application. METHODS: Seventy-five patients with lower cervical spine injury were treated based on the sub-axial injury classification system. The 11 cases of less than 4 points received conservative treatment, according to fracture morphology, disco-ligamentous complex status and neurologic status, six cases of 4 points and 58 cases of more than 4 points received surgical treatment through different approach. Cronbach’s α coefficient and Kappa coefficient were used respectively to investigate internal consistency reliability and retest reliability, index of content validity was used to inspect content validity. RESULTS AND CONCLUSION: The internal consistency reliability of sub-axial injury classification system was greater than 0.8, it indicated that the system had a high reliability. The retest reliability of disco-ligamentous complex and sub-axial injury classification system was moderately credible, the retest reliability of Kappa coefficients of morphology, neurologic status and proposed management were greater than 0.6. Average value of content validity index was 0.936, which proved that all entries of sub-axial injury classification system could guide the diagnosis and treatment of lower cervical injury nicely. Seventy-five patients with lower cervical spine injury were treated by the system with low incidence of complications and there was no aggravation of neurological status, and the ASIA grade was improved. Sub-axial injury classification system has the advantages of high reliability and validity, simple use and easy master, and plays an important role in guiding the surgical decision and surgical approach. Related Articles | Metrics

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Anesthesia depth monitoring based on sample entropy of local field potentials Shi Li, Wei Guan-jun, Li Xiao-yuan, Wang Zhi-zhong, Shi Hui-ge 2012, 16 (48):  9114-9120.  doi: 10.3969/j.issn.2095-4344.2012.48.035 Abstract ( 326 )   PDF (617KB) ( 583 )   Save BACKGROUND: Currently, the anesthesia depth monitoring is mostly based on the analysis of electroencephalogram of cerebral cortex, however, the electroencephalogram of cerebral cortex cannot reflect the functional status of the subcortical organization and do not contain high frequency information, meanwhile it is susceptible to external environment interference. For these reasons, anesthesia depth monitoring based on the electroencephalogram has inherent defects in stability and accuracy. OBJECTIVE: To analyze the effect of sample entropy of the local field potentials in the anesthesia depth monitoring and to realize real-time anesthesia depth monitoring. METHODS: Firstly, rats were chosen as the model animals. The sample entropy of the local field potentials of the rat's primary visual cortex was calculated during the whole anesthesia process and the dynamic changes of the sample entropy curve were analyzed to determine the anesthesia states. Secondly, the sample entropy of the local field potentials was statistically compared with the time lengths of the rat's tail-flick latency to thermal stimulation, as well as the local field potentials median frequencies and spectral edge frequencies respectively. The correlative analysis was performed according to median frequencies and spectral edge frequencies, and then the validity of the method presented in this paper for judging the anesthesia state was verified. RESULTS AND CONCLUSION: The results showed that the sample entropy of the local field potentials rapidly, accurately and stably reflects the depth of anesthesia, and constantly monitors the depth of anesthesia. Related Articles | Metrics