The biomechanical effect of the collar of a femoral stem on total hip arthroplasty

To investigate the biomechanical effect of collars, finite element analyses are carried out through two hip joints that are implanted using collared and collarless stems, respectively, and an intact hip joint model. For the analyses, the sacrum, coxal bone, and the cancellous and cortical bones of a femur are modelled using finite elements based on X-ray computed tomographic images taken from a 27-year-old woman. From the results, it is found that a collar with perfect calcar contact prevents stem subsidence and decreases the proximal–lateral gap and the lateral stem tilting. Therefore, it can impart reasonable biomechanical stability for total hip arthroplasty. However, its low load transmission ability and increased stem tilting effect due to the imperfect contact between the collar and the calcar are found to be serious problems that need to be solved. Results of clinical follow-up are presented for supporting the computational results.     

Bone remodelling analysis of a bovine femur for a veterinary implant design

The response of bovine bone to the presence of an implant is analysed with the aim of simulating bone remodelling in a developing model of a polymeric intramedullary interlocking nail for veterinary use. A 3-D finite element model of the femur diaphysis is built based on computed tomography images and using a CAD-based modelling pipeline. The bone remodelling process after the surgery is analysed and compared with the healthy bone. The remodelling law assumes that bone adapts to the mechanical environment. For the analyses a consistent set of loads is determined for the bovine walk cycle. The remodelling results reproduce the morphologic features of bone and provide evidence of the difference on the bone behaviour when comparing metallic and polymeric nails. Our findings indicate that an intramedullary polymeric nail has the advantage over the metallic one of improving long-term bone healing and possibly avoiding the need of the implant removal.     

Serum kinetics of soluble triggering receptor expressed on myeloid cells-1 differs in relation to the type of arthroplasty

Context: Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) participates in the inflammatory process.

Purpose: To describe changes of sTREM-1 in the serum after hemiarthroplasty (HA) and total hip arthroplasty (THA).

Methods: Serial blood samples were drawn from 122 patients with hip fracture. Interleukin-6 (IL-6), sTREM-1, and C-reactive protein (CRP) were measured.

Results: IL-6 and CRP were similarly increased after both HA and THA. sTREM-1 was increased early in HA and late after THA. The only parameter that was higher among patients who developed systemic inflammatory response syndrome was IL-6.

Conclusions: Kinetics of sTREM-1 differs among patients undergoing HA of the hip and those undergoing THA.     

Cryo‐Immunoelectron Microscopy of Adherent Cells Improved by the Use of Electrospun Cell Culture Substrates

Electrospun nanofibres are an excellent cell culture substrate, enabling the fast and non‐disruptive harvest and transfer of adherent cells for microscopical and biochemical analyses. Metabolic activity and cellular structures are maintained during the only half a minute‐long harvest and transfer process. We show here that such samples can be optimally processed by means of cryofixation combined either with freeze‐substitution, sample rehydration and cryosection‐immunolabelling or with freeze‐fracture replica‐immunolabelling. Moreover, electrospun fibre substrates are equally suitable for complementary approaches, such as biochemistry, fluorescence microscopy and cytochemistry.     

应用坚固内固定技术治疗颌骨骨折的效果分析

目的：探究坚固内固定技术对颌骨骨折的治疗运用,为颌骨骨折的治疗方法选择提供理论指导。方法：选取我科自2009年4月-2012年7月收治的80例下颌骨骨折患者行手术切开复位、小型和微型钛板坚固内固定术治疗,纳入内固定组,并选取同期80例行颌间固定的颌骨骨折患者,纳入颌间固定组,对比两组患者治疗效果。结果：两组患者术后3个月张口度及张口型均得到明显改善,内固定组改善程度较颌间固定组更为显著（P〈0．05）;内固定组治疗周数、口臭及咬合错乱发生率均低于颌间固定组（P〈0．05）;内固定组疗效评价优43例,良26例,有效率86．3％,颌间固定组分别为31例和17例,有效率60．0％,内固定组治疗效果显著优于颌间固定组（P〈0．05）。结论：坚固内固定技术具有组织相容性高、口功能恢复快、不良反应发生率低等优势,是治疗颌骨骨折的安全、可靠、简便的治疗方案,能够有效保证患者的预后和生活质量,值得临床普遍应用。     

Skeletal Manifestations of Hydatid Disease in Serbia: Demographic Distribution,Site Involvement,Radiological Findings,and Complications

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9±18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn''t develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.     

Rapid Accumulation of Endogenous Tau Oligomers in a Rat Model of Traumatic Brain Injury: POSSIBLE LINK BETWEEN TRAUMATIC BRAIN INJURY AND SPORADIC TAUOPATHIES*

Traumatic brain injury (TBI) is a serious problem that affects millions of people in the United States alone. Multiple concussions or even a single moderate to severe TBI can also predispose individuals to develop a pathologically distinct form of tauopathy-related dementia at an early age. No effective treatments are currently available for TBI or TBI-related dementia; moreover, only recently has insight been gained regarding the mechanisms behind their connection. Here, we used antibodies to detect oligomeric and phosphorylated Tau proteins in a non-transgenic rodent model of parasagittal fluid percussion injury. Oligomeric and phosphorylated Tau proteins were detected 4 and 24 h and 2 weeks post-TBI in injured, but not sham control rats. These findings suggest that diagnostic tools and therapeutics that target only toxic forms of Tau may provide earlier detection and safe, more effective treatments for tauopathies associated with repetitive neurotrauma.     

Connexin-43 hemichannels contribute to the propagation of μ-calpain-mediated neuronal death in a cortical ablation injury model

We investigated the role of the astrocytic and neuronal hemichannels (HCs) in the spread of cortical neuronal death in a rat cortical injury model. Over time (by 6 h), propidium iodide (PI)-positive cells with labeling either with anti-neuron specific enolase or anti-parvalbumin (indicating GABAnergic interneurons) antibody spread in the deep cortical layers adjacent to the injury and co-localized with activated μ-calpain. Connexin (Cx)-43, glial fibrillary acidic protein (GFAP), activated μ-calpain and α-fodrin breakdown product (FBP) increased post-injury, peaking at 1 h, in the injury and adjacent areas. GFAP-Cx43-positive reactivated astrocytes exhibited similar distribution to the dead neurons. Cx43 and Cx36 primarily comprise HCs in the astrocyte and neuron, respectively. Ethidium bromide (EtBr) uptake was enhanced post-injury, and confirmed in the Cx43- and Cx36-positive cells. A Cx43-HC inhibitor Gap26 prevented the opening of the Cx43-HC and Cx36-HC, μ-calpain activation, α-fodrin proteolysis and death in the deep cortical neurons. Collectively, opening of the astrocytic Cx43-HC and neuronal Cx36-HC would induce the regional spread of cortical neuronal death through μ-calpain activation in the rat brain injury model.     

快捷小切口与常规切口人工髋关节置换治疗老年股骨颈骨折的对比观察

目的：通过观察我院老年股骨颈骨折患者临床治疗资料,对比分析采用快捷小切口与常规切口人工髋关节置换术该疾病的临床效果。方法：将我院2010年1月2013年1月期间收治的100例老年股骨颈骨折患者按照不同的切口方法随机分为A与B两组,分别进行快捷小切口与常规切口人工髋关节置换术治疗,对比分析使用两种方法下地活动用时间、术后引流量、切口长度、出血量情况以及治疗效果等。结果：两组患者经各自手术治疗后,临床症状均有改善,A组患者在下地活动用时间、术后引流量、切口长度、出血量情况等方面均优于B组,差异具有显著性（P〈0．05）,而在术后髋关节功能对比方面差异不显著。结论：采用快捷小切口人工髋关节置换手术治疗高龄股骨颈骨折患者,具有手术时间短、恢复快、创伤小、瘢痕不明显等多种优点,值得临床上推广与进一步研究。     

开放性骨折患者发生医院感染的临床特征及危险因素分析

目的:研究开放性骨折患者发生医院感染的临床特征及危险因素,为降低院内感染提供临床参考。方法:回顾性分析于2013年3月-2015年3月间院内收治的1860例开放性骨折患者临床资料,对存在院内感染患者的感染类型、病原菌类型及相关危险因素进行分析,应用SPSS19.0统计软件对数据进行研究。结果:1860例患者中共计65例出现医院感染情况,发生率为3.49%,感染类型主要为骨髓炎占35.38%,肺部感染伴血气胸占23.08%,颌面部创伤后发生颅内感染占18.46%;65株病原菌中包括38株革兰氏阴性菌,占58.46%,23株革兰氏阳性菌,占35.38%,4株真菌,占6.15%;病程、骨折部位、损伤程度及住院时间为开放性骨折医院感染的独立危险因素,差异具有统计学意义(P0.05)。结论:通过分析开放性骨折患者医院感染的临床特征及危险因素,有利于医院防治工作的开展,为医院感染防治提供理论支持,具有重要指导意义。