[Middle and long-term results of total hip arthroplasties for secondary post-traumatic arthritis and femoral head necrosis after acetabular fractures].

OBJECTIVE: To evaluate middle and long-term results of total hip arthroplasties (THA) for the treatment of secondary hip traumatic osteoarthritis and femoral head necrosis after acetabular fractures. METHODS: From January 2000 to December 2005, 33 patients with secondary hip traumatic osteoarthritis and (or) femoral head necrosis after acetabular fractures were treated with THA. There were 21 males and 12 females, ranging in age from 27 to 69 years old, with an average of 52 years old. Twenty-three patients were performed with open reduction and internal fixation: 5 patients were treated with anterior approach; 12 patients, posterior approach; 6 patients, combined approaches; other 10 patients, conservative treatment in the early stage. All THA were performed with posterior-lateral approach. Bone union was achieved in the all acetabular fractures. Removal of all implants was necessary in 5 patients, and partial removal in 3 patients. Cemented cup was implanted in 6 patients and uncommented cup in 27 patients. Intraoperative and postoperative complications were observed, and Harris hip scores before surgery and 10 years after operation were compared. The prosthetic loosening, osteolysis or revision were used to evaluate 10 years survival rate of prosthesis. RESULTS: All the patients were followed up,and the duration ranged from 10 to 15 years, with a mean of 12 years. One patient died at the 10th year after operation. The Harris score at the 10th year was higher than the preoperative one. One and two patients were performed with revision total hip arthroplasty caused by aseptic loosening alone and aseptic loosening combined with osteolysis respectively. Osteolysis occurred in 1 patient; deep venous thrombosis in 4 patients; dislocation of prosthesis in 2 patients. One patient had infection of incision and one patient had infection around the prosthesis. Ten years survival rate of implant was 84.8% (28/133). CONCLUSION: THA is an effective method to treat secondary hip traumatic osteoarthritis and (or) femoral head necrosis after acetabular fractures in improving hip joint functions with high implant survival rate and good middle and long-term results.

Rhynchophylline Protects Against the Amyloid ß-Induced Increase of Spontaneous Discharges in the Hippocampal CA1 Region of Rats.

Accumulated soluble amyloid ß (Aß)-induced aberrant neuronal network activity has been recognized as a key causative factor leading to cognitive deficits which are the most outstanding characteristic of Alzheimer's disease (AD). As an important structure associated with learning and memory, the hippocampus is one of the brain regions that are impaired very early in AD, and the hippocampal CA1 region is selectively vulnerable to soluble Aß oligomers. Our recent study showed that soluble Aß1-42 oligomers induced hyperactivity and perturbed the firing patterns in hippocampal neurons. Rhynchophylline (RIN) is an important active tetracyclic oxindole alkaloid isolated from Uncaria rhynchophylla which is a traditional Chinese medicine and often used to treat central nervous system illnesses such as hypertension, convulsions, tremor, stroke etc. Previous evidence showed that RIN possessed neuroprotective effects of improving the cognitive function of mice with Alzheimer-like symptoms. In the present study, we aimed to investigate the protective effect of RIN against soluble Aß1-42 oligomers-induced hippocampal hyperactivity. The results showed that (1) the mean frequency of spontaneous discharge was increased by the local application of 3 µM soluble Aß1-42 oligomers; (2) 30 µM RIN did not exert any obvious effects on basal physiological discharges; and (3) treatment with RIN effectively inhibited the soluble Aß1-42 oligomers-induced enhancement of spontaneous discharge, in a concentration-dependent manner with an IC50 = 9.0 µM. These in vivo electrophysiological results indicate that RIN can remold the spontaneous discharges disturbed by Aß and counteract the deleterious effect of Aß1-42 on neural circuit. The experimental findings provide further evidence to affirm the potential of RIN as a worthy candidate for further development into a therapeutic agent for AD.