Effect of remnant cholesterol levels on carotid intima thickness in patients with type 2 diabetes mellitus evaluated by ultra-high frequency ultrasound / 中华超声影像学杂志

Objective:To discuss the effect of remnant cholesterol (RC) levels on carotid intima thickness (CIT) in patients with type 2 diabetes mellitus (T2DM) by ultra-high frequency ultrasound.Methods:A total of 60 patients with T2DM who received treatment in Henan Provincial People′s Hospital from May 2021 to July 2022 were prospectively recruited, and they were divided into a higher RC group (31 cases) and a lower RC group (29 cases) according to the RC levels. Thirty-one age, sex and body mass index(BMI)-matched healthy volunteers were selected as control group. Carotid CIT, carotid media thickness(CMT) and intima-media thickness(CIMT) were measured by 24 MHz ultra-high frequency ultrasound probe. The difference of general clinical data, laboratory indicators and CIMT, CIT, CMT among the three groups were compared, and the influencing factors of CIT in T2DM patients were explored by multivariate regression analysis.Results:①There were no statistical significances in gender, age, BMI, high-density lipoprotein cholesterol (HDL-C) and CMT among the three groups (all P>0.05). There were no statistical significances in duration of diabetes, fasting blood-glucose and glycated haemoglobin between the two subgroups of T2DM (all P>0.05). ②Compared with the control group, CIMT and CIT were thicker in the T2DM group (both P<0.05). ③CIT was thicker in the higher RC group than in the lower RC group ( P<0.05), while the difference of CIMT was not statistically significant the two groups ( P>0.05). ④Multivariate regression analysis showed that RC was the influence factor of CIT in patients with T2DM(β=0.610, P=0.005). Conclusions:CIT is significantly thicker in T2DM patients with higher RC than in those with lower RC, and RC is the influence factor of CIT, which suggests that more attention should be paid to the detection of RC in T2DM patients.

WANG Xinlu's Experience in Treating Metabolic Syndrome based on “Blood Turbidity” / 中医杂志

This paper summarized professor WANG Xinlu's experience in treating metabolic syndrome （MS） based on the “blood turbidity” theory. It is believed that blood turbidity is the key pathological factor for the onset of MS. Blood turbidity accumulates internally， and the zang-fu （脏腑） organs become useless， leading to MS. With long-term blood turbidity， phlegm and stasis are cemented， and the condition is worsened， having changed syndromesfrequently. In clinical practice， the basic treatment method is to clear and dissolve blood turbidity， taking self-prepared Modified Huazhuo Xingxue Decoction （加味化浊行血汤） as the basic formula， and flexibly modifying it according to different stages and manifestations of the disease. Simultaneously， supplementary modern medicines are used to treat abnormal indicators of western medicine.

Anatomic distribution and clinical target volume margin of para-aortic lymph node metastasis in cervical cancer / 中华放射肿瘤学杂志

Objective:To determine the regional boundary of para-aortic lymph node (PAN) metastasis in cervical cancer, and to explore the clinical target volume (CTV) margin.Methods:Eight-six patients with cervical cancer metastasis to PAN below and above left renal vein (LRV) were retrospectively included in this study. The anatomical relationship of the metastatic PANs and surrounding structures were analyzed according tocontrast-enhanced computed tomography (CT) and three dimensional reconstruction images.Results:Eight-six patients had metastatic PANs belowLRV: metastatic nodes were located onthe medial side of ovarian vessels and ureters, behind the renal veins, duodenum, mesenteric vessels, in front of the anterior border of lumbar vertebra and psoas. The inferior mesenteric vein was close to the left anterior side of PANs. Where the duodenum appeared, no node was presenton the anterolateral side of the inferior vena cava (IVC).Above the LRV, 27 patients had retrocrural node involvement along the azygos and hemiazgos vein, and 25/27 cases were located below the junction level of cardia and oesophagus, and 5/27 patients had metastatic lymph nodes between IVC and the right crura of diaphragm, all below the level of coeliac trunk artery.Conclusions:CTV margin delineation of PAN below and above LRV is recommended:superiorly, the junction level of cardia and oesophagus; laterally, crura and the medial side of ovarian vessels and ureters and inferior mesenteric vein; anteriorly, the posterior side of the coeliac trunk artery and renal veins and duodenum, mesenteric vessels; posteriorly, the anterior border of lumbar vertebra and psoas.

Prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing / 中华内科杂志

Objective:To investigate the prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing.Methods:Subjects of the study were those who underwent physical examination in the physical examination center of Nanjing Drum Tower Hospital from 2009 to 2016. The prevalence and risk factors of pre-hypertension and hypertension in young (aged 18-44 years old) and middle-aged people (aged 45-59 years old) were analyzed.Results:A total of 142 857 participants aged 18-59 years old were analyzed. Among them, 64 220 cases in the pre-hypertension group and 13 912 cases in the hypertension group. The prevalence of hypertension was 9.74% (12.51% in males and 5.82% in females). The prevalence of pre-hypertension was 44.95% (53.31% in males and 33.15% in females). In the middle-aged group, the prevalence of pre-hypertension and hypertension were 51.68% and 15.13%, respectively, which was higher than that in the young group (37.95% and 4.13%, respectively). The prevalence of pre-hypertension and hypertension in 2013-2016 was 45.37% and 10.65%, respectively, which was higher than that in 2009-2012(44.52% and 8.78%). In addition, the prevalence of abnormal blood glucose metabolism, abnormal blood lipid metabolism and abnormal glucose and lipid metabolism in the pre-hypertension group was higher than that in the normal blood pressure group, but lower than that in the hypertension group ( P<0.001). A logistic regression analysis indicated that age, overweight or obesity, hyperglycemia, hypertriglyceridemia and hypercholesterolemia were risk factors of pre-hypertension in male. Age, overweight or obesity, hyperglycemia, hypertriglyceridemia, hypercholesterolemia and hyper-low density cholesterolemia were associated with hypertension in male and with pre-hypertension and hypertension in female. Conclusions:Middle age, overweight/obesity, elevated fasting plasma glucose, elevated triglyceride and elevated total cholesterol were risk factors of pre-hypertension and hypertension in both men and women. Intervention on the related risk factors should be conducted as early as possible.

Advances in magnetic resonance imaging guided radiation therapy / 生物医学工程学杂志

Image-guided radiation therapy using magnetic resonance imaging (MRI) is a new technology that has been widely studied and developed in recent years. The technology combines the advantages of MRI imaging, and can offer online real-time tracking of tumor and adjacent organs at risk, as well as real-time optimization of radiotherapy plan. In order to provide a comprehensive understanding of this technology, and to grasp the international development and trends in this field, this paper reviews and summarizes related researches, so as to make the researchers and clinical personnel in this field to understand recent status of this technology, and carry out corresponding researches. This paper summarizes the advantages of MRI and the research progress of MRI linear accelerator (MR-Linac), online guidance, adaptive optimization, and dosimetry-related research. Possible development direction of these technologies in the future is also discussed. It is expected that this review can provide a certain reference value for clinician and related researchers to understand the research progress in the field.

Ultrasound evaluation of the carotid artery elasticity in the first-degree relatives of patients with type 2 diabetes mellitus by RF-data based quantitative analysis on vessel stiffness / 中华超声影像学杂志

Objective:To evaluate the carotid artery elasticity in the first-degree relatives of patients with type 2 diabetes mellitus.Methods:Ninety first-degree relatives of patients with type 2 diabetes who received treatment in the Department of Endocrinology of Henan Provincial People′s Hospital from October 2020 to June 2021 were randomly selected and designated as having a positive family history. Depending on the parental history of diabetes they were divided into three groups: 31 cases of family history positive in father (F), 31 cases of family history positive in mother (M) and 28 cases of family history positive in both father and mother (B). Thirty cases with matched age, height and weight without any history of diabetes, hypertension, hyperlipidemia and coronary atherosclerotic heart disease in their parents designated as control group were taken for comparison. Real-time intima-media thickness (RIMT) and R-VQS were employed to evaluate common carotid intima-media thickness (IMT), distance (Dist), diameter (Diam), hardness coefficient (HC) and pulse wave velocity (PWV). The differences among the groups were compared.Results:①There was no statistical significance in Diam among the four groups ( P>0.05). ②Compared with the control group, the IMT, PWV and HC in subjects with positive family history were increased, while Dist was decreased ( P<0.05). ③Paired comparison of the subjects with positive family history: the IMT, PWV and HC in B group were higher than in F and M group, and Dist was lower than in F and M group ( P<0.05). The PWV and HC in M group were higher than in F group, and Dist was lower than in F group ( P<0.05). There was no statistical significance in IMT between the F and M groups ( P>0.05). Conclusions:Carotid artery stiffness in the cases with positive family history is significantly higher than the control group. The decrease of carotid elasticity in B group is the most serious, M group takes the second place, while the F group is the least.

Advances in chronic obstructive pulmonary disease-obstructive sleep apnea syndrome / 中国医师杂志

Both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA) are common respiratory diseases. Both can exist at the same time, which is referred to as the " overlap syndrome (OS)". Epidemiological studies showed poorer outcomes with increased comorbidities and mortality, which indicated complicated interactions between COPD and OSA. Even though the underlying mechanisms of overlap syndrome have not yet well understood, the airway and systemic inflammation as well as oxidative stress induced by hypoxia played an essential role in the disease interactions and pathogeneses of comorbidities, mainly cardiovascular diseases. One other question is that how to treat the overlap syndrome. This paper summarizes the current research progress of the overlapping interaction and treatment.

Advances in chronic obstructive pulmonary disease-obstructive sleep apnea syndrome / 中国医师杂志

Both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA) are common respiratory diseases.Both can exist at the same time,which is referred to as the " overlap syndrome (OS)".Epidemiological studies showed poorer outcomes with increased comorbidities and mortality,which indicated complicated interactions between COPD and OSA.Even though the underlying mechanisms of overlap syndrome have not yet well understood,the airway and systemic inflammation as well as oxidative stress induced by hypoxia played an essential role in the disease interactions and pathogeneses of comorbidities,mainly cardiovascular diseases.One other question is that how to treat the overlap syndrome.This paper summarizes the current research progress of the overlapping interaction and treatment.

Expression and characterization of a keratinase encoding gene gm2886 in Streptomyces pactum ACT12 strain / 生物工程学报

By bioinformatics analysis, a putative keratinase gene gm2886 (Accession number: KY368946) was discovered in the genome of a feather-degrading strain, Streptomyces albidoflavus Fea-10. gm2886 was ligated into integrative Escherichia coli-Streptomyces shuttle vector pSET152 under the promoter PermE and added with C-terminal His-tag. The expression vector was transformed into Streptomyces pactum ACT12 by conjugal transfer and the recombinant protein GM2886-His6 was detected in fermentation broth. GM2886-His6 was purified and characterized. Its size was nearly 36 kDa. GM2886-His6 showed proteolytic activity towards a variety of substrates and could even degrade insoluble substrates, such as azure keratin and chicken feathers. The optimal pH and temperature of GM2886-His6 for proteolysis of casein was pH 10.0 and 50 ℃, respectively. The enzyme activity was inhibited by PMSF, but not EDTA, indicating that GM2886-His6 was a serine proteinase. Our results laid the foundation for the research of the molecular biological mechanism on feather-degrading and for the further utilization of Fea-10.

Expression of tyrosine and threonine protein kinase in carcinogenic process of colorectal cancer and its relationship with prognosis / 中华肿瘤杂志

Objective@#To investigate the expression of TTK (tyrosine and threonine protein kinase) in the process of colorectal cancer (CRC) development and its relationship to prognosis in CRC patients.@*Methods@#Colitis-associated colon cancer model was induced by azoxymethane (AOM) and dextran sulfate sodium (DSS) in C57BL/6 mice. Mice at four different stages of colon cancer development were obtained, named AD1 (inflammation of the recovery), AD2 (mild dysplasia), AD3 (adenoma) and AD4 (adenocarcinoma), as well as negative control (no treatment). The expression of TTK was measured by real time fluorescent quantitative PCR (qPCR) and immunohistochemical staining in mouse colon tissues and 24 pairs of CRC specimens. The relationship between TTK and prognosis was analyzed in a set of CRC genome-wide gene expression microarray data that was obtained from Gene Expression Omnibus (GEO) of National Center for Biotechnology Information (NCBI).@*Results@#The genome-wide microarray data from mouse AOM-DSS model indicated that the expression of TTK mRNA was gradually elevated during the development of colon cancer. The subsequent qPCR results showed that TTK mRNA levels in negative control, AD1, AD2, AD3 and AD4 groups were 1.05±0.42, 1.10±0.03, 1.38±0.15, 1.33±0.17 and 2.12±0.22, respectively. And TTK expression in AD2, AD3 and AD4 groups were significantly higher than that in negative control (P<0.05). The protein expression of TTK showed by immunohistochemical staining had similar tendency as the results of TTK mRNA. Besides that, the TTK mRNA levels in tumor tissues (0.71±0.10) from 24 CRC patients were significantly higher than those in paired adjacent normal tissues (0.18±0.04; P<0.001). The positive expression rate of TTK protein in 5 pairs of CRC clinical samples was 80.0%, and it was significantly higher than that in adjacent normal tissues (30.8%, P=0.014). Furthermore, according to a public transcriptomic data (GSE17536), the high levels of TTK were associated with poor prognosis in CRC patients.@*Conclusions@#Elevated expression of TTK is related to colonic carcinogenesis in both of mouse model and human CRC samples. TTK is a poor prognostic factor in CRC.

Effects of extracorporeal cardiac shock wave therapy on endothelial progenitor cells, vascular endothelial growth factor, and Interleukin-8 in patients with coronary heart disease / 医学研究生学报

Objective The extracorporeal cardiac shock wave therapy ( CSWT ) can promote angiogenesis in ischemic myo-cardium and improve myocardial perfusion , but its mechanisms remain to be clarified .This study aimed to explore the effects of CSWT on the endothelial progenitor cells (EPCs), vascular endothe-lial growth factor ( VEGF) and Interleukin-8 ( IL-8) as well as its re-lieving effect on angina pectoris in patients with coronary heart dis-ease. Methods After Dobutamine stress echocardiography ( DSE) and 99 mTc-MIBI myocardial perfusion imaging (MPI) at rest and un-der stress, 25 patients with coronary heart disease underwent 9 three-month cycles of CSWT .Before and after the treatment , we obtained the results of 6-min walk test, NYHA cardiac function grades , CCS angina pectoris classes, Seattle Angina Questionnaire (SAQ) scores, doses of nitroglycerin administered , left ventricular diastolic di-ameter ( LVDD) , and left ventricular ejection fraction ( LVEF) .We evaluated myocardial perfusion and myocardial contractile function using MPI and the peak systolic strain rate (PSSR) at rest and under stress, respectively. Results After CSWT, the numbers of EPCs and EPC-CFUs cultured in vitro were significantly increased as compared with the baseline (34.52±6.58 vs 19.56±4.28, P0.05).The PSSR showed no significant changes at rest (1.21±0.62 vs 1.04±0.43, P>0.05) but remark-ably increased under stress after CSWT (2.02±1.00 vs 1.35±0.66, P<0.01). Conclusion CSWT can up-regulate the expressions of VEGF and IL-8 and improve the function of EPCs in the peripheral blood , and thus plays an important role in relieving the symptoms of angina pectoris , promoting cardiac function and enhancing exercise tolerance in patients with coronary heart disease .

Preparation and characterization of polyhydroxyalkanoate bioplastics with antibacterial activity / 生物工程学报

Polyhydroxyalkanoates (PHAs), as a novel class of biopolymer, are attracting more attention due to their diverse material properties and environment-independent biodegradability. Here we report the preparation of PHA exhibiting efficient antibacterial activity by embedding Nisin, a food additive generally recognized as safe, into poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx), a type of PHA with high biocompatibility. We first prepared Nisin-containing PHBHHx films using solvent casting method. Confocal laser scanning microscopy analysis showed that a well-mixed integrated structure of the films with an even distribution of the Nisin particles in the PHBHHx matrices. Then the antimicrobial activity of PHBHHx/Nisin films against Micrococcus luteus was quantified on agar plate by measuring the size of inhibition zone. Cultivation in liquid media further confirmed the releasing of Nisin from the films and the long-time antibacterial activity. Results showed that the threshold of Nisin concentration for long-time and effective inhibition against bacteria growth is 25 μg/g. These results altogether establish a technological foundation for the application of PHA in biomedicine and food industry.

Expression of miR-181b in Colitis-associated Colon Carcinogenesis / 胃肠病学

Background:miR-181b is related to the progression of many tumors,however,its expression in colitis-associated colon cancer is not clear. Aims:To investigate miR-181b expression and its potential target genes in the process of colitis-associated colon carcinogenesis. Methods: Colitis-associated colon cancer model was established by combined administration of azoxymethane(AOM)and dextran sulfate sodium(DSS)in mice. The expression of miR-181b in colon tissue at different time points was measured by real time fluorescent quantitative PCR(qPCR). Target genes of miR-181b were screened preliminarily by genome microarray combined with miRNA target gene prediction softwares TargetScan, PicTar and miRDB. Expressions of target genes in colitis-associated colon cancer mice were detected by qPCR. Results:The expression of miR-181b was gradually elevated during the development of colitis-associated colon cancer. However, AOM or DSS alone did not change expression of miR-181b. Genome microarray combined with miRNA target gene prediction softwares showed that Ipmk,E2f5,Klf6,Prkcd,Bai3,Hic2 might be the target genes of miR-181b. qPCR showed that expressions of Ipmk,Prkcd,Bai3,Hic2 were significantly decreased in colitis-associated colon cancer than in control group. Conclusions:Expression of miR-181b in colon is upregulated with the development of colitis-associated colon cancer,but is irrelevant with simple chronic inflammation.

Effect of Extracorporeal Shock Wave on Proliferation, Cell Cycle and Intercellular Adhesion Molecule-1 Expression in Human Umbilical Vein Endothelial Cells / 中国循环杂志

Objective: To observe the effect of extracorporeal shock wave therapy (ESWT) on proliferation, cell cycle and intercellular adhesion molecule-1 (ICAM-1) expression in human umbilical vein endothelial cells (HUVECs). Methods: HUVECs were culturedin vitro at the concentration of (1×105/ml) and the cells were divided into 2 sets of groups:CSWT group, the cells were treated by different energy of (0.03, 0.09, 0.18, 0.24) mJ/mm2 respectively and corresponding Control group, in which the cells had no CSWT. HUVEC proliferation was detected by CCK colorimetric method, cell cycle was measured by lfow cytometry, mRNA and protein expressions of ICAM-1 were examined by RT-PCR and Western blot analysis respectively. Results: Compared with Control group, (0.09 mJ/mm2) CSWT group had promoted HUVECs proliferation,P0.05; (0.09 mJ/mm2) CSWT group showed decreased proportion of G0/G1 stage and increased S and G2/M stages, allP0.05. Compared with Control group, (0.09 mJ/mm2 ) and (0.03mJ/mm2) CSWT groups showed increased mRNA expression of ICAM-1 (9.27±0.95) vs (1.02±0.27),P<0.001 and (7.08±0.60) vs (1.02±0.27),P<0.01; (0.09 mJ /mm2) CSWT group had elevated protein expression of ICAM-1,P<0.05. Conclusion: ESWT especially at (0.09 mJ/mm2) may accelerate cell cycle transition from G0/G1 stage to S and G2/M stages, promote HUVECs proliferation and increase ICAM-1 expression which may play important roles in ESWT facilitated angiogenesis in vitro.

Extracorporeal shock wave and myocardial angiogenesis：effects on endogenous stem cells, cytokines and local microenvironment / 中国组织工程研究

BACKGROUND:Studies have shown that extracorporeal shock wave therapy is an effective, safe, and non-invasive treatment for ischemic heart disease, which can improve angiogenesis in the ischemic myocardium. OBJECTIVE:To summarize the research advances in promotion of angiogenesis for ischemic myocardium by extracorporeal shock wave therapy. METHODS:A computer-based online search of PubMed database and CNKI database was performed for relevant articles published between 1998 and 2014 with key words of “shock wave, ischemic heart disease, angiogenesis, cytokine, stem cel” in English and Chinese, respectively. Articles related to the promotion of angiogenesis for ischemic cardiovascular disease by extracorporeal shock wave were selected. Repetitive articles were excluded. According to inclusion criteria, 51 literatures were selected in result analysis. RESULTS AND CONCLUSION: Extracorporeal shock wave therapy can improve angiogenesis in the ischemic myocardium by mobilizing proliferation and differentiation of stem cels into vascular endothelial cels, and by enhancing the expression of growth factors such as vascular endothelial growth factor and basic fibroblast growth factor. Moreover, the extracorporeal shock wave therapy can create a local favorable microenvironment for angiogenesis by inhibiting inflammation, oxidative stress and apoptosis and by regulating components of the extracelular matrix. Extracorporeal shock wave therapy plays an important role in the angiogenesis of ischemic myocardium and displays a good clinical prospect in the treatment of ischemic heart disease. However, the specific mechanism requires further studies.

Effects of low-energy extracorporeal shock wave on human umbilical vein endothelial cells, vascular endo-thelial growth factor and interleukin-8 expression / 医学研究生学报

Objective Extracorporeal shock wave therapy ( ESWT ) can promote angiogenesis and collateral circulation es-tablishment by introducing shock waves to ischemia myocardium , however , the specific mechanisms remain unclearly .The study aimed to explore the effects of 0.09mJ/mm2 shock wave treatment on human umbilical vein endothelial cell (HUVEC) proliferation, vascular endothelial growth factor (VEGF) and Interleukin-8 (IL-8) expressions. Methods There were an experimental group and a control group in the experiment .The tubes of the experiment group were set in shock wave devices without the treatment of shock waves .As for the experiment group, 0, 0.03, 0.09, 0.18, 0.24 mJ/mm2 shock waves were introduced , followed by the addition of CCK8 solution and the measurement of A value at the wavelength of 450nm by microplate reader .The HUVEC cell lines were performed 0.09 mJ/mm2 ultrasonic shock energy , CCK8 colorimetric method were utilized to detect the HUVEC proliferation , real time PCR and flow cytometry were applied to detect the expressions of VEGF and IL-8 mRNA respectively . Results ① CCK8 colorimetric method revealed that 0.09 mJ/mm2 shock energy markedly promoted the HU-VEC proliferation compared with the control group , with A450 value comparison (0.70 ±0.04 vs 0.54 ±0.09, P0.05 ).②RT-PCR showed that the 0.09 mJ/mm2 energy significantly enhanced the expressions of VEGF and IL-8 mRNA compared with the control group (7.93 ±0.90 vs 1.07 ±0.40, 7.34 ±1.67 vs 1.00 ±0.09, P<0.001).③Flow Cytometry showed that the expressions of VEGF and IL-8 mRNA significantly increased after 0.09 mJ/mm2 ESWT compared with the control group (39.89 ±4.79 vs 20.98 ±3.30, 31.33 ± 5.61 vs 22.60 ±3.76, P<0.05). Conclusion Low-energy ESWs can surely promote HUVEC proliferation and increase the expres-sions of VEGF and IL-8, and the up-regulation of VEGF and IL-8 may play an important role in the promotion of angiogenesis by ESWT .

Clinical factors for operative effects in acetabular fracture: A Logistic regression analysis / 中国医师杂志

Objective The aim of this study was to evaluate the clinical factors contributing to the operative effects in patients with acetabular fracture.Methods A total of 129 cases of patients with acetabular fracture were retrospectively analyzed from Jun 2006 to Jan 2011 in The Second Hospital of Shaoxing.Of the 129 acetabular fracture patients,96 cases were in the superior group and 33 patients in the inferior group according to Merled'Aubigne-Postel methods.The potential clinical factors related to the operative effects in acetabular fracture patients were evaluated by the method of logistic regression analysis.Results The superior rate was 74％ in this study.Single factor analysis demonstrated that the diaplastic quality(x2=21.53,P ＜0.01),the femoral cartilage defect(x2 =17.50,P ＜0.01),the inra-aticular free bone(x2=12.18,P =0.0005),the type of fracture (x2 =7.24,P =0.0071) and the timing of operation (x2 =4.36,P =0.037) were correlated with operative effects in acetabular fracture patients.The binary logistic regression analysis indicated that non-anatomic diaplastic (OR =4.17,P =0.01)and the femoral cartilage defect(OR =3.11,P =0.03) were independent risk factors for operative effects in patients with acetabular fracture.Conclusions The prognosis of patients with acetabular fracture,which was complex,was affected by multiple factors.And introperatively,the anatomic reestablishment should be performed in order not to affect the post operative hip function.