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BACKGROUND: Gouty tophi are a chronic granulomatous caused by a deposition of monosodium urate crystal deposition in the body. Once broken, it may easily induce severe infection. Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting, and no such serious complications have been reported in literature. CASE SUMMARY: This is a 52-year-old Chinese male patient with a 20-year history of gouty arthritis. At admission, the gout stone in the patient's right ankle was broken and it secreted a white mucoid substance. During the course of treatment, the patient suffered from systemic inflammatory response syndrome multiple times. His condition gradually deteriorated, further complicated by hemophagocytic syndrome. After thorough removal of gout lesions and active anti-infection treatment and control of blood uric acid level, combined with multidisciplinary cooperation, the patient was finally cured. CONCLUSION: Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting. Timely and accurate diagnosis is very important to save patients' lives.

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A field litterbag experiment was conducted to investigate dynamics of total phenols and condensed tannin in the mixed leaf litter of Pinus massoniana (P) with other three broad-leaved species, i.e., Sassafras trumu (S), Cinnamomum camphora (C), Toona sinensis (T) during decomposition in low hilly lands, Sichuan Province, China. The mass ratio of P. massoniana : S. trumu (PS) was 6:4, 7:3, 8:2, P. massoniana : C. camphora (PC) was 6:4, 7:3, 8:2 and P. massoniana : T. sinensis (PT) was 6:4, 7:3, 8:2, respectively. The results showed that the degradation rate of condensed tannin in pure P. massoniana litter was 84.4%, being significantly lower than that in the mixed litters after 180 d. The degradation rate of condensed tannin and total phenols were the highest in PC 6:4, with 90.3% and 68.6%, respectively. The mixed litters promoted the decomposition of condensed tannin and total phenols in the P. massoniana litter. With decomposition time, the degradation rate of condensed tannin in mixed litters between P. massoniana and broad-leaved species initial increased, and then remained stable. The degradation rate of total phenols in pure P. massoniana litter, PT 7:3 and all the PC treatments increased significantly and then decreased during the 90 d decomposition. The degradation rate of total phenols in all the PS, PT 6:4 and 8:2 treatments increased with the decomposition time. The dynamics of total phenols and condensed tannin were closely related to litter quality, and the enzyme activities of polyphenol oxidase, peroxidase and leucine aminopeptidase.

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PURPOSE: To investigate the potential correlation between two different types of hip fractures and serum calcium levels. METHODS: We consecutively studied 101 cases of femoral neck fracture and 95 cases of femoral inter- trochanteric fracture between January 2011 and December 2013. Fasting blood samples were taken and serum calcium measurements were performed respectively in three periods: the time of admission, postoperation, and discharge. Creatinine, alkaline phosphatase and albumin were also analyzed. RESULTS: Considering the levels of serum calcium between two groups at the time of admission, post- operation and discharge, there was significant difference at admission and discharge (p <0.05), while there was no significant difference at the time of postoperation (p > 0.05). The magnitude of serum calcium fluctuation was larger in femoral neck group than femoral intertrochanteric group. Concerning alkaline phosphatase and albumin levels at admission, there was no significant difference between two groups (p > 0.05). CONCLUSION: The capability of reservation and restoration of serum calcium in patients with femoral neck fracture is better than that in patients with femoral intertrochanteric fracture. A low serum calcium level may be susceptible to femoral intertrochanteric fracture.

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Myositis ossificans circumscripta (MOC) is a kind of self-localized, benign and tumor-like lesions often seen in adults, with approximately 75% of cases caused by trauma. We reported a case of non-traumatic MOC occurred at the elbow joint in a 9-year old child and it has been excised by surgery. After 18 months follow-up, a favorable outcome has been achieved with the Broberg-Morrey score of 100. We suggest that surgical resection should be done as soon as the diagnosis is confirmed.

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According to Wolff׳s law, the structure and function of bone are interdependent. The disruption of trabeculae in the necrotic femoral head destroys the biomechanical transfer path, increasing the risk of a collapse in the cortical bone. Hence, biomaterials are needed to promote osteogenesis to aid in the reconstruction of a similar biomechanical transfer path that can provide structural and biomechanical support to prevent and delay bone deterioration. Fibular allograft combined with impaction bone grafting (FAIBG) is a hip preservation method that provides both biological repair materials and biomechanical support. This method has been used successfully in the clinical setting, but it still lacks biomechanical insight. In this paper, we aim to provide a biomechanical basis for treatment using FAIBG, we used subject-specific finite element (FE) methods to analyse the biomechanical transfer characteristics of hip models: physiological, pathological and postoperative. The physiological model provided insight into the biomechanical transfer characteristics of the proximal femur. The pathological model showed an abnormal stress distribution that destroyed stress transfer capability. The postoperative model showed that FAIBG can reconstruct the biomechanical transfer path of the femoral head and reduce the risk of a collapse in the cortical bone. In conclusion, FAIBG seems to treat necrosis of the femoral head.

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