Experimental study on skin irritation and anaphylaxis of liquid bandage / 医疗卫生装备

Objective To observe the skin irritation and anaphylaxis of the liquid bandage to facilitate its safety evaluation. Methods In case of skin irritation test,some New Zealand rabbits were divided into an unaffected skin group and an affected skin group, and had their skin observed for erythema, edema and etc after undergoing 1-d and 7-d administration respectively;in case of anaphylaxis,the guinea pigs went through drug sensitization respectively at the 1st,7th and 14th days and experienced re-sensitization 14 days after,and the symptoms of anaphylaxis were observed such as erythema and edema. Results The liquid bandage had no irritation to the unaffected and affected skin of New Zealand rabbit by single or multiple administration with the irritation mean value being lower than 0.5.There were no anaphylaxis symptoms such as erthema and edema found in the guinea pig by the liquid bandage.Conclusion The liquid bandage proves its skin safety by non-irritation to the unaffected and affected skin of New Zealand rabbit and non-anaphylaxis to the guinea pig.

Treatment of clavicular fractures using intramedullary nailing or K-wire versus plating fixation: a meta-analysis / 中国骨伤

<p><b>OBJECTIVE</b>TFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.</p><p><b>METHODS</b>Pubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.</p><p><b>RESULTS</b>Nine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.</p><p><b>CONCLUSION</b>The current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.</p>

Progress on treatment and research of quadrilateral plate fractures of acetabular / 中国骨伤

Acetabular is an important human joint for weight bearing. Quadrilateral plate is a crucial structure of medial acetabulum with special morphology and important function. Quadrilateral plate fractures are common fracture in acetabulum. Quadrilateral plate fracture is hard to expose and reduction because it is in the medial of acetabulum. At the same time,the bone in the quadrilateral plate is not easy to fixed for thinning bones and adjacent to the articular cavity. The operator should know well about the anatomy and choose the suitable internal fixation. After quadrilateral plate fractures, the femur head maybe displace medially even break into pelvis. That make reduction and treatment always be a challenge. With different kinds of fractures,the efficacy of treatment is not the same. This paper intend to review the relation of anatomic features,approaches, internal fixations, key point of treatment and efficacy.

Computer-aided design and custom-made guide in corrective osteotomy for complex femoral deformity / 华中科技大学学报（医学）（英德文版）

Preoperative planning of corrective osteotomy with traditional radiography has limitations in regards to determining the ideal osteotomy location and orientation in three-dimensional femoral deformities. Though a successful operation can be planned preoperatively, intraoperative contingencies might adhere to the procedural plan in the performance of operation. To efficiently perform a planned procedure, proposed is a design to implement three-dimensional reconstruction photography, based on computer-tomography (CT) scan. A custom-made guide was designed to navigate the osteotomy as planned, and additionally, a personalized intramedullary nail was used for fixation after osteotomy. Three-dimensional (3D) photography of deformed femur was established based on the CT dataset and transferred into 3D photography processing software for further planning. Osteotomy planes were designed and adjusted at deformity sites to correct the 3D deformities. The methodology of a custom-made osteotomy guide was introduced in femoral corrective osteotomy, for the first time, to navigate the operation as planned. After the virtual osteotomy and reduction of bone segments, the parameters of a custom-made intramedullary nail were measured for manufacturing. Findings Virtual operation in computer shows complete correction of the 3D deformity. The osteotomy guide, obtained by rapid-prototyping techniques, navigates mimicking surgery on rapid-prototyping model of the involved femur as planned. Internal fixation was achieved using the custom-made intramedullary nail. Interpretation three-dimensional visualization introduces an advantage in preoperative planning for corrective osteotomy of 3D femoral deformity, and the custom-made osteotomy guide is crucial to realize such a deliberate plan during the actual procedures. The internal fixator, such as an intramedullary nail, can be modified or personalized for fixation in unique cases.

Biological changes after axonal stretch and their mechanisms / 中国医学科学院学报

Research on peripheral nervous injuries, especially the stretched injuries, is important to improve the clinical effectiveness and alleviate the patients's pain. In recent years, the biological changes and mechanics of stretched axons have been hot topics. This article reviews the recent advances in the morphological changes of axons as well as changes in cellular membrane, cytoskeleton, cellular metabolism, and action potential after axonal stretch.

Effects of recombinant human osteoprotegerin and recombinant RANK protein on the differentiation of osteoclast precursors / 中国骨伤

<p><b>OBJECTIVE</b>To compare the effect of recombinant OPG-Fc and recombinant RANK protein on the differentiation of osteoclast precursors.</p><p><b>METHODS</b>Mouse osteoblasts cell lines were incubated with osteoclast precursors cell lines RAW 264.7 for 9 days with 10(-5) g/L rhRANK or rhOPG-Fc or PBS added to the coculture system. TRAP stain positive cells counting and cortical bone pit formation counting were performed in the 9th day.</p><p><b>RESULTS</b>Multinuleated TRAP stain positive cells were observed in the cocluture systems after 6 days incubation,and plenty of mature osteoclasts could be observed in the 9th day. With the addition of 10(-5) g/L rhOPG-Fc or rhRANK, multinucleated giant cells and cortical bone pit formation couting decreased significantly compared with the control group, and the rhRANK group decreased more significantly than the rhOPG-Fc group.</p><p><b>CONCLUSIONS</b>Both rhOPG-Fc and rhRANK can inhabit the differentiation of osteoclast precursors and prevent them forming mature osteoclasts,moreover,the rhRANK shows the significant inhabition effect than the rhOPG-Fc.</p>

Finite element analysis on a modified cannulated screw for fixation of femoral neck fracture / 医用生物力学

Objective To establish the three-dimensional finite element model of the cannulated screws for fixing the femoral neck fracture, and investigate stress distributions on three cannulated screws as well as determine whether internal fixation by a modified cannulated screw can provide sufficient stiffness and strength for the fixation. Methods The 3D finite element model was internal-fixed at the angle of 127°with femoral shaft under the inverted triangle mode to simulate loading on single legged standing condition. Stresses on three screws (No 1: the underneath screw, No 2: the anterosuperior screw, No 3: the posterosuperior screw) were calculated at different Pauwels angle (50°, 60°, 70°, 80°), respectively. A bore was drilled in the screw with the largest stress to study the effect of bore size and bore direction on the femoral neck fracture model with screw fixation. Results The stresses of three screws increased with the Pauwels angle increasing and reached the maximum value at 80°. The maximum stresses on No.1, No.2 and No.3 screw were 304, 515 and 154 MPa, respectively. When the No 2 screw had an opening bore with 1 mm in diameter, and the direction of the bore was not between 150°and 195°, the stresses on three screws were all within the safe limits. Conclusions From the mechanical point of view, three screws are subject to different stresses. The cannulated screws with side bore have good biomechanical properties for fixing the femoral neck fracture with safety and reliability, which can provide advantages for accelerating fracture healing by injecting drugs through the central and side bore into the fracture side.

Computer-aided design and custom-made guide in corrective osteotomy for complex femoral deformity / 华中科技大学学报（医学）（英德文版）

Preoperative planning of corrective osteotomy with traditional radiography has limitations in regards to determining the ideal osteotomy location and orientation in three-dimensional femoral deformities. Though a successful operation can be planned preoperatively, intraoperative contingencies might adhere to the procedural plan in the performance of operation. To efficiently perform a planned procedure, proposed is a design to implement three-dimensional reconstruction photography, based on computer-tomography (CT) scan. A custom-made guide was designed to navigate the osteotomy as planned, and additionally, a personalized intramedullary nail was used for fixation after osteotomy. Three-dimensional (3D) photography of deformed femur was established based on the CT dataset and transferred into 3D photography processing software for further planning. Osteotomy planes were designed and adjusted at deformity sites to correct the 3D deformities. The methodology of a custom-made osteotomy guide was introduced in femoral corrective osteotomy, for the first time, to navigate the operation as planned. After the virtual osteotomy and reduction of bone segments, the parameters of a custom-made intramedullary nail were measured for manufacturing. Findings Virtual operation in computer shows complete correction of the 3D deformity. The osteotomy guide, obtained by rapid-prototyping techniques, navigates mimicking surgery on rapid-prototyping model of the involved femur as planned. Internal fixation was achieved using the custom-made intramedullary nail. Interpretation three-dimensional visualization introduces an advantage in preoperative planning for corrective osteotomy of 3D femoral deformity, and the custom-made osteotomy guide is crucial to realize such a deliberate plan during the actual procedures. The internal fixator, such as an intramedullary nail, can be modified or personalized for fixation in unique cases.

Inhibitory effect of recombinant receptor activator of nuclear factor kappaB protein on bone loss in ovariectomized mice / 中国骨伤

<p><b>OBJECTIVE</b>To compare inhibitory effects of recombinant receptor activator of nuclear factor kappaB protein with bisphosphonate treatment (ALN) on osteoclasts activity and bone loss in ovariectomized mice.</p><p><b>METHODS</b>Twenty-four female KM mice were ovariectomized bilaterally and treated with recombinant receptor activator of nuclear factor kappaB protein, alendronate, or PBS. Twelve weeks later, body weight, biochemical markers of bone metabolism, Micro CT scan and bone morphology were examined.</p><p><b>RESULTS</b>After 12 weeks administration, the Micro CT scan and bone morphology values of each group were as follow. The control group: BMD (92.600 +/- 14.319) mg/cc, Tb.Th (0.094 +/- 0.011) mm, Tb.Sp (0.455 +/- 0.124) mm, BVF 0.192 +/- 0.023, SMI 1.388 +/- 0.328; the recombinant receptor activator of nuclear factor kappaB protein group: BMD (133.050 +/- 13.022) mg/cc, Tb.Th (0.098 +/- 0.009) mm, Tb.Sp (0.365 +/- 0.105) mm,BVF (0.291 +/- 0.025)%, SMI 0.661 +/- 0.384; the ALN group: BMD(128.013 +/- 16.040) mg/cc, Tb.Th (0.097 +/- 0.011) mm, Tb.Sp (0.376 +/- 0.104) mm, BVF 0.281 +/- 0.024, SMI 0.753 +/- 0.307. In the ovariectomized mice experiments, both recombinant receptor activator of nuclear factor kappaB protein and ALN significantly inhibited ovariectomy-induced bone loss. Compared to the control group (PBS), the recombinant receptor activator of nuclear factor kappaB protein group showed increased distal femur BMD and decreased trabecular spacing (Tb.Sp), whereas the control group had significantly decreased distal femur BMD, significantly decreased Tb.Th, and increased Tb.Sp. There was a significant difference in bone volume fraction among the groups. The TRAP-positive osteoclasts in distal femur bone slices were nearly complete inhibited for Recombinant receptor activator of nuclear factor kappaB protein group and alendronate group.</p><p><b>CONCLUSION</b>In vivo, recombinant receptor activator of nuclear factor kappaB protein effectively inhibits the activity of osteoclasts and the resulting bone loss, which has a similar effect as alendronate.</p>

Comparative study of perpendicular versus parallel double plating methods for type C distal humeral fractures / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus. However, there is still controversy concerning dual plate positions in terms of providing optimal stability. The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.</p><p><b>METHODS</b>Between March 2008 and June 2011, a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods. Of them, 24 patients were treated by perpendicular plating (group I) and 21 patients were treated by parallel plating (group II). The surgical time, blood loss, and union time were compared between the two groups. The flexion-extension arc, the total range of flexion and extension at the end of follow-up were compared between the two groups. The Mayo Elbow Performance Score (MEPS) was used to determine the elbow functional results.</p><p><b>RESULTS</b>All patients were followed up. The mean duration of follow-up was 16 months (range 12 - 25 months) in group I and 15.5 months in group II (range 12 - 25 months). There were no significant differences in the surgical time, blood loss, and the bone union time between the two groups. In group I, the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points. The rate of excellent and good results was 87.5%. In group II, the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points. The rate of excellent and good results was 90.5%. There were no significant differences in the MEPS, flexion-extension arc, and the total range of flexion and extension between the two groups.</p><p><b>CONCLUSIONS</b>Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation. The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.</p>

The significance of intraoperative computed tomograph scan for complex acetabular fractures / 中华骨科杂志

ObjectiveTo investigate the application of intraoperative Computed Tomograph (CT) using in surgery for complex acetabular fractures.MethodsFrom June 2008 to December 2010,14 patients (9 males,5 females; with the mean age of 45.1 years; range,28-62 years) with complex acetabular fractures were operated using intraoperative CT.Preoperative radiotherapy and CT scan were adopted to evaluate the fractures.Three dimensional reconstruction based on CT scan was used to mimic surgery.The surgery approach and the type of internal fixators were noted.Intraoperative C-arm and CT scan were used to evaluate the fractures reduction respectively.Decision of additional reduction was made by surgeons according to above mentioned methods respectively and the results were noted.Comparing to preoperative design,the change of surgery plan were noted.Overall time,frequency and radiation dose of intraoperative CT scan were also noted.ResultsAll patients in this study received average 2.7 times of intraoperative CT scan.Mean time of CT scan was 40.4 min and the overall dose of radiation was 47.2 mGy.Decision of additional reduction was made in 3 cases according to C-arm radiography and 4 cases according to CT scan (above mentioned 3 cases were included).The change of surgery plan was made in one case.In postoperative radiography evaluation according to Matta's score system,anatomical reduction were achieved in 8 cases,imperfect reduction in 3 cases and poor reduction in 3 cases.ConclusionIntraoperative CT scan increases the radiation time and dose of patients dramatically.When used to evaluate fracture reduction intraoperatively,it can't take the advantage of traditional C-arm radiography.When delicate preoperative plan is made with radiography and three dimensional reconstruction based on CT data,the efficiency of intraoperative CT scan for complex acetabular fractures are to be discussed.

Selective embolization for surgical treatment of carotid body tumor / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the value of carotid arteriography and selective embolization in surgical treatment of carotid body tumor.</p><p><b>METHODS</b>Seven patients with carotid body tumor were operated, and four patients were performed with carotid arteriography and selective embolization before operation. All patients were treated by stripping the carotid body tumor from the carotid artery. Treatment effectiveness of the patients with and without selective embolization were compared.</p><p><b>RESULTS</b>Seven cases were classified as Shamblin III type. The CT scan and digital subtraction angiography (DSA) showed the tumor lesion in the carotid bifurcation, and the tumor and its relation with the surrounding arteries were expressed by CT and three dimensional CT images. All cases of carotid body tumor were resected without any carotid artery ligation. No serious complications occurred after operation. There was average 160 mL blood loss in operation of four patients that had angiograms and were preoperatively embolized, and average 2.5 h were expended. There was average 600 mL blood loss in operation of three patients without preoperatively embolized, and average 4 h were expended. Preoperatively high-selected embolization of the tumor-feeding artery could effectively reduce the intraoperative bleeding. With 1.5-3 years follow-up, none of the carotid body tumor recurred in all the seven cases.</p><p><b>CONCLUSION</b>Carotid arteriography and embolization therapy may decrease blood loss and higher risk for operation in the patients with carotid body tumor.</p>

Surgical treatment of compound fracture of the ankle / 中华外科杂志

<p><b>OBJECTIVE</b>To report the clinical outcome of the treatment of compound ankle fractures by vacuum sealing drainage and spanning external fixator.</p><p><b>METHODS</b>From April 2005 to April 2009, 19 cases of Gustilo type III compound ankle fractures were treated, with type IIIA in 10 cases, Type IIIB in 7 and Type IIIC in 2. All cases underwent emergency debridement, and had the fractures fixed with spanning external fixator following indirect reduction, the wound closed with vacuum sealing drainage and repaired through direct suture, split-thickness skin graft or flap transposition.</p><p><b>RESULTS</b>In this series, following VSD of 5.0 to 18.0 d (mean 10.3 d), 2 cases had their wounds closed by direct suture, 12 by skin graft and 3 by flap transposition. The other 2 cases had repeated wound debridement and multiple use of VSD, and had their wounds repaired by flap transposition. All the 19 cases were followed up for 8 to 36 months with an average of 26 months. All the fractures united 3.0 to 10.0 (mean 3.8) months. At the final follow-up functional evaluation of the affected ankle joints was performed only to find excellent in 9 cases, good in 5, fair in 4 and poor in 1.</p><p><b>CONCLUSION</b>Gustilo type III compound ankle fracture can effectively be treated with VSD and spanning external fixator.</p>

The construction of two kinds of artificial bone and the comparison of their osteogenesis capability in vivo / 中国医学科学院学报

<p><b>OBJECTIVE</b>To construct artificial bone with collagen-hydroxyapatite (HA) or collagen-HA-chondroitin sulfate (CS) as the scaffolds, and observe their biological properties.</p><p><b>METHODS</b>The artificial bones were constructed by attaching recombinant human bone morphogenetic protein 2 (rhBMP-2) on those scaffolds. And then they were embedded into muscles of rats. Every weekend those newly formed bones were taken from muscles for comparing the difference in osteogenetic capability of two kinds of artificial bone in vivo.</p><p><b>RESULTS</b>Both kinds of artificial bones could induce bone regeneration in muscle. The collagen-HA-CS artificial bone was superior to the collagen-HA artificial in bone-guided degree.</p><p><b>CONCLUSIONS</b>The CS could promote the form action of new bone and accelerate the bone healing.</p>

Construction of a collagen gel dermis with improved biological property / 中国医学科学院学报

<p><b>OBJECTIVE</b>To improve the biological property of artificial skin.</p><p><b>METHODS</b>We have ameliorated Hansburgh and Middelkoop's method of manufacturing artificial dermis. The type I collagenase and Dispase were used to isolated neonate prepuce' dermis fibroblast. The gel dermis was constructed by compounding the fibroblast and collagen swelling solution. The property of the collagen gel dermis was measured.</p><p><b>RESULTS</b>The neonate prepuce's dermis fibroblast had property of high proliferation, high activation of the dermis, and it could secrete abundant extracellular matrix (ECM).</p><p><b>CONCLUSION</b>The collagen gel dermis is an useful dermis substitute.</p>