An iodine-coated titanium plate prepared with potassium iodide / 中华创伤骨科杂志

Objective:To explore the feasibility of preparing an iodine-coated titanium plate with potassium iodide and verify its antibacterial performance.Methods:Iodine was coated onto the surface of a titanium plate in electrolyte of potassium iodide using the electrophoretic deposition method. The signs and composition of the surface of the iodine-coated titanium plate were observed by scanning electron microscopy and energy dispersive spectroscopy. The experiment was conducted in a control group and 3 antibacterial test groups. The control group consisted of 10 titanium plates which had been pretreated but not loaded with iodine; the 3 experimental groups also had in each 10 titanium plates which had been pretreated and loaded with iodine in the electrolytes of concentrations of 1,000 mg/L, 2,000 mg/L and 4,000 mg/L, respectively. The antimicrobial tests in vitro were conducted with standard strains of staphylococcus aureus [1×10 6 Colony-Forming Units (CFU)/mL ATCC25923] to determine the antibacterial property of the plates. Results:The iodine-coated titanium plates appeared grey and their surface was evenly covered with a flat coating with no collapse. The scanning electron microscopy observed on the surface of the iodine-coated titanium plates an iodine coating with scattered irregular collapses in different sizes. The iodine content was 0 mass%, 5.10 mass%, 10.32 mass% and 15.05 mass%, respectively, in the control, 1,000 mg/L, 2,000 mg/L and 4 000 mg/L groups under the energy dispersive spectroscopy. Their counts of in vitro antibacterial colony were 56.00±5.09, 21.40±2.76, 9.10±2.51, and 2.00±1.88, respectively, showing significant differences between groups ( P< 0.05). Conclusions:A titanium plate with a steady and even iodine coating can be prepared by virtue of the electrophoretic deposition method in electrolyte of potassium iodide. The antibacterial property of an iodine-coated titanium plate is superior to that of a titanium plate without iodine coating.

Antibacterial effect of iodophor on Staphylococcus aureus biofilm / 中华创伤杂志

Objective:To investigate the antibacterial effect of iodophor on Staphylococcus aureus biofilm (BBF).Methods:Staphylococcus aureus were cultured in vitro and 480 pieces of titanium alloy plates were selected. On the surface of titanium plates, in vitro models of Staphylococcus aureus biofilms were established at days 7, 14, 21 and 28 respectively with 120 pieces of titanium plates at each time points. The biofilms at each time point were assigned to no iodophor immersion (PBS group), 5 g/L iodophor immersion for 5 minutes (5-min group) and 5 g/L iodophor immersion for 10 minutes (10-min group), according to the random number table method. FITC-ConA, propidium iodide (PI) and SYT09 were used to dye Staphylococcus aureus in PBS group. After dyeing, confocal laser scanning microscopy and scanning electron microscopy were used to observe the morphological structure of bacterial biofilms, and the Colony forming unit (CFU) was counted by the viable count method. In the other two groups, PI and SYT09 were applied to dye Staphylococcus aureus, and then confocal laser scanning microscopy and scanning electron microscopy were used to observe the changes of biofilms and bacterial viability after iodophor immersion. The antibacterial effect of iodophor was evaluated by the viable count method.Results:After dyeing Staphylococcus aureus with FITC-ConA and PI in PBS group, confocal laser scanning microscopy showed that the extracellular polymers of the bacteria increased gradually with the extension of culture time. The space structure of biofilm was gradually mature, changed significantly at day 21 and became mature at day 28. After staining Staphylococcus aureus with PI and SYT09 in PBS group, confocal laser scanning microscopy showed that the number of bacteria increased, and had a mountain-like shape. Scanning electron microscopy showed that the number of bacterial extracellular polymers increased gradually with the extension of culture time and a structured microenvironment was formed and gradually matured. In 5-min and 10-min groups, all bacteria were killed at days 7 and 14 [0(0, 0)CFU/ml], the antibacterial effect was weakened at 21 days, but the antibacterial effect of iodophor immersion in 10-min group [100 (100, 125)CFU/ml] was better than that in 5-min group [300 (275, 425)CFU/ml] ( P<0.05). There was no significant difference in iodophor immersion in 5-min group [500 (375, 700)CFU/ml] and 10-min group [250 (175, 400)CFU/ml] at 28 days ( P>0.05). Conclusions:The maturation of biofilm is the overall maturation of bacteria and bacterial extracellular polymers and the formation of a spatialized microenvironment. Bounded by the 21st day, biofilms are divided into young biofilms and mature biofilms. The main difference between them lies in the maturation of extracellular polymers and microenvironment. For the bacterial biofilm with culture time less than 21 days, the antibacterial effect of the iodophor immersion for 10 min is better than that of 5 min. However, for the bacterial biofilm with culture time greater than 21 days, there is no significant difference in the antibacterial effect of the bacterial biofilm of prolonged iodophor immersion time.

Preparation of the iodine-coating titanium implant in orthopedics and evaluation of antibacterial activity / 中华骨科杂志

Objective Iodine loading would be carried out on orthopedic titanium Kirschner-wire by electrophoretic deposition.And by this,a kind of orthopedic iodine-coated implant with antibacterial properties was supposed to be developed,that would provide a theoretical basis for the development of clinical orthopedic implants with antibacterial properties.Methods Iodine loading on the surface of titanium Kirschner-wire was carried out by electrophoretic deposition.PVP-I solution as 1 000 ppm,2 000 ppm and 4 000 ppm was prepared respectively (1 ppm=1 mg/kg=1 mg/L).Three kinds of iodine-coated orthopedic titanium Kirschner-wires with different iodine content were prepared by electrophoretic deposition at 200 V voltage for 30 min and then stoved after being washed with distilled water.The surface signs and composition structure of iodine coated titanium Kirschnerwire were studied through scanning electron microscopy (SEM) and energy dispersive spectrometer (EDS).Antibacterial experiments of Iodine coating titanium Kirschner needle were performed in vitro.Antimicrobial test:10 pieces of uncoated titanium Kirschner-wires;10 pieces of iodine-coated titanium Kirschner-wires with 1 000 ppm;10 pieces of iodine-coated titanium Kirschner-wires with 2 000 ppm;10 pieces of iodine-coated titanium wires with 4 000 ppm.Because iodine is easy to sublimate and does not withstand high temperature,all the titanium Kirschner needles are fumigated and disinfected by ethylene oxide (supported by the supply room of our hospital).Titanium wires were immersed respectively in 106 CFUJ/ml (ATCC25923) bacterial suspension of standard Staphylococcus aureus so that bacteria would be fully inoculated on the surface of the titanium wire.The sterilized titanium Kirschner needle was placed in a sterile culture cup and 30 ml suspension was added into the culture cup.The sterilized titanium Kirschner needle was completely immersed in the bacterial solutionand was kept at 37°C for 6 h before taking out.Take out the titanium Kirschner needle slowly,rinse the titanium Kirschner needle with 5 ml sterile PBS buffer,after rinsing the surface of titanium Kirschner needle,transfer the titanium Kirschner needle to the new sterile culture cup and add 5 ml sterile saline until the titanium Kirschner needle is completely immersed.Then put the titanium Kirschner needle into the ultrasonic oscillator to wash the surface of the bacteria fully.After 10 000 times dilution,100 μl was smeared on agar medium for culture (37°C) and the number of colonies was observed and counted 24 h later.Results The surface of three kinds of iodine coating titanium Kirschner-wires was covered with uniform iodized compound coating and had a brown look.The film structure was stable and there was no falling off after ultrasonic cleaning.SEM exhibited that the surface of Titanium Kirschner-wire is covered with a compact coating;the appearance structure is relatively flat and a slight collapse can be seen scattered in the surface of the wire.The results of EDS showed that the iodine content in the surface coating of 3 groups was 4.38 wt％,9.05 wt％ and 14.48 wt％.The bacteria growing on the surface of titanium needle were shaken down by ultrasonic vibration.The CFU counting was carried out after the bacterial solution being diluted,coated and cultured for 24 h.It can be seen that the antibacterial property increases continuously with the increase of iodine coating content.The antibacterial properties of iodine-coated implant which content 14.48 wt％ iodine was more than 1 orders of magnitude than the control group.The results showed that the plants coated with iodine had obvious antibacterial effect.Conclusion The iodine coated titanium wire was prepared by electrophoretic deposition,after being characterized by SEM,EDS and quantitative measurement,the successful loading of iodine was proved,the antibacterial experiment proved that the iodinecoated orthopedic titanium Kirschner-wire has a stronger antibacterial properties than the ordinary titanium Kirschner-wire under laboratory conditions.

Correlation between Executive Function and Activities of Daily Living for Patients with Periventricular White Matter Lesions / 中国康复理论与实践

@#Objective To study the relationship between executive function and activities of daily living for patients with periventricular white matter lesions (PWMLs). Methods From January, 2016 to January, 2017, 35 PWMLs patients and 35 normal controls were collected. Their executive function and activities of daily living were assessed with neuropsychological tests and Activities of Daily Living Scale (ADL).Results Compared with the normal control group, the scores of Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) significantly decreased (t>13.726, P<0.001), the times of Trail-Making Test and Stroop Colour Word Test significantly lengthened, the Verbal Fluency Test score decreased (t=6.891, P=0.013) and the Digit-Symbol Substitution Test score did not improve (t=3.372, P=0.072) in PWMLs group. The Z score of executive function was positively correlated with ADL score (r=0.438, P=0.008).Conclusion The executive function and activities of daily living are impaired in PWMLs patients, and their activities of daily living is related to the severity of the executive function impairment.

Preparation and structural characterization of TiO2 nanotube arrays on surface of orthopaedic titanium plate / 国际生物医学工程杂志

Objective The TiO2 nanotube arrays,fabricated on the surface of orthopedics,was characterized,to provide carrier for orthopedics plant surface modification or coating,and seek a new way for the prevention and treatment of orthopedics plant infection.Methods By adjusting certain parameters,TiO2 nanotube arrays were fabricated on orthopedic titanium plate surface using the method of anodic oxidation,with glycerol system as electrolyte,orthopedics titanium plate as anode,and platinum electrode as cathode.TiO2 nanotube arrays were characterized.The element composition of TiO2 nanotube arrays was analyzed by X-ray photoelectron spectroscopy (XPS),and the morphological changes of TiO2 nanotube arrays was observed at high temperature (300 ℃) by X-ray diffractomer (XRD).Results With glycerol system as electrolyte,TiO2 nanotube array with diameter of about 100 to 200 nm and the length less than 3μm can be fabricated on orthopedic titanium plate surface using anodic oxidation of 24 h.The surface of orthopedic titanium plate was changed from silver white to deep blue in the macroscopic view.The TiO2 nanotube array on orthopedics titanium plate surface was mainly composed of Ti element (75.88％),O element (20.16％),and F element (3.96％) by XPS analysis.TiO2 nanotube arrays morphology was stable when it was heated to 300 ℃ by muffle furnace.Conclusions The method of anodic oxidation can be applied to manufacture TiO2 nanotubes array on titanium plate surface.The array with stable morphology,the inner hollow shape,the bottom sealing,and a large specific surface area,can withstand high temperature,which can provide carrier for orthopedics plant surface modification or coating.

Establishment of a rabbit model of lumbar laminectomy and bone grains replantation / 中国比较医学杂志

Objective To establish a rabbit model of lumbar laminectomy and bone grains replantation and provide experimental evidence for the clinical application.Methods Eighteen healthy male New Zealand rabbits were selected and randomly divided into two groups:the control group (n=6) and experimental group (n=12).The rabbits of control group were given general anesthesia, and taking the L5 spinous process as the center to perfom left L5 laminectomy, using a micro lancet forceps to slowly bite the lamina and ligamentum flavum for fenestration and exposed to an approximately 0.8 cm x 0.3 cm sized bone window and then sutured the skin.The rabbits of experimental group were exposed to an approximately 0.8 x 0.3 cm sized bone window as well, and bone fragments were cut into small grains.Then the small bone grains were embedded in medical collagen sponge, to form an arch shape, and replanted them to the site of epidural fenestration.CT scan and histological changes were observed at 4, 8 and 12 weeks after operation.Results At 8 weeks after operation, CT examination showed that in the experimental group, a thin bone plate was formed by the bone grains.At 12 weeks after operation, the bone plate became thicker and was connected with the vertebral bone, and with continuous bone trabeculae.The spinal canal and volume were not obviously changed, and no spinal cord compression was observed. The rabbits of control group showed segment lamina defects, a small scar protruding into the spinal canal, and the vertebral canal was not completely reconstructed. Conclusions The bone grains replantation can effectively promote bone reconstruction in the laminectomized rabbits, and the formed bone plate can prevent epidural scar from intruding into the spinal canal, and can reduce the postlaminectomy adhesion.

Alterations in imaging and histopathology after aspiration of nucleus pulposus of rabbit lumbar intervertebral disc / 中国组织工程研究

BACKGROUND:It remains unclear what kind of changes in imaging and histopathology would appear in intervertebral disc after removal of nucleus pulposus over time. OBJECTIVE:To observe the alteration in imaging and histopathology of rabbit lumbar intervertebral disc after nucleus pulposus aspiration. METHODS:A total of 32 Japanese rabbits were subjected to nucleus pulposus aspiration in posterior lateral L 3/4 intervertebral disc with a 21-gauge hypodermic needle. L 2/3 intervertebral disc served as a normal control. At 2, 4, 8 and 12 weeks after aspiration, eight rabbits according to grouping received radiograph in the lateral position of lumbar vertebra. The height of L 3/4 and L 2/3 intervertebral space was measured and intervertebral disc height index was calculated. Rabbits received median sagittal MRI examination and histopathological examination of intervertebral disc. RESULTS AND CONCLUSION:The intervertebral disc height degraded slowly at 2, 4, 8, and 12 weeks after aspiration. However, the difference between 8 and 12 weeks was reduced. Compared with normal control, intervertebral disc height index significantly reduced at various time points (P<0.05). The nucleus pulposus signal intensity was gradual y reduced at 2, 4, 8, and 12 weeks after aspiration, and reached grade 4 of modified Thompson grading criteria at 8 weeks. After aspiration, gelatinous nucleus pulposus of disc slowly exhibited fissures with time, morphous was slowly disordered and showed significant fibrosis performance at 12 weeks. In nucleus pulposus region, more cartilage-like cells were found at 4 weeks after operation. The cells were active. Nucleus pulposus cells decreased significantly. At 8 and 12 weeks after operation, fibroblasts increased in nucleus pulposus region, and the number of cartilage-like cells reduced. The annulus fibrosus gradual y became distorted, disordered, with processes and layers, and fiber breakage appeared. These results indicated that after puncturing lateral annulus fibrosus and aspirating the nucleus pulposus, radiograph height of the intervertebral disc and MRI T2-weighted signal intensity gradual y reduced. Pathological changes were observed. However, the degeneration al eviated between 8-12 weeks.

Nursing of patients with spinal tuberculosis combined with open pulmonary tuberculosis / 现代临床护理

Objective To sum up the experience of nursing patients with spinal tuberculosis combined with open pulmonary tuberculosis? Methods Preoperative nursing was done to 16 patients with spinal tuberculosis combined with open pulmonary tuberculosis to enhance their medical appliance? The careful postoperative observations of conditions and incisions were done to prevent pulmonary infections? Results Of the 16 patients,15 were well cured and 1 was discharged with antituberculotics for home treatment due to refusing to transfer to other hospitals for financial reason? Conclusion The enhanced perioperative health education and nursing is significant for the success of the operations and rehabilitation of the disease?

Chlamydia pneumoniae as a causative factor of ankylosing spondylitis / 中华临床感染病杂志

Objective To investigate the association of chlamydia pneumoniae infection with ankylosing spondylitis (AS).MethodsSerum samples were obtained from 33 AS patients and 22 healthy controls.Enzyme-linked immunosorbent assay (ELISA) was applied to mearsure serum anti-Chlamydia pneumoniae antibodies (IgM/IgG),while immunofluorescence assay (IFA) was used to detect Chlamydia pneumoniae LPS antigen,and polymerase chain reaction (PCR) was used to amplify Chlamydia pneumoniae DNA in peripheral blood cells. Immunohistochemistical technique was applied to examine Chlamydia pneumoniae LPS antigen in synovial tissue from another 9 AS patients who received total hip replacement and 13 patients with comminuted femoral fractures.ResultsThe positive rates of Chlamydia pneumoniae IgM,LPS antigen and chlamydia pneumoniae DNA were higher in AS patients than those in healthy controls (78.8％ vs 22.7％,x2 =16.867,P =0.000; 66.7％ vs 31.8％,x2 =6.431,P =0.011; 33.3％ vs 9.1％,x2 =4.298,P =0.038).Chlamydia pneumoniae DNA positive rate was correlated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (Z =-2.774 and -2.829,P =0.004).In synovial tissues,chlamydial LPS-containing inflammatory cells were observed in 77.8％(7/9) AS patients,while those in fracture patients was 30.8％ ( 4/13 ) ( P =0.08 ).Conclusion Chlamydia pneumoniae infection is common in blood circulation and joint cavity of AS patients and may be associated with the pathogenesis of AS.

Constructing a rabbit model of intervertebral disc degeneration by simulating the removal of human nucleus pulposus through a posterior approach / 中国组织工程研究

BACKGROUND: Resection of the nudeus pulposus is the classical treatment for intervertebral disc protrusion, except a higher recurrence rate. OBJECTIVE: To verify the feasibility of establishing an animal model of intervertebral disc degeneration by puncture and aspiration via a posterolateral approach to simulate resection of human nucleus pulposus. DESIGN, TIME AND SE'I'FING: The experiment was conducted in the animal Experimental Center of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from October 2006 to February 2007. MATERIALS: Twenty Japanese big ear rabbits were selected to establish animal models of intervertebral disc degeneration. METHODS: Some nucleus pulposus tissues were abstracted from the L1-2 and L3-4 segment of 20 rabbits by the puncture and aspiration method using a 21-gaege hypodermic needle. Histological analysis was performed at 2, 4, 8, 12 weeks after surgery, and L2-3 segment was used as control group.MAIN OUTCOME MEASURE: Histological structure of the intervertebral disc was observed by homatoxylin-eosin staining. RESULTS: Hematoxylin-eosin staining revealed a great deal of complete nudeus pulposus tissues, clear boundaries between nucleus pulposus and annulus fibrosus in the control group, and the structure of near normal annulus fibrosus was almost normal, nucleus pulposus tissue had a large number of nucleus pulposus cells. In the experimental group, the nucleus pulposus cell reduced in amount in the fourth week, the nucleus pulposus at the twelfth week were mainly full of flbroblests, while few nucleus pulposus cells were found.CONCLUSION: It is successful to establishing an animal model of intervertebral disc degeneration by puncture and aspiration via a posterolateral approach based on simulating the resection of human nucleus pulposus. This model is available for repairing intervertebrai disc degeneration using tissue engineering techniques.

Retrograde neurocutaneous flap to repair dorsal skin defect of fingers / 中国矫形外科杂志

[Objective]To research the method to repair dorsal skin defect of fingers by using retrograde neurocutaneous flap.[Method]Adopting nutrient vessels of 4 nerve branches in hands of radial-ulnar nerve as pedicle,the flaps were designed and applied to repair dorsal skin defect of fingers.[Result]All 10 flaps in 5 cases survived and wound area were covered.[Conclusion]Retrograde neurocutaneous flaps have sufficient blood supply,with no injury to nominous vesels,and with long distance to repair.Therefore,it is an advantageous method to repair dorsal skin defect,futhermore,two flaps could be used to repair skin defect of two fingers at the same time.

Observation of the repair of rabbit radial defect with poly (L-lactic acid)/tricalcium phosphate scaffolds and degradation rate / 中国组织工程研究

BACKGROUND: Scaffolds are an important part in bone tissue engineering. However, no perfect scaffolds have been developed for bone tissue engineering yet.OBJECTIVE: To evaluate the repair of rabbit radial defects by poly (L-lactic acid)/tricalcium phosphate(PLLA/TCP) scaffolds prepared by rapid prototyping(RP) technology so as to find a new carrier for growth factors.DESIGN: A completely randomized controlled study was conducted. SETTING: Orthopaedic institute of a military medical university.MATERIALS: The study was conducted in the General Orthopedic Institute,Fourth Military Medical University of Chinese PLA, from May 2001 to February 2002. Twenty clean New Zealand rabbits with body mass of(2.5 ±0. 5) kg for this study were obtained from the Experiment Animal Center of Fourth Military Medical University of Chinese PLA. The animals were divided into experiment group and control group with 10 rabbits in each group.INTERVETIONS: PLLA/TCP scaffolds prepared by RP technology and loaded with or without bovine bone morphogenetic protein (BMP) were used to repair the rabbit radial defects of 15 mm.MAIN OUTCOME MEASURES: Main outcomes: ① microscopic observation results of transplanted materials of the two groups; ② degradation rate of scaffolds. Secondary outcomes: ① gross observation; ② radiographic results; ③ bone density.RESULTS: At week 12, bone defect healing in experiment group was good. X-ray examination showed continuous bone callus and partial molding of different degrees. Degradation rate of scaffolds was 39.6%, and bone density in the defected part reached 70% of the normal level. All the indexes of experiment group were superior to those of control group, and no healing was found in the defected area in control group.CONCLUSION: PLLA/TCP scaffolds prepared by RP technology and loaded with bovine BMP can repair radial defects of 15mm in rabbits.

First aid protocols for severe pelvic fractures / 中华创伤骨科杂志

Objective To discuss diagnostic classification and emergency treatment protocols for complex pelvic fractures. Methods The first aid management of 23 cases of major pelvic fractures were analyzed retrospectively. Results 22 of the patients survived, but one died of hemorrhagic shock.Conclusions Correct classification of severe pelvic fractures is of guidance value to the first aid management. Cooperation among multiple departments, comprehensive application of various surgical methods, early stabilization of hemodynamics, rapid repair of injured organs, stabilization of pelvic ring with external fixator are effective techniques to enhance the survival rate of patients with severe pelvic fractures.

Open reduction and internal fixation with bone grafting to treat calcaneal displaced intra articular fractures / 中华创伤骨科杂志

Objective To investigate the classification and treatment of displaced intra articular fractures of the calcaneus. Methods Twelve displaced intra articular fractures of the calcaneus in 8 patients were included in this study. Classification of calcaneus fractures was done according to Sanders' computed tomographic classification system. There were 2 cases of type Ⅱfractures, 4 type Ⅲfractures and 6 type Ⅳfractures. The open reduction and internal fixation (ORIF) and bone grafting were performed using a standard extended lateral approach, and the fractures were fixed with small fragment AO bridge plates with autogenous bone grafting. Average follow up was 28.6 months (range 24 to 33 months). The Creighton Nebraska Health Foundation Assessment Score System for fractures of the calcaneus was used for evaluation. Results The average score was 89.7 for type Ⅱ, 86.5 for type Ⅲ, and 73.5 for type Ⅳfractures. There was statistically significant superiority in treatment by ORIF compared with nonoperative methods (P0.05); whereas in type Ⅳfractures, the differences were significant between with and without bone grafting (P