Efficacy comparison between iliosacral screw fixation of the posterior pelvic ring fracture with the assistance of modified percutaneous three-dimensional printing guide template and conventional fluoroscopy / 中南大学学报(医学版)

Objective:The effect of three-dimensional(3D)printed bone-attached guide plate assisted cannulated screw fixation of pelvic fracture is reliable,but extensive soft tissue dissection is still required when installing the guide plate.This study aims to compare the efficacy of posterior pelvic ring fracture fixation with iliosacral screw insertion between the assistance of modified percutaneous patient specific 3D printed guide template and conventional fluoroscopy. Methods:From May,2019 and September 2021,28 patients sustained posterior pelvic ring fractures were randomized into 2 groups:A guide template group,in which the iliosacral screw was inserted for fixation of the posterior pelvic ring fracture with the assistance of modified percutaneous patient specific 3D printed guide template,and a fluoroscopy group,in which the iliosacral screw was inserted under the guidance of conventional fluoroscopy.The operation time,fluoroscopic frequency,intraoperative blood loss,and incision length were recorded for each screw insertion.Fracture reduction was evaluated according to the Matta criteria.The screw position was evaluated according to the modified Gras classification,and the functional outcome was evaluated according to Majeed score.The parameters of both groups were compared,and statistical analysis was performed. Results:All the 28 patients were followed up for 12-24 months.Of them,15 iliosacral screws were inserted in 14 patients in the guide template group,and 14 iliosacral screws were inserted in 14 patients in the fluoroscopy group.The operation time,fluoroscopic frequency,screw deviation,incision length,and blood loss in the guide template group were 20-30(25.8±2.8)min,9-15(12.2±1.9),2-4(2.6±0.7)mm,4-5(4.6±0.5)cm,and 5-10(7.8±1.7)mL,respectively,whereas those in the fluoroscopy group were 30-60(48.1±7.5)min,40-96(64.7±16.3),3-6(4.2±0.9)mm,0.8-1.2(1.0±0.1)cm,and 2-5(3.1±1.3)mL,respectively,and there were statistical significance(all P<0.001).Fracture reduction was evaluated according to the Matta criteria,and all the patients reached excellence and good(P=0.584)in the 2 groups.According to modified Gras classification,there were 12 Grade Ⅰ screws,3 Grade Ⅱ screws,and 0 Grade Ⅲ screws in the guide template group,and 10 Grade Ⅰ screws,3 Grade Ⅱ screws,and 1 Grade Ⅲ screw in the fluoroscopy group,with no statistical significance(P=0.334).The functional outcome was evaluated according to Majeed score at the last follow-up,without significant difference between the guide template group and the fluoroscopy group(P=0.908). Conclusion:Compared with the conventional fluoroscopy,it would cost less operation time,less fluoroscopic frequency and increase more accurate screw insertion to fixate the posterior pelvic ring fracture with the assistance of modified percutaneous patient specific 3D printed guide template.

Mechanism of racanisodamine on alleviating radiation-induced lung injury in mice / 中华放射医学与防护杂志

Objective:To investigate the protective effect of racanisodamine on lung injury in mice exposed to irradiation.Methods:C57BL/6 mice were randomly divided into control group, racanisodamine group, 18 Gy irradiation group (model group) and racanisodamine combined with 18 Gy irradiation group (treatment group), with 5 mice in each group. The mice in the treatment group received racanisodamine (5 mg/kg) intraperitoneally 3 d before irradiation and contained the whole experiments. Then, single chest irradiation of 18 Gy X-rays was performed both in the model and treatment groups. The racanisodamine group and treatment group received racanisodamine intraperitoneally once a day until 6 weeks after irradiation. The mice were killed at 6 weeks after irradiation. The lung histopathology was observed by HE staining. Serum and bronchial alveolar lavage fluid (BALF) inflammatory cytokines such as TNF-α, IL-1β and IL-6 were determined by ELISA method. Cell senescence was detected by SA-β-Gal staining. The expressions of Nrf2, p-Nrf2 and p62 in lung tissue were performed by immunehistochemistry and Western blot assays.Results:Compared with the model group, the scores of HE staining were decreased ( t=8.66, P<0.01), the number of infiltrated inflammatory cells in BALF were decreased ( t=10.70, P<0.01), and protein concentration in BALF had lower levels ( t=6.75, P<0.01), the serum TNF-α, IL-1β and IL-6 were decreased significantly ( t=8.17, 4.58, 6.54, P<0.01), the activity of SA-β-gal was decreased, and the expressions of Nrf2, p-Nrf2 were enhanced ( t=6.42, 7.30, P<0.01), while the expression of p62 was reduced ( t=4.62, P<0.01) in the treatment group. Conclusions:Racanisodamine plays the protective effect of radiation-induced lung injury by alleviating inflammation associating with the activating of Nrf2-related pathway, which reversed radiation-induced cell senescence.

An experimental study on a slow-release complex with rifampicin-polylactic-co-glycolic acid-calcium phosphate cement / 中南大学学报(医学版)

OBJECTIVE@#To prepare the slow-release complex with rifampicin (RFP)-polylactic-co-glycolic acid (PLGA)-calcium phosphate cement (CPC) (RFP-PLGA-CPC complex), and to study its physical and chemical properties and drug release properties in vitro.
@*METHODS@#The emulsification-solvent evaporation method was adopted to prepare rifampicin polylactic acid-glycolic acid (RFP-PLGA) slow-release microspheres, which were divided into 3 groups: a calcium phosphate bone cement group (CPC group), a CPC embedded with RFP group (RFP-CPC group), and a PLGA slow-release microspheres carrying RFP and the self-curing CPC group (RFP- PLGA-CPC complex group). The solidification time and porosity of materials were determined. The drug release experiments in vitro were carried out to observe the compressive strength, the change of section morphology before and after drug release. 
@*RESULTS@#The CPC group showed the shortest solidification time, while the RFP-PLGA-CPC complex group had the longest one. There was statistical difference in the porosity between the CPC group and the RFP-CPC group (P<0.05); Compared to the RFP-PLGA-CPC complex group, the porosity in the CPC group and the RFP-CPC group were significantly changed (both P<0.01). There was significant difference in the compressive strength between the RFP- PLGA-CPC complex group and the CPC group (P<0.01), while there was significant difference in the compressive strength between the RFP-CPC group and the CPC group (3 days: P<0.05; 30 and 60 days: P<0.01). The change of the compressive strength in the CPC was not significant in the whole process of degradation. The sizes of PLGA microspheres were uniform, with the particle size between 100-150 μm. The microspheres were spheres or spheroids, and their surface was smooth without the attached impurities. There was no significant change in the section gap in the CPC group after soaking for 3 to 60 days. The microstructure change in the RFP-CPC group was small, and the cross section was formed by small particles. The pores of section in the RFP-PLGA-CPC complex group increased obviously, and PLGA microspheres gradually disappeared until the 60th day when there were only empty cavities left. The RFP-PLGA-CPC complex group had no obvious drugs sudden release, and the cumulative drug release rate was nearly 95% in the 60 days. The linear fitting was conducted for the drug release behavior of the complex, which was in accordance with zero order kinetics equation F=0.168×t.
@*CONCLUSION@#The porosity of RFP-PLGA-CPC complex is significantly higher than that of CPC, and it can keep slow release of the effective anti-tuberculosis drugs and maintain a certain mechanical strength for a long time.

Clinical study on tongyan spray for post-stroke dysphagia patients: a randomized controlled trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effectiveness and safety of Tongyan spray composed of Chinese medicine for post-stroke dysphagia patients.</p><p><b>METHOD</b>One hundred and twenty-two post-stroke dysphagia patients were randomly assigned to the treatment group (61 cases) and the control group (61 cases). Basic treatment was given to both groups, with Tongyan spray additionally used in oropharynx for the treatment group, and the placebo used for the control group. After 28-day treatment, the clinical effect and safety were evaluated according to the standard swallowing assessment (SSA) scale.</p><p><b>RESULTS</b>One patient dropped out in each group, and 120 patients reached the final analysis of the study. The total effective rate for the treatment group was 71.7% (43/60), higher than 46.7% (28/60) in the control group (P<0.05), and the improvement on SSA scores of the two groups were significantly different after treatment (P<0.05). For grade 1 dysphagia patients (completely depending on nasogastric tube), the effective rate of the treatment group was 40.9% (9/22), and 12.5% (2/16) of the control group, without significant difference (P>0.05), while the improvement of SSA score was significantly different between the two groups after treatment (P<0.05). For grade 2-3 dysphagia patients (oral and nasogastric tube feeding), the total effective rate of the treatment group was 89.5% (34/38), higher than 59.1% (26/44) in the control group (P<0.05), and also the improvement on SSA scores was significantly different between the two groups after treatment (P<0.05).</p><p><b>CONCLUSION</b>Tongyan spray was an effective and safe method for post-stroke dysphagia patients.</p>