BACKGROUND:Self-made Distraction Reduction Fixation System is characterized by Distraction Reduction Fixation functions,which can completely fuse to the design of steel plate,and by no need to provide many surgical instruments,by reduction of bleeding and trauma.OBJECTIVE:To test changes in the stiffness of porcine short spinal segments in integrity and following destabilizing and internal fixation of the Distraction Reduction Fixation System.DESIGN,TIME AND SETTING:The control observation experiment was performed at the Laboratory of Biodynamics,Institute of Onhopedics,General Hospital of Chinese PLA from December 2004 to December 2005.MATERIALS:Twelve fresh porcine lumbar spines(T11-S2 segments)were bought from a market.Upper and lower segments were crossed and inserted with Kirschner wire to make porcine spine samples of the L1-7 segments.METHODS:Stiffness of intact samples was recorded during forward-bending,backward-bending,lateral-bending and axial rotation.Intervertebral discs,facet ioints,anterior and posterior longitudinal ligaments were removed to loose the spine.Stifrness of each motion was measured.Stiffness tests were repeated again after internal fixation on short segments using Distraction Reduction Fixation System.MAIN OUTCOME MEASURES:Stiffness in the intact,unstable and internal fixed spines during each motion.RESULTS:The stiffness iu unstable porcine spine were significantly lower than those in intact porcine spine(P<0.05),but the stiffness after internal fixation was significantly higher than in unstable porcine spine(P<0.05).No significant difference was detected in stifiness during forward-bending,lateral-bending and axial rotation(P>0.05)except that it was significantly higher during backward.bending after internal fixation compared with the intaet spine(P<0.05).CONCLUSION:Biodynamics confirms that the stiffness in short-segment fixation porcine after using Distraction Reduction Fixation System is markedly increased than in unstable porcine spine,except during backward-bending,which is comparable with that in intact porcine spine.

On the basis of studying processing method and quality control standard of Realgar,we did researches on the differences of toxicity and efficacy between new processing method(Washed by Acid)and traditional processing method(Grinding Without Water).The result showed that the efficacy was improved and the toxicity reaction Was lowered after Realgar being processed by new method.

This study discussed the dual affiliated institutions of one author in a scientific paper.This issue could give rise to troubles such as the dispute over signature rights, dispute over intellectual property rights, etc. Moreover, it could bring negative effects on the development of science. In addition, some suggestions were put forward to deal with this issue.

Objective To study the effect of procyanidin on neural cell apoptosis and the expression of Caspase-3 of cerebral ische-mia reperfusion(I/R) injury in rats. Methods 40 rats were randomly divided into 4 groups, which were sham operated group, I/R group, low dose procyanidin treated group and high dose procyanidin treated group. The focal middle cerebral artery occlusion (MCAO) model was made by suture-occluded method. After MCAO for 90min following 24h of reperfusion, neural cell apoptosis and the expression of caspase-3 was investigated with TUNEL and immunohistochemistry. HE staining and Trc staining was also used. Result Compared with sham opera-ted group, neural cell apoptosis rate and the expression of caspase-3 were increased at the 24th hour of reperfusion in the ischemic territory(P < 0.05) . Compared with I/R group, low and high dose procyanidin treated group reduced expression of caspase-3 and neural cell apopto-sis rate in a dose-dependent manor (P <0.05). The change of ischemic impairment in procyanidin treated group was less than that of I/R group, and the change of high dose procyanidin treated group was less than that of low dose procyanidin treated group. Compared with that of I/R group, cerebral infarction volume of procyanidin treated group was decreased in a dose-dependent manor (P < 0.05). Conclusion Procyanidin may reduce cerebral ischemia-reperfusion injure by reducing expression of caspase-3 and neural cell apoptosis.

Objective To fabricate cartilage extracellular matrix (ECM) oriented scaffolds and investigate the attachment, proliferation, distribution and orientation of bone marrow mesenchymal stem cells (BMSCs) cultured within the scaffolds in vitro. Methods Cartilage slices were shattered in sterile phosphate-buffered saline (PBS) and the suspension were differentially centrifugated untill the micro- fiber of the cartilage extracellular matrix was disassociated from the residue cartilage fragments. At last the supernatant were centrifugated, the precipitation were collected and were made into 2%-3% suspension. Using unidirectional solidification as a freezing process and freeze-dried method, the cartilage extracellular matrix derived oriented scaffolds was fabricated. The scaffolds were then cross-linked by exposure to ultraviolet radiation and immersion in a carbodiimide solution. By light microscope and scan electron microscope (SEM) observation, histological staining, and biomechanical test, the traits of scaffolds were studied. After being labelled with PKH26 fluorescent dye, rabbit BMSCs were seeded onto the scaffolds. The attachment, proliferation and differentiation of the cells were analyzed using inverted fluorescent microscope. Results The histological staining showed that toluidine blue, safranin O, alcian blue and anti-collagen Ⅱ immunohistochemistry staining of the scaffolds were positive. A perpendicular pore-channel structures which has a diameter of 100 μm were verified by light microscope and SEM analysis. The cell-free scaffolds showed the compression moduli were (2.02±0.02) MPa in the mechanical testing. Inverted fluorescent microscope showed that most of the cells attached to the scaffold. Cells were found to be widely distributed within the scaffold, which acted as a columnar arrangement. The formation of a surface cells layer was found on the surface of the scaffolds which resembled natural cartilage. Coclusion The cartilage extracellular matrix derived oriented scaffolds have promising biological, structural, and mechanical properties.

Objective To determine the effect of NEL-like type 1 gene (NELL-1) transfection in vivo in the repair of traumatic femoral head necrosis.Methods Twenty-four SD rats were randomly divided into three groups (8 rats per group) according to the lottery method,ie,sham group (served as normal control),NELL-1 treatment group (injected NELL-1 gene by recombinant adenovirus vectors around the hip one week after osteonecrosis model induced surgically) and placebo group (given an equal volume of saline solution at the same time after the induction of osteonecrosis).Femurs were taken from the animals 5 weeks after surgery.Gross observation was performed for morphology changes,X-ray assessment for femoral head height and length ratio (H/L),Micro-CT measure for bone parameters of femoral head including total volume (TV),bone volume (BV),total mineralized content (TMC),trabecular thickness (Tb.Th) and trabecular space (Tb.SP),and histological study for osteocytes,osteoblasts and osteoclasts.Results Preserved femoral head shape was noted in NELL-1 treatment group compared to the obvious flattening of the femoral head in placebo group.No heterotopic osteogenesis was observed in any group.Femoral head H/L ratio for 0.753 2 ± 0.040 2 in NELL-1 treatment group was higher than 0.598 4 ± 0.037 0 in placebo group (P ＜ 0.05),but lower than 0.920 2 ± 0.037 0 in sham group (P＜0.05).TV,BV,TMC and BMD between NELL-1 treatment and sham groups did not differ significantly (P ＞ 0.05),but all were increased compared to placebo group (P ＜ 0.05).There was no significant differences in Tb.Th and Tb.SP among three groups (P ＞ 0.05).Most osteocytes were alive in NELL-1 treatment group.More active osteoblasts and osteoclasts were noted in NELL-1 treatment group than those in placebo group.Conclusion NELL-1 gene transfection can preserve femoral head shape and bone content,promote osteoblast activity and neovascularization and hence is an effective treatment for rat traumatic osteonecrosis.However,the activity of osteoclasts is stimulated simultaneously.

Objective To observe the analgesic effect of quadratus lumborum block (QLB) in cesarean section under general anesthesia.Methods 50 patients underwent cesarean section under general anesthesia were randomly divided into two groups (n =25):patients in QLB group (group Q) received QLB at the end of surgery with 0.3％ ropivacaine 25ml,and the control group (group C) patients were disinfected at the same site but did not puncture.The visual analogue scale (VAS) and pain Bruggrmann comfort score (BCS) were recorded at 2,6,12,24,and 48 hours after surgery.The patient's general condition,vital signs and postoperative analgesia-related adverse reactions were recorded.Results There were no significant differences between the two groups in general information and surgical related indexes (P ＞ 0.05).The VAS scores of the Q group were lower than the control group at 2,6,12 and 24 hours,and the BCS score was higher than that in the control group (P ＜ 0.05).There was no difference in VAS score,BCS score after 48 hours,and no difference in adverse reaction rate between the two groups (P ＞ 0.05).Conclusions Quadratus lumborum block combined with intravenous analgesia can reduce the pain score within 24 hours after cesarean section under general anesthesia and improve postoperative analgesia comfort.

Objective To investigate the safety of trial of labor after cesarean (TOLAC) and clinical factors associated with successful TOLAC and to compare TOLAC with elective repeat caesarean section (ERCS) in terms of obstetric and neonatal outcomes.Methods A prospective cohort study was conducted among gravidas who had a history of lower segment cesarean section and were hospitalized in the Department of Obstetrics and Gynecology,the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January to December 2014.Exclusion criteria included indications for caesarean section (such as placenta previa,placenta accreta,twin pregnancy,breech presentation and severe preeclampsia),serious maternal complications after cesarean section,lower uterine segment thinner than 3 mm and poor healing of uterine incision.Totally,287 gravidas were enrolled.Among them,142 chose TOLAC and the other 145 requested ERCS.Clinical data of those gravidas were collected and statistically analyzed by t-test,Log-rank test,Chi-square or Fisher's exact test.Results (1) The success rate of TOLAC was 90.8％ (129/142).There was no significant difference in maternal age,gestational age,thickness of lower uterine segment,interval between the two deliveries and neonatal birth weight and asphyxia rate between the successful (n=129) and unsuccessful (n=13) groups (all P＞0.05).Although the two groups had no significant difference in postpartum hemorrhage (PPH) rate,the gravidas who failed in TOLAC lost more blood than those who succeeded [425 (195-675) vs 200 (50-1 400) ml,P＜0.05].Moreover,higher amniotic fluid contamination rate was observed in the unsuccessful group [6/13 vs 17.1％ (22/129),P＜0.05].In the TOLAC group,99.3％ (141/142) were under continuous fetal heart rate monitoring.Incomplete uterine rupture occurred in one women without serious maternal or neonatal outcomes.The reasons for 13 failed TOLAC cases were unbearable pain during labor,abnormal labor,fetal distress and threatened rupture of uterus.(2) Compared with the ERCS group,the TOLAC group showed shorter interval from last cesarean section to the indexed delivery[5 (2-18) vs 6 (2-19) years],younger maternal age [(31±4) vs (33 ±4) years old] and less blood loss [200 (50-1 400) vs 300 (100-1 500) ml] (all P＜0.05).Conclusion Our study shows that,those who preferred TOLAC were younger,or had shorter pregnancy interval from last cesarean section.The success rate of TOLAC is high for women undergoing systematic prenatal assessment and close management during labor with less blood loss and non-serious maternal and neonatal complications compared with ERCS.

Objective:To explore the effect of intraoperative autologous blood transfusion on coagulation function and inflammatory reaction after cesarean section.Methods:By retrospective analysis, 114 parturients who underwent caesarean section in our hospital from March 2017 to February 2019 with intraoperative blood transfusion were selected and divided into autologous group (57 cases) and allogeneic group (57 cases) according to the source of intraoperative blood transfusion. The changes of coagulation markers and inflammatory reaction indexes were detected and recorded respectively before and 3 days after operation, respectively. And the complications after blood transfusion were compared between the two groups.Results:On the 3rd day after operation, the expression of P65 gene and the optical density of P65 in both groups increased significantly, but the autogenous group was lower than the allogeneic group ( P<0.01); the granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-6 and IL-1β in both groups increased significantly, but the autogenous group was lower than the allogeneic group ( P<0.01); the D-dimer (D-D), thrombomodulin (TM), tissue plasminogen activator (t-PA) and fibrinolytic-antifibrinolytic complex (PAP) in both groups were slightly higher than those before operation, and the data between the two groups also changed, but with no statistical significance ( P>0.05). In addition, the incidence of complications in the autogenous group was 5.26%(3/57), which was significantly lower than that in the allogeneic group (17.54%, 10/57) (χ 2=4.25, P=0.04). Conclusions:Autologous blood transfusion has no significant effect on the coagulation function of parturients during cesarean section, but compared with allogeneic blood transfusion, autologous blood transfusion can effectively reduce the inflammatory reaction of parturients after operation, and has a significant effect on reducing the occurrence of complications after operation, which is conducive to improving the prognosis.

Objective To investigate the effects of the novel scaffold on repairing large,high-loadbearing osteochondral defects of femoral head in a canine model.Methods The biphasic scaffolds were fabricated using cartilage extracellular matrix (ECM)-derived scaffold (cartilage layer) and acellular bone matrix (bone layer) by phase separation technique.Articular high-load-bearing osteochondral defects with a diameter of 11-mm and the depth of 10-mm were created in femoral heads.The defects were treated with constructs of a biphasic scaffold seeded with chondrogenically induced bone marrow-derived mesenehymal stem cells (BMSCs).The outcomes were evaluated for gross morphology,histological,biomechanical and micro-CT analysis at the third and sixth month after implantation.Results The gross and X-ray results showed femoral head slightly collapsed at the third month and severely collapse at the sixth month.Histological analysis showed cartilage defects were repaired with fibrous tissue or fibrocartilage with severe osteoarthritis and the varied degrees of the collapse of femoral heads were presented.Micro-CT showed that the values of bone volume fraction in defect area were always lower than those of the normal area in the femoral heads.Biomechanical analysis showed rigidity of the subchondral bone in defect area was significantly lower than that in normal area in the femoral heads at the sixth month.Conclusion The ECM-derived,integrated biphasic scaffold seeded with chondrogenically induced BMSCs could not successfully repair the large high-load-bearing osteochondral defects of the femoral head.