Objective To compare the effect of calcium sulfate pellets made by different methods in repair of segmental radial defect of rabbits. Methods Eighty white New Zealand rabbits were sub-jected to defects of middle part of the left radial bone and divided into four groups according to repair ma-terials: control group (Group A, implanted with no artificial bone substitute), uncoated pressed calcium sulfate pellets (Group B), coated pressed calcium sulfate pellets (Group C) and coated pressed calcium sulfate pellets combined with rhBMP-2 (Group D). Histologic examination and biological test were done at 4, 8 and 12 weeks after operation. The data were processed with mono-factor variance analysis. Re-sults New bone formation was found on the defected bone in Group D and Group C, with better in Group D. The bone strength test showed that the anti-bending strength was (39.6±1.7) % in Group C and (47.5±2.1) % in Group D, which were higher than (21.3±2.7) % in Group A and (23.6±3.3) % in Group B, with higher anti-bending strength in Group D than that in Group C (F = 125.3 ,P <0.01). Conclusions For restoration of segmental bone defects, chitosan-coated pressed calcium sulfate pellet shows relatively high density and slightly slow resorption, which closely coincides with the growth rate of new bone. The coated pellet combined with rhBMP-2 can enhance its osteogeneais in restoring segmental Done defects.

[Objective]To explore the effects on surrounding tissue and bone regeneration by citrated calcium sulphate(CCaS) and Ostesset~.[Method]Bilateral or lateral femoral condyles were drilled into defects in 18 rabbits,and divided into 3 groups: A,12 rabbits,left defect filled with CCaS cylinder,right defect with osteoset~;B,3 rabbits,left defect with CCaS,right defect blank;C,3 rabbits,left defect with osteoset~GFDA3,right defect blank.The rabbits were sacrificed at 3 wks,6 wks and 13 wks,and defect samples were taken for histological exam,roengenographic observation and bone tissue calculation by image-plus CCD system.[Result]The defects that were not grafted were filled with bone marrow and there was minimal new bone,only at the margen of the defects CCaS and osteoset~GFDA3 implanted in the defects were gradually absorbed,and substituted by new bone trabecula,which became more mature and thicker.The area fraction and trabecula thickness of new bone in defects treated with CCaS were not significantly different from defects treated with osteoset~ after 3,6,13 wks.However,the degradation velocity of CCaS was slower than that of osteoset~.No inflammatory and foreign body response was observed.[Conclusion]Just like osteoset~,CCaS is more benefitial to new bone formation compared with osteoset~,because CCaS has relatively slower degradation velocity.

Objective To evaluate the causes,clinical manifestations and diagnosis of tarsal tunnel syndrome. Methods Operation was performed for 18 patients ( 21 sides) with tarsal tunnel syndrome. Preoperative Takakura index was 3-7 points with an average of 6.4 points. Ganglion was found in 15 cases (17 sides), varicosity in 2 cases (3 sides) and lipoma in 1 case. Results The symptoms disappeared without recurrence in 0.5 to 17 years' follow-up (average 7.3). Postoperative Takakura index was 9-10 points (average 9.7). Conclusion Tarsal tunnel syndrome is rare in the clinical practice with varied causes and different clinical manifestations. Operation can be performed with satisfactory results for the patients unsuitable for conservative treatment.

Objective A retrospective study of the results of surgical or non-operative treatment in patients with herniation of lumbar disc 10 years or longer before,in order to evaluate the efficacy of different therapeatic strategies for lumbar disc herniation. Method Definite diagnosis of lumbar disc herniation was made in all cases before treatment,and the follow-up period was 10 to 38 years. The patients were divided into three groups according to different treatment methods: non-operative group,simple nucleus resection group,and nucleus resection combined with space fusion group. The long term therapeutic effects and image change of the three groups were observed. The difference of height of intervertebral space at the herniation site was measured before treatment and at the latest follow-up. Adjacent spaces were also observed. The data were analyzed statistically by t -test and ? 2 -test. Results Among 98 cases in non-operative group,85 cases enjoyed almost a normal life and work;vertebral canal decompression was performed for the rest 13 cases because of intermittent claudication. The protruded space was narrowed for 3.17?1.65mm in height in average after non-operative treatment,and there was degeneration of adjacent spaces in 13 cases. Among the 84 cases in simple nucleus resection group,relative good outcome was seen in 71 patients,and the remaining 13 cases had to receive a second operation because of symptom relapse. The protruded space was decreased 5.50?1.51mm in height in average as measured at the latest follow-up comparing with that of before operation. The degeneration of the adjacent space was observed in 15 cases. In 71 patients who received nucleus resection combined with space fusion experienced a good relief of symptoms. The space,where disc herniation had occurred,fused very well and no re-narrowing occurred. Degeneration of the adjacent space was observed in 39 cases,but the patients were symptomless. Conclusions The effect of either non-operative therapy or operation for patients with lumbar disc herniation was good after a long-term follow-up if the indication was chosen properly. We suggest that non-operative therapy should be the first choice for the lumbar disc herniation. The relatively normal nucleus should be preserved as much as possible when nucleus resection was performed. Intervertebral fusion was a relative better treatment comparing with the other two treatments.

Objective The complications of internal fication for calcaneal fracture were summarized and discussed to increase awareness of these complications, and to improve decision making and efficacy of the treatment. Methods The patients admitted to our hospital from October 1997 to June 2003 were followed up. The fracture in 68 feet (66 patients) was treated with open reduction and internal fixation (ORIF) using steel plate. The complications associated with ORIF were analyzed and discussed as to etiology, incidence, diagnosis, prevention and treatment. Results The patients were followed up for 7 to 57 months. Complications were found in 14 cases, including postoperative wound dehiscence in 5 (infection in 2), malunion (failure to achieve reduction) and arthritis in 9, accompanied by nerve injury in 6. The percentage of complication was 20 6%. With timely treatment, good function was regained in most of the patients. Conclusion Should attention be paid to the operation, many complications could be avoided. ORIF with plate is one ot the options for the treatment of this fracture, but the operative technic and the device should be improved. As the anatomy of the calcaneus is different from a long bone, it is unsuitable to apply the principle and device that are used in the internal fixation of a long bone to this fracture. The plate and screws used in the fixation of the calcaneal fracture can not give enough support

0.05).The maximum relaxant forces of vitrification and fresh arteries groups were greater than the freezing group(P 0.05).The arteries of three groups began obvious relaxant responses when sodium nitroprusside was 10-7 mol/L, and nearly reached their maximal relaxant responses when sodium nitroprusside was 10-4 mol/L.CONCLUSION:The vitrification could preserve more active smooth muscle cells of arteries than the freezing method.The norepinephrine has better effect on contraction ability of artery, which preserved in the vitrification group than the freezing group;however, there is no difference in relaxation of sodium nitroferricyanide.

Objective To research and make one kind of intravascular soluble hollow stent for vascular anastomosis. Methods According to the chemical industry, CaCl2, polyethylene glycol (PEG)and gelatin were used to make one kind of intravascular soluble hollow stent for vascular anastomosis, whose surface was covered with CaCl2 membrane(CaCl2 hollow stent). After putting the stent into the two cut sides of vascular, the author put the two sides together, and dropped alginic acid sodium solution, CaCl2 solution, and glue respectively. As soon as the glue solidified, the anastomosis was finished. Results The CaCl2 hollow stent could not only support the cannel of vascular, but also generate two membrane in the two side of anastomosis site. Thus the thickness of sealant was increased. It was effective to prevent leaking of cyanoacrylate glue and its toxicity. Conclusion The CaCl2 hollow stent can generate two membrane in the two side of anastomosis site, and could increase seal effectively. Using this stent could improve the anastomosis patency by increasing the sealant thickness, and preventing leakage of cyanoacrylate glue and its toxicity.

[Objeetive]To report the repairing offect of cancellous bone defect with calcium sulphate.[Method]A defect 5mm in diameter and 12 mm in deep,which was drilled in the lateral aspect of rabbit lateral femoral condyle,was filled with CCaS(Citrated Calcium Sulphate)cylinder or Osteoset tablets respectively.Rabbits were killed 3,6,13 weeks after surgery.And then general oberservations and mechanical analyzing were conducted.[Result]After surgery,rabbits had good movements,spirits and eating,good healing of incision.There was no arthroedema and inflammatory response around the joints.Mechanical analyzing reports:both anticompressive strength and elasticity coefficient in the artificial bone repair bone defect area 3 weeks after surgery,were higher than in that of normal femur condyle;Anti-compressive strength and elasticity coefficient in the defect area 6 weeks,which drop comparing to 3 weeks,was lower than that of normal femur condyle;Anti-compressive strength and elasticity coefficient 13 weeks,which is higher than 6 weeks,is approaching normal.Mechanics intensity of two groups in the different time had no significant difference,but was significantly higher than one of the same time blank group.[Conclusion]To some extent,Calcium Sulphate has mechanical supportive effects on cancelloues bone defect in spite of the absorption and degradation of Calcium Sulphate.There is no significant difference between Citrated Calcium Sulphate and Osteoset tablets.

[Objective]To probe the efficacy of total hip arthroplasty(THA)in the treatment of patients with ankylosing spondilitis(AS).[Method]Ninety-eight THA were performed in 56 patients who had AS,and 42 patients(76 hips)were analyzed retrospectively with an average follow-up period of 5.6 years(ranged,2.5 to 5.5 years).The clinical results were evaluated by the Harris hip scoring system and radiographic analysis.[Result]For the latest follow-up,the average Harris hip score improved from 26.8 points(ranged,4 to 51 points)preoperatively to 85.2 points(ranged,55 to 94 points)at the final postoperatively evaluation.89.5% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperatively.One patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosis.There was no sign of loosening,dislocation or fracture of the prosthesis.According to the system of Brooker,the incidence of heterotopic ossification was 9.2 %(7 hips).[Conclusion]THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip joint.Compared with THA operated for other cause of disease,THA in AS leads to no high risk.

Periosteal autograft from different sources have been used to repair 1 5cm bone defects of radius in 10 rabbits.On the left side,sharp dissected grafts were implanted and the animals were sacrificed 4,8,14,30 and 60 days after operation.Bone formation was studied with X ray and histologic technique.The results showed that the way of sharp dissecting can preserve the periosteum completely,and good bone formation was found in this group.It suggested that the sharp dissecting of the periosteum is the important key for periosteal graft.