Objective To investigate the ability of repairing bone defect with the compound of hydroxyapatite(HA),red bone morrow (RBM), bone morphogenic protein(BMP)and fibrin sealant (FS),and the feasibility with the compounds as bone substitute material. Methods The animal models of bilateral radius bone defect were created by surgery in the New Zealand white rabbits, and were treated with the compound of HA, RBM, BMP and FS, by autograft and no implant as control.The effect were observed by gross, histopathological and X-ray examinations, and were determined by biomechanics at 2,4,8 and 12 weeks after operation. Results By gross, histopathological and X-ray examinations, the effect indicated that the bone defect were perfectly repaired with autograft and the compound of HA, RBM, BMP and FS at 12 weeks, but not with the no implant group. The effect of biomechanics had no statistically significant difference between the autograft and the compound of HA, RBM, BMP and FS. Conclusion The compound of HA, RBM, BMP and FS possesses much high bone inductive potentialities and the ability of rebuilding bone defect and can serve as an autograft substitute material.

Objective To discuss clinical results of treatment of trimalleolar fractures by minimally invasive surgical osteosynthesis. Methods From January 2002 to Doctober 2005, twenty-eight cases (mean age: 38.7 years) of trimalleolar fracture were treated by minimally invasive surgical osteosynthesis. Their lateral and posterior ankle joints were exposed through the Gatellier-Chastang incision. The sequence of reduction and fixation of ankle fracture was firstly the posterior ankle, then the medial and lateral malleolus, and distal tibiofibular syndesmosis lastly. Postoperatively, all the patients were fixed externally from 3 to 4 weeks with plaster splint. Results Follow-ups of 18 months on average revealed that all the cases healed. The healing time ranging from 2.8 to 4.5 months averaged 3.2 months. According to the Baird-Jackson scoring system, the results were rated as excellent in 16 cases, good in eight cases, moderate in three cases, and poor in one case, with the good-excellent rate being 85.7% . Conclusions The anatomical reduction and firm internal fixation are key factors in treatment of trimalleolar fractures. The minimally invasive surgical osteosynthesis is a good method due to the minimal invasion, a high rate of union, and fewer complications it results in.

A prospective study was conducted for 91 cases of fever patients after neurosurgical procedures during the period of January-December 2013.They were divided into non-infection (n =42) and infection (n =49) groups according to whether there was infection complication.And another 51 nonsurgical hospitalized patients without fever or infection were selected as control group.The levels of procalcitonin (PCT),C-reactive protein (CRP) and white blood cell (WBC) were detected respectively.Statistical analysis showed that the level of PCT had no significant difference between non-infection and control groups (P ＞ 0.05).However,it was markedly elevated in infection group than non-infection group (P ＜ 0.01).The level of CRP was significantly different between non-infection and control groups (P ＜ 0.01).And it was the same between infection and non-infection groups.The level of WBC had significant difference between non-infection and control groups (P ＜ 0.05) and infection and non-infection groups (P ＜ 0.01).The receiver operating characteristic (ROC) curve showed that either sensitivity or specificity of PCT was the highest.Compared with CRP and WBC,PCT may identify more accurately the causes of fever after neurosurgical procedures.

Objective To explore whether the polymorphisms within the tumor necrosis factor alpha (TNF-?) and TNF-? gene are associated with the clinical types of patients with chronic hepatitis B virus (HBV) infection. Methods By using a restriction fragment length polymorphism (RFLP) assay of polymerase chain reaction (PCR) products, the single nucleotide polymorphisms (SNPs) within TNF-? and TNF-? gene among 56 patients with chronic severe hepatitis B and 71 patients with chronic mild hepatitis B or asymptomatic carriers as well as 90 healthy controls were analyzed. The TNF-? concentration of serum in 56 patients with chronic severe hepatitis B and 30 healthy controls were determined by radio immunity assay (RIA). Results The frequencies of the TNF1/2 genotype and the TNF2 allele were significantly increased in patients with chronic severe hepatitis compared with healthy controls (25% vs 11.1%,P=0.028;12.5% vs 5.6%,P=0.036) and patients with chronic mild hepatitis B and asymptomatic carriers (25% vs 8.5%,P=0.011;12.5% vs 4.2%,P=0.015). Furthermore, heterozygotes carrying TNF2 allele had significantly higher levels of serum TNF-? than homozygotes for the wild type allele among all patients with chronic severe hepatitis B (P

Objective To evaluate the surgical effect of the surgical removal of both medial temporal lobe lesion and hippocampus amygdala for treating epilepsy. Methods Retrospectively analyzed 18 cases of epilepsy induced by the medial temporal lobe lesion and their hippocampal epileptic discharge was recorded by the deep electrode. Removed both medial temporal lobe lesion and hippocampus amygdala through medial temporal gyrus by modified pterional approach. The lesion had been totally removed in all of these 18 cases in naked eye. Evaluated the effect of surgery for epilepsy by Engel grading scale. Results These cases were followed up for average 2.8 years. Engel Ⅰ for 13 cases, Engel Ⅱ for 4 cases, Engel Ⅲ for 1 cases, Engel Ⅳ for none after operation. But there were lateral 1/4 quadrantanopsia in 2 cases, recent memory decreasing in 3 cases and none of death or any other complication. Conclusion Surgical removal of both medial temporal lobe lesion and hippocampus amygdala is a safe and effective method for treating epilepsy with less complication.

BACKGROUND: Interleukin-6 (IL-6), osteocalcin (OC) and bone alkaline phosphatase (BALP) are involved in bone metabolism, which is correlative with osteoporosis.OBJECTIVE: To observe expression properties of IL-6, OC and BALP in rats with osteoporosis.DESIGN: Control experiment with observation of randomized group division was designed.SETTING: Orthopedics Department of Shenzhen People's Hospital (2nd Affiliated Hospital of Medical College of Jinan University)MATERIALS: The experiment was performed in Animal Laboratory Room and Center Laboratory Room of Shenzhen People's Hospital from January 2002 to January 2003, in which, 60 SD female rats of 6 months were employed, averagely weighted 250 g. They were randomized into 3 groups, named ovariectomized (OVT) group, control and blank group, 20 rats in each.METHODS: In OVT group, the ovaries of rat were removed bilaterally to establish osteoporosis model. In the control, after the ovary was lifted out of abdominal cavity when the abdomen was opened, it was returned back and the abdomen was closed. In blank group, no any management was performed. In 2, 3, 4, 5 and 6 months after surgery, 4 rats were randomized from each group for assays of bone density, OC, IL-6 and BALP.MAIN OUTCOME MEASURES: Changes of bone density, OC, IL-6 and BALP of whole body of rat.assay in rats: In 4, 5 and 6 months, in OVT group, bone density was reduced remarkably compared with the control and blank group [in 4 months:(0.139 5±0.007 8), (0.147 0±0.000 8), (0.145 9±0.002 9) g/cm2; in 5 months: (0.137 9±0.000 9), (0.145 6±0.000 8), (0.144 7±0.000 5) g/cm2; in 6 months: (0.122 6±0.000 4), (0.145 0±0.002 1), (0.144 0±0.000 9) g/cm2, P sults of IL-6 assay in rats: At every time spots, IL-6 in OVT group was sults of BALP in serum of rats: In 4, 5 and 6 months, BALP in OVT group was higher significantly than the control and blank group [(2 026±4) vs (1 247±12), (1 291±7) nkat/L, (2 342±9) vs (1 273±18), (1 342±12) nkat/L,(2 633±15) vs (1 340±9), (1 357±8) nkat/L, P ＜ 0.05].CONCLUSION: In the rats with osteoporosis, bone density is decreased significantly and IL-6, OC and BALP are significantly expressed, which can be taken as the indexes for diagnosis and screen of osteoporosis.Zhang XM, Xu ZS, Xiao DM, Li R.Expression properties of interteukin-6, osteocalcin and bone alkaline phosphatase in osteoporosis rats Zhongguo Linchuang Kangfu 2005;9(43):190-2(China) [www.zglckf.com]INTRODUCTIONOsteoporosis induces complications, like bone fracture, which is associated with various factors, such as estrogen level. Osteocalcin (OC) is a kind of active multi-peptide secreted from osteoblasts,which plays the importance in regulating calcium metabolism and is a new biochemical mark in study on bone metabolism. Interleukin-6 (IL-6) provides powerful bone absorption and stimulation,which plays the important role in coupled information exchange ofbone absorption and formation. In this experiment, ovarietomy was done bilaterally in SD female rats to establish osteoporosis, afterwards, bone density, serum OC, IL-6 and bone alkaline phosphatase (BALP) were determined to probe into their relationship with the incidence of osteoporosis.

BACKGROUND:There is lack of an objective and standardized animal model for assessing the therapeutic effect of physical and medication treatment on bone defoct, the effectiveness of operation, as well as the role of bone substitute in the repairing of bone defects.DESIGN:Verified study on the experimental model of bone nonunion in rabbitsSETTING: Department of Orthopaedics in Shenzhen people' s Hospital MATERIALS:Twenty common grade pure New Zealand rabbits of either gender were selected with body mass of (2.5±0.5)kg,aged 6 to 8 months.METHODS :This experiment was carried out at the experimental animal center of Shenzhen people's Hospital between May and August 1999. 1.5cm bone segment (including periosteum)was cut off in the middle of forearm radius in 20 common grade pure NewZealand rabbits,the broken ends were covered with bone wax, 10 weeks later, the bone nonunion status was assessed by macropathological observation, pathohistological and X-ray examination.MAIN OUTCOME MEASURES:Observations on rabbit forearm radius defects by macropathological observation, pathohistological and X-ray examination.RESULTS :Twenty rabbits(40 side radius)were enrolled in this study and weeks later, bone defect region was found filled with fibrous cicatricial tissue without osseous connection ,bone wax was not absorbed, capitulum was ossified with medullary cavity blocked,a small amount of callus formed at both broken ends of fractural bone ,length of bone defect ranged from 0.8 to blocked under optical microscope,chondrocyte and osteocyte could be observed arranging disorderly and covered with fibrous membrane,defect reosseous connection could be detected at defect region at week 10,broken end was ossified and medullary cavity was blocked ,there was small amount of callus appeared at both broken ends displaying irregular shape.CONCLUSION:Bone nonunion experimental animal was successfully established on rabbits in this study, with pathological changes meeting the need of bone nonunion and displaying typical properties,which can be used as reliable and feasible experimental animal model.

Objective To investigate the causes,diagnosis and treatment of postoperative acute cholecystitis. Methods Clinical data of 9 cases with postoperaive acute cholecystitis were analyzed retrospectively. Results7 cases was confirmed by ultrasonography, 1 case was confirmed by CT, and 1 case died of gallbladder perforation, no operative mortality in emergency cholecystectomy. Conclusion The prevalent etiology is biliary stasis. Early diagnosis and treatment is the key point to decrease the death rate.

BACKGROUND: Studies have demonstrated that intermittent high glucose can have a more severe impact on vascular endothelial function in comparison with persistent hyperglycemia.OBJECTIVE: To investigate the effect of intermittent high glucose on the proliferation and apoptosis of endothelial progenitor cells (EPCs) from human peripheral blood in vitro as well as the production of malondialdehyde (MDA) and antioxidant. METHODS: Total mononuclear cells were isolated from human peripheral blood by Ficoll density gradient centrifugation and then the cells were placed on fibronectin-coated culture dishes. After 7 days of culture, the adherent cells were identified as EPCs by laser scanning confocal microscope. The cells were synchronized and then stimulated with glucose 5.5 mmol/L (normal control group), 20 mmol/L (constant high glucose group), and 5.5/20 mmol/L (intermittent high glucose group, 5.5 and 20 mmol/L glucose culture solution was changed every 8 hours) for 72 hours. EPCs proliferation and apoptosis was measured by MTT assay and flow cytometry, respectively. The content of MDA and the activity of superoxide dismutase (SOD) in culture solution were detected with colorimetry.RESULTS AND CONCLUSION: After EPCs were exposed to constant high glucose (20 mmol/L) and intermittent high glucose (5.5/20 mmol/L) for 72 hours, proliferated cells were significantly reduced and the apoptosis rate was significantly increased compared with those exposed to normal glucose (P < 0.01). Furthermore, there was a significant increase in MDA contents as well as a significant reduce in SOD activities in the constant high glucose and intermittent high glucose group (P < 0.01), especially in the latter group. These findings indicated that both intermittent high glucose and constant glucose could inhibit the proliferation and promote the apoptosis of EPCs; however, intermittent high glucose appears to worsen the effects on EPCs. This is maybe due to the increased oxidative stress.

ObjectiveTo evaluate the neuroprotective effect of gradient perfusion-rewarming after deep hypothermia circulatory arrest (DHCA) in piglets.Methods12 Shanghai piglets (3-4 weeks old) were randomly divided into two groups of A (experiment group) and B (control group),average weight (9.78 ±0.93)kg.Animal CPB model is completed with microinvasive technique.DHCA duration is 90 min in two groups.During the rewarming period,group A was rewarmed with gradient perfusion strategy,maintain the temperature for 15 min every 5 ℃ elevation of the core temperature.Group B was rewarmed according normal consistent rewarming strategy.PH-stat management is adopt in both groups.Blood gas analysis,rectal temperature,heart rate,ECG,blood flow rate of carotid artery,glumatic acid/aspartate level of jugular vein and protein NFB of brain tissue are monitored during and/or after the cardiopulmonary bypass (CPB).ResultsDuration of rewarming in group A is (67.3 ± 7.8) min,and (41.8 ± 3.6)min in group B (P ＜ 0.05).Sample collected at the beginning of CPB,15 min of rewarming,30 min of rewarming and 45 min of rewarming show that there is no difference between the blood flow rate at 15 min of rewarming; difference are shown at the 30 min and 45 min of rewarming (P ＜ 0.5 ).High performance liquid chromatography ( HPLC ) analysis show the obvious difference of glumatic acid level of jugular vein at 30 min of rewarming and 45 min of rewarming ( P ＜ 0.5),this kind of difference of aspartate can only be seen at the 45 min of rewarming.Histologic evaluation shows gradient rewarming has a better effect on preservation of CA1 area neuron in hippocampus,however,Immunohistochemistry doesn't find the same effect.ConclusionControlled gradient perfusion-rewarming strategy can improve the neuroprotective effect during DHCA,keeping the balance of the blood flow,cerebral local temperature and brain metabolism might be the mechanism.