目的观察带锁髓内钉固定结合自体骨髓移植治疗长管状骨骨折和骨折不愈合的疗效。方法对12例股骨、胫骨长管状骨骨折和骨折不愈合患者行带锁髓内钉固定、复位,同时行自体骨髓移植治疗(每2周移植1次,共移植3—6次)。结果所有病例均未出现骨折延迟愈合或不愈合,于10—18个月时取出髓内钉,未出现断钉、关节功能障碍、骨密度明显降低等。结论带锁髓内钉固定结合自体骨髓移植是一种可行的治疗长管状骨骨折与骨折不愈合的有效方法。

Objective To discuss the clinical efficacy of balloon occlusion technique in treating pernicious placenta previa.Methods Between January 2015 and March 2016,a total of 16 matcrnal patients with pernicious placenta previa,who were admitted to the Interventional Department of Qujing Municipal First People's Hospital,received balloon occlusion management to assist obstetrician in dealing with placenta previa.Central type of placenta previa with highly suspected placenta implantation were diagnosed in 15 patients by color ultrasound or MRI.Balloon catheters were placed in bilateral internal iliac arteries before cesarean section was carried out,and immediately after the fetus was taken out the balloons were inflated to temporary occlude the targeted arteries.Based on the hemostatic status the balloon catheters were timely retrieved.One patient received emergency temporary balloon occlusion of abdominal aorta,and laparotomy revealed that the placenta had penetrated to the subserosa of uterine anterior wall,and total hysterectomy had to be carried out.Results Successful balloon occlusion was achieved in all 16 patients.The mean blocking time of the artery was 15 minutes and the amount of blood loss was 300-1200 ml.Conclusion In treating pernicious placenta previa,balloon occlusion treatment before cesarean section is safe and reliable,it can significantly reduce the amount of blood loss during surgery,make quick and effective hemostasis,provide a clear surgical field for the performance of cesarean section,and,more important,save the maternal life.This effective technique has fully showed the necessity of multidisciplinary collaboration,including obstetrics,interventional radiology,etc.

Background and Objectives: With the growing incidence of acute myocardial infarction (MI), angiogenesis is vital for cardiac function post-MI. The role of bone marrow mesenchymal stem cells (BMSCs) in angiogenesis has been previously confirmed. Irisin is considered a potential vector for angiogenesis. The objective of the present study was to investigate the potential role of irisin in the angiogenesis of BMSCs. Methods: and Results: In vivo, irisin-treated BMSCs (BMSCs＋irisin) were transplanted into an MI mouse model. On day 28 post-MI, blood vessel markers were detected, and cardiac function and infarct areas of mice were evaluated. In vitro, paracrine effects were assessed by examining tube formation in human umbilical vein endothelial cells (HUVECs) co-cultured with the BMSCs＋irisin supernatant. The scratch wound-healing assay was performed to evaluate HUVEC migration. Western blotting was performed to determine PI3k/Akt pathway activation in the BMSCs＋irisin group. Transplantation of BMSCs＋irisin promoted greater angiogenesis, resulting in better cardiac function in the MI mouse model than in controls. In the BMSC＋irisin group, HUVECs demonstrated enhanced tube formation and migration. Activation of the PI3k/Akt pathway was found to be involved in mediating the role of irisin in the angiogenesis of BMSCs. Conclusions In cardiovascular diseases such as MI, irisin administration can enhance angiogenesis of BMSCs and pro-mote cardiac function via the PI3k/Akt pathway, optimizing the therapeutic effect based on BMSCs transplantation.

Objective To explore the efficacy of different incision surgeries combined with respiratory function exercise under the guidance of enhanced recovery after surgery (ERAS) in lung cancer patients. Methods From January 2020 to December 2022, a total of 200 patients in Taicang Affiliated Hospital of Soochow University were collected and randomly divided into 4 groups, with 50 patients in each group. Patients in group A received single-hole thoracoscopic surgery, preoperative ERAS concept education and respiratory trainer combined with routine respiratory function exercise; patients in group B received subaxillary non-invasive small incision surgery, preoperative ERAS concept education and respiratory trainer combined with routine respiratory function exercise; patients in group C received subaxillary non-invasive small incision surgery, preoperative routine hospitalization education and respiratory function exercise; patients in group D received single-hole thoracoscopic surgery, preoperative routine hospitalization education and respiratory function exercise. The postoperative recovery indicators and postoperative pain score were compared among the four groups. Results Compared with the other three groups, patients in group A had reduced incidence of pulmonary complications, earlier mobilization, earlier removal of the chest tube and shorter length of hospital stay (P＜0.05); compared with group B and group C, patients in group A had reduced postoperative pain score (P＜0.05). Compared with group C, patients in group B had reduced incidence of pulmonary complications, earlier mobilization, earlier removal of the chest tube and shorter length of hospital stay (P＜0.05). There was no significant difference in postoperative pain score between patients in group A and group D, and patients in group B and group C. Conclusions For lung cancer patients, single-hole thoracoscopic surgery combined with respiratory function exercise under the guidance of ERAS concept can effectively reduce the incidence of pulmonary complications and postoperative pain, and promote postoperative recovery.