BACKGROUND:With increasing freeze-drying time,the water content of allogeneic bone reduces along with the bone mechanical strength.The suitable dehydration degree that maintains mechanical strength of allogeneic bone and allows long-term preservation at room temperature remains controversial.OBJECTIVE:To detect the mechanical properties of bovine bone nail following different degrees of dehydration using the three-point bending mechanics tests.DESIGN,TIME AND SETTING:Biomechanical analysis,comparative observation.The experiment was performed at the Mechanical Laboratory of Southern Medical University between May 2007 and May 2008.MATERIALS:Bone nails,50 mm length and 3 mm diameter,made from healthy adult bovine femoral cortical bone were divided into control and freeze-drying groups (8,12,24 hours,respectively) with 20 samples in each group.METHODS:The water content of bone nails with or without freeze-drying was measured by SH10A Moisture Quick Determination Meter.Three-point bending mechanics tests were performed using MTS 858 Mini Bionix.The parameters included load range 0-2000 N,resolution 0.01 N,cross beam replacement resolution 0.001 mm,span 50 mm and loading speed (cross beam replacement speed) 2 mm/min.MAIN OUTCOME MEASURES:Water content,maximal load and elasticity load.RESULTS:The water content of control group was 7%-9%,and following freeze-drying for 8 hours,the water content was 5.5%-6%,which met the standard of freeze-drying bone;Compared with control group,the maximal load and elasticity load reduced respectively 0.004% and 0.000 8% (P＞0.05).Following freeze-drying for 12 and 24 hours,the water content was 3.5%-4% and 1%-1.5%;the maximal load reduced 21% and 37% and the elasticity load reduced 22.5% and 39% compared with control group (P＜0.05).CONCLUSION:Freeze-drying for 8 hours is the best time of dehydration.The mechanical load and elastic modulus reduce with increasing freeze-drying time.

[Objective]To investigate new methods of the management of closed rupture of Achilles tendon surgery to reduce postoperative skin necrosis.[Method]Small incisions and Absorbable sutures were used to manage 39 cases of closed Achilles tendon rupture,with proximal stump a Bunnell-type suture and remote stump percutaneous repair.[Result]In the 39 cases,three developed slight skin necrosis,of which two healed by changing dressings,the other one healed by debriding and sutureing.Follow-up of 10 months to 36 months was available for 35 cases.According to Arner-Lindholm efficacy evaluation standard,29 cases (82.9%) had excellent result,4(11.4%) had good result,with the good to excellent result of 94.3%.[Conclusion]Small incisions and Absorbable sutures used to manage the closed Achilles tendon rupture,with proximal stump a Bunnell-type suture and remote stump percutaneous repair is an effective and reliable methord for closed Achilles tendon repture,with small invasion,less impact on the skin blood supply,less skin necrosis,less re-rupture reinfection,and faster recovery.

ObjectiveTo observe the treatment effect of seveve acute pancreatitis (SAP) with gabexate combined with Xuebijing after local infusion. MethodsForty-four patients with SAP were randomly divided into receiving intravenous gabexate or Xuebijing alone (control group) group and receiving local infusion with gabexate combined with Xuebijing( experimental group) group. At 1,7,14 days of testing in diamine oxidase (DAO), lipopolysaccharide, IL-18, TNF-α, APACHE- Ⅱ score, T lymphocyte subpopulation and monocyte HLA-DR expression and single change in the number of nuclear cells were tested. ResultsBetween two patients groups at 1,7,14 days diamine oxidase, lipopolysaccharide, IL-18, TNF-α, APACHE-Ⅱ score showed a downward trend; T suppressor cells (Ts) reduced in their percentage; total T lymphocytes, T helper cell (Th), monocyte HLA-DR expression (percentage) and mononuclear cells showed an upward trend in the experimental group than control group, the differences being statistically significant (P ＜ 0.05). In the experimental group and control group, the pain relief time, intestinal function recovery time, the withdrawal of ventilator time, the incidence of sepsis, the rate of conversion to open surgery were statistically significant different (P ＜ 0.05 ). Conclusions Compared with intravenous drug use alone the implementation of gabexate combined with Xuebijing local infusion can reduce the early course of SAP patients intestinal permeability and reduce endotoxin translocation, protect intestinal barrier function of patients with SAP, improve the patients' immune function, symptoms, signs and reduce the rate of sepsis and transit operations.

Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

Objective To investigate the correlation between the incidence and characteristics of anemia in chronic heart failure population through retrospective analysis of patients hospitalized at the Hunan Provincial People's Hospital.Methods A total of 259 patients who were diagnosed as chronic heart failure (CHF) and hospitalized at the Hunan Provincial People's Hospital from October to November in 2012 was collected,and divided into cardiac function Ⅰ ～ Ⅳ grade,then their clinical characteristics was analyzed.Results (1)Compared with CHF patients without anemia,the creatinine value was significantly higher,the percentage of patients with severe heart failure was significantly higher in the CHF patients with anemia (P＜ 0.05).(2) Logistic regression analysis demonstrated that age (95％ CI:1.123 ～ 3.580,P ＜ 0.05),renal insufficiency (95％ CI:1.320 ～ 4.845,P ＜ 0.05),and cardiac function (95 ％ CI:1.368 ～ 3.385,P ＜ 0.05) in patients with heart failure were important risk factors for anemia.Conclusions Anemia was common in CHF patients.The poorer cardiac function was and the lower hemoglobin was,the higher incidence of anemia was.The patients with anemia had the characteristics of worse renal function and poorer nutritional status compared patients without anemia.Age,renal insufficiency,and cardiac function were important risk factors for anemia.

Objective To observe the effect of music therapy on stroke patients with depression.Methods 70 post-stroke depression patients were divided into the observation group and the control group according to the hospitalized number,the control group received conventional therapy neurology without giving antidepressants;the observation group were given music therapy group basis.Both groups were at the time of enrollment and after treatment using the Hamilton Depression Rating Scale (HAMD),Self-rating Depression Scale (SDS) for the two groups of patients assessed the degree of depression.Results After the treatment,the HAMD score of the observation group was (23.57 ± 10.33)points,compared with the control group[(28.20 ± 8.83)points],the difference was statistically significant (t =2.02,P ＜ 0.05);the SDS score of the observation group was (61.00 ± 10.67) points,compared with the control group [] (66.11 ± 10.38) points],the difference was statistically significant (t =-2.03,P ＜ 0.05).Conclusion Music therapy for depression in patients with post-stroke recovery has a positive meaning.

BACKGROUND: Defatting is to reduce the special cell surface antigens by clearing fat and lipoprotein, so as to decrease immunological rejection, improve the biocompatibility of allograft bone, and increase osteogenic potential. However, the effect of defatting on biomechanical performance of bone remains controversial.OBJECTIVE: To explore the influence of defatting on the biomechanics of bovine cortical bone samples.DESIGN, TIME AND SETTING: Randomized, self-controlled observation was performed in Futian People's Hospital of Guangdong Medical College between 2006 and 2008.MATERIALS: Eight pairs of healthy adult bovine femora were used. Bone blocks, 50 mm long and 10 mm wide, were selected from each pair of femora, and burnished into 24 pairs of 7 mm×7 mm×40 mm rectangular bovine cortical bone samples.METHODS: The 24 pairs of cortical bone samples were randomly divided into two groups (n=12). One of each pair was selected as test group sample, and the other as control group sample. The samples of test group were defatted In 500 mL chloroform and methanol mixture (1:1) for 24 hours, while control samples were immerged in deionized water for 24 hours. Six samples from each group were selected for axial compressive test and three-point bending test.MAIN OUTCOME MEASURES: Load and deflection of every sample.RESULTS: Axial compressive test showed that the maximum load and the maximum strain of defatted samples were significantly decreased compared with control group, but the fragility and elastic modulus were increased (P < 0.05). In three-point bending test, the maximum load and the maximum stress of defatted sampled were significantly decreased, the maximum deflection was decreased, and the elastic modulus was increased (P < 0.05).CONCLUSION: The mechanical strength of cortical bone decreased but the fragility increased after defatting.

Objective To report our self-designed guide module for placement of posterior column lag screws in anterior-posterior column acetabular plate using CT reconstruction data.Methods The CT scan data of 50 normal adult pelves were collected from February 2012 to April 2013,involving 30 males and 20 females with an average age of 46.4 years(range,from 25 to 69 years).The data were imported into Mimics 10.01 software for reconstruction of semi-pelvic models.Virtual cylindrical implants were placed intraosseously in both the left and the right posterior columns.The perpendicular distance (OP) from the insertion point O of the virtual cylindrical implant to the arcuate margin (P) and the distance (PI) from the point P to the point I,the crosspoint of the extension line of the ischial ramus and the arcuate margin were measured respectively.The angle (∠φ) between the direction of screws and the plane of guide module and the angle (∠θ) between the direction of screws and the long axis of guide module were also measured respectively.Results The average length of PI was 0.98 ± 0.13 cm,with 1.08 ± 0.22 cm in females and 0.95 ± 0.27 cm in males.The difference between genders was not statistically significant (P ＞ 0.05).The average length of OP was 1.09 ± 0.26 cm,with 1.06 ± 0.29 cm in females and 1.12 ± 0.24 cm in males.The gender difference was not statistically significant either (P ＞ 0.05).The mean value of ∠ φ was 55.43° ± 3.64°,with 55.33° ± 4.00° in females and 55.50° ±3.43° in males.The difference between genders was not statistically significant (P ＞ 0.05).The ∠θ value in females was 39.21 ° ± 2.45° and 35.58° ± 2.31 ° in males.The gender difference was statistically significant (P ＜ 0.05).Conclusions In design of the guide module,the nail holes should be located about 1 cm away from both the posterior edge and the medial edge,the angle between the screw direction and the module plane should be approximately 39° in females and 35° in males,and the angle between the screw direction and the long axis of the module approximately 55°.

Objective To evaluate the diagnosis and treatment of duodenal neuroendocrine tumors.Method We retrospectively analyzed data of 15 patients with duodenal neuroendocrine tumors admitted between August 1999 and July 2012.Result In all the 15 cases accurate and definitive diagnosis were achieved via pathological examination and immunohistochemistry.Clinical diagnostic methods included ultrasound,endoscopy,upper gastrointestinal imaging,abdominal CT,MRI,etc.7 cases underwent pancreaticoduodenectomy,2 cases were treated by local excision,4 cases by endoscopic excision,and total gastrectomy and distal gastrectomy was performed in one each case.Conclusions The diagnosis of duodenal neuroendocrine tumors is established mainly by endoscopy and diagnostic imaging.Surgical resection is the treatment of choice.Pancreatoduodenectomy and local excision is applicable for G2 and G3 patients while endoscopic excision can be used for G1 patients.

Objective To evaluate the correlation between homologous recombination repair protein RAD51 and methotrexate-enhanced radiosensitivity.Methods Western blot and RT-PCR assays were used to detect RAD51 expression in HOS osteosarcoma cells exposed to γ-ray irradiation alone and in combination with methotrexate.Colony formation assay was used to test the survival fraction of HOS cells exposed to γ-rays and methotrexate.Results Methotrexate inhibited both protein and RNA expressions of RAD51,and the combination of radiation and methotrexate enhanced the inhibition of RAD51 expression.Moreover,transfection of cells with RAD51 gene decreased cellular sensitivity to methotrexate and γ-rays.The sensitizer enhancerment ratios after irradiation in combination with methotrexate were 1.51 and 0.99,respectively.Methotrenate was a preferred radiosensitizer to HOS cell.Conclusions RAD51 might be involved in the methotrexate-enhanced radiosensitivity.