ObjectiveTo observe the effect of continuous irrigation on preventing dura mater adhesion after laminectomy.Methods30 New Zealand rabbits were used as the animal model. Laminectomy was performed in L 2 and L 6 segments of every rabbit respectively through two incisions. One incision was sutured directly, and as the control group. Irrigative pipe was put into the other incision as the irrigation group and continuously irrigating for 72 h. The animals were sacrificed at 4, 8 and 12 weeks postoperatively. The specimens were prepared for macroscopy, light microscopy, electron microscopy and computer image analysis.ResultsAt 12th week, macroscopy and light microscopy showed that in the control group epidural scar was dense and widespread, and adherent to dura tightly, but in irrigation group epidural scar was loose and limited, and adherent to dura scarcely. There was a significant difference between two groups (P<0.05). Electron microscopy showed that in control group the epidural tissue was mainly dense scar, and in irrigation group it was mainly fat tissue which mixed with a few of collagen fibers.ConclusionThe continuous irrigation has a preventive effect on adhesion of dura mater after laminectomy in rabbit.

ObjectiveTo observe the clinical therapeutic effect of postoperative infection of fracture bone of lower extremity treated with external fixation device combined with closed irrigation.Methods32 patients of long bones fracture of lower extremities with postoperative infections were treated with composite external fixation device combined with focus clearance and continuing closed irrigation.ResultsThrough 1.5～3 years follow-up, there was no infection relapse in 31 extremities, 26 bones' fractures healed in half a year, there was no malunion such as crispation or angulation and there was no complication of serious anchylosis.ConclusionIt is an efficient way to treat postoperative infection of fracture bone of lower extremity with external fixation device combined with closed irrigation.

Objective To investigate the expression level of collagen triple helix repeat containing 1 ( CTHRC1) in human gastric carcinoma and the relationship with the clinicopathological characteristics of gastric cancer?Methods The expression of CTHRC1 in human gastric carcinoma and normal gastric mucosa were detected by immunohistochemistry ( S?P method ) , and the correlation with various clinical characteristics, including gender,age,tumor diameter,degree of differentiation,depth of invasion,lymph node metastasis,TNM stage,was analyzed?Results ( 1 ) CTHRC1 expressed positive for 41 cases ( positive rate=53?95%) in 76 gastric carcinoma specimens, but only 1 case ( positive rate=3?33%) expressed positive in 30 normal gastric mucosa,the difference was statistically significant (χ2 =23?0332, P=0?000 )? ( 2 ) In early stage of gastric carcinoma,CTHRC1 was predominantly positive in the nucleus,but with the progression of the tumor,CTHRC1 expressed predominantly in cytoplasm?( 3) The expression of CTHRC1 was correlated with the depth of invasion (P=0?000),lymph node metastasis(P=0?009) and TNM?stage(P=0?007),but not with age,gender,size of the tumor and differentiated degree ( P>0?05 )?Conclusion CTHRC1 might play important roles in the occurrence,invasion and metastasis in human gastric carcinoma,and may be new therapy targets.

Objective To evaluate the operative results of the prolapse of lumbar intervertebral disc and segmental instability.Methods37 patients with prolapse of lumbar intervertebral disc and segmental instability were treated surgically, including nucleus gelatinosus extirpation,!lumbar fusion and transpedicular screw fixation with an average 9-month follow-up after the operation.ResultsAfter the treatment, the completely spine arthrodesis was obtained in all cases. Of 37 cases, 28 cases showed excellent clinical results, 7 cases were good, 2 cases improved, and the total fineness rate was 95.6%.ConclusionIt is an effective therapy for patients with prolapse of lumbar intervertebral disc and segmental instability that fusing and fixing the lumbar with transpedicular screw after nucleus gelatinosus extirpation.

BACKGROUND:Unicompartmental knee arthroplasty has become mainstream operation for treatment of unicompartmental osteoarthritis of the knee, but unicompartmental knee arthroplastystil has some problems, such as excessive bleeding-induced postoperative blood transfusion, increased blood transfusion rate, hospitalization expense and complication of blood transfusion. As tranexamic acid for total knee arthroplasty has achieved good effects. It is significant to investigate whether local application of tranexamic acid can effectively reduce blood loss in unicompartmental arthroplasty.
OBJECTIVE:To investigate the efficacy and safety of the intra-articular tranexamic acid injection in treating perioperative blood loss in patients undergoing unicompartmental knee arthroplasty.
METHODS:122 patients with knee osteoarthritis undergoing unicompartmental knee arthroplastyinthe Department of Orthopedics, the Second Affiliated Hospital ofDalian Medical University from January 2014 to August 2015wereenroled in this study. Al patients were randomly divided into two groups. Patients in the tranexamic acid group were injected with 10 mL of tranexamic acid (containing 1000 mg) + 10 mL of sodium chloride injection in the articular cavity before loosening the tourniquet. Patients in the control group received 20 mL of sodium chloride injection in the articular cavity. In both groups, the drainage tube was clipped for 3 hours after injection.At 48 hours after replacement, the drainage tube was puled out. We compared and analyzed hemoglobin levels and hematocrit at 2 days and 1 month postoperatively, total blood loss and drainage volume at 2 days postoperatively, the number of patients receiving blood transfusion, Hospital for Special Surgery scores of knee function at 1 week and 1 month postoperatively, and thrombosis at 1 week postoperatively, and evaluated effects of tranexamic acid on blood loss after unicompartmental knee arthroplasty.
RESULTS AND CONCLUSION:(1) Hemoglobin levels and hematocrit were significantly higher in the tranexamic acid group than in the control group at 2 days postoperatively (P< 0.05). No significant difference in hemoglobin levels and hematocrit was detected at 1 month postoperatively in both groups (P> 0.05). (2) Drainage volume and total blood loss were significantly less in the tranexamic acid group than in the control group at 2 days postoperatively (P< 0.05). (3) The number of patients receiving blood transfusion was significantly less in the tranexamic acid group (0 case) than in the control group (6 cases) (P< 0.05). (4) Scores of Hospital for Special Surgery were significantly higher in the tranexamic acid group than in the control group at 1 week postoperatively (P< 0.05). No significant difference in above socres was identified between the two groups at 1 month postoperatively. (5) No venous thrombosis was found at 1 week postoperatively in both groups. (6) These results confirm that during knee medial unicompartmental arthroplasty, intra-articular injection of tranexamic acid combined with 3 hours of blood occlusion can effectively reduce drainage volume, perioperative blood loss, blood transfusion, is beneficial to the early recovery of knee jointfunction after replacement, and does not increase the risk of lower extremity deep venous thrombosis.

Objective To compare the effects of different doses of FTY720 on inhibiting expression of Caspase-3 and neural apoptosisin rats with acute spinal cord injury (SCI), and find out the suitable dose. Methods 200 female SD rats were randomly divided into 5 groupswith 40 in each group. Group A (laminectomy but not contusion) were administered 0.3 ml normal saline by gavage. SCI model was establishedby Allen's WD method at the T9 level of spinal cord in other groups. Group B were administered 0.3 ml normal saline after modeling.Groups C, D and E were administered 0.3 ml FTY720- saline solution of 1, 3 and 5 mg/kg respectively. All the groups were sacrificed at 6 h,12 h, 24 h, 48 h, 72 h (n=8, per each time-point). Caspase-3 expression was detected with streptavidin-peroxidase immunohistochemistry,and neural apoptosis was detected with the TUNEL method. Results Positive Caspase-3 expression and neural apoptosis were not observedin Group A at 6 h. In Groups B、C、D and E, the number of apoptotic cells increased with increased time of acute SCI, peaked at 24 h afterinjury, and then gradually reduced. Caspase-3 expression was at equal pace with neural apoptosis. The difference of the number of apoptoticand Caspase-3 expression cells among all groups were significant, with the order Group B>Group C>Group D>Group A (P<0.05). However,there was no significant difference between Group D and Group E (P>0.05). The number of apoptotic and Caspase-3 expression cells negativelycorrelated with the dose of FTY720 when the dose was less than 3 mg/kg (P<0.05), and there was no relationship when the dose wasmore than 3 mg/kg (P>0.05). Conclusion FTY720 significantly reduces Caspase-3 expression and neural apoptosis in rats with acute SCI.There is a dose-effect relationship between the dose of FTY720 and the Caspase-3 expression and neural apoptosis. It's indicated that 3 mg/kg is the most appropriate dosage.

ObjectiveTo study the effect and mechanisms of nourishing Piyin Remedy (nPR) and bovine brain extract (bBE) on experimental spinal cord injury (SCI) of rat.Methods80 healthy SD rats were divided into 5 equal groups randomly: bBE group supplied through subarachnoid cavity, normal saline (NS) group supplied through subarachnoid cavity, nPR group, NS orally taken group, combined group. Animal models were made by Allen's equipment on T8～T9 segment. The spinal nerve function, somatosensory evoked potentials (SEP), retrograde and label technique of horseradish peroxidase, gross observation, histological and morphometric analysis were taken as the observed indices.ResultsThe values of observed indices of bBE group and nPR group improved evidently compared with their own control groups; that of combined group was prior to sole administration.ConclusionnPR can hold back the secondary SCI and accelerate the recovery of spinal nerve function; bBE can stimulate the improvement of injuried nerve fibers; the joint of nPR and bBE can make a synergic effect.

ObjectiveTo study the therapeutic effect and mechanisms of nourishing Piyin Remedy (nPR) on experimental rat spinal cord injury.MethodsThirty-two healthy SD rats were divided into 2 equal groups randomly: nPR group and injured group. Animal model of incomplete injury of spinal cord was made by Allen's equipment on rat's T8—T9 segment. The spinal nerve function,SEP,retrograde and label technique of horse radish peroxidase,gross observation,histological and morphometric analysis were taken as the observed indices.ResultsThe value of observed indices of nPR group were improved evidently compared with injured group.ConclusionNourishing Piyin Remede can hold back the secondary spinal cord injury and accelerate the recovery of spinal nerve function.

BACKGROUND:Hemiarthroplasty is a proven method for reconstruction of the hip joint function, especialy for the elderly patients who cannot tolerate the total hip arthroplasty. However, for the patients with osteoporosis, there are stil more controversial in clinical practice about using cemented or cementless femoral prosthesis for hemiarthroplasty. OBJECTIVE: To observe the repair effect of cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis. METHODS:The clinical data from 105 patients treated with hemiarthroplasty were retrospectively analyzed. Osteoporosis was diagnosed in these patients using the dual energy X-ray absorptiometry before surgery.Patients were divided into bone cement group (n=56) and cementless group (n=49) depending on different types of femoral stem prosthesis. The difference of efficacy between cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis was analyzed by comparing the operative time, volume of drainage, post-operative Harris scores of hip joint function and radiographic assessment (prosthesis subsidence, osteolysis, severe stress shielding, heterotopic ossification) during the folow-up after the replacement. RESULTS AND CONCLUSION:In the process of hemiarthroplasty in patients with osteoporosis, the operative time in the cement group was significantly longer than that in the cementless group (P < 0.05). However, there was no significant difference in the postoperative volume of drainage between these two groups (P > 0.05). At the 1, 3, 6 and 12 of folow-up after replacement, there were no significant differences in the Harris score of hip joint function, total effective rate and radiographic assessment between these two groups (P> 0.05). These results suggest that in the process of hemiarthroplasty in patients with osteoporosis, the clinical efficacy of cementless femoral prosthesis is similar to the cement femoral prosthesis, therefore two prostheses can al be selected; however, the operative time of the cement femoral prosthesis is longer than the cementless femoral prosthesis, so we can give priority to the cementless femoral prosthesis for patients with osteoporosis who can’t tolerate a long operative time because of the poor basic condition.

Objective To explore the correlation between serum uric acid ( SUA) and non alcohol fatty liver disease(NAFLD). Methods From October 2015 to December 2016,two hundred and forty?nine cases of NAFLD in Shengjing Hospital of China Medical University and 144 N?NAFLD patients were included in the study,to analyze their general data ( sex, height, weight, blood pressure ) , liver function, blood lipid and SUA. SUA was divided into four groups by four point method,group Q1 ( 99 cases) ,group Q2 ( 98 cases) ,group Q3 ( 98 cases ) , group Q4 ( 98 cases ) . The proportion of NAFLD in each group was compared and the relationship between SUA and NAFLD was analyzed by Logistic regression. Results There were statistically significant differences between the NAFLD group and the N?NAFLD group in gender,age,DBP,BMI,ALT,AST,γ?GT,SUA,TG,TC,HDL?C,LDL?C (P<0. 05),the differences in SBP,Tbil,Dbil and UDbil had no statistical significance ( P>0. 05);the proportion of NAFLD in group Q1,group Q2,group Q3 and group Q4 was 41. 41％(41/99),57. 14％(56/98),71. 43％(70/98),83. 67％(82/98),respectively,the differences between groups were statistically significant ( P=<0. 05); Logistic regression analysis showed that SUA was a risk factor for NAFLD (OR=1. 016,P<0. 05),after the adjustment of age,gender,BMI,diastolic blood pressure,TG,TC,HDL?C and LDL?C,OR=1. 008,P=0. 001. Conclusion SUA is an independent risk factor of NAFLD.