[Objective]To treat the femoral neck fracture using cannulated screw and BMP release system in animals,and to evaluate the possibility of treating femoral neck fracture and provide experimental basis for clinical application.[Method]Eighteen mongeral were used in this study.The model of bilateral femoral neck dislocation fracture was established.The control side was fixed using cannulated screw,and the experiment side was fixed with cannulated screw and injectable BMP release system.At 4,8,12 weeks,6 animals were sacrificed at one time point respectively.Results were obtained through histology,radiography,scintimetry and gross observation.[Result]The fracture line was vague at four weeks,and at eight weeks the fracture line almost disappeared.It was healed completely at twelve weeks.Radiological study showed that the healing of the fracture in experimental side was better than that of the control side.There was the same result of observation in histology.[Conclusion]The cannulated screw combined with BMP used in the experiment is effective and feasible.It may not only provide strong internal fixation but also infuse growth factor into site of fracture.It would accelerate the reconstructing of the vascular supply to the femoral head after the fracture and promote the restoration of bone.

Objective To observe 125I seed treatment effect and environmental radiation in the treatment of recurrent glioma.Methods 64 patients with recurrent glioma patients,according to the wishes of patients and their families were divided into observation group of 30 cases and a control group of 34 patients.Clinical outcomes and follow-up of 125I seeds around radiation were compared between the two groups.Results The treatment efficiency of observation group and control group was 60.0％ (18/30),and 35.3％ (12/34),respectively,which was statistically significant(x2 =8.39,P ＜0.05).Follow-up from 0 to 6 months,the ambient radiation rapidly decreased as the distance increaseing with the implantation point,radiation dose in a distance of 40cm has been close to the natural basis of radiation dose;125I seeds measured radiation dose continued to decay with increasing time after implantation.Four months later,it was close to the natural basis of radiation dose.Conclusion Conclusion 125I radioactive particles in the treatment of recurrent glioma have good curative effect.The effects of radiation on the surrounding environment crowd are easily protected.

Objective To assess the clinical value of high-frequency ultrasonography in diagnosis of the brachial plexus disease. Methods Forty-two patients with suspected brachial plexus disease underwent high-frequency ultrasonography. The ultrasonographic findings were compared with clinical data. Results Among the 42 patients, 33 were diagnosed as brachial plexus abnormalities, while 9 as normal according to clinical data. With high-frequency ultrasonography, 26 patients were diagnosed as abnormal brachial plexus and 16 patients as normal. The sensitivity, specificity and accuracy of ultrasonography in diagnosing brachial plexus abnormalities was 78.79%, 100% and 83.33 %, respectively. Conclusion High-frequency ultrasonography is useful in evaluating the brachial plexus disease and may become an important imaging methods for brachial plexus.

Objective To evaluate the curative effects of percutaneous osteoperiosteal decortication combined with distraction osteogenesis for treatment of nonunion of lower-extremity bones.Methods A retrospective analysis was performed of the 32 patients who had been treated using osteoperiosteal decortication combined with distraction osteogenesis from September 2011 to December 2014 for nonunion of lower-extremity fractures.They were 23 males and 9 females,with a mean age of 33.4 years (range,from 15 to 62 years).After their former internal or external fixators were removed,the 2 fracture ends were fixated by a retractile mono-lateral or circular external fixator.Under radiographic monitoring,a percutaneous incision was made with a 5 mm sharp chisel,down to the bone.Scar and ossified tissue between the fracture ends were debrided and cut along the fracture line.Mter the marrow cavity was reamed,a new irregular wound was created at sclerotic fracture ends.Scale-shaped chips (1 mm thin and 5 mm in diameter) were elevated using a chisel on surface of the cortical bone within 2 cm from the fracture ends.The external fixators were adjusted to compress the fracture sites.On the 8th day after operation,the eternal fixators were applied to distract and compress at nonunion sites to stimulate the osteogenesis.Results All the patients were followed up for an average of 12.5 months (range,from 8 to 42 months).Primary union was successfully achieved in 28 patients while delayed union occurred in 3 patients who finally achieved union after adjuvant therapies like shock wave and or local injection of bone marrow blood.The average time for union was 4.6 months(range,from 4 to 7 months).The mean time for external fixation was 6.2 months (range,from 5 to 8 months).One patient encountered nonunion of lateral tibial cortical bone 6 months after surgery but eventually achieved union by autologous ilium grafting.Joint functions in all postoperative patients were similar to those before operation.Conclusion Percutaneous osteoperiosteal decortication combined with distraction osteogenesis is a simple,minimally invasive and effective treatment for nonunion of lower-extremity bones,avoiding disadvantages brought by traditional surgery,like massive trauma and excessive bleeding.

Objective:To establish a reliable approach for measuring proximal femoral 3 dimensional anatomy, and to compare post-operative differences of proximal femoralanatomy in the inter-trochanter fractures with two kinds of antegrade nailings.Methods: Some computer assisted design ( CAD ) soft-wares, e.g.Mimics, were used to establish a reliable approach for measuring proximal femoral 3 dimen-sional (3D) anatomy.Intra-class correlation coefficient ( ICC) was used to test the reliability of intra-and inter-observers.The post-operative pelvic CT data of 19 cases of inter-trochanter fracture patients treated with InterTAN nailing and 21 cases of inter-trochanter fracture patients treated with proximal femo-ral nail anti-rotation ( PFNA) were retrospectively analysed and used to measure bilateral proximal femo-ral anatomical parameters, including 2D and 3D femoral neck-shaft ( NS) angle and femoral neck ante-version (NA) angle, and 2D and 3D anteversion angles of the intramedullary (IM) nailings.ICC was used to test the consistency of the NA angles in the different groups, and the paired student T-test was used to test the differences of the paired quantitative data.Results:The established measurement method hasdexcellent consistency within the intra-and inter-observers, with all the ICCs higher than 0.9.The paired student T-test showed no significant difference between the post-operative bilateral 2D or 3D NA angles.The ICCs results showed that there were no consistency between the post-operative bilateral 2D or 3D NA angles (P values were 0.099 and 0.055, respectively), but the excellent consistency between the 2D injured side NA angle and 2D IM nailing’ s NA angle, or between the 3D injured side NA angle and 3D IM nailing’s NA angle (the ICCs were 0.81 and 0.8, respectively, P values <0.001).In PF-NA group, 57%of the differences between the 2D post-operative injured side’s and intact side’s NA an-gles were higher than 15°, which was more than 15.78%in InterTAN group.The paired student T-test showed no significant difference between the post-operative injured side’ s 2D or 3D NS angles and the in-tact side’s respective 2D or 3D angles in PFNA group (P values were 0.925 and 0.367, respectively), but in InterTAN group, the post-operative injured side’s 2D or 3D NS angles were significantly smaller than the intact side’s respective angles (P values were 0.033 and 0.009, respectively).Conclusion:By analyzing and comparing bilateral proximal femoral anatomical parameters after two kinds of IM nailings procedures, the differences between the bilateral post-operative NA angles in PFNA group were significantly larger than those in InterTAN group.There was significant correlation between the NA angles of the injured sides and NA angles of IM nailings in both the groups.

Objective To investigate the serum C-reactive protein (CRP) level in patients with acute cerebral infarction and acute massive cerebral infarction with multiple organ dysfunction syndrome (MODS),and analyze the clinical value of CRP. Methods The serum CRP level of 50 patients of control group and 50 patients of cerebral infarction admitted to hospital within 7 days (30 patients were admitted into acute cerebral infarction group and 20 patients into acute massive cerebral infarction with MODS group) were determined by immune scatter turbidimetry. Results (1)In cerebral infarction patients,serum CRP level in 48 cases(96%) was equal and over 5 mg/L.In control group,serum CRP level in 3 cases(6%) was equal and over 5 mg/L(P＜0.0 5).(2)The level of serum CRP acute in cerebral infarction group and in acute massive cerebral infarction with MODS group increased significantly than that in control group (P＜0.01).The level of serum CRP in acute massive cerebral infarction with MODS group increased significantly than that in acute cerebral infarction group.(3)When the level of CRP＜25 mg/L,the incidence of MODS in patients with acute cerebral infarction was zero.When the level of CRP≥25 mg/L,the incidence of MODS increased gradually with the rise of CRP. Conclusions There is positive correlation between the serum level of CRP and the severity of acute cerebral infarction and the incidence of MODS.CRP is a useful marker in predicting the prognosis of acute massive cerebral infarction with MODS.

Objective Comparing the enhancement of contrast-enhanced ultrasound(CEUS) with the intensity of the blood signals of breast masses, and producing the parameter of peak intensity (PI), to determine whether they can reflect the differentiation of the benign breast masses from the malignant ones.Methods Fifty patients with the breast masses (25 benign,25 malignant) were implemented the contrastenhanced ultrasound inspection.The blood signals of the masses could be got before performing the CEUS,then the CEUS was performed.The enhancement of the masses was divided into 4 grades according to the enhancement of breast which was around the mass (no enhancement, low enhancement, equal enhancement,and high enhancement as well).The PIs of all masses and high enhanced massed were calculated by software in machine,then them were compared according to "the groups which had been classified by their maximal diameters.Results Forty-one of 50 cases showed an obvious enhancement using CEUS compared with the routine CDFI.Malignant masses were more obviously than that of benign ones ( P＜0.05).In the 50 cases,the no enhanceed ones( n = 2) and equal enhanced ones( n = 5) were benign,and 1 case of the low enhanced masses( n = 9) was malignant.The high enhanced masses ( n = 34) were malignant or benigh.About the high enhanced masses, there were statistics meanings using the parameter of PI for the masses whose maximal diameters＜2 cm( P＜0.05),and no statistics meanings when their maximal diameters≥2 cm(P＞0.05).Conclusions The CEUS of breast can improve the appreance of the tumor' s blood vessel obviously, especially for malignant masses.The PI of the breast benign masses are different from the malignant ones.Combination of them can help to discriminate benign masses from malignant ones.The parameter of PI is useless for differentially diagnosing the breast masses if their maximal diameters≥2 cm and the blood flow grade Ⅲ before CEUS.

BACKGROUND: The active component in recombinant human bone morphogenetic protein-2/poly(lactide-co-glycolide) (rhBMP-2/PLGA) microsphere prone to be absorbed or lost during solution with physiological saline, and the setting time is uncontrollable using blood solution, so it is necessary to explore an sustained-release carrier that can control the setting time.OBJECTIVE: To construct an injectable BMP release system by combing rhBMP-2/PLGA microsphere with fibrin glue. DESIGN, TIME AND SETTING: An experimental comparative study was performed at the Department of Othopaedics, General Hospital of Chinese PLA from January 2005 to April 2008.MATERIALS: PLGA (polylactic acid/polyglycolic acid 75/25, M_r=3 000, with 0.025 L/g viscosity) was supplied by Shandong Institute of Medical Instruments; rhBMP-2 was offered by The Academy of Military Medical Sciences; and fibrin glue was supplied by Hangzhou Puji Medicine Technology Development Co., Ltd.METHODS:The rhBMP-2/PLGA microsphere was prepared using W/O/W solvent evaporation methods. rhBMP-2 loaded PLGA microsphere were incorporated in fibrin glue to establish injectable BMP release system.MAIN OUTCOME MEASURES: The setting time,release behaviors, electron spectroscopy for chemical analysis (ESCA) as well as pH values of composites were measured.RESULTS:①Compared with fibrin glue, the setting time of composites were slightly increased.②Initial burst release of the composites occurred, the drug release exceeded 16.76% within 2 days, and 76.75% of the drug was release within 42 days. ③ESCA showed that composites prolonged release times.④The PH value of composites was between microsphere and fibrin glue.CONCLUSION: RhBMP-2/PLGA microsphere/fibrin glue composite has satisfactory slow-release effect and syringeability, which not only degrade partial acid environment but also maintain the biological effect of higher density. Therefore, it forms a promising synthetic bone graft.

BACKGROUND:Transverse acetabular fracture often involves the damage of anterior and posterior columns of acetabulum. The most popular fixation of the anterior and posterior columns needs the combined anterior and posterior approach. Big trauma is not conducive to patient’s recovery after surgery. Limited incision or percutaneous minimaly invasive lag screw placement can reduce soft tissue injuries, but the strength of the fixation lacks of biomechanical verification. OBJECTIVE: To compare different types of fixations for transverse acetabular fracture, explore the appropriate fixation options that can achieve effective fixation and reduce tissue injury by combing with repair approach and the condition of soft tissue. METHODS: The fourth generation of synthetic semi-pelvic sawbones was set as a template to establish a model of acetabular transverse fracture using finite element analysis. Five different fixation options were used to fix the transverse acetabular fracture. The magnitudes of anterior and posterior displacement of transverse fracture were compared to assess the stability of different options under a simulated condition of incomplete weight bearing stand. RESULTS AND CONCLUSION:The motion at anterior column was minimal when fixed by anterior column locking plate + posterior column screw and the minimum displacement at posterior column was the fixation of anterior column screw + posterior column locking plate. Both of the motions of these two fixations were less than the reconstruction plate fixation respectively. The worst fixation was the anterior column and posterior column lag screw fixation with the largest displacement. The anterior column locking plate + posterior column screw, accomplished by single approach, could not only reduce surgical trauma, but also has a stronger stability. Moreover, this fixation option is effective method to place posterior column lag screw under direct vision and reduce the difficulty of screw implantation.