Cobalt or chromium alloys are the most common clinical materials of prosthesis and there have been some investigators at home and abroad have done related researches about the genotoxic effects of cobalt and chromium ions and nanoparticles. People have certain understanding about the mechanism of production of ions as well as their influence on cells. However, chromium or cobalt nanoparticles genotoxicity related research is still in its preliminary stage. In each stage, the mechanisms, from creating of the particles, through entering cells, until finally causing genotoxic, are still contained many problems to be solved. This article reviews the research progress in mechanisms of production and genotoxic effects of cobalt, chromium ions and nanoparticles.
Chromium ; toxicity ; Cobalt ; toxicity ; DNA Damage ; Humans ; Ions ; Nanoparticles ; toxicity ; Prostheses and Implants

BACKGROUND: The incidence of the adjacent vertebral fracture after kyphoplasty is about 2.4%-23.0%, and 2/3 of new fractures occurred in adjacent vertebrae in 6 months. There is controversy addressing the reason which is the development of osteoporosis or the result of bone cement augment at present.OBJECTIVE: To determine the correlations between percutaneous kyphoplasty on adjacent vertebral endoplates stresses pressure under physiologianl load and a new fracture of adjacent vertebral body in physiological load.METHODS: Computed tomography (CT) data of an old female osteoporotic patient was selected, and a three-dimensional finite element model of the osteoporetic thoracolumbar spine T_(12)-L_1-L_2 was created by using kinds of computer aided design software.The height of vertebral L_1 was compressed by 60% to simulated the compressed fracture, and the height of L_1 became the 90% of normal to simulate the replacement, two columns-like PAMA mass (4 mL) was placed in vertebral L_1 to simulate pemutaneous kyphoplasty. The stress on inferior endplate of L_(12) and superior endplate of L_2 was compared with three models. RESULTS AND CONCLUSION: Compared to the normal vertebral body, the maximum stress in the adiacent vertebral bodies endplates increased by 76% for L_1 compress fracture model and increased by 27% for kyphoplasty model, respectively. The stress on the posterior part of vertebral body after percutaneous kyphoplasty have an average increase of 13.2%, of which 4.5% increase in the pedicle, isthmus, and 6.15% increased in the key points 25.6%, but with the wedge-shaped fracture of L_1 vertebral body compared to the model, percutaneous kyphoplasty after pedicle, isthmus and the articular process had reduced stress. The results indicate that the stress on inferior endplate of L-(12) and superior endplate of L_1 increased after percutaneous kyphoplasty under all loading conditions. Increased stress may lead endplate fracture, and increase the risk of adjacent vertebral body fracture. Further researches are needed to support the conclusion.

Objective To investigate the operative method and clinical rusults of repairing and reconstruction for bone and skin defect at medial malleolus.Methods Form January,2013 to January,2015,11 cases of patients with malleolus complex tissue defect were treated.According to the degree of damage to the cases were divided into four types,according to the type,selected flap,blood vessels,nerves,tendon graft,flap series connection iliac bone flap graft to repair,or direct ankle fusion,amputation to therapy.The Iliac flap donor site remained part of the anterior superior iliac spine and rebuild muscle starting and ending point,the donor sites wound was closed by skin graft.Results Followed-up of 1-24 months,in addition to amputation and ankle fusion each one exception,the remaining 9 patients underwent ankle reconstruction to reserve ankle.One case acquired infection,other 8 patients healed well,had different degree of recovery of the ankle function,the ankle function had recovery in different degree.AOFAS ankle-hindfoot score system:excellent in 4 cases,good in 4 cases,and poor in 1 case.Conclusion Ankle complex tissue defect classification method can be used to guide us to select the treatment options.Iliac bone flap series consisting mainly of composite tissue transplantation is a viable method of the medial malleolus defect reconstruction.

Bilateral Quchi (LI 11), Zusanli (ST 36), Shenshu (BL 23), Pangguangshu (BL 28),Yinlingquan (SP 9), Dazhui (GV 14) and Ashi points have been selected to treat 60 cases of acute gouty arthritis with the combination of moxa-stick moxibustion, and indomethacin and colchicines have been selected to treat another 60 cases as the control group. Two weeks after the treatment, the therapeutic effect of the two groups had significant difference with the effective rate of 93.3% in the former and 70.0% in the latter respectively (P＜0.01).

Objective To identify the practical microsurgical procedure for repairing in site of skin avulsion injury in hand, and evaluate the long-term following-up results. Methods From January 2001 to May 2005, 21 cases of skin avulsion injury in hand were treated in our department. The surgical procedures thumb skin was revascularized with vein graft from forearm, and the other part of injuried hand was resuffaced by the thickness skin graft taken from the original degloved skin, which was suitable for degloving injury in-graft, the dorsum and palm of hand was skin grafted by the original skin thinned, which was suitable for complete degloved injury at the proximal interphalangeal level. Results All the repaired skin were survival in 16 patients, partial necrosis occurred in 4 cases, which was severely crushed, required debridement and skin graft on the residual defect. Whole failure in 1 case, which underwent secondary amputation. Follow-up at 10-28 months shows acceptable cosmetic and sensible results, slight scarring was present on the volar as-pects of hand. The range of motion of the thumb and fingers was almost complete. All patients regained new jobs. Conclusion Individualization of mierosurgical methods for repairing in site of skin avulsion injury in hand does represent the best solution.

Objective To explore the methods of Y-V vascular pedicle lengthening technique for cover-age of the defect of great toe after wrap-around flap transfer, and decrease the morbidity of donor site in great toes. Methods Fifteen patients received three kinds of flap for immediate resurfacing of donor defect of the great toes during wrap-around flap transfer, all flaps were harvested with Y-V vascular pedicle lengthening technique. Among them, 9 cases received the free lateral tarsal flaps transplantation for coverage of defect in donor great toes, 5 cases was repaired by medial tarsal flaps, and only one was treated by the medial plantar flap. Results All the flaps survived postoperatively. The medial plantar flap encountered the venous crisis in postoperative 3 days, and regained the normal blood supply after continuous bleeding for 2 days. All patients were satisfied with cosmetic and functional outcome in average 10- month follow-up. The appearance and sensory function of donor toe repaired by medial tarsal flaps was best among three ones. Conclusion Depending on the Y-V vascular pedicle lengthening technique, the local pedical flaps of foots are enlarged scope for coverage of great toe after wrap-around flap harvest, which can decrease the complication of donor site at the most.

Objective To explore the toxicity and biological activity of cobalt nanoparticles (CoNPs) on osteoclasts,and to analyze the relationship between cobalt nanoparticles and osteolysis.Methods From November 2014 to July 2015,RAW264.7 cell was induced to osteoclast-like cell by LPS.Different concentrations of cobalt nanoparticles and cobalt chloride were added,and the cell morphology was observed under a microscope.24 h after induction on RAW264.7,cells were grouped into cobalt nanoparticles group (10,20,50,100 μmol/L),cobalt chloride group (10,20,50,100 mol/L) and control group.MTT assessment and Q-PCR were performed at 2 h,4 h,8 h,24 h,48 h post-treatment.Results With the increase of concentration (10,20,50,100 μmol/L) and the action time (2 h,4 h,8 h,24 h,48 h),the inhibition rate of cobalt nanoparticles and cobalt chloride on osteoclast like cells was significantly increased,and the inhibition rate of cobalt nanoparticles was higher.With different concentrations (10,20,50,100 μmol/L) of CoNPs and cobalt chloride,the relative expression of CAⅡ,Cat K gene mRNA expression decreased compared with the control group,when the concentration of CoNPs was in the range of 10-50 μ mol/L,the relative expression of CAⅡ and Cat K was increased,which was reduced in cobalt chloride group.Conclusion Different concentrations of cobalt nanoparticles and cobalt chloride can inhibit the proliferation and differentiation of osteoclasts,and cobalt nanoparticles is more pronounced,when the concentration of cobalt nanoparticles was 10-50 μmol/L,the relative expression of osteoclasts CAⅡ,Cat K increaseed,which was suppressed at the same concentration of cobalt chloride.

Adolescent ; Adult ; Ear, Middle ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mastoid ; diagnostic imaging ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

Objective To investigate the clinical value of hemostatic silk in prevention of wound bleeding and wound healing after endoscopic submucosal dissection (ESD). Methods Experiment group: animal model was made by rabbit underwent ESD simulation in its' stomach and laying hemostatic silk on its' wound;control group: animal model was made by pig underwent ESD simulation in its' colon without any healing management. All the ulcers sites were endoscopically and pathologically examined to evaluate the hemorrhage and healing of the wound on 3 days, 1 week, 2 weeks and 4 weeks after the procedure. Results The blood loss in experiment group was significantly lower than that in control group. The wounds of all the experimental pigs underwent colon ESD successfully covered with hemostatic silk postoperatively. Endoscopic pathological examination shown better healing procedure in experiment group. No procedure-related adverse event occurred in both groups. Conclusions Hemostatic silk has potential application value in healing the wound after ESD demonstrated by animal experiment.

OBJECTIVE:To evaluate the effects and safety of Bencycloquidium bromide nasal spray in the treatment of acute rhinitis after a cold. METHODS:A multicenter,dose parallel controlled,randomized,double-blind,placebo-controlled clinical tri-al was conducted. Two hundred and thirty-eight patients with acute rhinitis after a cold were selected and divided into group A(24 cases),B(24 cases),C(24 cases),D(24 cases),E(23 cases),F(24 cases),G(23 cases),H(24 cases),I(24 cases),J (24 cases). Group A-C were given Bencycloquidium bromide nasal spray 22.5μg,45μg,90μg,respectively,bid,spraying it once for each nostril. Group D-F were given Bencycloquidium bromide nasal spray 22.5 μg,45 μg,90 μg,respectively,tid,spraying it once for each nostril. Group G-I were given Bencycloquidium bromide nasal spray 22.5 μg,45 μg,90 μg,respectively,qid,spray-ing it once for each nostril. Group J was given placebo. All groups were treated for(4±1)d. Rhinorrhea score and continuous rhi-norrhea duration were compared among 10 groups,and the safety was evaluated. RESULTS:The rhinorrhea score and continuous rhinorrhea duration of 10 groups were improved significantly,with statistical significance (P<0.05). The improvement and trend of group I was slightly better than other 9 groups,without statistical significance(P>0.05). There was no statistical significance in the incidence of ADR among 10 groups(P>0.05). CONCLUSIONS:Bencycloquidium bromide nasal spray with 90 μg,qid times significantly improves rhinorrhea score and continuous rhinorrhea duration with good safety.