Objective To evaluate the clinical efficacy of AF (atlas fixator) internal fixation in treatment of thoracolumbar fracture and dislocation. Methods 42 cases of thoracolumbar fracture were treated by posterior AF internal fixation. Prior to surgery, anteroposterior and lateral radiographs, and CT scan through bone windows were done for all the patients. During surgery, all the pedicle screws were inserted by Mergerls method and proper insertion was confirmed by radiographs. Results The follow ups of 39 patients averaged 21 months (ranging from 6 to 29 months). After surgery, the correction of anterior vertebral body height averaged 40.2%, and of Cobbs angle 23.2?. 12 cases of incomplete spinal cord injury had significant improvement and 2 ones of complete spinal cord injury had no improvement. Conclusion The AF screw is especially helpful in reconstruction of stability of thoracolumbar region after posterior decompression and reduction, because it results in simplicity, safety, less fixation segments, and little invasion or bleeding.

Objective To observe the clinical efficacy of bipolar hemi arthroplasty and PFNA internal fixation for elderly patients with unstable intertrochanteric fracture.Methods The data of 79 elderly patients with unstable intertrochanteric fracture in our hospital from Au-gust 2013 to August 2014 were analyzed retrospectively.According to different surgical methods,79 cases were divided into observation group (n =40)and control group(n =39).The observation group were treated by artificially double-acting avascular replacement,and the control group received PFNA internal fixation.The operation time,intraoperatve blood soss,bedridden time,clinical effecacy and complications were recorded and observed.Results The operative time and bed time of observation group were significantly shorter than those of control group, the difference was statistically significant(P <0.05).The total postoperative complication rate of observation group was 20.00%,which was higher than 20.51% of control group,the difference was statistically significant (P <0.05).The Harris scores in observation group 3 months and 6 months after surgery were significantly higher than those in control group,the differences were statistically significant(P <0.05).Con-clusion Both artificially double-acting avascular replacement and PFNA internal fixation have a good effect on elderly patients with unstable intertrochanteric fracture.The artificially double-acting avascular replacement has the advantages of less blood loss,faster recovery and less postoperative complications,which is conducive to improving the quality of life of patients.

Objective To study spiral CT features and pathological basis of nodular goiter ,so that to improve the diagnostic accuracy of nodular goiter.Methods CT findings in 34 patients with nodular goiter confirmed by pathology were retrospectively analyzed and compared with pathological findings. Results Thyroid density in the patients with NG was lower than that in the normal. There was no statistically significant difference in the density between single and multi-NG. Most lesions(28/34) were multiple, round or oval, with different size and smooth edges. The density of majority lesions was lower than nearby normal tissue. Most lesions (27/34) were uniform in density. Central necrosis(5/34)often appeared in the bigger lesions(diameter＞3.0 cm). The CT value of the lesions was increased (47.1±42.2) HU after enhancement,but lower than surrounding thyroid tissue. Calcifications in the lesions(6/34)were puncticular,plaque or crustiform. Single or multiple cystic-solid or solid nodules could be seen in pathology, without a continuous capsule in the majority. Some patients (5/13) with single NG shown on imaging study were multi-NG in the pathology. Three cases of diffuse NG showed by CT were malignant in pathology. Conclusion There are certain characteristics for NG on spiral CT. Comprehensive evaluation may improve the accuracy of CT diagnosis.

Tissue engineering composites for bone defect treatment is currently a hot spot of the research field.Mechanical loading on tissue engineering composites is important to bone formation and related research has attracted more and more attention.In the field of tissue engineering research,the establishment of a standardized animal model is the basis of experimental research for exploring the effects of different mechanical loading on in situ repair of bone defect and its action mechanism.This paper reviews the approaches used to establish experimental model of bone defect under mechanical loading such as animal selection,defect preparation,fixation and loading mode in order to provide a reference for related research.

Objective To explore the MRI features of pelvic endometriosis outside the ovary.Methods 13 patients with pelvic endometriosis outside the ovary were imaged.Their clinical and imaging data were reviewed retrospectively.All cases were con-firmed by pathology.An enhanced MR using T1 WI sequence both in sagittal and transverse position was performed after T2 WI fat-suppression sequence and T1 WI sequence.Our MRI study was focused on the distribution of lesions locating in the deep pelvic cavity and abdominal wall,and the features of MRI signals .Results 13 lesions were found,in which 4 lesions located in the rectouterine pouch of Douglas,2 cases the bladder wall,2 cases the unilateral cystic inlet of ureter,1 case the anal canal wall,and 4 cases the ab-dominal wall.10(10/13)lesions were shown as solid nodules while 3(3/13)lesions as cyst-solid ones.All lesions showed moderate-ly heterogeneous enhancement.Conclusion Pelvic endometriosis outside the ovary mainly shows solid or cyst-solid lesions that lo-cates in the urinary,uterus,rectal wall and spaces around them.MR images show a higher value for the detection of the lesions out-side the ovary.

BACKGROUND:The mechanical valves used in the adult Luo-Ye pump have a large size and great destruction to blood, which are not suitable for infant ventricular assist pump. Therefore, designing and producing a high molecular valve with smal size and low incidence of thrombosis is a research hotspot. OBJECTIVE:To design and produce a valve of 20 mL infant Luo-Ye pump, and to test its basic functions and fatigue properties. METHODS:The size and shape of valve was designed with MASTERCAM software, polyurethane valve was obtained through producing the valve model and plastic injection;the static leakage, pressure drop and fatigue resistance of polyurethane valve were tested according to the ISO5840 requirements. RESULTS AND CONCLUSION:The polyurethane trefoil valve was produced, but the failure rate of plastic injection was high;the basic function of the trefoil valve met the ISO5840 requirements bascial y;after continuously operated 1.0×107 times, stroke volume of 20 mL Luo-Ye pump was changed 5.2%, and two polyurethane valves and valve leaflets did not change and damage. Polyurethane trefoil valve was designed and produced successful y;polyurethane valves could meet the needs of 20 mL Luo-Ye pump, which already have the ability to clinical trials.

Electrocardiac signal is one of the most important signals which is used to trigger ventricular assist device (VAD), and the delay time of VAD assistance is very important to get a satisfied result. Proper delay will give VAD relatively enough time to assist, avoiding left heart failure caused by the collision of the heart and VAD during systolic phase. This becomes much more important when the left atrium drainage is insufficient. The aim of our study is to set up an equation to calculate the delay time by RR interval. We try to set up an equation about RR and R-Ao like: R-Ao = A x (RR)n + B(A and B are constant). RR represents the RR interval and R-Ao represents the duration of the period between the peak point of QRS and the point of aortic valve closing; First, calculate RR according to weighting average method, and then, calculate the anticipant R-Ao according to the before-mentioned equation. After adjustment, R-Ao will be used as assistance delay time. R-R interval was measured in 457 selected pediatric patients who were undergiong left heart catheterization and who did not have arrhythmias. From the ECG recording during catheterization, R-R interval was measured while R-Ao was obtained from aortic pressure wave chart; Plot graphs with R-Ao as dependent variable and (RR)n as independent variable; find out correlating model and calculate the arguments A and B of R-Ao = A x (RR)n + B. The results showed that the relation between (RR)1/3 and R-Ao is the most significant, the relation coefficient is 0.733, the regress coefficient is -0.182 (P < 0.001) and the interception is 1.070. This means that R-Ao = (-0.182) (RR) 1/3 + 1.070. The likelyhood degrees of different sections differ markedly. When heart rate is less than 120 beats per min. The relation argument is about 0.733 while 0.45 when heart rate is more than 120 beats per min, Therefore, we can use the equation R-Ao = (-0.182) (RR)1/3 + 1.070 to calculate R-Ao when heart rate is less than 120 beats per min.
Adolescent ; Algorithms ; Child ; Child, Preschool ; Counterpulsation ; methods ; Electrocardiography ; Heart ; physiology ; Heart-Assist Devices ; Humans ; Signal Processing, Computer-Assisted

To compare the effects on hemodynamics of univentricular support with that of biventricular support on experimental ischemic biventricular dysfunction so as to provide experimental basis for clinical usage of the Luo-Ye pump. Eight canines were placed with a left ventricular assist device (LVAD; left atrial-aorta bypass) and a right ventricular assist device (RVAD; right atrial-pulmonary artery bypass). Left anterior descending coronary artery(LAD) was ligated, three minutes later, the proximal of right coronary artery (RCA) was ligated to establish animal madel of acute ischemic biventricular dysfunction. First start the LVAD, and then RVAD was started five minutes later. The hemodynamic data were recorded including central venous pressure(CVP), cardiac output (CO), mean artery pressure(MAP), and pulmonary artery pressure(PAP) and pulmonary capillary wedge pressure (PCWP). During biventricular assist devices (BVAD) the hemodynamics were improved remarkably, MAP increased from 37.4 +/- 8.8 mmHg to 84.2 +/- 9.7 mmHg (P < 0.01) (the normal level), CO increased from 0.82 +/- 0.1 L/min to 1.33 +/- 0.12 L/min (P < 0.01), CVP decreased from 14.6 +/- 2.3 cmH2O to 4.2 +/- 1.5 cmH2O (P < 0.01), PCWP decreased significantly from 14 +/- 3.9 mmHg to 1.6 +/- 0.9 mmHg. These data suggest that LVAD during biventricular dysfunction could not improve the hemodynamics to normal level. Howere BVAD could increase CO and MAP to normal level and decrease heart work and myocardial oxygen consumption, which could help to improve myocardial metabolism and myocardial function. Therefore, BVAD is the first choice in treating severe biventricular dysfunction which was not respond to drug therapy and intra-aortic balloon pump (IABP).
Animals ; Dogs ; Heart-Assist Devices ; Hemodynamics ; Myocardial Ischemia ; complications ; Ventricular Dysfunction ; etiology ; physiopathology ; surgery

BACKGROUND: The silk fibroin/type II collagen composite scaffold has been prepared by low-temperature bio-3D printing technology in the previous study and the scaffold has good mechanical properties. Studies have shown that mechanical stimulation is beneficial to bone remodeling, and gradient loading strain is beneficial to the activation of osteoblasts and osteoclasts. OBJECTIVE: To co-culture silk fibroin/type II collagen composite scaffolds with chondrocytes under compression loading, to observe the proliferation of cells, and to observe the preliminary repair effect of silk fibroin/type II collagen composite scaffold on cartilage defects. METHODS: The silk fibroin/type II collagen composite scaffold was prepared by low-temperature 3D printing to detect the porosity of the scaffold. The passage 3 mouse chondrocytes ADTC-5 were inoculated on the silk fibroin/type II collagen composite scaffold and cultured under static culture and mechanical load respectively. (1) Static culture: blank scaffold was set as control, and cell proliferation was detected by MTT assay at 1, 3, 5, 7, 10, 14 days of inoculation. (2) Culture under mechanical load: blank scaffold was set as control. At 1 day after inoculation, 0％, 1％, 5％, 10％, 15％, 20％ compressive strains were applied to the cell-scaffold complex, and continued to load for 3 days. Cell proliferation was detected by MTT assay, and the distribution, adhesion and morphology of the cells on the scaffold were observed by scanning electron microscopy and hematoxylin-eosin staining. A cartilage defect of 3.5 mm in diameter was made in the bilateral knee joint of New Zealand rabbits. The silk fibroin/type II collagen composite scaffold was implanted onto the left side, and no material was implanted onto the right side. The repair site was observed at 8 weeks after surgery. RESULTS AND CONCLUSION: (1) The porosity of the scaffold was (89.3±3.26)％, which was conducive to cell attachment. (2) After 5 days of static culture, the chondrocytes proliferated well on the surface of the composite scaffold. Under 0％, 1％, 5％, 10％, 15％, 20％ compressive strains, the cell proliferation on the scaffold first increased and then decreased, wherein the cell proliferation was highest under 10％ compressive strain, and lowest under 20％ compressive strain. (4) Under the scanning electron microscopy, the chondrocytes in the 0％ load group were distributed in the surface of the scaffold with irregularities, the cell morphology was obvious, and the cell protrusions were fully extended. There were few or no chondrocytes on the contact surface of the 10％ load group, and more cells distributed on the lateral and internal surfaces of the first layer, but the cell morphology was flat with obvious protrusions. (5) Hematoxylin-eosin staining showed that the chondrocytes in the 0％ load group were concentrated on the surface of the scaffold, and there were almost no cells in the pores, while the chondrocytes in the 10％ load group were distributed in the scaffold pores. (6) There was still a circular defect model with no scaffold implantation, and no obvious repair appeared; similar hyaline cartilage appeared in the defect after scaffold implantation, but there was no adhesion to the surrounding defected cartilage, and the new hyaline cartilage was independent. Overall, the adsorption, proliferation and growth of chondrocytes on the silk fibroin-type II collagen scaffolds is better when the compressive strain is 10％, and the composite scaffold can be used as a repair material for cartilage defects.

Objective To explore the skin management methods for preventing pressure ulcers in the patients with aortic dissection surgery. Methods Totals of 134 cases of patients with aortic dissection surgery were implemented the standardized and personalized skin management methods for preventing pressure ulcers. The“Waterlow patients pressure sore risk assessment scale”was applied in assessing the skin condition of preoperative and postoperative patients. The prevention methods according to the risk factors of pressure ulcer,including the targeted health education,improve the compliance of prevention methods;using the silicone gel pad,water gel or foam dressing to decompress the pressurized parts during the operation,when the operation time was over 2 hours, lifted patients' head and foot every half hour and changing stress points;during the postoperative time turning-over and using the air bed. Results The scores of pressure ulcer were(10. 43 ±2. 79)and(13. 93 ±3. 28)before and after surgery. All the 134 patients did not have pressure ulcer before surgery. One day after the operation, 3 patients had phaseⅠpressure ulcer,with an incidence of 2. 24% . Within the 3 cases of pressure ulcer patients, 1 patient was emaciation,2 patients had long operation time(11. 5 and 14. 5 hours,respectively),whose pressure ulcer scores were 22 to 23 belong to the risk level. Conclusions Patients with aortic dissection during perioperative period have a high risk of pressure sores. The implementation of specific preventive measures can effectively reduce the incidence of pressure sores. Long procedure and partial compression caused by fixed position are the greatest difficulties in preventing the pressure sores,and they are also the problems needed to be solved in the future.