Objective To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) for patients with fresh osteoporotic vertebral compression fracture (OVCF).Methods From February 2010 to November 2011,103 patients with fresh OVCF were assigned to receive either PVP or conservative treatment according to their choice or the choice of surgeons.There were no significant differences between the 2 groups regarding general clinical data (P ＞ 0.05).The pain was scored at pre-treatment,1,4,12,24 and 48 weeks post-treatment in all the patients.The vertebral re-fractures were recorded in both groups at follow-ups.The 2 groups were compared in terms of postoperative pain relief and risk of re-fracture.Results The overall pain relief at 1,4 and 12 post-treatment in the PVP group was significantly greater than in the conservative treatment group (P ＜ 0.05).The pain relief at night at 1,4 and 12 post-treatment was significantly greater in the PVP group than in the conservative treatment group (P ＜ 0.05).At one year post-treatment,7 vertebral re-fractures were observed in the PVP group (18.4％,7/38) and 12 ones in the conservative treatment group (20.3％,12/59),with no significant difference between the 2 groups in the risk of re-fracture (Hazard ratio =0.909,95％ CI:O.36 ～ 2.29,P =0.841).Conclusion Compared with conservative treatment,PVP may significantly reduce the pain for patients with fresh OVCF but does not increase the risk of vertebral re-fracture.

Objective To research the effect of perioperative thermal preservation on hemostatic function in elderly patients with laparoscopic rectal cancer resection.Methods Eighty-six elderly patients with laparoscopic rectal cancer resection with ASA Ⅰ-Ⅱ were randomly divided into control group (43 patients) and test group(43 patients).Control group was given routine operation,test group was given routine operation and thermal preservation.The nose pharynx temperature was monitored and recorded respectively on preanesthesia,30,60,90 min post-anesthesia and after operation.The level of prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),platelets (PLT),D-dimer(DD),fibrinogen (FBG),yon Willebrand factor (vWF) were detected on preanesthesia,30,60,90 min post-anesthesia and 24,48 h post-operation.Results The temperature in control group on 30,60,90 min pest-anesthesia and after operation [(36.1 ± 0.2),(36.0 + 0.1),(35.7 + 0.1),(35.6 ± 0.2) ℃] was significantly lower than that on preanesthesia [(36.8 ± 0.2) ℃] and the same time in test group [(36.8 ± 0.0),(36.7 ± 0.1),(36.7 +0.2),(36.8 ±0.2) ℃] (P ＜0.05).The level of PT,APTT and TT in control group on 30,60,90 min post-anesthesia and after operation were significantly longer than those on preanesthesia and the same time in test group (P ＜0.05).The level of PLT in control group after operation and on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group(P ＜ 0.05).The level of DD and vWF in control group on 24,48 h post-operation were significantly higher than preanesthesia and the same time in test group (P ＜ 0.05).The level of FBG in control group on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group (P ＜ 0.05).The hemostatic function had no significant change in test group (P ＞0.05).Conclusion The perioperative thermal preservation in elderly patients with laparoscopic rectal cancer resection can alleviate hemostatic function suppression and promote recovery.

Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P<0.05). There was no significant difference in the improvement rate of life quality and the incidences of myelosuppression,severe myelosuppression,severe nausea and vomiting,severe constipation and diarrhea,liver and renal damage(P>0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.

Objective To investigate the clinical effect of transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defects at foot and ankle and functional reconstruction.Methods From January,2008 to January,2013,25 pediatric patients with soft tissue defects at foot and ankle were transplantation of the free anterolateral thigh flap and iliotibial band.Of the 25 cases,there were 12 cases at heel,8 cases at dorsum of foot,3 cases at medial malleolus and 2 cases at external malleolus.All the cases were accompanied with different degree of fracture or dislocation,and with soft tissue defect such as achilles tendon,extensor tendon of dorsal,collateral ligament of ankle.The length of soft tissue defect which were reconstructed with iliotibial band were 3 cm to 16 cm.The causes of injury:19 cases were crushed by motorcycle or bicycle,4 cases were crushed machines,2 cases were injuryed in traffic accidents.The areas of free anterolateral thigh flaps were 8 cm × 5 cm to 18 cm × 12 cm.All the patients begined to early rehabilitative exercise under the protection of orthosis after 2 weeks of the operation.Results All cases were followed up from 6 to 24 months,averaged of 14 months.All the flaps survived,and only 2 cases with necrosis of small area in distal,and which were healed by dressing.The healing time were 12 to 24 days,and the average of 15.1 days; The surgery function were assessed according to Thermann's scale,and the results was 14 cases for excellent,9 cases was good,the general was 2 cases,and the excellent and good rate was 92％.Conclusion The transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defect at foot and ankle and functional reconstruction is a safe and effective strategy,and it has the advantages such as covering the wound at foot and ankle approvingly,reconstruction of power device once,the flap and iliotibial band were in the same wound,the trauma of doner site is small invasive,early recovery functional exercise,shorten the treatment cycle,and relieve the suffering of children.

Objective To investigate the efficacy of endovascular stenting complicating other craniocervical artery stenosis (OCAS) in patients with atherosclerotic subclavian artery stenosis/occlusion (SASO).Methods The clinical data of receiving endovascular stenting therapy in patients with atherosclerotic SASO were analyzed retrospectively,including demographic characteristics,vascular risk factors,complicating OCAS,as well as stenting for SASO and follow-up results.Results A total of 65 patients with SASO were included in the study,47 of them were males and 18 were females (mean age of 64 ± 9 years).Forty-six patients (70.8％ ) complicated OCAS.The overall technical success rate was 95.4％,in which the patients with stenosis (n =58) were 98.1％ and those with complete occlusion (n =7) were 71.4％.The complications occurred in 4 patients.There were no intervention-related serious stroke and death.Mean follow-up was 24 ± 19 months,6 patients with restenosis and 10 with clinically relevant events were found.They mainly occurred in patients with OCAS.The first angioplasty patency rates were 94.5％,81.8％ and 81.8％,respectively at 12 and 24 months after procedure and at the end of follow-up.The survival rates of no clinically relevant events were 92.9％,74.6％ and 68.3％,respectively.Conclusions Endovascular stenting can safely and effectively treat the SASO patients complicating OCAS.Its overall clinical outcome may be affected to some extent by OCAS.

Objective To investigate the value of hyperintense vessel signs (HVS) on fluidattenuated inversion recovery (FLAIR) sequence for assessing the patterns of collateral blood flow in adult moyamoya disease (MMD).Methods Forty-one adult patients with non-hemorrhagic MMD retrieved from Nanjing Stroke Registry Program between August 2008 and January 2011 were identified by digital cerebral angiography and performed the examination of FLAIR sequence in Jinling hospital.According to the different sites of HVS located in the territory of the middle cerebral artery,the patterns of HVS were classified into grades 0-3: Grade 0,absence of HVS ; Grade 1,HVS limited in the cerebral sulci of temporal lobe and Sylvian fissure ; Grade 2,HVS in the cerebral sulci of frontal and parietal lobe regions and Sylvian fissure;and Grade 3,HVS in the combined territories of Grade 1 and Grade 2.According to the intracerebral collateral blood flow,steno-occlusions of the arteries were classified into three types: Type 1,residual antegrade flow across steno-occlusive lesions; Type 2,retrograde flow via leptomeningeal vessels; Type 3,the combined collateral blood flow of Type 1 and Type 2.The relationship between the patterns of intracerebral collateral blood flow and the location of HVS was analyzed.Results Of 41 adult patients with non-hemorrhagic MMD,there were 3 patients presented with unilateral vascular lesions and 38 with bilateral vascular lesions,so the total number of vascular lesions of the cerebral hemispheres was 79.Because three patients showed the absence of HVS in bilateral hemispheres,the total number of the presence of HVS of the cerebral hemispheres was 73.Therefore,the percentage of the presence of HVS was 92.4％ (73/79) in vascular lesions of the cerebral hemispheres.Importantly,the patterns of slow collateral blood flow corresponding to Grade 1 HVS were all antegrade (7/7) ; the collateral patterns corresponding to Grade 2 HVS were mainly retrograde leptomeningeal flow (95.0％,19/20) ; and the patterns corresponding to Grade 3 HVS were mainly slow combined collateral blood flow(84.8％,39/46).Furthermore,with the changing sites of HVS from the cerebral sulci of temporal lobe to the cerebral sulci of frontal and parietal lobe regions,the directions of collateral flow changed with a shift from antegrade to retrograde,which was statistically significant.Conclusion The different locations of HVS can reflect the different patterns of collateral blood flow,and the locations of HVS may predict the directions of intracerebral collateral blood flow in adult MMD patients.

Objective:To investigate the effect of huaier granule combined with docetaxel + epirubicin + cyclophosphamide (TEC) neoadjuvant chemotherapy on the disease control rate and the levels of extracellular fragment of human epidermal growth factor receptor 2 (HER2-ECD) and tumor abnormal protein (TAP) in patients with advanced breast cancer.Methods:From April 2013 to June 2016, 94 patients with advanced breast cancer in Shengjing Hospital Affiliated to China Medical University were selected and randomly divided into observation group ( n=47) and control group ( n=47). The control group was treated with TEC neoadjuvant chemotherapy, and the observation group was treated with TEC neoadjuvant chemotherapy combined with huaier granules for 12 weeks. The curative effect, incidence of adverse reactions, cellular immune function indexes (CD8 + , CD4 + , CD4 + /CD8 + ), serum HER2-ECD and TAP levels were compared before and 12 weeks after treatment. The patients were followed up for 3 years after treatment, and the 1-year, 2-year and 3-year survival rates were compared between the two groups. Results:After 12 weeks of treatment, the disease control rate of the observation group was higher than that of the control group, with statistically significant difference ( P<0.05); during the treatment, the incidence of gastrointestinal reaction, neutropenia, thrombocytopenia and abnormal liver function of the observation group was lower than that of the control group, with statistically significant difference ( P<0.05); after 12 weeks of treatment, the serum CD8 + level of the observation group was lower than that of the control group, and the serum CD4 + , CD4 + /CD8 + level was higher than that of the control group, with statistically significant difference ( P<0.05); after 12 weeks of treatment, the serum levels of HER2-ECD and TAP in the observation group were lower than those in the control group, with statistically significant difference ( P<0.05); the 3-year survival rate in the observation group was higher than that in the control group, with statistically significant difference ( P<0.05). Conclusions:Huaier granules combined with TEC neoadjuvant chemotherapy in patients with advanced breast cancer can reduce serum HER2-ECD, TAP levels, which can enhance the immune function of the body, reduce the toxic and side effects, improve the long-term survival rate, and have a significant effect.

BACKGROUND: Poly (lactic-co-glycolic-acid) (PLGA)/nano-hydroxyapatite (nHA) composite microspheres may continuously release drug in phosphate buffer solution in vitro.OBJECTIVE: To prepare 5-fluorouracil (5-Fu)-loaded PLGA/nHA microspheres, and research the effect of nHA on drug loading,encapsulation efficiency and in vitro release.DESIGN, TIME AND SETTING: An in vitro materials observation was performed at Laboratory of College of Materials Science and Engineering, South China University of Technology between February and July 2009.MATERIALS: PLGA was provided by Jinan Daigang Biomaterial Co., Ltd.; nHA by Key Lab for Special Functional Materials,Ministry of Education; 5-Fu by Shanghai Kaiyang Biomaterial Co., Ltd.METHODS: 5-Fu, a water-soluble anti-cancer drug, was used as model drug, and was firstly adsorbed by nHA and coated with biodegradable and blocompatible materials of PLGA so as to prepare PLGA/nHA-5-Fu composite microspheres by a single-emulsion solvent evaporation method (S/O/W). nHA and drug-loaded nHA were analyzed by transmission electron microscope (TEM), scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR). Drug loading and encapsulation efficiency as well as in vitro release of microspheres were studied with SEM, laser particle size analyzer, and UV-spectrophotometer.MAIN OUTCOME MEASURES: Interaction between nHA and 5-Fu; drug loading, encapsulation efficiency, and in vitro release of Microspheres RESULTS: FTIR showed that nHA had a strong adsorption with 5-Fu. Drug loading and encapsulation efficiency of PLGA/nHA-5-Fu composite microspheres were 3.83% and 86.78%, respectively, which were significantly greater than PLGA-5-Fu microspheres. After initial burst, composite microspheres released more slowly than PLGA microspheres alone. At day 27, the cumulative release rate of composite microspheres and PLGA microspheres alone were 84.87% and 99.87%,respectively.CONCLUSION: Because nHA has a strong adsorption with 5-Fu, PLGA/nHA-5-Fu composite microspheres compared to PLGA-5-Fu microspheres alone enhances drug loading and encapsulation efficiency, and has a better drug delivery effect.

We investigated the development of an injectable, biodegradable hydrogel composite of poly(trimethylene carbonate)-F127-poly(trimethylene carbonate)(PTMC11-F127-PTMC11 )loaded with bone morphogenetic protein-2 (BMP-2) derived peptide P24 for ectopic bone formation in vivo and evaluated its release kinetics in vitro. Then we evaluated P24 peptide release kinetics from different concentration of PTMC11-F127-PTMC11 hydrogel in vitro using bicinchoninic acid (BCA)assay. P24/ PTMC11-F127-PTMC11 hydrogel was implanted into each rat's erector muscle of spine and ectopic bone formation of the implanted gel in vivo was detected by hematoxylin and eosin stain (HE). PTMC11-F127-PTMC11 hydrogel with concentration more than 20 percent showed sustained slow release for one month after the initial burst release. Bone trabeculae surround the P24/ PTMC11-F127-PTMC11 hydrogel was shown at the end of six weeks by hematoxylin and eosin stain. These results indicated that encapsulated bone morphogenetic protein (BMP-2) derived peptide P24 remained viable in vivo, thus suggesting the potential of PTMC11-F127-PT- MC11 composite hydrogels as part of a novel strategy for localized delivery of bioactive molecules.
Animals ; Biocompatible Materials ; chemistry ; Bone Morphogenetic Proteins ; pharmacology ; Bone and Bones ; drug effects ; Dioxanes ; chemistry ; Drug Delivery Systems ; Hydrogels ; chemistry ; Osteogenesis ; drug effects ; Peptides ; Prostheses and Implants ; Rats

Objective To explore the clinical effect of anteromedial thigh perforator flap for repairing soft tissue defect in lower extremity.Methods From January 2009 to December 2012,12 patients with soft tissue defect of lower extremity were treated with free anteromedial thigh perforator flap.Among them,there were 5 cases of wound in front of tibia,4 cases of dorsal foot wound,3 cases of heel wound;the wound size was 3.0 cm ×3.5 cm-7.0 cm × 9.5 cm;3 cases were repaired with free perforator flap of descending genicular artery,2 cases with free anteromedial thigh perforator flap,and 7 cases with medial vastus muscle perforator flap.Results All the transplants survived.Among them,1 case of anteromedial thigh perforator flap and 1 case of descending genicular artery perforator flap appeared vascular crisis postoperative.After anticoagulation and antispasmodic treatment aggressively,the flaps survived.One case of descending genicular artery perforator flap necrosis in edge,and then were cured by changing dressing.Twelve cases were followed up 6-12 months after operation (average 8.6 months),and the texture of flaps were good,the appearance appropriate ;7 sensation of 5 free flaps after nerve anastomosis came back to S; the donor sites in all cases were sutured directly and healed,leaving only the linear scar,and no effect on function.Conclusion The anatomy of anteromedial thigh perforator flap is constant,and the operation is convenient.The clinical result of repairing soft tissue defect of lower extremity is satisfying.