BACKGROUND:Different methods of internal fixation can be selected during the repair of femoral shaft fractures in the clinic, including bridging combined internal fixation and metal locking plate screw fixation.
OBJECTIVE: To compare the biomechanical properties of bridging combined internal fixation and metal locking plate screw fixation for femoral shaft fracture.
METHODS:Eighteen femoral samples were colected and randomly divided to three groups, with six in each group. In the normal control group, no treatment was given. In the other groups, models of femoral shaft fracture were established. In the bridging combination group, samples underwent bridging combined internal fixation. In the locking plate screw group, samples underwent metal locking plate screw fixation. Biomechanical test was conducted in samples of the three groups. In the femoral compression experiments, we recorded the maximum displacement under the maximal load 500 N. In the femoral flexion experiment, we recorded the maximum displacement under the maximal load of 100 N. In the femoral retroversion experiment, we recorded the maximum displacement under the maximal load of 100 N.
RESULTS AND CONCLUSION: (1) Compression experiment at different loads: the maximum displacement was larger in the bridging combination group and locking plate screw group than in the normal control group. Under the maximum load of 500 N, the maximum displacement was significantly larger in the bridging combination group and locking plate screw group than in the normal control group (P < 0.05). Moreover, the maximum displacement was significantly less in the bridging combination group than in the locking plate screw group (P< 0.05). (2) Flexion experiment under different loads: the maximum displacement was larger in the bridging combination group and locking plate screw group than in the normal control group. Under the maximal load of 100 N, the maximum displacement was significantly larger in the bridging combination group and locking plate screw group than in the normal control group (P< 0.05). Moreover, the maximum displacement was significantly smaler in the bridging combination group than in the locking plate screw group (P < 0.05). (3) Retroflexion experiment under different loads: the maximum displacement was larger in the bridging combination group and locking plate screw group than in the normal control group. Under the maximal load of 100 N, the maximum displacement was significantly larger in the bridging combination group and locking plate screw group than in the normal control group (P < 0.05). Moreover, the maximum displacement was significantly smaler in the bridging combination group than in the locking plate screw group (P < 0.05). (4) These results suggested thatin vitro simulated femoral shaft fracture bridging combination fixation and metal locking plate screw system can obtain good fixation effect; the design meets the principle of biomechanics. Among them, bridging combined internal fixation can maintain a smaler displacement, suggesting good deformation resistance under compressive stress, anteflexion and retroflexion stress.

BACKGROUND:There are less studies addressing whether bone marrow mesenchymal stem cells from systemic lupus erythematosus patients are different from healthy people.
OBJECTIVE:To compare the multi-differentiation capacity of bone marrow mesenchymal stem cells isolated from systemic lupus erythematosus model mice and normal control mice.
METHODS:Bone marrow mesenchymal stem cells of systemic lupus erythematosus model mice and C57BL mice were isolated and cultured fol owed by osteogenic and adipogenic differentiations, respectively. Differentiation abilities of two kinds of mouse bone marrow mesenchymal stem cells were observed.
RESULTS AND CONCLUSION:Passaged bone marrow mesenchymal stem cells from C57BL mice were long spindle-shaped and evenly distributed, while bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice showed slow growth and were relatively smal er than those from C57BL mice. After osteogenic induction, the amount of calcium salt and calcium nodules were significantly less in the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice than from normal control mice. PCR detection showed that expressions of Runx2, alkaline phosphatase and osteocalcin were also significantly decreased in the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice. After adipogenic induction, the number of lipid droplets in the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice was significantly less than the control group, and PCR detection also showed significantly decreased expression of adipogenic genes, including PPARγ2 and lipoprotein lipase. These findings suggest that the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice exhibit lower osteogenic and adipogenic capacities than those from normal C57BL mice, and also have the impaired multi-differentiation ability.

Objective To study the changes and management of systemic and pulmonary hemodynamics during anhepatic period in patients undergoing orthotopic liver transplantation without veno-venous bypass.Methods Sixty-eight patients with end-stage liver disease undergoing orthotopic liver transplantation were enrolled in this research. Monitoring and recoding CVP, MAP, CI, HR, MPAP, PAWP PVR, SVR at different time points: preincision, before anhepatic, 5, 30 min of anhepatic, 5, 30, 60 min of neohepatic,ending of operation, 12 h and 24 h after operation. All the patients were divided into three groups according CVP during anhepatic period: group A(CVP <4 mmHg) ,group B(4 mm Hg≤CVP≤6 mmHg) ,group C (CVP>6 mmHg). Besides, calculating the concentration of dopamine, norepinephrine ,epinephrine and the volume of urine during of operation. Results There were different changes during different operation periods. During anhepatic period, HR, PVR and SVR increased, while CVP, CI, MAP, PAP, PAWP decreased(P<0.05). At early neohepatic period, HR decreased and CVP,PAWP, MPAP,CI,PVR SVR increased ,At the beginning of neohepatic period, MAP dacreased or increased quickly, and became steadily after 5 min. Among the three groups, the changes of hemodynamics in group B was slightest,and the concentration of dopamine, norepinephrine and epinephrine was smallest (P< 0.05 ). Conclusions The systemic and pulmonary emodynamics fluctuated sharply during anhepatic and early neohepatic period. It is important and useful to manage CVP 4 -6 mmHg, MABP ≥ 60 mmHg by infusing liquid and vasoconstrictors,such as dopamine, norepinephrine or epinephrine during anhepatic period.

Objective To evaluate the clinical value of determination of composition of kidney stones by shap and density and of prediction of the efficacy of extracorporeal shock-wave lithotripsy (ESWL) by X-rays. Methods The data of 358 patients were analyzed,with 204 male and 154 female and with 276 cases of solitary stones and 82 cases of multiple stones.Determine the composition of kidney stones by shap and density,predict the efficacy of ESWL by X-rays,and choose the appropriate method of treatment.Analyze stone chemical property by Infrared stone composition automatic analyzer to checkout the prediction results before surgeries. Results 339 cases were successful to remove stones after treatment.The prediction results of 308 cases (86.0％) were consistent in stone chemical property,and the preperative prediction results of 339 cases (94.7％) were consistent in ESWL efficacy. Conclusions Determination of composition of kidney stones and prediction of the efficacy of ESWL by X-rays were feasible.

Objective To systematically evaluate the optimal indwelling time of double?J stent in the treatment of ureteral complicated calculi post?ureteroscopy. Methods A total of 161 patients with complicated ureteral calculi were enrolled in this study from August 2012 to August 2015. All patients received the treatment of ureteroscopic holmium YAG Laser lithotripsy and were randomly divided into 3 groups according to varied double?J stent indwelling time: group A < 2 weeks (n = 43),group B from 2 ~ 6 weeks(n = 67),and group C>6 weeks (n = 51). Complications of three groups were compared and the hydronephrosis after removing double?J stent was recorded. Results The rate of complications of group C was significantly higher than that in group A and group B (P<0.017). However,group A(10/43)has a higher rate of ureterostenosis after removing double?J stent compared with group B(4/67)and group C(3/51),while no statistical significance was observed between group B and group C. Conclusion The incidence of complications after lithotripsy increased with the indwelling time of double?J stent,but the short indwelling time would led to ureterostenosis. Therefore,the optimal indwelling time of double?J stent after flexible ureteroscopy was 2 to 6 weeks,and the indwelling time for patients with injury ureteral mucosa could be appropriately prolonged.

Objective:To explore the clinical efficacy of liver transplantation for Wilson's disease(WD).Methods:From January 1999 to November 2021, clinical data were retrospectively reviewed for 16 recipients with WD undergoing liver transplantation.There were 9 males and 7 females with an age range of 29.5(14~54)years.They were followed up by telephone, outpatient services and hospitalization.The starting point of follow-up was operation date.And recipient death was an endpoint.Postoperative survival, improvement of neuropsychiatric symptom, changes of corneal K-F ring, altered levels of liver function and serum copper-protein at Month 1 post-operation were observed.The follow-up deadline was November 24, 2021.Results:15 recipients underwent classical orthotopic liver transplantation and the other one recipient underwent living-related liver transplantation.No perioperative deaths occurred.All 16 recipients were followed up for 122(6~260)months.The 1-, 5-, and 10-year survival rates were 93.8%、85.2%and 75.8%, respectively.Among 10 recipients with corneal K-F ring positive with varying degrees after operation and was disappeared in 2 recipients at 7 and 11 months.Among 5 recipients with neuropsychiatric manifestation, 4 recipients showed ameliorative neuropsychic symptoms with varying degrees after operation and 1 recipient died.All the levels of liver function and serum copper-protien of all recipients recovered obviously in 1 month and the 1-, 5-, and 10-year post-operation.Conclusions:Classical orthotopic liver transplantation and living-related liver transplantation not only effectively improves copper metabolism of patient with WD and relieves their severe neurological manifestation, but also improves their life and prolongs survival, which is worthy of clinical promotion.