1.Biomechanical evaluation of repairation of cancellous bone defect with calcium sulphate
Hua CHEN ; Xuezhong TIAN ; Boxun ZHANG
Orthopedic Journal of China 2006;0(05):-
[Objeetive]To report the repairing offect of cancellous bone defect with calcium sulphate.[Method]A defect 5mm in diameter and 12 mm in deep,which was drilled in the lateral aspect of rabbit lateral femoral condyle,was filled with CCaS(Citrated Calcium Sulphate)cylinder or Osteoset tablets respectively.Rabbits were killed 3,6,13 weeks after surgery.And then general oberservations and mechanical analyzing were conducted.[Result]After surgery,rabbits had good movements,spirits and eating,good healing of incision.There was no arthroedema and inflammatory response around the joints.Mechanical analyzing reports:both anticompressive strength and elasticity coefficient in the artificial bone repair bone defect area 3 weeks after surgery,were higher than in that of normal femur condyle;Anti-compressive strength and elasticity coefficient in the defect area 6 weeks,which drop comparing to 3 weeks,was lower than that of normal femur condyle;Anti-compressive strength and elasticity coefficient 13 weeks,which is higher than 6 weeks,is approaching normal.Mechanics intensity of two groups in the different time had no significant difference,but was significantly higher than one of the same time blank group.[Conclusion]To some extent,Calcium Sulphate has mechanical supportive effects on cancelloues bone defect in spite of the absorption and degradation of Calcium Sulphate.There is no significant difference between Citrated Calcium Sulphate and Osteoset tablets.
2.Analysis of short-term death after transcatheter hepatic arterial chemoembolization in 265 patients with liver cancer
Jinsong YANG ; Ren TIAN ; Xuezhong ZHANG
Clinical Medicine of China 2000;0(12):-
Objective To explore the effective way to decrease serious complications and to minimize the mortality following transcatheter hepatic arterial chemoembolization (TACE).Methods In 265 liver cancer patients experiencing TACE,the causes of death in 19 (20 days after TACE) were analyzed.Results 9 cases died of liver failure,4 died of the rupture of liver tumors, and 2 died of upper digestive tract bleeding.Gastroduodenal perforation,pulmonary embolism,myocardial infarction,and hyperkalemia resulted in death in one case,respectively.The mortality rates of primary liver cancer and liver metastasis were 9.2% and 1.4%,respectively (P
3.Treatment of gradeⅡsupination adduction ankle fractures with impaction of tibial plafond using double-plate fixation
Yanqing WANG ; Minghui LIU ; Xuezhong TIAN ; Shikong JIA
Tianjin Medical Journal 2015;(9):1059-1062
Objective To evaluate the effect of double-plate treatment on grade Ⅱsupination adduction ankle frac? tures with impaction of tibial plafond. Methods A total of 17 patients of gradeⅡsupination adduction ankle fractures with impaction of tibial plafond were treated surgically in our hospital. Anteromedial approach to the medial malleolus was taken to expose the tibial plafond and the vertical medial malleolus fractures. One distal radius plate was placed on the anteromei?dal tibial plafond, and another buttress plate was placed on the medial malleolus. Bone grafting was used to restore the height of the collapsed tibia. Lateral malleolus fractures were treated with reconstruction plate. The fracture union after operation was detected by X-ray examination. American Orthopedic Foot and Ankle Society (AOFAS) ankle hind foot score was used to assess the ankle function. Results Sixteen of 17 patients were followed up postoperatively for a mean period of 2.6 ± 0.9 years. CT cross-sectional study found that the collapsed articular surface of 12 (70.6%) patients was mainly located in the an?teromedial one-fourth area, with the worst at anterior margin. Bony fusion was achieved in all patients after an average peri?od of 2.9±0.5 months. No internal fixation loosening or fracture redisplacement was found by X-ray. The average range of an?kle joint activity was 16.4°±2.8° for dorsiflexion, and was 39.2°±5.3° for plantarflexion. According to AOFAS ankle hindfoot scale, ankle function was excellent in 14 patients and good in 2, with excellence rate of 100%. Conclusion The application of double-plate fixation to treat gradeⅡsupination adduction ankle fractures with impaction of tibial plafond can play a key role in reducing fracture redisplacement and osteoarthritis.
4.Dynamic change in learning and memorising ability after hemispheric irradiation in rats
Xuezhong LI ; Shiyao BAO ; Kangren ZHAO ; Yie TIAN ; Zhilin ZHANG
Chinese Journal of Radiation Oncology 1992;0(01):-
Objective To study the sequence of learning and memory loss in the rat after hemispheric irradiation. Methods After Sprague Dawly(SD) female rats were anaesthetized with chloral hydrate, their cerebral hemispheres were irradiated with a single dose of 5,15 or 30?Gy by 4?MeV electron. On D3,D7,D30 and D60, the learning and memorizing ability was measured with the Y maze test. Results On D3 and D7, the learning ability of SD rats was impaired most but partly restored in 1 to 2 months. In observation of memory loss, the intensity of cerebral function damage was in direct proportion to the increase of radiation dose.Conclusion The learning and memorizing ability of rats can be damage by hemispheric irradiation with the severity of impairment and possibility of recruitment depending on the dose.
6.Effect of sedation with midazolam combined with propofol on delirium in mechanically ventilated patients in intensive care unit
Xiaoyun FU ; Jie HU ; De SU ; Fei GAO ; Xuezhong YANG ; Tian YU
Chinese Journal of Anesthesiology 2015;35(3):344-346
Objective To evaluate the effect of sedation with midazolam combined with propofol on delirium in mechanically ventilated patients in the intensive care unit (ICU).Methods Five hundred and twenty-two patients who required sedation and analgesia,endotracheal intubation and mechanical ventilation used to assist respiration,aged 28-64 yr,weighing 41-82 kg,were randomized into 2 groups according to the sedation protocols during therapy:sedation with midazolam group (group M,n =240) and sedation with midazolam + propofol group (group MP,n=232).In M and MP groups,sedation was induced with midazolam infusion 0.03-0.17 mg/min,and analgesia was induced with sufentanil infusion 0.07-0.14 μg/min.In group MP,when hemodynamics was stable,pressure support was 8-10 cmH2O,tidal volume>400 ml,RR <25 bpm,and FiO2<45%,sedation was induced with propofol infusion 0.8-2.0 mg/min instead,lasting for 12-24 h.Richmond Agitation Sedation Scale score was maintained at-1 to-2 during vcntilation.The development and duration of delirium were recorded.Delirium was divided into hyperactive delirium,hypoactive delirium and mixed delirium 3 subtypes,and the development and duration of the 3 subtypes of delirium were also recorded.Results There was no significant difference between the two groups in the incidence and duration of delirium.Compared to group M,the incidence of hyperactive delirium was significantly decreased,and no significant change was found in the incidence of hypoactive delirium and mixed delirium and the duration of the 3 subtypes of delirium in group MP.Conclusion Sedation with midazolam and propofol can decrease the development of hyperactive delirium,but can not shorten the duration of delirium in mechanically ventilated patients in the ICU.
7.Reference value range of pulse oximetry plethysmographic waveform parameters in the normal adults
Chen LI ; Jun XU ; Fei HAN ; Xiaocui ZHANG ; Yangyang FU ; Liangliang ZHENG ; Daoyuan JING ; Ruifeng ZENG ; Xiaohe LIU ; Banghan DING ; Yingping TIAN ; Yanfen CHAI ; Zhongqiu LU ; Huadong ZHU ; Xuezhong YU
Chinese Journal of Emergency Medicine 2016;25(12):1294-1300
Objective To Pulse oximetry saturation has been wildly used clinically.It has been reported that pulse oximetry plethysmographic waveform (POP) reflected the peripheral tissue perfusion.In this study,we parameterized POP,observed the value of POP parameters in normal adults,and established the normal reference value range.Methods A multi-center prospective descriptive study.Total of 1 019 adult volunteers with normovolemia from 7 cities were enrolled in this study.Sex,age,height,weight and pulse oximetry data in awake and spontaneous breathing under in quiet conditions in the room temperature were collected.POP parameters and perfusion index were analyzed using MATLAB 2012a software.The normal reference value ranges of POP parameters,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),were formulated.Results Statistical differences of POP parameters were detected between men and women in the normal adult.The 95% confidence reference value of POP parameters in normal population was as follows:Amp (104.8-2298.7) PVA and AUC (3265.8-6028.5) PVPGin total,Amp (129.4-2433.6) PVA and AUC (3319.0-5862.2) PVPG in male;Amp (89.5-2138.2) PVA and AUC (3163.9-5929.9) PVPG in female.Conclusions POP,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),had normal reference value ranges in normal adults.
8.Risk factors of acute kindey injury in critical patients in emergency department
Xuefang LI ; Kui JIN ; Liyuan TIAN ; Yangyang FU ; Jian GAO ; Jiayuan DAI ; Huadong ZHU ; Xuezhong YU ; Jun XU
Chinese Journal of Emergency Medicine 2021;30(6):749-753
Objective:To investigate the incidence and risk factors of acute kidney injury in patients admitted to the resuscitation room of the Emergency Department.Methods:Patients were enrolled from the resuscitation room of our hospital from September to December 2018 by a retrospective cohort study. Patients were divided into AKI group and non-AKI group according to whether AKI occurred within seven days after admission. Demographic characteristics, APACHEⅡ score, whether to use nephrotoxic drugs,24-hour fluid volume, and patients survival time were collected. Multivariate regression analysis was used to explore the risk factors for AKI. Cox regression was used to study the effect of the occurrence of AKI on survival and to analyze the influence of AKI severity on the death risk of patients in the resuscitation room.Results:Among 238 critical patients who were finally included, 108 patients developed AKI(45.4%), 83 patients were in AKI stage 1 (34.9%), and 25 patients were in AKI stage 2-3 ( 10.5%).APACHEⅡ score>13( OR=1.11, 95% CI (1.08-1.16), P <0.01), vasoactive drugs ( OR=2.20, c95% CI (1.08-4.49), P=0.03), diabetes mellitus ( OR=2.33, 95% CI (1.23-4.42), P=0.01), and fluid load> 3 L( OR=3.10, 95% CI (1.17-8.25). P=0.02) were independent risk factors for AKI. After adjustment for APACHEⅡ score and age by multivariate COX regression, AKI remained an independent risk factor for death in emergency patients, and the severity of AKI significantly increased the risk of death in these patients(AKI 1: HR=1.45, 95% CI (1.08-2.03), P =0.04; AKI 2~3: HR=3.15, 95% CI (1.49-4.81), P=0.03). Conclusions:AKI occurred commonly in the resuscitation room of the emergency department. APACHE Ⅱ score>13, vasoactive drugs, diabetes, and fluid load>3 L were independent risk factors for AKI. The risk of death increased with the aggravation of AKI severity.