BACKGROUND:Calcium citrate has a better solubility than calcium phosphate, calcium sulfate, and other calcium biomaterials. The synthetic calcium citrate has a good denseness, and stably releases calcium ions at a high efficiency during the degradation. Consequently, it may be more suitable for the fil ing of fracture defects, providing needed calcium ions for early fracture healing.
OBJECTIVE:To prepare calcium citrate biomaterials with a novel formulation based on the natural bio-mineralized oyster shel s and citric acid so as to expect to get a good application in fracture healing repair.
METHODS:Crushing, grinding, and chemical reaction methods were used for refinement. Particle size analyzer, X-ray diffraction, scanning electron microscope, and Fourier transform infrared spectroscopy were adopted for analysis of the size distribution, composition, mineral phases, and micro-morphology. Biological characteristics were evaluated through a simulated body fluid experiment.
RESULTS AND CONCLUSION:Oyster shel powder was reacted with saturated citric acid to produce the calcium citrate material that had uniform crystal structure and compact bonding among crystal bodies, and exhibited a certain mechanical ability. The calcium citrate material had a good crystal structure that was conductive to prolong the degradation time. The calcium citrate released calcium ions slowly, and did not produce dramatic changes in the pH value (7.20-7.46) of the surrounding in the dissolution process. With the gradual degradation of calcium citrate materials, Ca2+concentration in solution increased gradual y and stably, and ultimately achieved an appropriate concentration of 7 mmol/L, suitable for osteoblast proliferation and differentiation. Calcium citrate prepared using natural oyster shel has good biological properties, and exhibits a natural superiority to artificial bone materials.

Objective To investigate the changes of interleukin-1β (IL-1β) in rat brain after subarachnoid hemorhage (SAH) and its relation to cerebral edema and vasospasm.Methods Subarachnoid hemorrhage rat model was produced by anterior cerebral artery perforation method.The brain water content was measured by dry-wet weight method.Hematoxylin-eosin (HE) staining was used to assess vasospasm in the basilar artery,and the expression of IL-1β after SAH was examined by Western blot.Results After SAH,the cerebral edema gradually occured from 1 d,reached the peak at 7d.The level of IL-1β protein started to increase in 1 d,reached its peak in 7d,and remained at a relative high level in 14d.There's correlation between the level of IL-1β protein and changes of cerebral edema.Conclusion After SAH,The level of IL-1β gradually rised and fits remarkably well with the time course of cerebral edema,which may indicate that IL-1β leads to the development of cerebral edema after SAH.

Objective:To investigate the effect of Yupingfeng on hyaluronic acid (HA) and Foxp3+Treg in patients with nasopharyngeal carcinoma.Methods:A total of 58 cases of nasopharyngeal carcinoma were divided into two groups, 30 cases in the treatment group, 28 cases in the control group. Patients in two groups were treated with synchronous radiotherapy and chemotherapy treatment, the treatment group was treated with the Yupingfeng granules through oral administration, 10 g/time, tid for 2 courses. The serum Foxp3+ Treg markers of each group were detected by flow cytometry assay before treatment and after treatment, and the level of HA in serum was detected by radio immunoassay.Results:After radiotherapy and chemotherapy, the contents of Foxp3+ Treg and HA were significantly decreased in two groups (P<0.05), and the decrease of treatment group was more significantly (P<0.01). Correlation analysis showed positive correlation between Foxp3+ Treg and HA (P<0.05). After treatment, the incidence of side effects in two groups was significantly decreased. And there was significant difference between two groups (P<0.05).Conclusions:Combined chemotherapy and radiotherapy with Yupingfeng treatment can decrease the levles of Foxp3+ Treg and HA in nasopharyngeal carcinoma patients. Yupingfeng can also effectively reduce the side effect due to radiation and chemotherapy.

Objective:To investigate the safety and effect of complete mesocolie excision (CME) combined with arterial infusion chemotherapy (AIC) and intra-peritoneal interstitial sustained-release chemotherapy (IPISRC). Methods:A total of 104 patients were classified under the experimental group and underwent CME combined with AIC and IPISRC. The other 98 patients were classified un-der the control group and only received radical surgery. Pre-and post-operative blood routine examinations, as well as liver and kidney function tests, were conducted for both groups. Post-operative adverse reactions and incidence of complications were recorded. Cancer and para-neoplastic tissues were sampled in experimental group. The post-surgery 5-fluorouracil (5-FU) concentration in the drainage fluid as well as those in the peripheral blood , were determined. Three-year follow-ups were conducted, during which the local recur-rence rate, liver metastasis, progression-free survival rate, and total survival rate were recorded. Results: No significant differences were found in the white blood cell count, hemoglobin count, liver and renal functions of the patients before and after the surgery, and rate of adverse reaction and complications between the two groups after surgery (P>0.05). In experimental group , the 5-FU concentra-tion was significantly higher in the cancer tissues than in the para-neoplastic tissues . The 5-FU concentration in experimental group was also significantly higher in the intra-peritoneal drainage liquid and reached its peak in the peripheral blood on day 3 post-surgery . Local recurrence and liver metastasis rates were significantly lower in experimental group than those in control group, whereas the pro-gression-free and three-year overall survival rates were significantly higher in experimental group than in control group (P<0.05). Con-clusion:The tharepy of pations of experimental goup is safe and effective. This method significantly improves the progression-free and three-year survival rates of the patients as well as significantly reduces the local recurrence and liver metastasis rates of colon cancer.

Objective To compare the efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity. Methods From January 2014 to January 2015,77 patients diagnosed as great saphenous varicosity were enrolled. They were randomly divided into two groups, 37 patients received endovenous laser treatment combined with transilluminated powered phlebectomy and the other 40 patients underwent traditional surgical treatment. The related indicators were compared.Results The mean operation time,average bleeding volume,operative incisionquantity and average hospitalization time of EVLT+ TIPP group were (66.1±14.7) min,(24.4±10.5) ml,5.7±1.7,(5.6±1.4) d respectively,of control group were (84.3±18.5) min,(59.0±15.6) ml,8.0±1.8,(10.1±3.1) d respectively,there were significant differences between the two groups(t =-4.749,-11.460,-5.714;P<0.001) .There were no significant complications in the two groups.In the EVLT+ TIPP group,6 patientsoccurred patsubcutaneous induration, 5 patients occurred subcutaneous hematoma and 7 patients had skinparesthesias.In the traditional operation group,2 cases occurred patsubcutaneous induration,3 cases occurredsubcutaneous hematoma and 2 cases had skin paresthesias.The EVLT+ TIPP group was slightly higher than thetraditional operation group in the complications, but there were no significant differences between them ( P>0.05).During a mean follow?up time of (18±7) months(12 months to 24 months),1 patient recurrence in theEVLT+ TIPP group,2 cases recurrence in the traditional operation group.The recurrence rates of the two groupswere similar,the difference was not significant between them(P=1.000) .Conclusion Endovenous lasertreatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective andsafe.It also has the advanta and better cosmetic results.

Objective To evaluate the effects of Amplatz thrombectomy device (ATD), thrombolysis (TL), and surgical thrombectomy (TX) on venous wall morphology complicated with acute femoral vein thrombosis in dogs. Methods The femoral venous thrombosis model was induced in 36 adult mongrel dogs. The thrombosed veins were treated with ATD ( n =12), TL ( n =12), and TX ( n =12), respectively. Results Clearance of thrombus was successful in all cases. One week after treatment, the rate of venous patency in ATD, TL, and TX group was 75%, 33%, and 25%, respectively ( P

Objective Pulmonary hypertension (PH) was an independent predictor of mortality and new onset cardiovascular events in maintenance hemodialysis (MHD) patients. Recent studies revealed PH complicated by pericardial effusion (PE) increased mortality in non-CKD (chronic kidney disease) population. No such evidence existed in MHD patients. Methods We enrolled 108 MHD patients with diagnosed PH by echocardiography (61 with PE) between 2009 and 2011. All patients had been followed-up for 2 years. The endpoints were all-cause mor-tality, cardiovascular (CV) mortality and new onset CV events. Results The mean age was (60.2 ± 14.1) years, 55.6% were males and SPAP was (53.0 ± 15.4) mmHg. 12.0% were severe PH and 1.9% were moderate-to-severe PE. The overall mortality, cardiovascular mortality and new on-set cardiovascular events in PE and non-PE group were 34.4% vs. 21.3%、 23.0% vs. 12.8% and 54.1% vs. 42.6%, respectively (P > 0.05). Kaplan-Meier curve showed there was no difference on all-cause mortality , CV mortality nor new-onset CV events between PE and non-PE group (Log Rank P > 0.05). Conclusions Compared with patients without PE, the presence of PE in patients with PH did not increase the mortality and worsen the cardiovascular outcome in MHD patients.

Objective To investigate clinical efficacy and safety and complications of transurethral plasmakinetic resection of prostate ( PKRP) for benign prostatic hyperplasia ( BPH) .Methods Totally 186 BPH patients were underwent PKRP .Comparison of clinical parameters before and after operation .Results Following-up at 3 and 6 months after the operation showed that international prostate symptom score ( IP-SS),quality of life(QQL),residual urine volume(RUV) scores increased and maximal urinary flow rate ( Qmax) scores decreased .The incidence of complications was 8.2%.Conclusion PKRP have efficacy in the treatment of BPH , and PKRP is safer and less complications .

Objective To investigate the application value of split type tubercle on the surgical treatment of unilateral thyroid benign nodules.Methods 180 cases of unilateral benign thyroid nodules were selected,and they were randomly divided into split type tubercle resection group(group A,n =90) and hemithyroidectomy group(group B,n =90) according to the digital table.The clinical effects were compared in the two groups.Results There was no complication such as hypocalcaemia and postoperative hemorrhage.1 case of group A and 2 cases of group B had transient vocal cord palsy,there was no statistically significant difference (P ＞ 0.05).There were 6 cases postoperative nodule recurrences in group A,and 5 cases in group B during 6 months to 5 years follow-up,there was no statistically significant difference(P ＞0.05).The thyroid stimulating hormone(TSH) levels of the two groups showed no statistically significant difference before operation (P ＞ 0.05).However,the TSH level of group A (2.76 ± 1.34)IU/mL was lower than (4.31 ± 2.01)IU/mL of group B 1 year after operation,and the difference was significant between the two groups (t =9.235,P ＜ 0.05).Conclusion The split type tubercle resection is worthy to properly applied in surgical treatment of unilateral benign thyroid nodules.

Objective:To investigate the value of paraspinal approach and intraperative neuromonitoring in surperior laryngeal nerve (SLN) protection during thyroidectomy.Methods:214 cases of thyroid cancer admitted in our hospital from Jun. 2017 to Feb. 2018 were randomly divided into 2 groups. Patients in control group used the neck white line approach, while patients in observation group used paraspinal approach and intraperative neuromonitoring on the basis of the control group. Operation time, blood loss and SLN injury were compared between the two groups.Results:Operations were successfully performed in 214 cases. The amount of blood loss was (16.64±4.10) ml in the control group and (16.58±3.90) ml in the observation group ( t=0.086, P=0.931) . The operation time was (74.52±17.94) and (72.06±15.31) min ( t=0.792, P=0.430) . There was no significant difference in intraoperative blood loss or operation time between the two groups ( P>0.05) . SLN was seen in 134 (74.44%) of 180 nerves and 98 (89.09%) of 110 nerves, showing significant differences between the two groups ( Z=-3.02, P=0.003) . Temporary SLN injury occurred to 6 cases (4.65%) in the control group after operation, while it didn’t occurred to any one in the observation group ( Z=-2.012, P=0.044) . Conclusion:Application of paraspinal approach and intraperative neuromonitoring can improve the efficiency and safety of thyroidectomy, and is significant for SLN protection during thyroidectomy.