Objective To discuss the indication, surgical technique and curative effect of humeral head replacement in treatment of complex proximal humerus fracture in old patients. Methods From 2000 to 2006, 23 patients with complex proximal humerus fractures were treated with humeral head replacement and fixated with bone cement in old patients. Rehabilitation training was performed after operation.Results Of all, 19 patients were followed up for average 1.8 years, which showed no infection, nerve injury or periprosthetic fracture except for one patient with semiluxation. NEER score system was used to evaluate the function joint prosthesis. Mean NEER score was 82.1 points, including 80-89 points ( satisfactory) in 17 patients and 70-79 points (unsatisfactory) in 2, with satisfaction rate of 89%. No patient needed revision. Conclusion With strict indication, active reconstruction of rotating cuff and stable structure of the joint, planned postoperative rehabilitation training, the humeral head replacement is a good method for treating complex proximal humerus fractures in the old patients.

Objetive:To detect the gene mutation of a patient with anhidrotic ectodermal dysplasia. Methods: Genomic DNA was extracted from the peripheral blood of the patient and all the exon fragments were obtained by PCR. These fragments were sequenced directly. Results: In EDA gene a novel base transition was detected: -48A→G. Conclusion: There is a new base transition in EDA gene in this patient

This device is an apparatus which can remove intracranial hematoma rapidly and offer a mild damage to the brain tissue.So,with the device,the hematoma which cased by hypertensive cerebral hemorrhage can be removed effectively,and the damage caused by cerebral hemorrhage can be lighten,and the mortality can be reduced,This device is making up of overcoat tube,rotation-sucking tube,guide tube,and spray tube,which can be used for rotating broken suction and multidirection spraying washing.Used clinically to treat more than 400 patients with hypertension cerebral hemorrhage,the device can lighten space occupying effect of intracranial hematoma rapidly,and thus many patients are saved.It's indicated this device is the most effective device for removing brain hematoma at present.

Objective To observe destruction of tibias created in ablating of the swine limbs in vivo with radiofrequency,the influence on the surrounding organization structure,and the repair process of lesions for treating bony tumor.Methods There were eight pigs included in the first part of the experiment.RFA was performed under DSA guidance at the same position of the diaphysis and the upper end of their right tibias in hind leg during anesthesia,then X-ray and CT examinations were performed at different time points after RFA,and subsequently the pigs were executed by depth anesthesia.Control specimens,specimens of the immediate time,the third day,the tenth day,the twenty-fourth day,the fifth week,the eighth week,the twelfth week after RFA were obtained at the diaphysis and the upper end of their tibias.X-ray and CT examinations of these specimens were performed.These specimens were observed both by naked eye and under microscope.The observation included the general state of the laboratory animals after RFA,the configuration of RFA lesions in the gross specimen and the corresponding histologic changes,the boundary of necrosis in RFA lesions and the corresponding boundary of the gross specimen.There were sixteen pigs in the second part of the experiment.RFA was performed at the same position of the diaphysis and the upper end of their right and left tibias in hind leg during anesthesia,and the pigs were immediately executed by depth anesthesia after RFA to get thirty-two capitulum specimens and thirty-two diaphysis specimens.The scope of necrotic tissue in RFA lesions was observed and measured.The border and scope of necrotic tissue in RFA lesions were observed.Major axis,minor axis,and necrosis volume were measured.The independent sample t test was employed to compare the volume of necrotic tissues between capitulum and diaphysis.The one sample t test was employed to analyze volume of necrotic tissue among capitulum,diaphysis and the standard data.Results No accidental death of the animals occured in the first experimental.The loss of neurological function of the hind leg did not happen.Coagulation necrosis in cancellous bone of capitulum and marrow of diaphysis lesions created in ablating was observed.On 3th to 10th day after RFA,inflammatory cells infiltrated in hemorrhage tape and then granulation tissues formed.Granulation tissues replaced necrotic bone gradually from outside to inside.Low density band was showed on images of X-ray and CT examination in the specimen of 10th day,and it extended inward.The immature bone was observed in fibrous tissue sited at the edge of lesions,which appeared as sclerosis on X-ray and CT examination.The scope of necrotic tissue in RFA lesions included coagulation necrosis and hemorrhagic zone of its periphery.The dead bone and secondary pathological fracture appeared in two of eight pigs.RFA hardly damaged compact bone in the diaphysis,but the damage of soft tissue was observed outside the compact bone.In the second experiment,the shape of lesions in cancellous bone of capitulum was ellipsoid,with long axis of(2.59±0.21) cm,minor axis of(2.15±0.10) cm,and volume of(6.34±0.27) cm3.The shape of lesions in the diaphysis of tibias was ellipsoid,with long axis of(4.53±0.20) cm,minor axis of(1.71 ±0.22) cm,and volume of(7.14±0.36) cm3.There was significantly difference of necrosis volume between the capitulum and diaphysis lesions,(t=2.011,P＜0.05).The virtual necrosis volume of the capitulum and diaphysis lesions was significantly different from the presumed volume with RFA instrument(t=-613.371,-295.878,P＜0.01).Conclusion Cancellous bone of the capitulum can be damaged by RFA,but the compact bone of the diaphysis can hardly be damaged.The intact compact bone can be helpful to protect the surrounding soft tissues.X-ray and CT examination can be used in the evaluation of curative effect of RFA for treating bone tumors.Pathological fracture of the diaphysis may appear after RFA.

Objective To compare and analyze the clinical efficacy of locking plates versus artificial joint replacement for proximal humeral complicated fractures.Methods The retrospective data of 200 cases with locking plate or artificial joint replacement for the treatment of comminuted proximal humeral fractures were collected from February 2013 to July in our hospital.Patients were divided into locking plate group (n =114) and artificial joint replacement group (n =86) according to the treatment.The pain,functional recovery,activity,anatomical position,complications and Neer score after treatment were compared between the two groups.Results In artificial joint replacement group,Neer score was excellent in 34 cases,good in 23 cases,fair in 25 cases,poor in 4 cases,and the excellent and good rate was 66.3％ (57/86).In locking plate group,Neer score was excellent in 53 cases,good in 47 cases,fair in 10 cases,poor in 4 cases,and the excellent and good rate was 87.7％ (100/114).The excellent and good rate was higher in locking plate group than in artificial joint replacement group (x2 =13.35,P＜0.001).The scores of pain,functional recovery,activity and anatomical position were (26.9 ± 8.5),(22.4 ± 7.1),(19.8 ± 5.5) and (8.0 ± 1.8) respectively in locking plate group,and (24.8±10.2),(20.2±6.7),(18.1±6.6) and (7.9±2.1) respectively in artificial joint replacement group.There were significant differences in scores of functional recovery and activity between groups (t＝ 2.22 and 1.99,P =0.014 and 0.024),while no significant differences were found in scores of pain and anatomical position (t=1.59 and 0.36,P＝0.057 and 0.359).There were 2 cases with ankylosis,1 case with malunion and 1 case with humeral head necrosis in locking plate group,and 1 case with ankylosis,1 case with wound infection,1 case with refracture and 1 case with humeral head necrosis in artificial joint replacement group after treatment.There were no significant differences in complications between groups (x2 =0.17,P=0.683).Conclusions The locking plate and artificial joint replacement are effective in the treatment of comminuted proximal humeral fractures.Compared with artificial joint replacement,the locking plate can improve the functional recovery,activity and Neer score evaluation with a low technical requirement,which is an ideal method for comminuted proximal humeral fractures.

Ablation Techniques ; adverse effects ; Animals ; Bone and Bones ; pathology ; Disease Models, Animal ; Extremities ; Swine

Objective To investigate the effects of Qinma Formula on endogenous anti-inflammatory system in rats with chronic obstructive pulmonary disease (COPD); To discuss its mechanism of action. Methods Rat models of COPD were made by modified smoked lipopolysaccharide method. 70 healthy SPF male Wistar rats were randomly divided into normal group, model group, Western medicine control group (aminophylline group), TCM medicine control group (Liujunzi Decoction group) and Qinma Formula high-, medium-, and low-dose groups, with 10 rats in each group. Each medication group was given relevant medicine for gavage. The pathological changes of lung tissue were observed under light microscope; the alveolar lavage fluid (BALF) and venous blood were collected and the related indexes were tested; the levels of serum IL-1β, IL-6 and IL-10 were detected by ELISA. Results Compared with normal group, BALF white blood cells, neutrophils, macrophages, lymphocyte, hemoglobin and platelet count in rats of model group increased significantly (P<0.05). Compared with the model group, BALF white blood cells, neutrophils, and macrophages in rats of Qinma medium- and high-dose groups and Liujunzi Decoction group decreased significantly (P<0.05); white blood cells, hemoglobin, and platelet count in rats of Qinma medium-, high-dose groups and aminophylline group decreased significantly (P<0.05); levels of IL-1β and IL-6 in serum decreased significantly (P<0.05); level of IL-10 in serum increased significantly (P<0.05). Conclusion Qinma Formula can effectively inhibit the inflammatory response through the regulation of inflammatory response-related cytokines.

Objective: To explore the preparation methods of nanomete r powder of ZrO 2 for dental application. Methods:Zirconia gel wa s dehydrated by heterogeneous azeotropic distillation process and n-butanol was used as azeotropic solvent. The properties of ultrafine powder obtained via dec ompression (process b), atmosphere pressure (process c) and direct ethanol-wash ing (process a) were studied. Results: After drying and calcini ng the gel, the ultrafine powder obtained from process a,b and c was about 25 n m,22 nm and 17 nm respectively. 3Y-TZP ceramic prepared with the three kinds of nanometer powder had bending strength of 660 MPa,710 MPa and 640 MPa; fracture toughness of 4.34 MPa?m 1/2 ,4.77 MPa?m 1/2 and 4.24 MPa?m 1/2 , respectively. Conclusion: By the heterogeneous azeotropic dis tillation process, zirconia ultrafine powder without hard agglomeration (d BE T=17 nm) can be obtained.

Objective: To highly express rh-Endostatin from Pichia pastoris and purify it to homogeneity. Methods: Constructed Pichia pastoris X33/pLW202 was amplified and inoculated to ferment media. The supernatant of the strain was collected after induction. Through ultrafiltration, affinity and gel chromatography, rh-Endostatin with high purication was obtained. Results: 60mg/L rh-Endostatin was obstained from supernatant. HPLC showed its purity was above 98%. Conclusion: High level expression of secreted rh-Endostatin has been successfully achieved in Pichia pastoris expression system.