BACKGROUND:Better fusion of bone cement and bone interface can reduce prosthesis loosening rate.Marrow cavity is the place where bone cement fusion takes place,so its preparation is important to improve bone cement filling quality.OBJECTIVE:To evaluate bone cement-bone interface fusion in marrow cavity washed with high-pressure pulsed water syringe versus marrow cavity brushing.DESIGN,TIME AND SETTING:The comparative observation was performed at Animal Laboratory and Orthopaedic Laboratory of the First Hospital of Harbin Medical University from July 2002 to June 2003.MATERIALS:Forty fresh horse ulnas were randomly divided into 2 groups(n=20):washing group and control group.METHODS:The articular surfaces of the proximal ulna and cortex of horse ulnas were sawn to expose the trabecular bone,and only 15 cm proximal ulna was retained.The marrow cavity was opened with marrow cavity drilling and marrow cavity file along the line parallel to the longitudinal axis,proximal diameter 1.5 cm,5.5 cm deep,and self-developed marrow cavity bolt was put into the cavity until 5 cm deep.The marrow cavity of washing group was treated with high-pressure washing,1 000 mL fluid for each model,and the cavity was brushed once after washing with every 300 mL fluid for a total of 3 times.At the last time,100 mL water was used to clean the cavity following by wiping until the cavity was dry.The control group was not given any treatment.Both groups were infused with bone cement by the same method,and the models of each group were scanned by CT(interval 4 mm).MAIN OUTCOME MEASURES:Number of trabecular bone closely or not closely connected by bone cement section surrounding to calculate the rate of combination;condition of surfaces of marrow cavity and bone cement in the column by amplifier.RESULTS:CT scanning showed that interface connection rate of washing group was 64.47%,while the control group was 26.67%;the differences were statistically significant(P

BACKGROUND: Previous research reveals that, single-layer human amnion is effective to cure superficial bums, but it is still unsatisfactory.OBJECTIVE: To observe the effects of double-layer radiation-treated human amnion on the healing of deep second-degree burn wound.DESIGN, TIME AND SETTING: Randomized control study was performed at the Animal Experimental Center in the First Affiliated Hospital of Harbin Medical University (Harbin, Heilongjiang, China) from December 2006 to May 2007.MATERIALS: Fifty adult Wistar rats of clean grade were burned and then assigned into five groups at post-injury 4, 6, 8,10 and 12 days, with ten rats in each group. Subsequent to the chorion removal, the fresh human amniotic membrane was dried and prepared into double-layer films, which were aporate or porous. Human amnion was then radiated using γ-ray for further use.METHODS: Following dorsal skin epilatiou and the anesthesia, all the rats were immersed for 8 seconds in boiling water to induce rat models of deep second-degree burns. One side of the burn wound was applied human amnion, while the other side was applied oil gauze.MAIN OUTCOME MEASURES: Gross observation of the bum wound was carried out at post-injury 4, 6, 8, 10 and 12 days. Meanwhile, light microscope, scanning electron microscope and transmission electron microscope were employed to detect the histological changes of the burn wound, as well as bacteriological examination.RESULTS: Fifty rats were all involved in the result analysis. Sphacelism and crust were found in the burn wound treated with oil gauze, with the presence of focal ulcer at post-injury 12 days. Under light microscope, few hairs regenerated in dermis, especially hair follicle and hair root; Scanning electron microscope suggested a large amount of inflammatory exudates and leukocytes; Transmission electron microscope revealed an unclear structure of the cells. Bacteriological examination also indicated that the bacteria aecreted on the surface of burn wound. The treatment of double-layer radiation-treated human amniou healed the burn wound at post-injury 10 and 12 days, and the hairs grew with the same manner as that of normal skin. Epidermis tissues were proved to be normal skin at post-injury 12 days by means of light microscope, scanning electron microscope and transmission electron microscope. Bacteriology was detected to be negative.CONCLUSION: Double-layer radiation-treated human amnion plays a protective role on the burn wound in rats. It may facilitate epithelial growth, avoid wound infection and accelerate the healing of deep second-degree burn.

Objective:To explore the clinical and electrophysiological characteristics of flail arm syndrome (FAS).Methods:Clinical and electrophysiological data were collected on 13 FAS patients and 31 persons with upper limb onset amyotropic lateral sclerosis (UL-ALS), including the amplitude of compound muscle action potential (CMAP) related to median nerve, ulnar nerve, and axillary nerve motor conduction. A split-hand index (SI) was calculated by dividing the CMAP amplitude of abductor pollicis brevis by that of the abductor digiti minimi. Clinical features, the CMAP amplitudes and SIs were compared between the FAS and UL-ALS patients.Results:Compared with UL-ALS patients, the age at onset among the FAS patients was older (averaging 60.9 years). The development to the second stage was longer (24±6 months). The upper limb reflexes of 15% of the FAS patients had disappeared and those of 77% were weakened, while the lower limb reflexes of 54% of the FAS patients were active and 38% were weakened, significantly different from the UL-ALS patients. However, there were no significant differences in the CMAP amplitudes of the median and ulnar nerves, nor in SI between the FAS and UL-ALS patients. The SIs of the FAS patients with upper motor neuron signs were significantly lower than those of FAS patients without such signs. Among the FAS patients, the average CMAP amplitude of the ulnar nerve was the highest, followed by those of the median and axillary nerves. Among the UL-ALS patients, however, the average CMAP amplitude of the ulnar nerve was not significantly different from that of the axillary nerve.Conclusions:FAS patients with upper motor neuron signs are more likely to have slip hand. The CMAP amplitude of their axillary nerve tends to be lower than that of their median and ulnar nerves. FAS seems to be a special type of ALS.

Objective To study pulmonary wedge angiography ( PWA ) with hemodynamic the evaluation of children with congenital heart disease and pulmonary artery hypertension ( PAH) . Methods Hemodynamic measurement and pulmonary wedge angiography were performed in 50 children with congenital heart disease. Comparison and analysis were made from the data obtained from PWA and catheterization. Results After PWA, the patients were categorized into 3 groups according to the measured hemodynamics parameters:group A [ n=15, patients with normal mean pulmonary artery pressure ( mPAP≤25 mmHg) and normal pulmonary vessel resistance (PVR﹤300 dyne?s?cm5)], group B [n=24, patients with PAH (mPAP﹥25 mmHg) but normal PVR] and group C (n=11, patients with PAH and elevated PVR (PVR≥300 dyne?s?cm5). Rote of tapering (ROT) was significant lower in group C than in group A and B (F=42. 559,P﹤0. 05). Pulmonary circulation time (PCT) was higher in group C than in group A and B (F=6. 037,P﹤0. 05). ROT correlated negatively with PVR (r = -0. 606, P ﹤0. 05). PCT index correlated positively with PVR (r=0. 783,P=0. 01). There was no significant correlation between PCT and mean pulmonary artery hypertension (mPAP). Conclusions PWA may help to make quantitative analysis of the pulmonary vascular status in patients with congenital heart disease.

Objective: To compare the long-term outcomes in ST-elevation myocardial infarction (STEMI) patients who underwent early or late delayed percutaneous coronary intervention (PCI) using drug-eluting stents (DES). Methods: This study was a retrospective, observational and single-center study. Consecutive STEMI patients (n=977), who admitted to Fuwai Hospital in 2013 and underwent successful selective PCI using drug-eluting stents (DES) within 3 to 35 days after symptom onset were enrolled and divided into the early delayed PCI (3-14 d) group (n=495) and the late delayed PCI (15-35 d) group (n=482). General clinical data of the patients and related data of coronary angiography and interventional therapy were collected, and the endpoint events were followed up. The primary endpoint was 2-year major adverse cardiac and cerebrovascular events (MACCE) including cardiac death, recurrent myocardial infarction, definite or probable stent thrombosis and ischemic stroke. The secondary endpoint was 2-year ischemia-driven target vessel revascularization. The incidence of endpoint events of the two groups was compared, and it was compared again after the primary baseline characteristics such as age and gender were matched by the propensity scoring method at a 1∶1 ratio. Results: A total of 910 (93.1%) patients who underwent delayed PCI were transferred from other hospitals, and 292 (29.9%) patients received thrombolysis before PCI. The time interval before PCI was 14 (10, 20) days. The incidence of 2-year MACCE (3.0%(15/495) vs. 2.3%(11/482), P=0.468) and ischemia-driven target vessel revascularization (3.8%(19/495) vs. 5.0%(24/482), P=0.385) were similar between the two groups. The incidence of 2-year MACCE (3.3%(15/453 vs. 2.4%(11/453), P=0.426) and ischemia-driven target vessel revascularization (4.2% (19/453) vs. 4.9%(22/453), P=0.632) were also similar between the two groups after matching propensity score. Conclusion The long-term clinical outcomes after early delayed PCI using DES is statistically equivalent to those of late delayed PCI using DES for STEMI patients who missed the time window for emergency PCI.