Objective To investigate the efficacy of antibiotic cement column combined with iliac bone graft in the treat-ment of open fracture with bone defect of distal femur.Methods From October 2014 to March 2021,16 patients of open frac-ture bone defect of distal femur were treated with antibiotic bone cement column and iliac bone graft,including 12 males and 4 females.The age ranged from 28 to 68 years old.There were 11 cases of traffic accident injury,5 cases of falling injury,3 cases as Gustilo type Ⅰ,5 cases as type Ⅱ and 8 cases as type Ⅲ A.AO classification was used:9 cases of C2 type and 7 cases of C3 type.The time from injury to final bone grafting ranged from 4 to 119 days.The length of bone defect ranged from 2 tol0 cm.Fractures healing time,complications and knee function Merchan score were recorded.Results All the 16 patients were fol-lowed up from 9 to 29 months.The incisions of 16 patients healed in one stage without postoperative infection,plate fracture,limb shortening and valgus and varus deformity.The healing time randed from 4 to 10 months.Knee joint function according to the Merchant scoring standard,showed that 8 cases were excellent,4 cases were good,3 cases were fair,and 1 case was poor.Conclusion The use of antibiotic bone cement column combined with iliac bone graft in the treatment of open and complex bone defects of distal femur is an effective surgical method to prevent infection,assist fracture reduction,increase fixation strength and significantly reduce the amount of bone grafting.

To study immunophenotype and cytotoxicity of the immunocytes in bone marrow and peripheral blood after activation by combined cytokines, mononuclear cells (MNC) of bone marrow and peripheral blood were activated by IFN-gamma, IL-1, IL-2 and McAb-CD3 in vitro. The cell amount and morphology during culture were observed. Cytochemical staining and immunophenotype analysis were done before and after culture in two groups of MNC. Cytotoxicity was tested by MTT method. The results showed that the cell number of two groups increased obviously in culture (P < 0.05), while the peripheral blood mononuclear cells increased more markedly (P < 0.05). The cytochemical staining showed POX decrease, but PAS increase in two groups. The positive ratios of CD3(+), CD56(+) and CD38(+) cells in two groups increased obviously after culture (P < 0.05), but there was no significant difference between those two groups. CD3(+) CD56(+) cells increased obviously in peripheral blood mononuclear cells activated by cytokines (P < 0.05), but CD3(+) CD56(+) cells did not increase in bone marrow mononuclear cells. There was no significant difference between two groups' cytotoxicity. It was concluded that IFN-gamma, IL-1, IL-2 and McAb-C D3 increased cell number and cytotoxicity of both bone marrow and peripheral blood mononuclear cells that can be used in cell immunotherapy.
ADP-ribosyl Cyclase ; immunology ; ADP-ribosyl Cyclase 1 ; Antibodies, Monoclonal ; pharmacology ; Antigens, CD ; immunology ; Bone Marrow Cells ; cytology ; drug effects ; immunology ; CD3 Complex ; immunology ; CD56 Antigen ; immunology ; Cell Count ; Cell Division ; drug effects ; Coculture Techniques ; Cytokines ; pharmacology ; Cytotoxicity Tests, Immunologic ; Cytotoxicity, Immunologic ; drug effects ; HL-60 Cells ; Humans ; Immunophenotyping ; Interferon-gamma ; pharmacology ; Interleukin-1 ; pharmacology ; Interleukin-2 ; pharmacology ; K562 Cells ; Leukocytes, Mononuclear ; cytology ; drug effects ; immunology ; Membrane Glycoproteins ; Time Factors

OBJECTIVETo study a new effective approach which repairs large defects of skin and soft tissue in neck and face.

METHODThis procedure accomplishes repetitive sub-platysmal expansion to form large musculocutaneous flap with underlying pedicel. The surgeon slides it toward neck and face to repair the defects of skin and soft tissue.

RESULTEleven patients, who had such defects in neck, face, cheek, chin or submental skin and soft tissue, underwent this treatment. All the flaps survive with no complications of blood supply deficiency or necrosis. The short-term and long-term results are both satisfying.

CONCLUSIONThis method, making repetitive sub-platysmal expansion to form musculocutaneous flap and then slide it toward neck/face to repair large defects of skin and soft tissue, proves to be safe and reliable. And appropriate cases and strict operations are important.

Adult ; Dermatologic Surgical Procedures ; Face ; surgery ; Female ; Humans ; Male ; Neck ; surgery ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo study the formulation and technique of preparation of rapid-dissoluted EGb (Extract of Ginkgo biloba) droppills.

METHODTaking the dissolution percentage of total flavonoids in EGb and weight variation as index, the formulation and technique of EGb droppills were optimized by the orthogonal experiment.

RESULTT50 was 3.62 min and mean weight variation was 2.80%.

CONCLUSIONRapid-dissoluted EGb droppills can increase the dissoluting rate distinctly and reach the purpose of preparation.

Drug Stability ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; isolation & purification ; Flavonoids ; analysis ; Ginkgo biloba ; chemistry ; Plants, Medicinal ; chemistry ; Solubility ; Technology, Pharmaceutical ; methods

OBJECTIVETo investigate the protective effect of insulin on vascular endothelial cells of rats at early post-burn stage,and its mechanism.

METHODSAdult male Sprague-Dawley rats were randomly divided into 3 groups: i. e, sham scald group (n = 7), scald group (n = 7) and treatment group (n = 7). The rats in the latter 2 groups were subjected to 30% TBSA full-thickness burns with 94 degrees C water, and the sham scald rats were treated with 37 degrees C water. Intra-peritoneal injection of 40 ml/kg isotonic saline solution and subcutaneous injection of 3 units/kg insulin were given to the rats in treatment group after being subjected to 30% TBSA full-thickness burns. Subcutaneous injection of equal amount of isotonic saline was given to the sham and burn groups. The changes in vascular endothelial cell structure were observed with electron microscopy at 24 post-scald hours(PSH). Meanwhile, the blood glucose contents, the serum levels of nitric oxide (NO) and nitric oxide synthetase (NOS) were determined with oxidase method and colorimetric method, respectively.

RESULTSThe injury of arterial endothelial cells in the treatment group was obviously alleviated compared with that in burn group. The blood glucose content in the treatment group (7.1 +/- 0.7 mmol/L) was significantly lower than that in scald group (8.2 +/- 1.0 mmol/L, P < 0.05), though it was much higher in both groups than that in sham scald group (4.9 +/- 0.8 mmol/L, P < 0.01) at 24 PBH. The serum content of NO, total NOS and cNOS in treatment group were obviously higher than those in scald group (P < 0.01), but there was no obvious difference in iNOS content between the two groups(P > 0.05).

CONCLUSIONInsulin exhibits protective effect on vascular endothelial cells in severely scalded rats at the early post-burn stage, and it is attributed to its promotion of cNOS level leading to NO production.

Animals ; Blood Glucose ; analysis ; Burns ; blood ; drug therapy ; pathology ; Disease Models, Animal ; Endothelial Cells ; drug effects ; pathology ; Insulin ; therapeutic use ; Male ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley

AIMTo study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin.

METHODSOne thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis.

RESULTSIn 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08% of cases with excess foreskin and in 2.58% of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence.

CONCLUSIONThe new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.

Adolescent ; Child ; Child, Preschool ; Circumcision, Male ; methods ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Pain, Postoperative

OBJECTIVETo explore the spatial and temporal characteristics of measles patients younger than 1 year old in Shandong province.

METHODSA total of 5309 cases of measles, whose patients were younger than 1 year old in Shandong province between year 1999 and 2008 were collected. The epidemic features of measles were described, and the annual infant incidence was calculated. Software ArcGIS9.3 was applied to draw the spatial map of the disease, and the software GeoDa0.95i-beta was adopted to analyze the spatial autocorrelation.

RESULTSThe incidence among infants younger than 1 year old reported in Shandong province rose from 23.45/100 000 (206 cases) in 1999 to 269.60/100 000 (2791 cases) in 2008.5309 cases covered all month-aged infants under 1 year old, except 12 months old. Most patients (3494 cases) aged between 6 - 9 months old; especially the infants around 8 months old, accounting for 20.7% (1100/5309). The epidemic peak was between March and May, accounting for 45.5% (2414/5309). The spatial and temporal distribution features showed an up and down temporal trend and an increase from east to west in spatial trend. The global Moran's I values of measles incidence among infants in Shandong province were 0.346, 0.150, 0.396, 0.213, 0.477, 0.354 and 0.331 in year 1999, 2001 - 2002, 2005 - 2008 (P < 0.01) and 0.076 in year 2004 (P < 0.05). The local spatial autocorrelation analysis showed that southwest and northwest districts of Shandong were highly clustered districts of measles.

CONCLUSIONIn Shandong, the measles incidence among infants younger than 1 year old rose obviously; especially the infants aged between 6-9 months age. The epidemic peak was between March and May. A positive spatial correlation was found, the disease showed a distinct regional distribution feature, and a cluster district was found.

China ; epidemiology ; Geography ; Humans ; Incidence ; Infant ; Infant, Newborn ; Measles ; epidemiology ; Space-Time Clustering

OBJECTIVETo reproduce a stable mouse model of deep partial-thickness scald and to determine the hypoxia status in the wound.

METHODS(1) A homemade scald-producing apparatus with constant steam (92 °C) emission was used to reproduce scald injury on the back (2 cm in diameter) in 80 male BALB/c mice for different duration (2, 4, 6, and 8 s), with 20 mice for each scald duration. The nozzle was aligned perpendicularly to the back of mice, 2 cm above the skin surface. The gross condition of wound was observed with naked eyes immediately after injury. Skin samples of 5 mice with different burn duration were harvested 0, 12, 24, and 48 h after scald for histopathological observation with hematoxylin and eosin staining, to screen the scalding time and time for biopsy of scalded skin to determine proper scalding time for the experiment. (2) Model of deep partial-thickness scald was reproduced with the desired scalding time as shown in the preliminary experiment in another 5 BALB/c mice. The hypoxia status in subcutaneous tissue was observed with immunohistochemical staining 72 h after scald. Another 20 BALB/c mice were divided into normal control group (n = 5, without scald) and deep partial-thickness scald group (n = 15, scalded for a suitable duration as determined in the preliminary experiment) according to the random number table. The subcutaneous oxygen content in wound center, the margin of the wound, and the normal skin adjacent to the wound was detected with laser Doppler transcutaneous oxygen tension 72 h after scald, with 5 mice in each region. Data were processed with one-way analysis of variance.

RESULTS(1) The wound of mice with different scald durations was pale, clean, and no exudate was observed right after injury. (2) The burn depth developed gradually along with the scalding time and sample harvesting time, and it became stable 24 h after scalding. A deep partial-thickness injury was observed in the dermis of mice scalded for 4 s and harvested 24 h after scald, and it was shown that the external hair sheath was still present, and it was determined to be a deep partial-thickness scald. (3) Dense staining of pimonidazole (hypoxia) was found in deep partial-thickness scald wound 72 h after scald, especially in the marginal zones of the wounds. The partial oxygen pressure in the wound center, wound margin, and normal skin around the wound was respectively (36.2 ± 3.2), (37.0 ± 1.4), (37.4 ± 2.7) mm Hg (1 mm Hg = 0.133 kPa), showing no statistically significant difference among them (F = 74.705, P > 0.05), but they were significantly lower than that of the control group [(53.1 ± 2.4) mm Hg, with F values respectively 82.377, 91.375, 100.531, P values all below 0.05].

CONCLUSIONSDeep partial-thickness scald model can be reproduced in (20.0 ± 1.0) g male BALB/c mice by scalding with 92 °C hot steam for 4 s, and the depth of wound becomes stable 24 h after scalding. Hypoxia can be found in the scalded wounds, especially in the marginal zones of the wounds.

Animals ; Burns ; complications ; metabolism ; pathology ; Disease Models, Animal ; Hypoxia ; etiology ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred BALB C

OBJECTIVETo evaluate the feasibility and short-term clinical effect of transperitoneal laparoscopic modified retroperitoneal lymph node dissection (LmRPLND) in the management of clinical Stage I nonseminomatous germ cell testicular tumors.

METHODSFrom October 2004 to July 2006, 7 patients aged 26-36 (mean 30) years underwent LmRPLND with modified unilateral template dissection for clinical Stage I nonseminomatous germ cell testicular tumors, which were 3.0 cm x 2.5 cm x 2.0 cm to 6.5 cm x 4.5 cm x 3.0 cm in size, 3 cases on the left and 4 on the right, all diagnosed by ultrasound, computerized tomography (CT) and chest X-ray and confirmed by biopsy following radical orchiectomy. Those with positive lymph nodes received 3 courses of chemotherapy.

RESULTSSuccess was achieved in all the 7 cases, the operative time ranging from 120 to 210 min (mean 160 min), blood loss from 50 to 200 ml (mean 150 ml), and with no blood transfusion. The drainage tubes were removed 1-2 days after surgery. The mean postoperative hospital stay was 5.5 days. The follow-up lasted 6-32 (mean 14) months, which revealed normal erection and ejaculation in all the patients, but no major postoperative complications. Pathologically, lymph nodes were negative in 6 cases and positive (1/18) in 1. Normal results were obtained in HCG and AFP tests as well as in retroperitoneal ultrasound and chest X-ray examinations. The patient with positive lymph nodes was treated by adjuvant chemotherapy for 3 courses and found free of malignancy during a 6-month follow-up.

CONCLUSIONLmRPLND is a safe and minimally invasive treatment option for patients with clinical Stage I nonseminomatous germ cell testicular carcinoma. With fewer complications and faster recovery, it appears to be a desirable substitute for the open procedure.

Adult ; Follow-Up Studies ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Male ; Neoplasm Staging ; Testicular Neoplasms ; pathology ; surgery ; Treatment Outcome

Objective:To explore correlation between fibrinogen(Fg)level and coronary stenotic degree in aged coronary heart disease(CHD)people and its possible pathogenesis.Methods:A total of 112 patients,who were >65 years and diag-nosed as CHD by coronary angiography(CAG),were selected as CHD group.Another 108 non-CHD patients hospitalized during the same period were enrolled as non-CHD group.According to CAG results,CHD group was divided into single vessel coronary disease group(n=30,single vessel group)and multi vessel coronary disease group(n= 82,multi vessel group).Serum levels of Fg,D-dimer(D-D),C reactive protein(CRP),homocysteine(Hcy)and brain natriuretic peptide (BNP)were measured and compared between two groups.The correlation between serum Fg level and Gensini score was analyzed in CHD patients.Results:Compared with non-CHD group,there were significant rise in serum levels of Fg,D-D, triglyceride(TG),apolipoprotein B(ApoB),lipoprotein a,CRP,BNP and Hcy in CHD group,P=0.001 all;in CHD group,compared with single vessel group,there were significant rise in serum levels of Fg,D-D,ApoB,uric acid,lipo-protein a,CRP,BNP,Hcy,and significant reductions in serum levels of high density lipoprotein cholesterol,ApoA1 and ApoA1/ApoB in multi vessel group,P<0.05 or <0.01. Serum Fg level was significant positively correlated with coronary stenotic degree(Gensini score),r=0.303,P=0.001. Fg was independent risk factor of CHD(OR=2.74,95% CI:1.95~3.97,P=0.001).Conclusion:Serum Fg level is significant positively correlated with coronary stenotic degree in aged CHD patients.Its mechanism of triggering atherosclerosis may be related to risk factors such as dyslipidemia,hyper-homocysteinemia and inflammations etc.