BACKGROUND:Biodegradable implants cannot only rebuild bone defect site, moreover, with the gradual degradation of the materials, new bone tissue can completely replace the graft materials to fil bone defects. OBJECTIVE:To summarize the research progress of biodegradable materials combined with osteogenic factor in orthopedics. METHODS: We took the “biodegradable materials, factors, cel active factor, bone tissue engineering” as the search terms in Chinese and English, respectively, to retrieve the related literatures from PubMed, Wanfang and CNKI database during 2000 to 2015 by computer. RESULTS AND CONCLUSION: Biodegradable medical polymer materials can be divided into natural polymer materials and synthetic biodegradable materials. Natural polymeric materials have good biocompatibility, but poor mechanical strength. The mechanical strength of synthetic biodegradable materials is higher than that of natural polymer materials, but the synthetic biodegradable materials are likely to cause local accumulation of acidic substances, produce local inflammation. The biodegradable medical polymer materials combined with osteogenic factor can improve the mechanical strength and osteoinductive ability of materials, but as a bone repair material, it stil has many problems to be solved.

Objective To compare the safety and efficacy of varied treatments for cardioversion of paroxysmal atria] fibrillation (AF) in the aged patients and to explore choice of electrical cardioversion with direct current. Methods Clinical data of cardioversion with lanatoside (cedilandid) or propafenone, a sodium channel blocker prolongs refractoriness, for 57 aged patients with paroxysmal AF were summarized to observe their cardioversion and control of heart rate. And, synchronous electrical cardioversion will be offered to those with severe complications and ineffective with drug treatment within 24 h after the onset of AF. Results An emergency cardioversion ratio was 28.1 % with lanatoside within 24 h with a satisfactory control of ventricular rate, as compared with that of 62.2% with propafenone (P

Objective To investigate the application of B -Learning mode in the teaching of department of burns surgery.Methods 234 students were divided into two parts by digital table method randomly.The experimental group was applied by the means of B -learning mode,while the control group was taught by the traditional way.And the results were evaluated.Results The basic theory scores(75.39 ±12.04)points in the students of experimental group were higher than those of the control group(68.27 ±12.38)points.The practice scores(76.42 ±11.89)points in the students of experimental group were higher than those of the control group(65.36 ±12.05)points.Students'professional knowledge scores(79.92 ±12.85)points in the experimental group were higher than those of the control group(71.56 ±13.01)points.Both percentage and score were higher in the experimental group than in the control group in comprehensive ability.Conclusion Blending learning gives students a potential time,environment and recourse to learn.By integrating learning ability and nursing skills improved,B -learning mode plays an important role in improving the quality of burn department internship.

Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures.Methods 21 cases(24 feet)of comminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic calcaneus titanium plate.The fractures were classified according to the Sanders system into Sanders Ⅱ,Ⅲ and Ⅳ subgroups.Results All cases were followed up for 9～20 months(14months in average).All cases recovered with good healing of fracture.According to Maryland score,the results were excellent in 14 feet,good in 7 feet,fair in 2 feet,and poor in 1 foot.The excellent and good rate was 87.5％.Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed,which is helpful to recover calcaneus to its normal length,width,height,Gissane angle and Bohler angle.A reliable internal fixation is helpful for early stage functional excise after surgery,which can maximize the recovery of the ankle function.

Objective To establish and verify the personalized reference interval of blood cells.Methods The results of blood cells from 2 089 health subjects in 2014,2015 and 2016 were collected.The ratio of the later results to the previous results was defined as the fluctuation (λ).The ratio (λ1) of the results of 2015 to the results of 2014 was calculated and λ1 was analyzed statistically to establish the fluctuation reference interval (CIλ).The ratio (λ2) of the results of 2016 to the results of 2015 was calculated.λ2 was used to verify λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and CIλ.CIp was verified by results of 2016.The ratio of the upper and lower limits of CIp was calculated.The ratio of the upper and lower limits of the reference interval (WS/T 405) was calculated.Results The values of CIλ were as follows:WBC (0.66 to 1.53),L(0.67 to 1.51),M (0.50 to 2.00),N(0.56 to 1.78),E(0.4 to 2.51),PLT(0.76 to 1.32),RBC(0.92 to 1.12),Hb(0.92 to 1.11),Hct(0.91 to 1.12),MCV(0.95 to 1.07),MCH(0.95 to 1.05)and MCHC(0.94 to 1.06).The validation tests of CIλ and CIp showed that both CIλ and CIp were suitable for this laboratory.Compared with the reference interval of professional criteria,the ratio of the upper and lower limits of the CIp was smaller than that of traditional criteria.Conclusion CIp for this laboratory was established and verified.Compared with traditional criteria,CIp should be more personalized and highly sensitive.

Objective To understand the skeletal metabolism in glucocorticoids-treated children with kidney diseases and to evaluate the role of Alfacalcidol plus calcium supplements.Methods A retrospective self-controlled study was performed in children with kidney diseases,admitted to Department of Pediatrics,Peking University First Hospital from July 2012 to November 2014,and they conformed to the inclusion and exclusion criteria.Inclusion criteria:children with renal diseases were included when they were administered with glucocorticoids,Alfacalcidol and calcium at the enrollment and follow-up,whose proteinuria was in remission or improved on follow-up,and renal function defined by glomerular filtration rate was more than 80 mL/(min · 1.73 m2),and they were followed up for at least 3 months.Exclusion criteria:whereas on follow-up,children with renal diseases were excluded if glucocorticoids was discontinued,or the follow-up period was less than 3 months,and related parameters were not available at the initial and finial visit.Serum levels of calcium,phosphate,alkaline phosphatase,25-hydroxy-vitamin D (25-OH-VitD) were detected,and bone mineral density at the left radius and mid tibia was measured by using quantitative ultrasound at the initial and finial visit.The levels of calcium,phosphate,alkaline phosphatase,25-OH-VitD and bone mineral density were compared between the initial and finial visit.Results A total of 29 cases (23 male,6 female) were recruited.Their ages at study entry were 2.4 to 14.9 years.Underlying disorders were primary nephrotic syndrome(17 cases),IgA nephropathy (4 cases),lupus nephritis (3 cases),purpura nephritis (2 cases),acute glomerulonephritis (1 case),Sjogren's disease(1 case),and autoimmune disease(1 case).At the time of enrollment,the course of disease was 1 to 69 months (median course of disease was 8 months),the duration of using corticosteroid was 0-60 months (median duration was 5 months),and the follow-up time was 92-409 days.The serum calcium,alkaline phosphatase and 25-OH-VitD levels at finial visit[(2.29 ±0.11) mmol/L,(153.21 ±71.00) U/L,and (40.96 ± 11.40) nmol/L,respectively] were significantly higher as compared with those at initial visit [(2.17 ± 0.16) mmol/L,(114.10 ±64.48) U/L,and (31.64 ± 10.99) nmol/L,respectively],and the differences were significant (all P ＜ 0.01),whereas there was no significant difference in serum level of phosphorate between initial and finial visit[(1.45 ±0.25) mmol/L vs.(1.48 ± 0.25) mmol/L] (t =-0.452,P ＞ 0.05).Meanwhile,there was significant difference in serum level of albumin level between initial and finial visit [(31.41 ± 9.31) g/L vs.(42.09 ± 4.00) g/L,t =-3.670,P ＜ 0.001].Compared with baseline assessment,bone mineral density at the left radius and tibia improved or maintained in 24/29 patients,whereas that of 5/29 patients declined.However,compared with initial and finial visit of bone mineral density in all patients(0.09 ± 1.58 vs.0.22 ± 1.07 at the left radius;0.93 ± 1.13 vs.1.00 ± 1.35 at the mid tibia),there was no significant difference (all P ＞ 0.05).Conclusions Bone loss can be prevented by Alfacalcidol plus calcium supplement in glucocorticoids-treated children with kidney diseases.

Recently, negative pressure wound therapy (NPWT) is a rising technology to improve wound healing. In clinical application, it benefits fast debridement and wound close, limits infection, and promotes wound healing. It is an effective therapy for all kinds of acute or chronic wound. Currently, researches demonstrate that NPWT promotes angiogenesis, granulation tissue growth, and extracellular matrix remodeling through regulating the signaling of anti-inflammatory cytokines, mechanicalreceptor and chemoreceptor, which is related to several growth factors and inflammatory factors. Here we focus on the recent advances in the mechanism of NPWT in promoting wound healing, looking forward to providing a review of NPWT and related researches.

OBJECTIVETo study the effects and the therapeutic mechanism of hyperbaric oxygen (HBO) on prostaglandin E(2) (PGE(2)) in alveolar bone and gingiva of experimental periodontitis in animal.

METHODSExperimental periodontitis was produced by silk thread sutures combined with high content sugar diet. For HBO therapy, they were exposed to a pressure of 0.25 MPa (2.5ATA), breathing pure oxygen one session a day for 60 min. The treatment course was 2 weeks. The value of PGE(2) in gingiva and alveolar bone was analyzed by enzyme immunoassay (EIA).

RESULTSThe value of PGE(2) in gingiva of control group was 3.21 ng/g, and that of PGE(2) in alveolar bone was 3.22 ng/g. The contents of PGE(2) in gingiva (13.96 ng/g) and alveolar bone (13.32 ng/g) of periodontitis group increased markedly than control group (P < 0.01). The contents of PGE(2) in gingiva (5.21 ng/g) of HBO group were 62.7% which was lower than that of periodontitis group, and the value of PGE(2) in alveolar bone (4.05 ng/g) were 69.6% lower than that of periodontitis group. The difference of PGE(2) in gingiva or alveolar bone was significant for the HBO group and periodontitis group (P < 0.01).

CONCLUSIONSThe contents of PGE(2) in alveolar bone and gingiva increased markedly when experimental periodontitis has formed. The value of PGE(2) in alveolar bone and gingiva reduce markedly after HBO exposure, and the decreased rate of PGE(2) in alveolar bone is more evident than that of PGE(2) in gingiva after HBO therapy.

Alveolar Process ; metabolism ; Animals ; Dinoprostone ; metabolism ; Disease Models, Animal ; Female ; Gingiva ; metabolism ; Guinea Pigs ; Hyperbaric Oxygenation ; Male ; Periodontitis ; metabolism

PURPOSE: This study aimed to evaluate the prognostic impact of lymphovascular invasion (LVI) in patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). MATERIALS AND METHODS: We collected data from 180 patients who were treated with RNU from 2005 to 2013 at our institution. The Kaplan-Meier method with log-rank test and Cox proportional hazards regression models were used for univariate and multivariate analyses. RESULTS: LVI was present in 28 patients (15.6%), which was associated with higher pathological tumor stage (p < 0.001), tumor necrosis (p=0.012), lymph node metastasis (p=0.017) and multifocality (p=0.012). On multivariate analysis, LVI was an independent prognostic factor of recurrence-free survival [RFS: hazard ratio (HR)=2.954; 95% confidence interval (CI)=1.539–5.671; p=0.001] and cancer-specific survival (CSS: HR=3.530; 95% CI=1.701–7.325; p=0.001) in all patients. In patients with node-negative UTUC, LVI was also a significant predictor of RFS (HR=3.732; 95% CI 1.866–7.464; p < 0.001) and CSS (HR=3.825; 95% CI=1.777–8.234; p=0.001). CONCLUSION: LVI status was an independent predictor in patients with UTUC who underwent RNU. The estimate of LVI could help physicians identify high-risk patients and make a better medication regimen of adjuvant chemotherapy.
Carcinoma, Transitional Cell ; Chemotherapy, Adjuvant ; Humans ; Lymph Nodes ; Methods ; Multivariate Analysis ; Necrosis ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Prognosis ; Urinary Tract

Objective:To investigate therapeutic effect of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion.Methods:A total of 80 patients with malignant pleural effusion in Maoming People's Hospital from January 2018 to February 2021 were enrolled, and all patients were divided into 2 groups according to the random number table methods, each group with 40 cases. The control group was treated with small-bore catheter minimally invasive drainage combined with cisplatin thoracic perfusion, and the study group was treated with small-bore catheter minimally invasive drainage combined with cisplatin sequential recombinant human vascular endostatin thoracic perfusion. And then the clinical efficacy, expressions of vascular endothelial growth factor (VEGF) expression, pain degree and adverse reactions were compared of both groups.Results:The treatment efficacy rate of the study group was higher than that of the control group [90% (36/40) vs. 75% (30/40)], and the difference was statistically significant ( χ2 = 5.04, P < 0.05). After treatment, the level of VEGF in pleural fluid and serum of the study group was lower than that of the control group [(304±106) pg/ml vs. (598±159) pg/ml,(103±43) pg/ml vs. (189±49) pg/ml], and the difference was statistically significant ( t = 6.62, P < 0.001; t = 6.23, P < 0.001). After treatment, the visual analogue scale (VAS) score of the study group was lower than that of the control group [(3.7±0.3) scores vs. (4.4±0.7) scores], and the difference was statistically significant ( t = 2.10, P < 0.05). The incidence of adverse reactions including stethalgia, fever, nausea and vomiting in both groups had no statistically significant differences (all P > 0.05). Conclusions:Cisplatin sequential recombinant human vascular endostatin thoracic perfusion combined with small-bore catheter minimally invasive drainage can effectively ameliorate clinical symptoms, inhibit the expression of VEGF, and alleviate pain degree with no serious adverse reactions in patients with malignant pleural effusion.