Objective To observe the ultrastructural alteration and healing characteristics of osteoporotic fracture, and to elucidate its cellular mode of healing. Methods Eighty female SD rats of 8 months old, which had the weight of 290 to 340 g, were randomized into two groups of 40 each: the osteoporotic fracture model(OPFM) and the common fracture model(CFM). After anesthesia, the bilateral posterior transperitoneal approach was performed in the OPFM group and the bilateral ovaries were removed; and in the CFM group, only the sham operations were performed. Three months later, the fracture of femoral middle shaft were created and fixed with a Kirschner pin through medullary cavity. The callus of each rat was examined by transmission electron microscopy(TEM) and scanning electron microscopy(SEM) in 5 days and 1, 2, 4, 6, 8, 12 and 16 weeks postoperatively. Results TEM showed that the number of chondrocyte in OPFM group was greater, but function was lower than that of CFM group. Volume of collagen secreted by the chondrocyte was less and arranged irregularly during the fracture healing period in OPFM group. Number and function of osteoblasts in OPFM group were lower than that of CFM group. Extracellular collagen was disordered and sparse, but function of osteoclasts in OPFM group was more active than that of CFM group. The SEM showed that the collagen in callus of CFM group was dense and arranged in good order or pyknotic. Conclusion The fracture healing of the osteoporotic fractures is due to the decrease of the osteoblastic formation and the increase of the osteoclastic resorption as well as the poor bony healing quality.

Objective To observe the expression of platelet-derived growth factor A(PDGF-A) and PDGF-?R in callus during osteoporotic fracture healing and to explore further into the mechanism or effect of PDGF-A and PDGF-?R on osteoporotic fracture healing. Methods The expression and change of PDGF-A and PDGF-?R in different period of osteoporotic fracture healing(5, 7, 14, 28, 42 days) were investigated by means of immunohistochemistry(ABC method). Results There were different cells origin (chondrocyte, osteoblast, osteocyte, vascular endothelial cell, et al) and degree of expression of PDGF-A and PDGF-?R in callus during different period of osteoporotic fracture healing. Conclusion PDGF-A moderates and participates in osteoporotic fracture healing. The decrease of osteoporotic fracture repair capacity may correlate with abnormality of PDGF-A secretion.

[Objective] To evaluate the results of open reduction with bone autografting and calcaneus reconstruction with internal fixation in treatment of intra-articular calcaneus fracture. [Methods]From January 2005 to May 2007, 17 cases/19 feet of intra-articular calcaneus fractures received treatment of reconstruction plate and bone autografting, with 15 male/18 feet, 2 female/ 2 feet. Patients’ age ranged from 19 to 67 years (mean, 37.5 years). Fracture occurred in left side in 9 cases, right in 6 cases, both sides in 2 cases. All patients received treatment of open reduction with bone autografting and calcaneus reconstruction with internal fixation.[Results]All the patients achieved bone union. One stage union was achieved in 15 feet. Poor blood-supply was found in 3 feet and bone union was achieved after systematic treatment. Wound exudation was found in 1 feet, and bone union was achieved after dressing change treatment. All patients were followed up for an average of 19.7 months (10-38 months). The average union time was 2.5 months, without infection found.X-ray and CT were used to measure Bhler angle, width and axial length, all the indexed showed significant difference (P

Objective:To explore the possible specific perinatal risk factors in the development of autism through comparing the perinatal risk factors between patients with autism and other psychotic disorders.Methods: In this retrospective research,197 cases with autism and 93 cases with other psychotic disorders were selected and assessed with the self-made scale of perinatal risk factors.Statistical analyses were performed using t test and Chi-square test.Results:Compared with the control group,the autistic subjects had a significantly higher frequency of the perinatal risk factors(51 % vs.68%,P=0.003),particularly the rate of catching a cold during their mothers' pregnancy(14.2% vs.6.5%,P=0.038)and the rate of prematurity(10.7% vs.3.2%,P=0.022)than the control subjects.Feeding methods was different between the two groups(P=0.038).Conclusion:Catching a cold during mothers' pregnancy,prematurity and feeding methods may be related to the development of autism.

SUMMARY Diffusion spectrum imaging ( DSI) , a newly developed MRI technique, affords the capacity to map complex fiber architectures in tissues with sufficient angular resolution by imaging the spectra of tissue water diffusion. By contrast, diffusion tensor imaging (DTI) , the currently widely used technique based on the 2nd order tensor model, obtains an approximation of the complex diffusion, and provides only one global maximal direction corresponding to the primary eigenvector for each voxel. As a generalized model-free diffusion imaging technique, firstly, DSI employs the probability density function to describe the diffusion process in each voxel; secondly, a sufficient dense signal sample derived from repeated applications of diffusion-weighed gradients ensures its capability to resolve the diffusion probability density function; thirdly, specific computer visualization techniques are used to extract the diffusion information and reconstruct the geometrical properties of tissue microstructure. The capacity to unravel complex tissue architecture, recent improvements in hardware and ongoing optimization of sequence design and algorithm enable a rapid growth of DSI for research use and future incorporation into clinical protocols. This paper introduces the basic principles of DSI and then compares the characteristics of DSI and DTI schemes. Finally, the typical applications of DSI to date are reviewed.

[Objective]To observe expression of inducible nitric oxide synthase and peroxynitrite anion around the prostheses,and study the relationship between the osteolysis and inducible nitric oxide synthase peroxyni-trite.[Method]Interface tissues were obtained at three Delee-Charnley acetabular sections and seven Gruen femur sections in six revision total hip arthroplasty surgery. The tissues were prepared for immunohistochemical assays to determine the expression of iNOS and nit rotyrosine (NT)-a specific“footprint”of peroxynitrite. Pre-revision X-ray films were observed to determine the incidence of osteolysis regions and non-osteolysis regions. The correlation between the positive cells and the severity of osteolysis were analyzed and compared.[Result]Data showed that zone Ⅲ has much higher iNOS positive immunostaining than that of zone Ⅰ and Ⅱ at acetabulum, and the expression of zone 1、2、6、7 was significantly higher than the other zone at femur(P

OBJECTIVETo explore the clinical effects of negative pressure wound therapy (NPWT) combined with artificial dermis grafting and autologous skin grafting on repair of open joint wounds and/or wounds with exposed bone fracture.

METHODSEleven patients with open joint wounds and/or wounds with exposed bone fracture, hospitalized from November 2008 to November 2014, were enrolled in the study. According to the differences of the first stage treatment, all patients were divided into experimental group ( n = 6, including 4 patients of open joint wounds, 1 patient of wound with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture), and control group ( n 5, including 2 patients of open joint wounds, 2 patients of wounds with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture). After debridement, the wounds in both groups were grafted with punctured artificial dermis, while NPWT was only used over the artificial dermis of experiment group for 1 week. In the operation at sacsod stage, autologous split-thickness skin was grafted on the vascularized artificial dermis in both groups. Results In 5 patients of open joint wounds in experimental group, the artificial dermis was vascularized well, autologous skin grafts survived, and wounds were healed. In 3 patients of open joint wounds in control group, the artificial dermis grafting all failed due to local infection, and then these wounds were repaired with local tissue flap grafting. Artificial dermis in 3 patients of wounds with exposed bone fracture in both groups was vascularized well after grafting, and the wounds were healed after autologous skin grafting, whether or not NPWT was used.

CONCLUSIONSNPWT combined with artificial dermis grafting and autolognus skin grafting can be used for repairing open joint wounds and/or wounds with exposed bone fracture.

Debridement ; Dermis ; transplantation ; Humans ; Negative-Pressure Wound Therapy ; methods ; Skin Transplantation ; methods ; Skin, Artificial ; Surgical Flaps ; Wound Healing

OBJECTIVE To investigate the present situation of the nosocomial infection in our hospital in order to decrease the infection rate. METHODS A total of 40 554 patients were inspected from Oct 2004 to Sept 2005.There were 626 patients with nosocomial infection. RESULTS The nosocomial infection was 1.54%.Old patients were the main components.The longer they were in hosptial,the more risk of infection they had.Elder monitoring department and hematological department were the most common infected units.Respiratory tract was the most common infected site of the body.The entity of disease for the most infection was malignant tumor.Invasive treatment was one of the causes for the infection. CONCLUSIONS The infection rate of our hospital was relatively low.We should establish the system to control the infection.Use the advanced statistical software well be to aid the control and discover the anti-infection deficiency from the statistical view-point.

OBJECTIVE To summarize the infection cases and the factors causing site infection after operations,and investigate the measures to prevent and reduce exogenous incision infection.METHODS Discharged patients from Jan 1st,2003 to May 31st,2006 in our hospital were investigated for retrospective analysis on incision infection cases.RESULTS Totally 111 incision infection cases were reported from 54 286 cases.The nosocomial infection rate in this cohort was 0.21%(111/54 286),which was 33.44% of total surgical incision infection cases.CONCLUSIONS Incision infection is one of the most commonly encountered concomitant symptoms,it is as well the bottleneck for our hospital to reduce average stay length of surgical patients and patients′ hospitalization expenses,and to speed up turnover of beds.Incision infection rate is also an important criterion to evaluate the management quality and medical technology quality within and among hospitals.Effective measures should be taken to decrease incision infection rate and to resolve the problem that is difficult to hospitalize and expensive to treat.