Objective To investigate osteoporosis and its main associated factors in patients with type 2 diabetes (DM). Methods Bone mineral density(BMD)of lumbar vertebrae 2～4 and proximal femur in 40 type 2 diabetic patients were measured with dual energy X-ray absorptiometry and compared with control group(30～35 years old). Serum Ca, P, ALP and connective peptide in type 2 diabetes mellitus patients were measured. Results The area under the connective peptide releasing curre in osteoporosis group was lower than that of non-osteoporosis in type 2 diabetes. Conclu.sion BMD is correlated with the pancreatic islet function. The patients with pancreatic islet failure develop osteoporosis easily.

Objective To observe the effect of oral minirin in postoperative transsphenoidal surgery patients with central diabetes insipidus. Methods The changes in the urine volume and osomlality after two weeks of minirin medication (0. lmg, 3 times each day) were observed in 34 patients with central diabetes insipidus underwent transsphenoidal surgery. Results After two weeks of minirin therapy,the average daily urine volume decreased from 7985.40 ±410. 36 ml to 2277. 87 ± 328. 94 ml,and the average plasmas osmolarity increased from 301. 68 ± 3. 59 ml/d to 313. 26 ±4. 87 mOsm/ kg. No adverse reaction was observed during the therapy. Conclusions Minirin is effective and safe in the therapy of postoperative transsphenoidal surgery patients with central diabetes insipidus.

Objective To study the diagnosis and treatment of superior mesenteric venous thrombosis (MVT). Methods The clinical data of 13 MVT cases were retrospectively analyzed. Results The diagnosis of MVT in all 13 cases were comfirmed by surgery. Of them,diagnosis for 6 cases was made preoperatively, and misdiagnosed preoperatively in 7.11 patients were cured, and 2 died. Conclusions Because the symptom does not accord with physical sign in the early stage of MVT, the diagnosis of MVT is difficult . B US and CT are useful in the diagnosis of MTV.Intra and post operative coagulation treatment is the key to prevent the recurrence and to reduce the mortality.

[Objective]To explore the experiences of professor ZHENG Qizhong to use classical prescription treating the cold-heat complex pediatric diseases.[Method]By following professor ZHENG Qizhong, gathering the cases that are all treated by professor ZHENG Qizhong to treat pneumonia asthma case using Xiao Qinglong Decoction plus Shigao, abdominal pain and diarrhoea cases using Banxia Xiexin Decoction, diarrhoea and pertussis cases using Wumei pill, pneumonia asthma accompanied by diarrhea case using Mahuang Shengma decoction, analysing the mechanism of the upper prescription and the clinical experiences of treating cold -heat complex paediatric diseases. [Results] Cold -heat complex paediatric diseases are very common in paediatric acute or chronic diseases, professor ZHENG Qizhong has an original idea and in -depth study of classical prescription, and using them flexibly to treat various paediatric diseases such as pneumonia asthma, abdominal pain, diarrhea, pertussis, etc, and always acquires good results. [Conclusion]The clinical experiences of ZHENG Qizhong using the classical prescription to treat Cold-heat Complex Paediatric Diseases is effective and has the value to study, popularization and application.

Objective To investigate the application value of functional exercise pathway in enhanced recovery of patients undergoing hepatectomy.Methods Fifty primary hepatic carcinoma patients who had undergone liver resection in Anhui Province Hospital from December 2014 to August 2015 were randomly divided into experimental group (n =25) and control group (n =25).Postoperative length of hospital stay,hospitalization charges,complications,postoperative pain score,postoperative ambulation and intestinal ventilation time were compared between these groups.Measurement data with normal distribution were represented as ((x) ± s) and comprison between groups was analyzed using the t test.Comparisons of count data were analyzed by the x2 test.Results Postoperative length of hospital stay of the experimental group [(7.00 ± 2.27) days] were shorter than control group [(9.36 ± 4.58) days] (t =3.090,P =0.003),and hospitalization expense was lower in the experimental group [(28 184.57 ± 8 675.65) yuan] (t =2.281,P =0.025).Compared with control group (40％),the experimental group (20％) had lower overall complication incidence (t =4.286,P =4.286),and general complications incidence (8％) is lower than that in control group (24％),however,the incidence of operation characteristic complications had not statistical significance in two groups.Besides,the intestinal recovery time in the experimental group was shorter than control group (experimental group 36.56 hours,control group 45.24 hours,t =2.390,P =0.019).Conclusion The application of functional exercise pathway in postoperative enhanced recovery exercise of patients undergoing hepatectomy is safe and effective,which can reduce the patients' postoperative hospital stay,hospital costs,and the general incidence of complications incidence,and be helpful for the intestinal function recovery.

Objective: To investigate the situations of on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou, so as to provide more data support for emergency medical rescues of the similar incidents of massive casualty. Methods: Two medical workers with a certain clinical experience were sent to Hangzhou 120 emergency medical centers to collect data of the on-site rescue on 21st July, 2017, including ambulance call-outs, on-site command and traffic conditions, and on-site triage and evacuation of the victims. They were then sent to the hospitals receiving the victims to investigate the situations of these victims including the general information (such as gender, age, admitted hospitals, and number of admission, discharge, and transferring in the first two weeks after the accident) and injury assessment [such as injury position and type, injury severity evaluation by New Injury Severity Scoring (NISS), and burn severity evaluation for victims with burns]. Results: (1) A total of 15 ambulances reached the accident site for rescue. The traffic and transportation were jammed and interrupted after this accident. On-site triage and distribution were disorderly conducted. (2) Clinical data of 53 victims were collected, including 24 males and 29 females, with the age of 8 to 70 (34±14) years old. They were sent into 6 hospitals in Hangzhou. Two victims died on the day of accident. Up to two weeks after this accident, 28 (52.8%) victims were discharged from the hospitals and received follow-up in outpatient department. Five victims with severe injuries were transferred to the other hospitals. (3) Based on the results of NISS, the injury severities were mild in 29 (54.7%) cases, moderate in 9 (17.0%) cases, serious in 3 (5.7%) cases, and severe in 12 (22.6%) cases. Those 2 dead victims were classified into the severe category due to the highest NISS score of 75. For all of the victims, skin and soft tissue defects were most common. Six (11.3%) victims were combined with burns. According to the classification of burn severity, there were one case of mild, one case of serious, and 4 cases of severe. Conclusions The gas explosion accident in Hangzhou caused massive casualties with complex injuries. The local emergency medical rescue responded quickly, but during the rescue process, lots of aspects should be further improved.

BACKGROUND:The remediation and treatment of bone defects present considerable challenges,with a variety of clinical intervention strategies available.One such approach,the Masquelet technique,has demonstrated high rates of success and reliable outcomes and is currently employed in clinical practice.However,the underlying mechanisms of this technique remain incompletely understood,and certain challenges persist in its clinical application,indicating that this technique is not yet fully mature. OBJECTIVE:To compile and categorize the biomaterials currently employed in research aimed at improving the Masquelet technique,in order to provide insights and references for the further development of this technique. METHODS:A literature search of the China National Knowledge Infrastructure and PubMed databases was conducted,spanning publications from January 2013 to November 2022.The search terms used included"Masquelet technique;induced membrane technique;induced membrane;biomaterial;bone defect"in both Chinese and English.A total of 58 articles meeting the inclusion criteria were reviewed. RESULTS AND CONCLUSION:(1)The emergence and continual development of the Masquelet technique provide a therapeutic strategy for treating bone defects.Some researchers are focusing on developing superior spacer materials,autograft substitutes,and membrane materials that mimic the properties of the induced membrane,to simplify the two-stage procedure,shorten treatment duration,and reduce patient distress.(2)Calcium sulfate,silicone,poly(lactic-co-glycolic acid),and polypropylene can replace polymethylmethacrylate bone cement to form induced membranes in animal experiments or clinical applications,each with their advantages.Contrary to expectations,common materials such as titanium and polyvinyl alcohol sponge cannot replace polymethylmethacrylate bone cement.(3)Autograft substitutes are diverse,with allograft bone,β-tricalcium phosphate,absorbable gelatin sponge,α-calcium sulfate hemihydrate,bioactive glass,titanium,and tantalum demonstrating their ability to reduce the quantity of autologous cancellous bone graft required in the second stage of the procedure.Among them,allograft bone,β-tricalcium phosphate,bioactive glass,titanium and tantalum can replace autogenous bone as grafts,and other materials need to be mixed with autogenous bone,in both clinical and fundamental experiments.(4)Biomimetic-induced membranes,human amnion,human decellularized dermis,polytetrafluoroethylene,and even autogenous cortical bone have been shown to possess properties similar to the induced membrane.(5)Most of the application and research of biomaterials in this technology still exist in the stage of basic research and have not been applied in clinical practice or popularized on a large scale,but the above materials can provide more sufficient theoretical basis and new ideas for the exploration of Masquelet technical mechanism,the improvement of surgical methods and clinical application.

In order to improve the nutritional value and bio-availability of sheep bone enzymatic hydrolysates, we tried to ferment the hydrolysates with lactic acid bacteria (LAB) to enhance free Ca²⁺, to generate oligopeptide and antioxidative activity. First, we isolated 7 LAB strains from commercial starters and selected Lactobacillus plantarum as the starter for its highest protease-producing ability. The content of released Ca²⁺ was evaluated when the fermenting conditions were optimized by the method of responsive surface design. When supplemented with 1% maltose and inoculated 4% L. plantarum, at initial pH 5.5 and 37 ℃ for 14 h, Ca²⁺ content in the hydrolysates increased significantly (P<0.05), as well as the generation oligopeptide (P<0.01), and the content of hydroxyproline (P<0.01). The count of L. plantarum in the fermented hydrolysates reached to 94.6×10⁸ CFU/mL. L. plantarum fermentation significantly enhanced the ability to scavenge free radicals DPPH, ·OH and O₂⁻· (P<0.01, P<0.05). Therefore, fermenting sheep bone hydrolysates by L. plantarum can increase free Ca²⁺, oligopeptide and antioxidative ability.

OBJECTIVE: To summarize the research progress on the mechanism related to traumatic brain injury (TBI) to promote fracture healing, and to provide theoretical basis for clinical treatment of fracture non-union. METHODS: The research literature on TBI to promote fracture healing at home and abroad was reviewed, the role of TBI in fracture healing was summarized from three aspects of nerves, body fluids, and immunity, to explore new ideas for the treatment of fracture non-union. RESULTS: Numerous studies have shown that fracture healing is faster in patients with fracture combined with TBI than in patients with simple fracture. It is found that the expression of various cytokines and hormones in the body fluids of patients with fracture and TBI is significantly higher than that of patients with simple fracture, and the neurofactors released by the nervous system reaches the fracture site through the damaged blood-brain barrier, and the chemotaxis and aggregation of inflammatory cells and inflammatory factors at the fracture end of patients with combined TBI also differs significantly from those of patients with simple fracture. A complex network of humoral, neural, and immunomodulatory networks together promote regeneration of blood vessels at the fracture site, osteoblasts differentiation, and inhibition of osteoclasts activity. CONCLUSION TBI promotes fracture healing through a complex network of neural, humoral, and immunomodulatory, and can treat fracture non-union by intervening in the perifracture microenvironment.
Humans ; Fracture Healing/physiology* ; Brain Injuries/metabolism* ; Brain Injuries, Traumatic ; Fractures, Bone ; Osteogenesis