Myoblast transplantation has been carried out for a certain period,but its efficiency in repairing inherited myopathy or severe muscular injury is not satisfactory.The improvements in myoblast culture,transplantation approach,recipient and cell preparation before transplantation,scaffold material and its selection,and body immunity can positively influence transplantation efficacy,and improve recipient function.In addition,these improvements influence the prospect of myoblast transplantation or cell-mediated gene therapy.

[Objective]To assess the early diagnosis and treatment and outcome of patients with crush syndrome in earthquake disaster.[Method]We conducted a retrospective analysis of 27 patients with crush syndrome and subsequent acute renal failure (ARF) and wound complication who were treated in our university hospital.All of patients had been extricated from buildings that collapsed in the Wenchuan earthquake.Crush injury involved the upper extremities and low extremities.Each patient received intravenous fluids and diuretic drugs.Twenty-one patients received hemodialysis.Emergency fasciotomy performed in 11 patients and amputation were performed in 16 patients,4 to 102 hours after extrication.[Result]No patient died.Twenty-one patients among the ARF patients were retracted from hemodialysis.Among the patients who were performed fasciotomy or amputation,13 patients had wound complication including infection,however,the wounds in 10 patients were healed by dressing change,debridement and coordinate treatment with ICU and related subjectives.[Conclusion]Crush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF.Wound healing is a difficult task for the crush syndrome patients.The authors believe that immediate intensive care therapy and multisubjective coordination would improve the survival rate.

[Objective]To discuss the injury severity and treatment of 236 patients with upper limb injuries in Wenchuan Earthquake.[Method]The basic informations of patients with upper limb injures in Wenchuan Earthquake,and the injury mechanisms,clinical symptoms and treatment were collected and analyzed.[Result]In 236 cases of patients with upper limb injuries,there were 208 patients,378 cases with fracture,and 64 cases with open fracture.There were 35 cases of clavicle fracture,31 cases of scapula fracture,113 cases of humerus fracture,46 cases of ulna fracture,87 cases of radial fracture and 66 cases of carpometacarpai phalangeal fracture.Fifty cases received debridement and suture,60 cases received fracture reduction and internal fixation and 7 cases received external fixation.Totally,19 limbs were carried on amputation,and only one patient died of hyperkalemia and combined injury.[Conclusion]Analysis of patients with injury mechanisms,clinical symptoms and treatment can provide advices for rescuing and treating of patients with upper limb injuries in earthquake or other disaster cases.

Objective To evaluate the clinical outcomes of treating Freiberg's disease with dorsal wedge osteotomy and Charlotte breakage screw fixation.Methods From June 2010 to June 2014,11 patients with Freiberg's disease were treated at our department.They were 5 males and 6 females at an average age of 32 years(range,from 15 to 52 years).X-ray revealed osteosclerosis and collapse of the metatarsal head.According to Smillie classification system,there were 5 cases of stage Ⅱ and 6 ones of stage Ⅲ.The duration of symptoms was from 7 to 48 months (average,23 months).The metatarsal heads were rotated to reconstruct the joint surface.After dorsal closed V-shaped osteotomy,Charlotte breakage screws were implanted.Results All wounds healed with no complications in the early postoperative period.The 11 patients were followed up for 14 to 48 months (average,19 months),showing obvious pain relief.X-ray showed that the osteotomy sites got solid union in all patients at an average time of 10 weeks (range,from 8 to 13 weeks) after operation.Average shortening of the metatarsal was 1.5 mm (range,from 1.1 to 1.8 mm).The American Orthopaedic Foot and Ankle Society(AOFAS) score,Lesser Metatarsophalangeal-Interphalangeal Scale(LMIS) score,and range of motion at one day,one month and one year after operation were significantly improved compared with the preoperative ones (P ＜ 0.05).Significant differences were also observed between all postoperative time points (P ＜ 0.05).No such complications happened as referred pain from the adjacent metatarsophalangeal joint,displacement,nonunion,necrosis or infection.All patients returned to sports and recreational activities at 6 months after operation,except one case of stage Ⅲ who had constant swelling in the metatarsophalangeal joint but eventually recovered at 10 months after operation.According to patients' satisfaction at the last follow-ups,including 7 cases were excellent,3 good and one poor.Conclusion Dorsal closed V-shaped osteotomy with Charlotte breakage screw fixation is an effective procedure for Freiberg' s disease of stages Ⅱ and Ⅲ,because it leads to effective reconstruction of the metatarsophalangeal joint,allows early joint motion and avoids a second operation.

Objective To investigate the graduate students' mental pressure after the full im-plementation of the charging system and explore effective countermeasures of alleviating the psycho-logical pressure. Methods 413 full-time graduate students of Grade 2014 were randomly selected in a university of Shandong province. The graduate students' psychological pressure scale and self-designed questionnaire survey were used. The data were analyzed using SPSS 17.0 software, statistical descrip-tion of the survey data, independent sample t test, ANOVA. Results ①The psychological pressure of full-time graduate students at their own expense was in themedium pressure level; ②The economic pressure and academic pressure of the male graduate students were higher than those of the female graduate students (P=0.000,P=0.042), the rural economic pressures were greater than urban students graduate students graduate students (P=0.000); Professional graduate economic pressures were greater than academic graduate students (P=0.027);There is difference in the pressure of interpersonal commu-nication among different majors (P=0.016); ③78.75% (315/400) of the graduate students tuition fees, living expenses were mainly from their parents and the national and school awards; ④The percentage of those who completely agreed with the following view: full charge than at public expense is more advantageous to graduate education, comprehensive charge is advantageous to the education career development and comprehensive charge embodies the fairness of education was 84.75% (339/400), 71.25% (285/400) and 68.00% (272/400). Conclusion The full-time graduate students at their own expense have a more rational understanding of the charging policy; economic and academic pressures are the two outstanding pressure sources of the graduate students at the present stage. Graduate should improve their ability to cope with stress, and government and schools should take various measures to help students relieve stress.

Objective To evaluate the long-term efficacy of vascularized pisiform transfer for patients with Kienb(o)ck's disease in Lichtman stages Ⅲ-Ⅳ. Methods Eleven patients were reviewed to analyze results after lunate resection and vascularized pisiform transfer for Lichtman stages Ⅲ and Ⅳ. There were six men and five women. Age ranged from 20 to 67 years with a average of 41.0±14.3 years. According to Lichtman stage. There were 4 cases in stage Ⅲa, 5 cases in stage Ⅲb, and 2 cases in stage Ⅳ. Assessment criteria included subjective assessment of pain, visual analogue scale (VAS), range of motion (ROM), grip power,Cooney wrist score and radiographic changes on each follow-up visit. The radiographic changes including pis iform bone location, shape, sclerosis change, osteoarthritis, carpal height ratio, Nattrass index, Radioscaphoid angle and ulnar variance were recorded. Results The follow-up periods of all of cases were 61-202 months,with an average of 104.1 months. Pain had improved in 10 patients and disappeared in 7 cases. The VAS score was 2.2±1.9 at follow-up visit. Range of motion of injured wristw as only 65.3% of opposite side. Grip power was 84.3% of the contralateral hand. According to Cooney score, the results were excellent in 1 case, good in 7cases, fair in 2 cases and poor in 1 case, with the excellent and good rate of 72.7%. Radiologically, 8 cases had normal position of the pisiform bone, 2 had volar displacement and 1 had ulnar displacement which leaded to widen scaphopisiform space. Six pisiform bones had normal trabecular structure, three had degenerative changes. Bone sclerosis was seen in 2 cases and osteoarthritis was found in 3 patients. Compared with radiographic parameter before surgery, carpal height ratio and Nattrass index significantly lowered and radioscaphoid angle significantly increased. Conclusion Lunate resection and vascularized pisiform transfer is an effective method for Kienb(o)k′s disease in stages Ⅲ-Ⅳ. Although carpal collapse appeared postoperatively,the results show high patient satisfaction and good function after vascularized bone transplantation.

Objective To determine the influence factors for limb salvage of bone fracture patients with hyperpotassemia caused by Wenchuan earthquake,to discuss the clinical symptom and to improve the clinical treatment. Methods The clinical symptom, drug therapy, limb incision decompression, hemodialysis, and limb salvage of hyperpotassemia caused by earthquake were analyzed by logistic regression. Results All the 37 patients received drug therapy: 9 patients received incision and decompression singlely,8 received hemodialysis singlely,and the other 20 received decompression and hemodialysis simultaneously. The concentration of potassium decreased from (6.25 ± 0.91) mmol/L to (4.47±0.65) mmol/L,with significant difference (P＜0.05).Five patients with Gustilo III grade open injury received amputation at the concentration of potassium of (6.13±(0.78)) mmol/L, while the concentration of potassium for the other 32 patients was (6.25±0.31) (mmol/L). There was no significant difference between them(P>0.05). Logistic regression analysis found the time of compression, the time before incision and decompression, and the time before hemodialysis were the main factors to affect limb salvage. The OR value of these factors was 4.394, 3.793 and 5.432;while the P value was 0.013, 0.047, and 0.015, respectively. Conclusion Decreasing the time of compression, appropriate incision and decompression, and hemodialysis help improve the result of limb salvage in hyperpotassemia patients with bone fracture caused by earthquake.

To detect the properties of natural xenogeneic bone derived materials which were processed with different physical and chemical treatments, we made fully deproteinized bone(FDB), partially deproteinized bone (PDPB), partially decalcified bone(PDCB) from pig ribs. Their morphological features, constitute components and mechanical properties were examined by scanning electron microscopy, x-rays diffraction analysis, mechanical assay and so on. The results showed that FDB, PDPB and PDCB maintained natural network pore system. The ratios of calcium to phosphorus were 1.81, 1.74 and 1.50, and the protein contents were 0.01% +/- 0.02%, 22.41% +/- 0.83% and 35.75% +/- 2.12% respectively. The sequence of their mechanic strength was PDCB > PDPB > FDB. These data indicate that FDB, PDPB and PDCB possess natural network pore system. Their organic and inorganic component ratios and contents are different, so their mechanic properties are not alike. Additionally, more investigations will be necessary to detect the biocompatibility of the three different scaffold materials of natural derived bone.
Animals ; Biocompatible Materials ; chemistry ; Biomechanical Phenomena ; Bone and Bones ; chemistry ; Materials Testing ; Swine ; Tissue Engineering

To evaluate the application of self-reinforced ploy-DL-lactide (SR-PDLLA) absorbable screws in the treatment of spongy bone and intra-articular fractures, the internal fixation with SR-PDLLA absorbable screw was performed on 58 cases,of which 25 were medial malleolus fractures, 14 condyle of humerus fractures, 9 tibial plateau fractures, 7 ulnar olecranon fractures, and 3 lateral malleolus fractures. Observations were made on the orthopaedic operation sites and overall conditions frequently and radiography was performed for periodic analysis. The results showed that SR-PDLLA absorbable screws were particularly effective and reliable, they had good biocompatibility in the treatment of spongy bone and intra-articular fractures and could be used safely in clinical practice.
Absorbable Implants ; Adolescent ; Adult ; Ankle Injuries ; surgery ; Bone Screws ; Child ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Humeral Fractures ; surgery ; Internal Fixators ; Lactic Acid ; chemistry ; Male ; Middle Aged ; Polyesters ; Polymers ; chemistry

Deep venous thrombosis (DVT) is an important cause of disability and mortality after major orthopedic surgery. The roles of perioperative treatment and prevention of DVT in patients with femoral neck fractures who require major surgery have not yet been well explored in Chinese clinical practice. Here we report a case of calf muscular venous thrombosis in a 55-year-old woman with femoral neck fracture before surgery. Preventive and treatment measures including the administration of heparin sodium, application of venous foot pump and placement of inferior vena cava filter were taken. The condition of the patient was stable during the perioperative period and the surgery was successful. Besides, postoperative examination showed that the femur healed well and the functional recovery was satisfactory. Our results suggest that femoral neck fracture patients combined with DVT can receive surgery after accurate preoperative assessment and proper preoperative treatment.
Female ; Femoral Neck Fractures ; surgery ; Humans ; Middle Aged ; Perioperative Care ; Vena Cava Filters ; Venous Thrombosis ; therapy