Objective To observe the value of flexible bronchoscopy (fiberoptic bronchoscopy/electronic bron choscopy, abbreviation bronchoscopy) in the diagnosis and treatment of patients with decannulation dififcult after tracheotomy. Methods 17 cases with decannulation difficult after tracheotomy which were diagnosed and treated by lfexible bronchoscopy were reviewed and evaluated. Result Among the 17 patients with decannulation dififcult, except one failure in decannulation because of upper airway scar contracture with atresia after brain injury, the rest was successful, and decannulation rate was 94.1%. Except one patient with displacement of metal stents, and one patient with breathing dififculty after the decannulation, there was no other adverse reactions and deadly complications. Conclusion Flexible bronchoscope plays an important part in the diagnosis and treatment of the patients with decannulation dififcult after tracheotomy. It is safe and reliable, so it is worthy of clinical promotion.

BACKGROUND: Under wear particles stimulation, mononuclear macrophages, fibroblasts, and osteoblasts can produce a large amount of inflammatory factors, leading to periprosthetic osteolysis. But the precise mechanisms remain unclear. OBJECTIVE: To analyze the molecular biological mechanism underlying osteolysis induced by titanium wear particles . RESULTS AND CONCLUSION: Cleaned titanium particles stimulation induced an unbalanced ratio of RANK mRNA to OPG mRNA. Over-expressed RANK bound to RANK ligand and promoted osteolysis. No RANK mRNA expression was detected in the LPS group, but OPG mRNA expression was transiently increased at 4 hours. NF-κB/inflammatory cytokine, rather than RANK/OPG, is the main signal pathway for LPS to induce osteolysis. After LPS binding to titanium particles, these two signal mechanisms, RANK/OPG and NF-κB/inflammatory cytokine, have synergistic effects during artificial joint loosening.

Biological Clocks ; Genetic Therapy ; Heart Diseases ; therapy ; Humans ; Stem Cell Transplantation

Objective To investigate the clinical characteristics,treatment and prognosis of spine and spinal cord stab injury with foreign bodies retained in wound.MethodIn a group of 128 cases of spine and spinal cord stab injury that admitted to our department from January 1995 to November 2005,19 had foreign bodies retained in wound.The result of 19 cases were analyzed retrospectively.ResultOperations such as scrutinization of the spinal canal,clean-up of the hematoma,extraction of foreign bodies were performed according to different conditions for 19 cases of spine and spinal cord stab injury with foreign bodies retained in wound of 19 patients,one(5.3%) died,two happened cerebrospinal fluid leakage,one meningomyelitis and wound infection was observed.Of 14 cases with neurological injury,scores of ASIA scales of 13 patients increased after comprehensive rehabilitation treatment(P

?Objective:To investigate the behavior of absorbable coral hydroxyapatite (Interpore 500R) as bone tissue engineering scaffold. Methods: Marrow stromal stem cells harvested from legally aborted human fetus were cultured in DMEM containing 100 ml/L fetal boving serum and induced to differentiate towards osteoblasts.Then the cells were seeded onto absorbable coral hydroxyapatite , then the composite was implanted subcultaneously into the back of nude mice .Cell materia attachement was observed with scanning electron microscope,type I collegen secretion was studied with laser confocal microscope and new bone formation was studied histologicaley. Results: The cells could adhere to absorbable coral hydroxyapatite and secrete collagen I.Mature bone tissue was found in the implanted composite 40 day after transplantation. Conclusion: Absorbable coral hydroxyapatite Interpore 500R is a favorable bone tissue engineering scaffold.

Objective To explore the experience in scalp operation of craniopagus and repairing of scalp and dura defect after separating Methods Analysis the cause and management of the complication after skin expander implantation Discuss the characteristic of repairing skull soft tissue defect by expanded scalp flap and fiber capsule Results Dural and scalp defect could be repaired satisfactory with expanded scalp at one stage Conclusion It's necessary and important for successful separation in D type craniopagus with preoperation care, an elabarate operative management, careful postoperative observation and timely treatment for complication

Objective To investigate the clinical effect of acellular allogenic dermis combined with split-thickness autogenous skin graft for coverage of wound in extremity joint. Methods After contraction scar, giant pigmented nevus and capillary hemangioma being removed, acellular allogenic dermis with split-thickness autogenous skin graft was used to repair 25 cases of wounds of elbow, ankle, knee and wrist joints. The area of wounds was from 7cm?11cm to 12cm?19cm. Out of 25 wounds, there were 4 in wrist, 8 in elbow, 7 in ankle and 6 in knee joints. The survival rate of graft skin and improvement degree of joint function were observed. Results All grafts survived and had the smooth surface without obvious pigmentation and wound contraction. The function of joint was significantly improved after operation. Conclusion Tissue-engineered dermis with autogenous epithelium is an ideal graft for coverage of various wounds in extremity joint.

Humans ; Microvessels ; Neovascularization, Pathologic ; Neovascularization, Physiologic ; Plaque, Atherosclerotic ; pathology

Objective To investigate the changes in cerebral oxygen metabolism during liver transplantation in patients with liver cirrhoses.Methods Sixteen ASAⅢorⅣpatients with liver cirrhoses(14 male,2 female)aged 25-67 yrs,weighing 45-80 kg undergoing liver transplantation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Swan-Ganz catheter was placed in pulmonary artery (PA)via right internal jugular vein(IJV)for cardiac output(CO)monitoring and sampling mixed venous blood. Left IJV was cannulated and the catheter was advanced cephalad until jugular bulb for blood sampling.Anesthesia was induced with midazolam,fentanyl,propefol and vecuronium and maintained with isoflurane inhalation and intermittentⅣboluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.PaCO_2 was maintained between 30-45 mm Hg.Blood samples were taken from radial artery,pulmonary artery and jugular bulb simultaneously for blood gas analysis before operation(T_0,baseline),10 min before anhepatic phase(T_1)20 min after onset of anhepatic phase(T_2),30 min after graft reperfusion(T_3)and at the end of operation(T_4).Oxygen delivery(DO_2),oxygen consumption(VO_2),oxygen content of jugular bulb blood (CjvO_2),cerebral arterial-venous oxygen content differences(Ca-jvO_2)cerebral oxygen extraction ratio(CERO_2) and CBF/CMRO_2 were calculated.Results The mean duration of operation was(364?51)min and the mean intraoperative blood loss was(1340?430)ml.CO was significantly increased before anhepatic phase(T_1), during neohepatic phase(T_3)and at the end of operation(T_4)but decreased during anhepatc phase(T_2)as compared with the baseline value at T_0.Hb,CaO_2,Ca-jvO_2 and CERO_2 were all decreased while SjvO_2 and CBF/ CMRO_2 were increased during operation;DO_2,VO_2 and CjvO_2 were decreased during anhepatic phase;DO_2 was increased during other phases;VO_2 was increased at the end of operation as compared with the baseline(T_0)(P＜0.05 or 0.01).Conclusion There is no cerebral oxygen deficiency during liver transplantation in patients with liver cirrhoses.