Objective To compare the clinical outcome of shape memory alloy (SMA) embra-cing fixator and reconstruction plate fixation in treatment of displaced or comminuted midshaft clavicle fractures. Methods There were 65 patients with displaced or comminuted midshaft clavicle fractures surgically treated with either a SMA embracing fixator or a reconstruction plate. The patients were divided into two groups according to fixation methods, ie, SMA embracing fixator group (30 patients at average age of 28.1 years) and reconstruction plate group (35 patients at average age of 26.1 years). All pa-tients were followed up for mean 12 months and shoulder function was evaluated using shoulder score. Results Compared with reconstruction plate group, SMA embracing fixator had shorter operation time, smaller wound incision and less loss blood (all P < 0.05). However, there was no statistical difference in aspects of hospital stay, cost, JOA shoulder score and bone union rate between two groups (all P > 0.05). Conclusion The internal fixation with SMA embracing fixator is better than reconstruction plate fixation in treatment of midshaft clavicle fractures.

Lung distension belongs to chronic obstructive pulmonary disease (COPD) in modern medicine.In recent years,its disease incidence and mortality have increased year by year.Supported by the traditional Chinese medicine (TCM) standardization of the State Administration of TCM project-TCM preventive treatment practice guidelines-prevention of lung distension recrudescence,the first draft of the TCM Preventive Treatment Practice Guideline on Prevention of Lung Distension Recrudescence was formulated on the basis of preventive treatment theory,evidences from both ancient and modern literatures,and through the Delphi method as well as expert consensus conference.And then,peer review comments were collected,which laid the foundation for the further improvement of this guideline.This guideline was aimed to achieve the industry consensus,to improve the quality of life (QoL) in patients of the stable period,to reduce the economic burden of patients,as well as to improve both the theoretical connotation and practical value of preventive treatment in TCM.

Objective To investigate the effect of different frequencies of endoscopic ultrasonography (EUS) on diagnosis of duodenal submucesal lesions. Methods A total of 210 elevated duodenal lesions detected by routine endoscopy in 201 patients were examined by EUS at different frequencies according to lesion features and image clarity. Endoscopic resection was applied in 27 lesions with informed consents,and pathological findings were compared with the results of EUS. Results The accuracy of EUS was 81.4% (22/27). Ultrasound of low frequency was superior in displaying overview of lesion and was more suitable for lesions larger than 1.5 cm in diameter or lesions of hyperecho. On the other hand,ultrasound of high frequency was more reliable to reveal minute structures and could be employed in scanning lesions smaller than 1.5 cm in diameter. Combination of different frequencies of ultrasound could provide more details in larger lesions. Conclusion Application of appropriate frequency or combined frequencies of ultrasound in examination of elevated duodenal lesions is beneficial to achieve more accurate diagnosis.

Articular cartilage damage is very common in clinical practices. Due to the low self healing abilities of articular cartilage, it must be repaired or substituted by implants once natural articular cartilage is damaged. On the other hand, the various technologies currently used for healing damaged articular cartilage are little satisfactory, and rarely restore full function or return the tissue to its natively normal state. Tissue engineering technology holds great promise for the healing of damage or defects of articular cartilage. Tissue engineered articular cartilage is one of the most promising methods for repairing articular cartilage trauma and defects. In this paper, the authors review the research progress of three elements such as seed cells, growth factors and scaffolds which constitute tissue engineered articular cartilage.
Animals ; Cartilage, Articular ; injuries ; surgery ; Chondrocytes ; transplantation ; Humans ; Mesenchymal Stem Cell Transplantation ; methods ; Osteoblasts ; cytology ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective To investigate the clinicopathological features and correlation between synchronous multiple early gastric cancer (SMEGC)and single early gastric cancer (EGC).Methods From January 2008 to December 2016,the clinical data of 994 patients with EGC who underwent open or laparoscopic gastrectomy surgery were collected from the electronic medical data base of the First Affiliated Hospital of Nanjing Medical University and Xuzhou No.1 People's Hospital.The data of patients including gender,age,tumor morphologys,tumor location,tumor size,histological type,depth of invasion,lymph nodes metastasis,lymphovascular metastasis,peripheral nerve invasion,and blood types were analyzed.T test and Chi square test were used for statistical analysis.Results Among 994 EGC patients,27 cases (2.7％) were SMEGC,and 967 cases (97.3％) were single EGC.The percentage of male and female of single EGC were 71.4％ (690/967) and 28.6％ (277/967),respectively;the percentage of male and female of SMEGC were 88.9％ (24/27) and 11.1％ (3/27),respectively,and there was statistically significant difference in the gender composition ratio between single EGC and SMEGC (x2 =3.975,P=0.046).The incidence of ulcer in single EGC and SMEGC were 50.6％ (489/ 967) and 29.6 ％ (8/27),respectively,and the difference in the incidence of ulcers between single EGC and SMEGC was statistically significant (x2 =4.653,P=0.031).There were no statistically significant differences between single EGC and SMEGC in gross morphology,depth of invasion,lymph nodes metastasis,lymphovascular metastasis,peripheral nerve invasion,tumor location,pathological type and blood types (all P＞0.05).In the SMEGC patients,the incidence of main lesions invading the mucosa was 48.1％ (13/27) and submucosa invasion was 51.9％ (14/27);and for minor lesions,the corresponding incidences were 77.8％ (21/27) and 22.2％ (6/27),respectively,and the difference was statistically significant (x2 =5.063,P＜0.05).There were no statistically significant differences between the main lesions and minor lesions in tumor size,pathological type,with or without ulcers,gross morphology and tumor location (all P＞0.05).Conclusions The main risk factors of SMEGC are male and no ulcerative lesions.The clinicopathological features are similar between main lesions and minor lesions in SMEGC.

The bio-tribological properties of an artificial joint can be obviously improved by surface modification technologies. In this paper, the benefits and disadvantages of various surface modification methods-such as surface coating, plasma treatment, surface texture and surface grafting modification-are discussed. The aim of surface coating and/or plasma treatment is to improve the surface hardness of the materials, thus enhancing the wear resistance of artificial joints. However, these technologies do not effectively alleviate stress concentration of material in the short times in which artificial joints bear physiological impact load, resulting in easy fracture. Surface texture serves mainly to improve the lubrication properties through micro-concavities on the material surface for storage lubricant. Surface texturing can realize improvements in bio-tribological properties, but it does not enhance the impact resistance of the joint. Surface grafting modification is implemented mainly by grafting hydrophilic or other specific functional groups to improve the surface hydrophilicity and wetability, thus enhancing lubricating performance and reducing the coefficient of friction.
Arthroplasty, Replacement ; instrumentation ; Biocompatible Materials ; chemistry ; Humans ; Joint Prosthesis ; Lubrication ; Polyethylenes ; Prosthesis Failure ; Stress, Mechanical ; Surface Properties ; Weight-Bearing ; physiology