BACKGROUND:Silver ion dressing can reduce tissue necrosis, accelerate the epithelial formation, relieve the patient’s pain during the treatment, and strengthen various growth factors for wound repair, which is based on the theory of wet healing theory. It has obvious advantages for chronic wound healing, such as anti-infection and promoting wound granulation and epithelial hyperplasia.
OBJECTIVE:To observe the efficacy of silver ion dressing used in healing of chronic wound.
METHODS:A total of 40 patients who had chronic wounds were selected from Tangshan Branch Hospital of Nanjing General Hospital of Nanjing Military Command. Al cases were divided into two groups. The treatment group was treated with silver ion dressing, and the control group was treated with routine dressing. Secretions extracted from wound were used for bacterial culture prior to and 7, 14, and 21 days after treatment. Healing condition and velocity were observed and wound pain was assessed using visual analog scale.
RESULTS AND CONCLUSION: The detection rate of wound bacteria in the treatment group was significantly lower than that of the control group (P<0.05). And the time of healing was shorter in the treatment group than the control group (P<0.05). Wound pain during dressing change was relieved (P<0.05). Medical costs showed no difference between the two groups (P>0.05). No adverse reaction occurred in the two groups. These findings indicate that silver ion dressing used in chronic wound healing can prevent infection and promote wound granulation or epithelial hyperplasia. It can effectively promote wound healing and has no bad reaction.

Objective To explore the impact of placenta polypeptide injection on fracture healing time and the incidence of infec-tion in patients with limb fractures .Methods 138 cases with limb fractures admitted to our hospital from February 2010 to Febru-ary 2012 were randomly divided into two groups ,and each group had 69 patients .The control group was given conventional treat-ment while the observation group was given placenta polypeptide injection on the basis of the conventional treatment .The bone healing time and infection rates were observed .Results The limbs fracture healing time of observation group was significantly shorter than that of control group (P<0 .05) .The infection rate of observation group (1 .45% ) was significantly lower than that of control group (10 .14% ,P<0 .05) .Conclusion The placenta polypeptide injection for treatment of limb fractures can effectively decrease fracture healing time ,and significantly reduce the rate of infection .

BACKGROUND:Vacuum-sealing drainage in wound skin grafting can close wound, reduce the leakage, promote granulation hyperplasia and improve skin new speed.
OBJECTIVE:To compare the clinical effects of two kinds of wound surface dressings used in wound skin grafting.
METHODS: Eighty patients who needed skin grafting for trauma were retrospectively studied and chosen from September 2010 to March 2012. They were divided into two groups: biomaterial group (dressings mainly made of luffa fibers) and synthetics group (seaweed polyvinyl alcohol foam). The vacuum-sealing drainage device and wound dressing were removed after 1 week treatment. The skin grafting coverage and wound healing time were recorded.
RESULTS AND CONCLUSION:Al patients of two groups got effective skin grafting coverage rate, and no patient appeared with infection and nonunion. The skin grafting coverage and wound healing time of the biomaterial group significantly differed from the synthetics group (P< 0.05). These findings indicate that compared to the synthetic material group, the biomaterial group can be better for effective drainage, good circulation, bacteria inhibition and fast repair.

Objective To observe the clinical characteristics and therapeutic effect of aphakic retinal detachment (ARD) eyes and pseudophakic retinal detachment (PPRD) eyes.Methods The clinical data of 805 patients,including 321 ARD and 484 PPRD eyes were retrospectively analyzed.The patients'visiual acuity,refraction,intraocular pressure were examined,and the patients also underwent slit-lamp microscopy and direct and (or) indirect ophthalmoscopy.The preoperative best-corrected visual acuity (BCVA) was between light perception (LP) and 0.6.Mainly according to the PVR grade and retinal holes position to take the scleral buckling or vitrectomy combined with scleral buckling.The 805 eyes were divided into 1995-1999 group (243 eyes) and 2000-2007 group (562 eyes) according to operative time.The follow-up ranged from 3 to 25 months,with an average of 12.3 months.The success standard of surgery was set as anatomic retinal reattachment and the last follow-up time was considered as the judgment time.The surgical complications were recorded at each follow-up time points.The composition of PPRD,the visual acuity,ocular lesions,surgical methods and results before operation and visual acuity after operation in two groups were analyzed and compared by Mantel-Haenszel chi-square test.Results The average interval from lens extraction to RD occurrence was 15.4 months in PPRD eyes and 39.1 months in ARD eyes.The final total anatomic success rate was 95.9%,and was 93.5% in the scleral buckle eyes and 97.2% in vitrectomy eyes.The BCVA was better than 0.3 after operation only in 11.9% of the 805 patiens,and the visual acuity increased more than 2 lines in 67.3%.Compared with the ARD eyes,early onset,high proportion of total posterior vitreous detachment,severe PVR,wide RD range,low detection rate of retinal hole and low antomic success rate were found in PPRD eyes.Compared with the 1995-1999 group,the proportion of vitreous surgery,anatomic success rate and better visual acuity were found in 2000-2007 group.Conclusions The ocular lesions of ARD and PPRD is more complicated,the therapeutic effect are improving in recent years.

BACKGROUND:The development of spinal non-fusion technology promoted movement function protection of adjacent segment and operating segment. In the treatment of cervical spondylosis surgery, non-fusion technology has been widely carried out. For middle-aged patients with cervical spondylosis, the demand for spinal joint movement function is high. Non-fusion technology can improve the postoperative quality of life and slow down the risk of adjacent segment degeneration. OBJECTIVE:To evaluate the clinical efficacy of anterior cervical different implant materials (fusion or non-fusion) in the treatment of single segment of the intervertebral disc degeneration of cervical spondylosis in middle-aged patients. METHODS:This study enrol ed 10 cases of single segmental radiculopathy and cervical myelopathy after cervical intervertebral disc replacement from June 2011 to June 2013. Simultaneously, 10 cases were randomly selected from patients with anterior interbody fusion as the control group. Before treatment, at 1 and 3 months, and 1 year after treatment, changes in range of motion of cervical vertebra were observed using imaging results. Therapeutic effects were assessed using Japanese Orthopaedic Association Scores, Visual Analog Scale and The Neek Disability Index in both groups. RESULTS AND CONCLUSION:Al patients did not suffer from incision fat liquefaction, infection and delayed healing, and had finished fol ow-up for more than 1 year. Results revealed that Japanese Orthopaedic Association Scores and Visual Analog Scale scores were improved at 1 and 3 months, and 1 year after treatment (P<0.05), and no significant difference was detected between the two groups (P>0.05). In the analysis of range of motion of cervical vertebra and The Neek Disability Index, there were significant advantages in non-fusion treatment group (P<0.05). For middle-aged patients with cervical spondylosis, due to its life demand for neck mobility, the repair program of non-fusion cervical intervertebral disc replacement has a clear advantage.

BACKGROUND:The new technique of spinal nonfusion is used for intervention of early spinal diseases. It can protect the spine motion function and treat the patients either. The interspinous U titanium alloy belongs to the new technique of spinal nonfusion. And this investigation will be a hot spot in the spinal nonfusion technique. OBJECTIVE:To explore the clinical mechanical property of spinal nonfusion interspinous U titanium alloy. DESIGN,TIME AND SETTING:Comparative observation. All patients were selected from the Department of Orthopaedics of Changhai Hospital between June 2006 and December 2007. PARTICIPANTS:A total of 28 patients with degenerative intervertebral disk protrusion and dynamic spinal stenosis,including 23 male and 5 female aged 41 to 58 years old. METHODS:All patients were randomly divided into two groups:intervertebral disectomy alone (n=20):affected segments were removed; implantation group (n=8):affected segments were removed and interspinous U titanium alloy was implanted following interspinous ligament. MAIN OUTCOME MEASURES:The height of the intervertebral space and vertebral canal area of the affected segment as well as JOA scores for lumbar vertebra postoperatively and during follow-up. RESULTS:All 28 patients were included in the final analysis. The height of the intervertebral space and vertebral canal area of the affected segment in implantation group were significantly increased compared with intervertebral disectomy alone group (P

Objective To investigate the vision-related quality of life (VRQoL) of patients with monocular rhegmatogenous retinal detachment (RRD) before and after relative surgery, and analyze its influencing factors. Methods A total of 92 patients with monocular RRD were asked to complete the Chinese-version low vision quality of life questionnaire (CLVQOL) preoperatively and at the end of the follow-up time. Results The Cronbach ? coefficient of the questionnaire was more than 0.7. The lowest scores were at the item of "adjustive ability" before the surgery, and the scores of the questionnaires were significantly higher at the end of the follow-up time. The item whose score changed most caused by the surgery was "adjustive ability". The visual acuity in RRD eyes before the operation and the changes of the visual acuity was the chief independent risk factor of the questionnaire score before surgery and the changes of scores due to surgery, respectively. Conclusions CLVQOL can be used to assess the VRQoL of patients with monocular RRD after surgery. The qualities of life of patients with monocular RRD decrease sharply. VRQoL, especially the adjustive ability, improves obviously after operation, but the patient would be inconvenient for doing some precision work or daily house work. Improving the visual acuity of the RRD eye, giving early surgery and avoiding complications help to improve the VRQoL of the patients with monocular RRD.

BACKGROUND:Chitosan and its derivatives have become one of the most active research topics in the field of tissue-engineered scaffold material substitute for cartilage owing to their porous structure, ease of chemical modification, and high affinity to in vivo macromolecules. OBJECTIVE:To summarize chitosan and its derivatives in terms of design, modification and its application in tissue engineering. METHODS:A computer-based search of CNKI and PubMed databases was performed for papers on application of chitosan and its derivatives in cartilage tissue engineering published from January 1990 to January 2015 with the key words“chitosan;chitosan derivatives;scaffold;tissue engineering;cartilage”in Chinese and English. RESULTS AND CONCLUSION:Chitosan is a natural polymer from renewable resources, modification of chitosan has been found to be necessary for its advanced tissue engineering applications. The modification of chitosan can be divided into two categories including chemical modification and physical blending, which improve its biological properties such as biocompatibility and biodegradability. Recent studies have suggested that chondrocytes maintained round morphology and preserved synthesis of cel-specific extracel ular matrix molecules on chitosan substrates in vitro and chitosan scaffolds seeded with chondrocytes showed partial repair of cartilage defects in vitro. Chitosan and its derivatives are promising candidates as a supporting material for tissue engineering applications.

Objective Pedode foxatoon at the level of fracture vetebral technology is widely used in rebuilding spnal fracture recently.The purpose of minimally invasive surgery for thoracolumbar fractures is to reduce the injury , fix segments, and rebuild the stability of the spine .This study aimed to investigate the short-term clinical effect of pedicle fixation at the fractured vertebra via the pa-ravertebral intermuscular approach for the treatment of thoracolumbar fractures . Methods We treated 24 cases of thoracolumbar fracture by pedicle fixation at the fractured vertebra via the paravertebral intermuscular approach , rebuilt spinal stability , and corrected kyphotic deformity .We evaluated the improvement of pain symptoms and life quality using The Visual Analogue Scale ( VAS) and The MOS 36-Item Short-Form Health Survey (SF-36), and assessed the corrected status of vertebral height loss and kyphotic deformity by radiographic measurement .All the patients were followed up for over 12 months. Results The VAS score of the patients was signifi-cantly higher while the SF-36 score remarkably lower before surgery than the scores in 12 months which were ([7.65 ±0.13] -[1.54 ±0.07], P<0.05) and ([90.21 ±2.02]-[117.21 ±1.02], P<0.05).Imaging evaluation showed desirable correction of the reduced height of the injured vertebrae and kyphotic deformity . Conclusion Pedicle fixation at the fractured vertebra via the pa-ravertebral intermuscular approach , with its advantages of minimal invasiveness and fewer segments of fixation , can effectively correct vertebral height reduction and kyphotic deformity .

Objective Construct the finite element model of vertebral pedicle screw fixation in thoracolumbar fractures can obtain the intuitive systematic mechanical effects under different motion conditions, it has a very important significance to the patients' rehabilitation, evaluation of system stability and prognosis.In this study, the biomechanical effects of different motion states of thoracic and lumbar spine fracture models were analyzed by the finite element analysis method.Methods We selected 1 orthopedic health volunteers from Nanjing General Hospital of Nanjing Military Region in June 2014, established the finite element model by the CT scan data of the healthy volunteer, used the geometric cutting method for fracture simulation and replacement, assembled posterior orthopedic internal fixation system of vertebral pedicle screw, simulated the different motion states and obtained the stress nephogram and displacement graph of the nail-stick system..Results For the six-nail and two-rod internal fixation system of posterior nail-stick system which set nails through injured vertebrae, we used the finite element operation method to simulate the biomechanical characteristics of different modes of motion in space, it combined by the movement of six directions(flexion, dorsiflexion, left side bend, right side bend, left twist, right twist).The maximum stress(94.99±1.72MPa) and the maximum displacement(0.1854±0.0052mm) and the of the dorsiflexion were significantly lower than that of flexion[(126.82±5.56)MPa、(0.2502±0.0050)mm]、left side bend[(152.18±9.13)Mpa、(0.3172±0.0048)mm]、right side bend[(159.58±13.54)Mpa、(0.3315±0.0051)mm](P<0.05).Conclusion The method of finite element analysis can obtain clear and intuitive biomechanical data, which provides effective evidence for the evaluation of surgical efficacy, the development of postoperative rehabilitation methods and the evaluation of the stability of thoracolumbar spinal system.