Objective To discuss the possibility of interventional diagnosis and treatment of uterine artery bleeding after curettage. Methods Select the emergent patients with uterine artery bleeding after curettage as the basis for study. Three women with uterine artery bleeding underwent femoral artery puncture and transcatheter uterine artery embolization. Bilateral selective artery angiographies were performed, and then underwent artery embolization after exhibiting the bleeding sites. Results Three patients were promptly and correctly diagnosed and arterial embolization were then attempted under DSA. No recurrence of bleeding during the angiographic and clinical follow up simultaneously with no serious complication. Conclusions Uterine arterial DSA and interventional embolization of uterine artery are effective in the diagnosing and treatting emergent uterine artery bleeding after curettage.

Objective To assess the clinical value of the mi nimally invasive plate fixation technique in treatment of metaphyseal comminute d fractures of long tubular bones.Methods Sixty-eight patients with metaphyseal comminuted fractures o f femur or tibia were treated with min imally invasive percutaneous plati ng and early recovery movement from April 1999to October 2001.Results All the patients were followed up for a mean time of 10months.The postopera tive radiograph showed that reducti on and internal fixation were satisfactory in sixty-five patients.Lateral angular deformity of 8?occurred in one c ase,and 2cm shortage of the lower lim b in two cases.Sixty-eight patients obt ained bone union and satisfactory clinical function.There were no deep i nfec-tion,nonunion or other complicatio ns.Conclusion For metaphyseal comminuted fractur es of long bones of lower extremities,minimally invasive percutaneous plate fixation is o f significant value due to the advant ages of less iatrogenic trauma,rigid fixation and early movement.[

Objective To discuss our tentative application of the anatomic plate in the treatment of distal tibia fractures in order to develop a new effective fixation technique for this kind of fracture. Methods From November 2000 to September 2001, the authors applied Linkdistal tibia anatomical plates in the treatment of distal tibia fractures, which involved metaphysis in 12 cases, including 8 males and 4 females, aged from 18 years ～66 years, with 38 years on average. All the cases were of high energy injuries and complicated with ipsilateral fibular fracture. According to AO/ASIF classification: three were type A1, five were A2, three were A3, and one was B1; three of them were close fractures, five were type IO1 open fractures, and four were IO2. Results All the cases healed at one stage without infection or exposure of the implant. Bone callus could be found 2 3 weeks after operation. Bone union was achieved within 3～6 months, with 4 months on average. No delayed union or non union occurred. Functions of ankle joints recovered completely. Conclusion The anatomical plate for distal tibia is supperior to the traditional plates in both biomechanical and biological aspects. It is the best choice for the treatment of distal tibia fractures.

[Objective]To discuss a reasonable treatment for unstable intertrochanteric hip fractures in senile patients by comparing the effects of hemiarthroplasty and DHS fixation.[Method]Totally 126 intertrochanteric hip fractures in senile patients with complete clinical data were retrospectively analyzed,who were treated with hemiarthroplasty or DHS fixation from June 2002 to October 2005.Of the 126 patients,53 were treated with hemiarthroplasty,73 were treated with DHS fixation.All of them had multiple medical co-morbidities and were combined with severe osteoporosis.According to modified Even-Jensen classification,all of them belonged to unstable fractures.Comparison was made between the two treated groups in terms of operative time,blood transfusion during or after surgery,time for bed rest postoperatively,postoperative complications and St.Michael hip score one year after surgery.[Result]The average duration of follow-up for hemiarthroplasty and DHS fixation was 16 and 18 months respectively.Compared with the group of DHS fixation,the group of hemiarthroplasty experienced shorter time for bed rest postoperatively,fewer postoperative complications and higher St.Michael score 1 year after surgery,and the differences between two groups had statistical significance(P0.05).[Conclusion]Cemented hemiarthroplasty has the advantages of allowing early full weight bearing after surgery,low complication rate and satisfactory functional recovery.It is a reasonable treatment for unstable intertrochanteric hip fractures in senile patients.

[Objective]To investigate the feasibility of the fabrication of tissue-engineered anterior cruciate ligament(ACL)in vitro by studying biocompatibility and mechanical property of the braided polyvinyl alcohol(PVA)materials.[Method]Firstly,human ACL cells and NIH3T3 cells were isolated,expanded in vitro and seeded onto the surface of the braided PVA scaffold materials,the adhesion,proliferation and three-dimensional growth of cells on the scaffold were observed by SEM.Secondly,the biomechanical properties of the braided PVA scaffold materials were measured with electro-biomechanical machine.[Result]The braided PVA scaffold materials had no cytotoxicity,ACL and NIH3T3 cells adhered,grew and proliferated well both on the surface and in the holes of the braided PVA scaffold materials.The maximum load,the maximum strain and ultimate tensile stress of the braided PVA scaffold materials respectively were 169.78?9.18N,11.67?1.38% and 52.21?2.88MPa.[Conclusion]The braided PVA scaffold materials possess good biomechanical properties and biocompatibility,it may become an ideal biomaterial for fabricating tissue-engineering ACL if the biomechanical properties can be improved.

BACKGROUND: Polyvinyl alcohol (PVA) displays limitation to cell adsorbability. Can collagen improve the adsorbability of PVA to cells?OBJECTIVE: To develop a novel type composite of PVA and collagen, and explore the feasibility to serve as soft tissue substitute.DESIGN: Single sample observation.SETTING: Guangzhou Red Cross Hospital, Jinan University Medical College, Guangzhou Institute of Traumatic Surgery.MATERIALS: Fifteen New Zealand rabbits of 2.0-3.0 kg, either male or female, were provided by Medical Experimental Animal Center of Guangdong Province. The experiment was carried out in the Laboratory of Guangzhou Institute of Traumatic Surgery, and the experimental procedure was accorded with the animal ethical standards. Bovine typeI collagen was purchased from Guangzhou Trauer Biotechnology Co., Ltd. and PVA-124 from Guangzhou Chemical Reagent and Instrumentation Co., Ltd.METHODS: The experiment was performed in Guangzhou Red Cross Hospital, Jinan University Medical College between July 2003 and December 2006. ①Preparation of PVA-collagen material: 5 g/L bovine type I collagen was mixed with 5% PVA-124 at a ratio of 1 : 1. The mixture was freeze-dried at vacuum until becoming gelatinous. The internal structure was observed under the use of scanning electron microscope. ②Cytotoxicity test: PVA-collagen composite was cut into pieces of 10 mm×5 mm× 1 mm, put into 48-well culture plate after sterilized by Y ray, cultured with 1×104 3T3 cells in each well. Cell growth was observed under scanning electron microscope and laser scanning confocal microscope. ③Embedding test in vivo: Two longitudinal incisions were cut at the two sides of spine. The subcutaneous tissue was separated bluntly to form subcutaneous lacuna. Four pieces of PVA-collagen material were implanted in the lacuna and fixed. Nine specimens and the surrounding tissues were harvested from three rabbits each at one, four, eight and sixteen weeks postoperatively for pathological observation.MAIN OUTCOME MEASURES: The internal structure of gel film under scanning electron microscope, cytotoxicity test and embedding test in vivo results.RESULTS: ①Internal structure of PVA-collagen material:PVA-collagen material showed white gel shape after freeze-drying at vacuum. Penetrating three-dimensional pores were observed in the surface and inner section under scanning electron microscope. ②Cytotoxicity test results showed that 3T3 cells grew normally on the PVA-collagen material. ? Embedding test in vivo results suggested that one week after PVA-collagen implantation, foreign body reaction occurred, and the interface between material and tissue was clear. Four weeks later, only rare lymphocyte infiltration was observed, and a great amount of fibroblast hyperplasia formed collagen fibrils and false simple cuboidal epithelium coating material. In 8 weeks, no lymphocyte infiltration, neutrophilic granulocyte infiltration or foreign body giant cell were found; dense capsule wall and capsule coating material generated from a great amount of fibroblasts were observed. In 16 weeks, extending collagen fibrils were found arranged regularly with shrank nucleus, showing long ovoid or long fusiform in shape; no new formation small vessels, lymphocyte, neutrophilic granulocyte infiltration or foreign body giant cell infiltration were observed. The capsule wall was stable and thinned. CONCLUSION: PVA-collagen composite has good cell compatibility and tissue compatibility but no toxic or adverse effect. It can serve as in vivo implant.

Objective To evaluate the therapeutic effect and safety of ureteroscopy pneumatic lithotripsy(PL) and extracorporeal shock wave lithotripsy(ESWL) in the treatment of distal ureteral calculi.Methods 368 cases of distal ureteral calculi were divided into the PL treatment group(178 cases) and the ESWL treatment groups(190 cases).The clinical datas were compared between the two groups.Results PL treatment group 97.19% patients became stone free in 4 weeks,and in ESWL treatment group the stone free rate was 73.16%(P

BACKGROUND: Simple polyvinyl alcohol (PVA) has limited ability to cell adhesion. There are not generally accepted studies on improved effects of collagen protein modified polyvinyl alcohol on cell adhesion and proliferation.OBJECTIVE: To investigate the feasibility of PVA/type Ⅰ college (COL-Ⅰ) as anterior cruciate ligament (ACL) scaffolds in tissue engineering.DESIGN, TIME AND SETTING: The controlled observation experiment was performed at the Fourth Affiliated Hospital, Medical College. Ji'nan University, Guangzhou Red Cross Hospital, Guangzhou Institute of Trauma Surgery from August 2006 to October 2007.MATERIALS: COL-Ⅰ gel was produced by Guangzhou Institute of Trauma Surgery.METHODS: PVA filature was used to weave fascicular scaffolds. NIH-3T3 cell line and human ACL cells were in vitro incubated, amplified, and then implanted on the PVA/COL scaffolds.MAIN OUTCOME MEASURES: The growth of NIH-3T3 cell line and human ACL cells on the PVA/COL scaffolds and the secretion of extracellular matrix were observed using scanning electron microscope. Cell compatibility of PVA/COL scaffolds was assessed. Mechanics characteristic of PVA/COL scaffolds was measured by using the electric. tensile force apparatus. Mechanical property of PVA/COL scaffolds was analyzed using the SPSS 11.5 software package.RESULTS: NIH-3T3 cell line and human ACL cells on the PVA/COL scaffolds adhered, proliferated, and secreted extracellular matrix. NIH-3T3 cell line highly grew compared with human ACL cells on the PVA/COL scaffolds. The adhered number of NIH-3T3 cell line and human ACL cells was significantly increased on the PVA/COL scaffolds. NIH-3T3 cell line and human ACL cells presented well morphology on the PVA/COL scaffolds. COL-Ⅰ could promote the secretion of extracellular matrix from NIH-3T3 cells, but its effects on human ACL cells were not significant. Tensile force test showed that load-extension curve of the materials was identical to ACL of human and rabbits, and the scaffolds possessed strong flexibility. The maximal load, ultimate stress and elastic modulus were respectively 52.61 N, 14.96 MPa and 202.08 MPa.CONCLUSION: COL-Ⅰ accelerates the adhesion and proliferation of NIH-3T3 cell line and human ACL cells on the surface and in the pore of the PVA/COL scaffolds, promotes the secretion of extracellular matrix from NIH-3T3, and PVA filature material has mechanical property and good cell compatibility.

OBJECTIVE: In order to observe the clinical effects of sliding osteotomy for patients with severe knee osteoarthritis and varus knee due to complex femoral extra-articular deformity to achieve the medial and lateral soft tissue balancing during total knee arthroplasty. METHODS: From June 2014 to January 2018, a total of 22 patients with severe knee osteoarthritis and complex extra-articular malformation of femurs were treated with total knee arthroplasty. There were 5 males and 17 females in this group, aged 48 to 76 years old, with an average age of (61.3±13.8) years old. All the patients had varus deformities caused by extra-articular deformities of femur. Hip-knee-ankle(HKA) angle was(158.8±9.7) ° before operation, and the average Knee Society Score (KSS) clinical score was 32.6±6.1;KSS function score was 35.8 ±9.6;the average Hospital for Special Surgical (HSS) score was 39.7±4.6;the average range of motion before operation was (80.6±10.7) °. The mechanical alignment method was used in joint replacement. The flexion space was balanced first. The coronal plane vertical sliding osteotomy was performed on the medial femoral condyle for the imbalance of coronal plane. The sliding distance of the osteotomy block was determined by straightening the gap between the inner and outer sides of the space until the space was balanced. After the separated segments were fixed with several screws, the prosthesis was installed as usual. RESULTS: The wounds of all patients healed in the first stage, and no wound complications occurred. All the 22 patients were followed up, and the duration ranged from 18 months to 3 years with an average of (28.2±10.1) months. X-ray showed that the fracture line disappeared for 2 to 5(3.5±1.5) months without nonunion. HKA angle measured at the latest follow up was (178.8±0.7) °, which wassignificantly different from that before operation. The HSS score was 91.3 ±6.0;KSS clinical score 93.7±3.5;KSS functional score 81.2±6.5;and the average range of motion of knee joint was(121.7±11.6) °, which was statistically significant compared with that before operation. CONCLUSION For severe knee osteoarthritis patients with complex femoral extra-articular deformity, sliding osteotomy is performed. For severe varus deformity, downward sliding the medial femoral condyle is performed. The operation is relatively simple and the damage is small. It is easy to achieve the balance of internal and external soft tissue in flexion extension space. The short-term clinical effect is satisfactory.
Aged ; Arthroplasty, Replacement, Knee ; Female ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery* ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome