Oncolytic adenovirus is known to carry out the transformation of adenovirus,which has kill-ing role on tumor defective gene phenotypes,and Can be used as vector for tumor targeted tbempy drugs.At pres-ent,H101 and dl1520 and other biological products are gained from adenovirus type 5-specific gene fragments,which targeted tumor cell defects in the p53 gene expression,can specifically recognize tumor cells and Carry out proliferation and lysis of tumor cells.These biological products can be used as vectors to carry the anti-tumor genes and result in more powerful anti-tumor effects.

Objective To evaluate the effect of vacuumassisted closure (VAC) combining surgical treatments on chronic osteomyelitis after severe open fractures. Methods Fifty-eight patients with severe high energy open fractures were enrolled,35 patients were randomized to the experimental group and had identical treatment except that VAC was applied to the wounds between irrigation and debridement procedures, 23 patients were randomized to the control group and underwent initial irrigation and debridement followed by standard fine mesh gauze dressing. The infection rate, therapeutic effect and health condition were evaluated between the two groups. Results All patients were followed up for 14 - 36 (28.0 ± 7.3 ) months.Control group developed 7 cases ( 30.4%, 7/23 ) with deep infections, whereas experimental group developed 2 cases (5.7%,2/35) with deep infections. There was significant difference between the two groups (P =0.024). There were 24 cases (68.6%,24/35) grade A healing in experimental group,whereas there were 13cases (56.5%, 13/23) grade A in control group,the difference was very singificant (P＜0.05). The health total score of experimental group was higher than that of control group at 3,9 months after operation (P =0.013,0.005). Conclusions Patients treated with VAC have a higher recovery rate,shorter length of stay and satisfactory curative effect compared with patients randomized to the traditional methods. VAC represents a promising new therapy for osteomyelitis after severe open fractures.

OBJECTIVE To investigate the pathogenic causes of community-acquired pneumonia(CAP) in adult patients in Tongling.METHODS A prospective study was performed on 260 consecutive adult patients with CAP in Tongling city during last three years.Bacteria culture of sputum and serological tests in paired serum samples were detected.RESULTS Of 260 patients with etiological evaluation,128(49.2%) patients had an identifiable etiology,63(24.2%) had positive outcome from sputum cultured,atypical pathogens were detected from 75(28.8%)patients.Pathogens identified in 128 patients were:Mycoplasma pneumoniae(35.4%),Chlamydia pneumoniae(17.7%) and Streptococcus pneumoniae(13.6%).6.5% All patients had mixed infection.The resistance rate of S.pneumoniae to penicillin and erythromycin was 5 and 50%,respectively.CONCLUSIONS Atypical pathogens have important role in CAP,of which M.pneumoniae is the most common pathogen.S.pneumoniae and K.pneumoniae are the commonly encountered bacteria for CAP in Tongling.

BACKGROUND:Treatment prescription for intervertebral space infection is controversial. Conventionally,lying in bed,physical therapy,symptomatic therapy,and a large dosage of antibiotics were used frequently;however,the application of antibiotics was still controversial. OBJECTIVE:To explore the implantation of calcium sulfate powder combined with antibiotics for the treatment of suppurative spondyfitis of the thoracic vertebra. DESIGN,TIME AND SETTING:A retrospective case analysis was performed at Department of Orthopaedics,Affiliated Hospital of Guangdong Medical College from October 2000 to August 2008. PARTICIPANTS:A total of 24 patients with suppurative spondyfitis of the thoracic vertebra,including 9 males and 15 females and aging 42-71 years,were provided by Department of Orthopaedics,Affiliated Hospital of Guangdong Medical College. Suppurative spondyfitis of thoracic vertebra occurred on T6/7(n=9) ,T7/8(n=6) ,T8/9(n=3) ,T10/11(n=4) ,and T6/8(n=2) . Among all patients,8 cases had severe pain,myospasm of dorsal muscles,passive position,difficulty of turning over,and lateral or bilateral melosalgia;11 had anorexia and athrepsy;2 had paresis of both lower extremities and difficulty of automatic micturition;3 had diabetes mellitus. METHODS:After the 24 patients with suppurative spondyfitis of the thoracic vertebra received the cleaning operation on focus infection through latero-anterior thoracic cavity,the defect area of bone was inserted with titanium case filled with the calcium sulfate cement combined with antibiotics,and then the internal fixation and a plenty of antibiotics were applied after the operation. MAIN OUTCOME MEASURES:Recovery rate was evaluated using JOA assay,and blood sedimentation and bone healing were observed. RESULTS:All the 24 patients received the follow-up with the mean duration of 5.8 years. One case did not recovered,but other 23 patients recovered obviously. The recovery rate was 30%-100%. Blood sedimentation decreased from(86.74?10.56) mm/h before operation to(26.40?5.42) mm/h at 5 months after operation. Bone fusion occurred on all 24 patients,and the time lasted for 3-8 months. Relative death,complications,and infection-induced relapse were not found during the following up. CONCLUSION:To insert the titanium case filled with the calcium sulfate cement combined with antibiotics into the defect area of bone created by the cleaning operation on focus infection and combine with the application of the internal fixation by one stick and two screw and the brace for back and lumbar is an effective therapy for treatment of suppurative spondyfitis of the thoracic vertebra.

Present research of bone marrow mesenchymal stem cells (BMSCs) mainly contains the studies of the characteristics of biology, the induced differentiation, the mechanism of regulation and so on. The research of the characteristics of biology and the osteogenic and adopocitic induction are comparatively mature, showing many biological characteristics such as adherence, plasticity, heterology, self-renewal, rapid clone formation and transplantation. Adherence combined with density gradient centrifugation method is widely used in the isolation and purification of BMSCs. As to neural induction, there are many uncertainties, such as morphous of typical neurons, specific labeling, excitability, synaptic connection with other neurons, synaptic potential, and whether the induction of fully functional neurons from BMSCs is possible. In addition, the research of the regulation mechanism is mostly uncertain, and there are still many safety problems.

OBJECTIVETo discuss the clinical results of anterior windowing of the femur to remove the femoral component and cement in revision total hip arthroplasty.

METHODSFrom September 1999 to May 2011, 31 revision cases received anterior windowing of the femur in operation. There were 12 male and 19 female, with the average age in operation was 61.8 years (from 40 to 83 years). The reason for revision included aseptic loosening in 12 cases, infection in 4 cases, breakage of femoral stem in 11 cases and acetabular liner wear in 4 hemi-arthroplasties. Nine cases were cemented and 22 were non-cemented for the primary stem. The position of the window located in the anterior femur with 6 cases of complete windowing from the proximal to the end of the stem. Another 25 cases received regional windowing just around the tip of the stem. In revisions, non-cemented rectangular revision stem were used for 27 cases and two-stage surgery were used for 4 infection cases.

RESULTSIn all revisions, femoral stems and cement fragments were removed successfully and safely without any complications of fracture and perforation of new stems. All femur windows showed successfully union for average 14 weeks (12-18 weeks). There were some postoperative complications. One recurrent dislocation was treated using plaster external fixation for 8 weeks. One case with dislocation and fracture along with the window was revised by cerclage fixation. One periprosthetic fracture due to trauma was treated by cerclage fixation. The average Harris score of the hip improved to 83 points (75 to 90 points) at an average 5.5 years follow-up (0.5 to 12.0 years). Twenty six cases were completely followed up. Revision femoral stems were well-fixed without any subsidence or loosening.

CONCLUSIONSAnterior windowing of the femur is a proven technique which can be used to remove femoral stem and cement conveniently and safely without any fractures in revision total hip arthroplasty.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Bone Cements ; Device Removal ; Female ; Femur ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Reoperation

Animals ; Lung ; immunology ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; physiopathology ; Spleen ; immunology ; pathology ; fas Receptor ; analysis

Objective:To search for a method for radical resection of pancreatic and duodenal malignancy involving the mesentery root and for the long post-operation survival of patients.Methods:From Jan.2004 to Aug.2006,a total of 26(16 male and 10 female. aged 27-70)patients with pancreatic and duodenal malignancy involving the mesentery root were treated in our department.The patients included 3 with duodenal malignancy and 23 with pancreatic malignancy.Curative resection was performed by the extended pancreaticoduodenetomy(Whipple procedure)combined with mesentery root resection(MRR)for all patients.The outcomes,safety and the post-operation survival rate were analyzed retrospectively.Results:Thirteen patients were treated with Whipple procedures combined with MRR,9 were treated with partial portal vein/superior mesenteric vein(PV/SMV)and reconstruction of the vessel,and 4 patients received pre-shunt between PV and SMV with artificial vessel graft before the extended Whipple and MRR procedures.The operation time was 2.5 to 7(4.4?1.1)hour,and blood loss was 300 to 5 000(1892?1414)ml with the blood transfusion of 0 to 5 600(2 100?1 586)ml.There was no death in our group and 7(27%)had post-operation complication.The post-operation hospital stay was 10 to 30 days.The pathologic examination showed negative surgical margins for all specimens.The tumor size was 4 to 10 (6.17?2.03)cm.After a follow-up of 9 to 38 months,the pain was relieved in all patients.One of the 3 patients with duodenal adenocarcinoma had liver metastasis at 10 months after operation,and the other 2 survived 10 months and 27 months without evidence of tumor reccurence.The patient with pancreatic micro-adenocarcinoma died of local reccurence 9 months after operation.The patient with neuroendocrine carcinoma died of organ failure 24 months after operation.The patient with lymphoma have survived for 24 months after operation.The 1-year and 2-year accumulated survival rates in the 20 cases with pancreatic ductal cancer were 86.6% and 45.6%. respectively.Conclusion:The extended Whipple procedure with MRR is safe and effective.It can obtain R0 resection in patients with malignant tumors(over 5 cm in diameter)in the head,neck and uncinate process of the pancreas and duodenal.

Objective To evaluate the clinical outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures. Methods From January 2008 to March 2009, 9 patients (4 males and 5 females) with a vertically unstable pelvic fracture were treated with modular external fixator with lumbopelvic distraction spondylodesis. According to the classification of Tile, 9fractures were classified as type C. This fixation construct comprises a vertical lumbopelvic distraction component which fixed L4.5 and the posterior superior iliac spine and a transverse fixation which fixed anterior iliac spine with external fixator. Results All patients were followed up 12-18 months after surgery, with an average of 14.3 months. Postoperative X-ray showed satisfactory reduction of pelvic fracture. Pelvic fractures healed in all patients without loss of reduction 3-6 months after operation. According to Matta reduction evaluation criteria, 6 patients were excellent and 3 good. For the two patients with sacral neurological injuries,appropriate surgical decompression was performed to improve the symptom and minimize the deformity. No iatrogenic complications of neurovascular injury occurred. Patients now walk unassistedly without pain in the waist or legs, and with no shortening of lower limbs or claudication. By considering symptom and satisfactory scores, the Majeed functional assessment revealed that seven patients had excellent results and two good at one year. Conclusion External fixator with lumbopelvic distraction spondylodesis that allowed early mobilization and ambulation, with general applicability and definite safety, is an effective surgical technique for the treatment of vertically unstable pelvic fracture.

Objective To investigate the safety , feasibility , and clinical application value of digital sub-traction angiography ( DSA) -guided insertion of totally implantable venous access port ( TIVAP) in patients with digestive system cancer .Methods We retrospectively analyzed the data of 15 digestive system cancer patients who were inserted with TIVAP under DSA guidance between April 2013 and January 2016, recorded the TIVAP-related complications and indwelling time, and investigated the patients’satisfaction about TIVAP.Paired rank sum test was used for the differences in patients’quality of life before and after the insertion of TIVAP.Results Of the 15 digestive system cancer patients , operation success rate of TIVAP insertion was 100%, with the success rate of venipuncture on first attempt being 100%.The incidence of complication was 6.67% ( 1/15 ) , which was manifested as pull feeling at the neck occurring in the eighth month after insertion .The indwelling time of TIVAP was from 2 to 28 months, with a median value of 9 months.Patients’satisfaction rate of TIVAP was 86.67%(13/15).The proportion of patients with a good quality of life was 100%(15/15), statically signifi-cantly higher than that before the insertion [46.67%(7/15), Z=-3.416, P=0.000).Conclusions TIVAP insertion under DSA guidance in digestive system cancer patients is safe and feasible , with few complications and fair patient satisfaction .It may improve the patient ’s quality of life , worthy of clinical application .