Acellular dermal matrix as a good tissue repair material is now widely used in the multi-disciplinary field.But acellular dermal matrix is hard to meet the different requirements of different fields.Composite acellular dermal matrix is a new type of biological materials builded on the basis of the structure of ADM.It has more excellent features that can better satisfy the different Transplant environment.The research progress of composite ADM in recent years is summarized in this paper.

Mini health technology assessment (Mini-HTA) was developed from traditional HTA,based on the hospital needs.It is a very important decision making method and reference tool for the hospital policy makers.Currently there is no report of using Mini-HTA ease on introducing new equipment in China.Present paper introduces the Mini-HTA to provide reference for others hospitals in China.

Objective To investigate the meaning of PURA gene and its protein in nephridial tissue of the rats with endemic fluorosis of coal burning. Methods Thirty-six SD rats of 80 - 100 g, body weight were randomly divided into control group, low fluorosis group and high fluorosis group according to body weight, 12 in each group, the number of female and male in each group was the same respectively. The control group, Low fluorosis group and high fluorosis group rots were fed with 1.5,25.0,60.0 mg/kg fluoride content in feedstuff, to establish the animal model of fluorosis. Expressions of both mRNA and its protein of PURA gene in rat nephridium tissue, were determined by RT-PCR and immunohistochemistry after four-month experimental period. Results The expressions of PURA mRNA[(2.74± 1.06),(4.29 ± 2.11)] and its protein[ (28 827.91 ± 4801.94),(61 146.96 ± 4997.55)] in low fluorosis group and high fluorosis group was higher than that in the control group[ ( 1.13 ± 0.87), (7131.95 ± 1524.54), all P < 0.05]. And the expressions of PURA mRNA and protein in high fluorosis groups was higher than that in low fluorosis greup(all P < 0.05). Conclusion High fluoride can lead to the high expression of PURA gene mRNA and protein in the rat nephridium tissue exposed to sodium fluoride.

The c-erbB-2 oncogene, which is a new human proto-oncogene similar to EGFR structurally, generates a glycoprotein of tyrosine kinase family with a molecular weight of 185,000 To evaluate the prognostic significance of c-erbB-2 oncogene expression in colorectal carcinoma, We analysed 73 colorectal carcinomas in paraffin sections immunohistochemically, using the monoclonal antibody specific for the c-erbB-2 oncogene product and correlated with clinicopathological data. The results were as follows 1) The immunoreactivity for c-erbB-2 oncogene was localized to cell membrane of the tumor cells and occasionally observed within the cytoplasm. 2) The positivity of c-erbB-2 oncogene expression was 71.2%(52/73) of the colorectal carcinomas overall. According to the histological types, the positivity of c-erbB-2 oncogene in adenocarcinoma(77.4%) was higher than that in mucinous carcinoma(36.4%)(p<0.05). 3) Expression of c-erbB-2 oncogene was significantly correlated with lymph node metastasis or distant metastasis(p=0.0117), Dukes stage(p=0.0432), and TNM classification(p=0.0102). These results suggest that c-erbB-2 oncogene expression may be used as a prognostic factor of colorectal carcinoma because of its correlation with other clinicopathological prognostic factors.
Humans ; Neoplasm Metastasis

PURPOSE: The purpose of this study is to evaluate the clinical results of modified Stoppa approach in acetabular fractures. MATERIALS AND METHODS: Twelve patients who underwent surgery using the modified Stoppa approach for acetabular fractures were enrolled. There were 10 cases of isolated acetabular fracture, two cases of acetabular fracture combined with pelvic ring injury. There were two cases of anterior column fracture, nine cases of both column fracture, and one case of T-type fracture according to Letournel classification. The clinical outcomes were evaluated from Harris hip score (HHS) at postoperative one year and complications. The radiologic result was evaluated according to Matta criteria; anatomical, imperfect, and poor. RESULTS: According to the radiological results, there were eight cases of anatomical, three cases of imperfect, and one case of poor reduction. The average HHS was 82.5 and 10 patients had excellent or good results. The other two patients had poor results due to lumbosacral plexopathy and poor reduction, respectively. The complication included one case of incomplete sciatic nerve palsy, which was recovered at postoperative three months. CONCLUSION: Internal fixation of acetabular fractures using the modified Stoppa approach had satisfactory clinical and radiological outcomes. The modified Stoppa approach can be a useful option for acetabular fractures with appropriate indication and anatomical information.
Acetabulum* ; Classification ; Hip ; Humans ; Sciatic Neuropathy

The cardiovascular and CNS effects of MIDAZOLAM 0.25 mg/kg were studied in 40 patients, randomised and emergency operations(20 males and 20 females). The effects of the administration of MIDAZOLAM intravenously on the cardiovascular and central nervous system were determined. The results were as follows: 1) It had short duration of action and absence of vascular irritation compared with MIDAZOLAM. 2) Three minutes after injection, mean systolic pressure decreased from 132+/-16 mmHg to 115+/-18 mmHg and diastolic pressure from 87+/-11mmHg to 77+/-13 mmHg. One minute after injection heart rate increased from 89+/-19 beat/min to 95+/-20 beat/min and after three minutes returned to prior level. 3) Our study shows that the intraveous administration of MIDAZOLAM 0.25mg/kg produces. a statistically significant, but clinically unimportant, decrease in blood pressure and an increase in heart rate. 4) The effects of MIDAZOLAM on the central nervous system were determined from the time of onset of injection. Spontaneous eye closure, loss of eyelash reflex and apnes were observed at 113+/-66 sec, 133+/-65 sec, and 147+/-58 sec, after injection of MIDAZOLAM. 5) MIDAZOLAM as an induction agent for anesthesia is not indicated for in out-patient surgery due to the extended duration of drowsiness losting over 3 hours in the recovery room. 6) MIDAZOLAM was sufficient as an induction agent for general anesthesia.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Central Nervous System ; Emergencies ; Heart Rate ; Humans ; Male ; Midazolam ; Outpatients ; Recovery Room ; Reflex ; Sleep Stages

Anterior approaches to the cervical spine for performing decompression, fusion and/or instrumentation are common and useful methods for treating many conditions, including degenerative diseases. One of the rare, but serious complications of an anterior cervical approach is respiratory insufficiency as a result of upper airway obstruction, which is due to airway narrowing and prevertebral soft tissue swelling. We experienced a case of serious airway obstruction that was caused by soft tissue edema combined with postoperative hematoma after an anterior cervical spine approach. We report here on this case and include a review of the relevant literature.
Airway Obstruction ; Decompression ; Edema ; Hematoma ; Respiratory Insufficiency ; Spine

PURPOSE: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. METHODS: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal and neonatal characteristics were retrospectively reviewed, and major pulmonary outcomes such as duration of mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) plus death at 36-week postmenstrual age (PMA) were compared between INSURE (n=48) and prolonged MV groups (n=36). The factors associated with INSURE failure were determined. RESULTS: Duration of MV and the occurrence of BPD at 36-week PMA were significantly lower in INSURE group than in prolonged MV group (P < 0.05), but BPD plus death at 36-week PMA was not significantly different between the 2 groups. In a multivariate analysis, a reduced duration of MV was only significantly associated with INSURE (P=0.001). During the study period, duration of MV significantly decreased over time with an increasing rate of INSURE application (P < 0.05), and BPD plus death at 36-week PMA also tended to decrease over time. A low arterial-alveolar oxygen tension ratio (a/APO2 ratio) was a significant predictor for INSURE failure (P=0.001). CONCLUSION: INSURE was the noninvasive ventilation strategy in the treatment of RDS to reduce MV duration in extremely premature infants with gestational age less than 28 weeks.
Bronchopulmonary Dysplasia ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature* ; Infant, Newborn ; Intubation* ; Intubation, Intratracheal ; Multivariate Analysis ; Noninvasive Ventilation ; Oxygen ; Pulmonary Surfactants ; Respiration, Artificial ; Retrospective Studies

The goal of an osteotomy around the hip joint for treating hip dysplasia is to delay or prevent osteoarthritis by reducing the stress to the hip joint. This can be archived with anterolateral displacement of the acetabulum and an osteotomy around the hip joint is indicated for the young and active patients, besides performing total hip arthroplasty. As the osteotomy site is close to the hip joint, we can obtain more correction with performing this type of surgery than is possible with other types of pelvic osteotomies and we can get excellent radiological and clinical outcomes. But periacetabular rotational osteotomy is a rather difficult procedure, there may be complications and a long learning curve is needed to learn the surgical technique. A dual approach for periacetabular rotational osteotomy is easier with direct exposure of the osteotomy site and there are fewer complications than that with performing a Berneses periacetabular rotational osteotomy, as described by Ganz. Therefore, it is recommended for beginners. The osteotomy site of the proximal femur is usually around the lesser trochanter, but femoral neck osteotomy may be performed in rare cases. The preoperative planning for obtaining a correction angle of the osteotomy site is the most important factor, and excellent results can be archived by performing an accurate procedure.
Acetabulum ; Arthroplasty ; Displacement (Psychology) ; Femur ; Femur Neck ; Hip ; Hip Joint ; Humans ; Learning Curve ; Osteoarthritis ; Osteotomy

PURPOSE: The purpose of this study is to evaluate clinical outcomes and complications after fasciotomy in acute compartment syndrome. MATERIALS AND METHODS: Seventeen cases diagnosed as compartment syndrome and underwent fasciotomy from January 2011 to February 2015 were evaluated retrospectively. We investigated the causes and regions of acute compartment syndrome, the methods of wound management, the necessity of skin graft, and the complications including amputation and infection. RESULTS: According to the causes of acute compartment syndrome, there were 7 fractures, 1 traumatic hematoma, 6 reperfusion injury, and 3 rhabdomyolysis. The regions of acute compartment syndrome were 3 cases of thigh, 10 cases of leg, and 3 cases of foot. One case had acute compartment syndrome involving thigh, leg, and foot. Of 17 cases, 3 cases died due to reperfusion injury and one case with severe necrosis of soft tissues underwent amputation. Among the 13 cases excluding 4 cases with death or amputation, 3 cases underwent split thickness skin graft. Shoelace technique and/or vacuum-assisted closure (VAC) was used for 9 cases, and wound closure without skin graft was achieved in all except one case, while 2 cases required skin graft among 4 cases without shoelace technique or VAC. There were 2 cases of infection. CONCLUSION: Acute compartment syndrome caused by reperfusion injury had poor outcomes. Shoelace technique and/or VAC were useful for management of wound after fasciotomy.
Amputation ; Compartment Syndromes* ; Foot ; Hematoma ; Leg ; Necrosis ; Negative-Pressure Wound Therapy ; Reperfusion Injury ; Retrospective Studies ; Rhabdomyolysis ; Skin ; Thigh ; Transplants ; Wounds and Injuries