BACKGROUND: Three-dimensional (3D) printing technology is a new rapid prototyping and rapid manufacturing technology. OBJECTIVE: Through the analysis of the related papers, the paper summarizes and discusses the research progress of 3D printing technology, the prospect of application in joint replacement and the status quo and development trend of 3D printing technology in joint replacement.METHODS: The relevant literature was retrieved by the first author with the China Journal Full-text Database (CNKI) and PubMed database from 1985 to 2015. The key words were 3D printing technology, rapid prototyping, arthroplasty, joint replacement. The included 81 articles were analyzed.RESULTS AND CONCLUSION: Basic research and clinical application of 3D printing technology and joint replacementtechnology are becoming more and more popular. 3D printing further optimizes in the communication and teaching in joint replacement, and avoids intraoperative and postoperative complications. According to the needs of different teaching materials, 3D printing can print out different parts of the real body with different characteristics of print by 3D printer. The surgical simulation exercises with 3D limb printing different materials are the best way to improve theoperation skills. 3D printing technology in the osteotomy guide precision has basically completed multicenter clinical trial,and toward to the clinical application of small scale stage. The construction of individualized treatment plan and theapplication of active biological organs by 3D printing technology will become the new research direction of jointreplacement.

Adolescent ; Adult ; Amanita ; Chemical and Drug Induced Liver Injury ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Mushroom Poisoning ; therapy ; Retrospective Studies ; Young Adult

Objective To investigate the most suitable anaesthesia method for the tension-free herniorrhaphy.Methods A total of 422 unilateral inguinal hernia cases from 2002 to 2005 were collected and randomly divided into the local anaesthesia group and epidural anaesthesia group. Observation indices and some relative data, such as operative duration, date of ambulation, date of foodintake, length of hospital stay, operation-correlated complications, anaesthesia complications, usage rate of ancillary drug, satisfactory rate for anesthesia, cost of hospitalization, were included and recorded in the questionnaire, and all the patients who took the tension-free herniorrhaphy were asked to answer it as the follow-up research. Results It was found that the occurrence of postoperative anaesthetic complications, the cost of hospitalization, length of stay of local anaesthesia group were significantly less than those of epidural anaesthesia group, and the date of moving and the date of foodintake were also significantly earlier than those of the other group (P0.05). Conclusion The local anaesthesia is suitable for most of the tension-free herniorrhaphy, and it may be used as the conventional anaesthetic method.

BACKGROUND: Abnormal curvature of the cervical spine reflects in large measure the degenerative changes of the cervical vertebrae. OBJECTIVE: The effect of manipulative therapy has been recognized in restoring normal cervical curvature, and aimed to further probe into the effect of this therapy on blood flow velocity in the vertebrobasilar arteries of patients with cervical spondylosis. DESIGN: A non-randomized and controlled concomitant study. SETTING: Departments of Spinal Orthopaedics and General Sugery of a University hospital, and the Outpatient Department of Orthopaedic Institute of a college of Traditional Chinese Medicine. PARTICI PANTS: From January 1999 to December 2001, 60 patients with cervical spondylosis were treated in the Department of Spinal Orthopaedics in Ruikang Hospital, Third Department of Surgery, First Affiliated Hospital of Guangxi College of Traditional Chinese Medicine, and Outpatient Clinic of Institute of Orthopaedics, Guangxi College of Traditional Chinese Medicine. The patients were divided into spondylosis group with abnormal curvature(30 cases) and spondylosis group without normal curvature(30 cases) . Thirty healthy subjects were also included to serve as the control group.METHODS: Manipulation was applied in these patients and the cervical curvature and blood flow velocity in the left vertebral artery (LVA) and right vertebral artery(RVA) as well as in the basilar artery(BA) were measured before and after the treatment for comparison. The correlation coefficients between them were also calculated.MAIN OUTCOME MEASURES: ① The cervical curvature before and after manipulation in spondylosis group and control group; ② The blood flow velocity in maximal systolic phase and end-diastolic phase in the specified arteries.RESULTS: The blood flow velocity in maximal systolic phase and end-diastolic phase decreased in LVA, RVA and BA in patients with abnormal cervical curvature, whose blood velocities in maximal systolic phase in these arteries was less than those in control subjects and patients with normal curvature ( P ＜ 0.05). After manipulation, the velocity in these arteries in creased apparently in patients with abnormal curvature. The changes in systolic velocity in LVA and systolic in BA were correlated to the curvature before manipulation, and after that, the maximal systolic velocity in LVA,maximal systolic velocity in RVA and BA were all related to the changes of the cervical curvature. CONCLUSION: Abnormal cervical curvature is the anatomical basis for abnormalities of the vertebrobasilar arteries. Manipulative therapy can restore the cervical curve and blood flow velocity in these arteries.

BACKGROUND:Retinoid X receptor (RXR) plays a central role in the regulation of intracellular receptor signaling pathways. The activation of RXR has protective effect on H2O2-induced apoptosis of H9c2 ventricular cells in rats. But the protective effect and mechanism of activating RXR in cardiomyocytes against hypoxia/reoxygenation (H/R)-induced oxidative iniury are stillunclear. METHODS:The model of H/R injury was established through hypoxia for 2 hours and reoxygenation for 4 hours in H9c2 cardiomyocytes of rats. 9-cis-retinoic acid (9-cis RA) was obtained as an RXR agonist, and HX531 as an RXR antagonist. Cultured cardiomyocytes were randomly divided into four groups:sham group, H/R group, H/R+9-cis RA -pretreated group (100 nmol/L 9-cis RA), and H/R+9-cis RA+HX531-pretreated group (2.5 μmol/L HX531). The cellviability was measured by MTT, apoptosis rate of cardiomyocytes by flow cytometry analysis, and mitochondrial membrane potential (ΔΨm) by JC-1 fluorescent probe, and protein expressions of Bcl-2, Bax and cleaved caspase-9 with Western blotting. Allmeasurement data were expressed as mean±standard deviation, and analyzed using one-way ANOVA and the Dunnett test. Differences were considered significant whenP was <0.05. RESULTS:Pretreatment with RXR agonist enhanced cellviability, reduced apoptosis ratio, and stabled ΔΨm. Dot blotting experiments showed that under H/R stress conditions, Bcl-2 protein level decreased, while Bax and cleaved caspase-9 were increased. 9-cis RA administration before H/R stress prevented these effects, but the protective effects of activating RXR on cardiomyocytes against H/R induced oxidative injury were abolished when pretreated with RXR pan-antagonist HX531. CONCLUSION:The activation of RXR has protective effects against H/R injury in H9c2 cardiomyocytes of rats through attenuating signaling pathway of mitochondria apoptosis.

Acute Disease ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Toluene ; poisoning ; Xylenes ; poisoning ; Young Adult

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Objective To investigate the injury characteristics and prognostic risk factors of patients with craniocerebral injury so as to provide some suggestions for the improvement of medical prevention,intervention and treatment measures.Methods Trauma database system was applied to collect the medical records of 661 patients with traumatic brain injury admitted to the Department of Neurosurgery of 105th Hospital of Hefei in 2009.Their general conditions,injury characteristics and outcomes were analyzed and the risk factors affecting their outcomes were investigated by Logistic regression analysis.Results Of the patients with craniocerebral injury,the males accounted for 70％ (463/661).The patients at 45 years old or so had the highest incidence of craniocerebral injury.Patient number in the second half of one year was 1.65 times more than that in the first half of one year (412/249 ).Most patients were injured from traffic accidents (87.7％,580/661 ) and 512 patients (77.5％) suffered from multiple injuries.ISS,injury causes,age and injury incidence quarters showed close correlation with the final outcome.Conclusions The patients with craniocerebral injury demonstrates distinctive characteristics in aspects of gender,age,incidence time,injury causes,and multiple injuries,but the ultimate outcomes are related to the injury severity,injury causes,age and other factors.

Objective To investigate the distribution and drug resistance of bacterial pathogens isolated from orthopedic wounds.Methods Data of bacterial strains isolated trom orthopedic wounds in the Third Hospital of Hebei Medical University from January 2008 to December 2012 were retrospectively analyzed.Strains were identified by using French bioMérieux Vitek32 identification system,and the drug susceptibility was tested by Kirby-Bauer method.Chi-square test for linear trend was performed to reveal the changes of distribution and drug resistance of the strains.Results A total of 2 456 bacterial strains were isolated,vith 1 652 (67.26％) gram-negative bacilli,777 (31.64％) gram-positive cocci,26 (1.06％) fungi,and 1 (0.04％) gram-positive bacillus.The top five pathogens were Staphylococcus aureus (666 strains,27.12％),Pseudomonas aeruginosa (606 strains,24.67％),Acinetobacter baumannii (355 strains,14.45％),Escherichia coli(188 strains,7.65％) and Enterobacter cloacae (187 strains,7.61％).The positive rate of Acinetobacter baumannii was on the rise during 2008 and 2012 (x2 =35.266,P ＜ 0.0l).The rates of pan-drug resistant strains in Acinetobacter baumannii and Pseudomonas aeruginosa were 6.20％ (22/355) and 0.17％ (1/606),respectively.The rates of extended-spectrum β-lactamases positive strains in Escherichia coli and Klebsiella pneumoniae were 39.89％ (75/188) and 29.23％ (19/65),respectively.The rates of methicillin-resistant strains in Staphylococcus aureus and coagulasenegative Staphylococcus were 40.69％ (271/666) and 52.38％ (22/42),respectively.The rate of vancomycin-intermediate strains in Enterococci was 3.70％ (2/54).The positive rate of methicillin-resistant &aphylococcus aureus was on the rise during 2008 and 2012 (x2 =18.317,P ＜ 0.01).Staphylococcus aureus were sensitive to teicoplanin,vancomycin and linezolid; Resistance rates to rifampicin and amikacin were 11.29％-33.33％; Resistance rates to penicillins and erythromycin were 76.80％-100.00％; Resistance rates to cefazolin,cefuroxime,cefoxitin,amikacin and levofloxacin were on the rise (P ＜ 0.05) ; And resistance rates to sulfamethoxazole (28.11％-48.35％) were on the decline in the same period (P ＜ 0.01).Resistance rates of Pseudomonas aeruginosa to imipenem,meropenem and sulfamethoxazole were on the rise (P ＜ 0.05) ; Resistance rates to ciprofloxacin,levofloxacin,amikacin,gentamicin and piperacillin/ tazobactam were on the decline (P ＜ 0.05) ; Resistance rates to cefoperazone/sulbactam were the lowest (9.15％-20.51％).Resistance rates of Acinetobacter baumannii to imipenem,meropenem,levofloxacin,piperacillin/tazobactam,sulfamethoxazole were on the rise (P ＜ 0.01); Resistance rates to cefoperazone/ sulbactam were the lowest (11.86％-19.70％).Escherichia coli and Enterobacter cloacae were sensitive to imipenem and meropenem,and the resistance rates to cefoperazone/sulbactam and piperacillin/tazobactam were low (0-14.29％); Resistance rates of Escherichia coli to piperacillin,cefepime,amikacin,levofloxacin,cefoperazone/sulbactam were on the decline (P ＜ 0.05) ; Resistance rates of Enterobacter cloacae to cefoxitin were on the rise (P ＜ 0.01),while the resistance rates to piperacillin,ceftazidime,cefoperazone,ceftriaxone,levofloxacin were on the decline (P ＜ 0.05).Conclusion During 2008 and 2012,the predominant bacterial pathogens of orthopedic wound in patients of the Third Hospital of Hebei Medical University are Staphylococcus aureus,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli and Enterobacter cloacae,and most strains are multiple drug resistant.

Objective To improve the understanding of severe anaphylactic reactions to infliximab retreatment. Methods Delayed hypersensitivity to infliximab in two patients with ankylosing spondylitis who had previously received infliximab and resumed after discontinuation over 4 years were reported and the related literatures were reviewed. Results Two patients ( 1 male, 1 female ) who were diagnosised with ankylosing spondylitis for more than 10 years, both individuals had received infliximab treatment during a clinical trial approximately 4-5 years prior to further therapy. On day 6 after subsequent infusion, one patient had pruritic skin rash covering her whole body, followed by flustered, dyspnea, hypotension and anaphylactic shock, she was successfully treated with epinephrine and glucocorticoid. Another patient experienced a skin rash and itching 9 days after reinfusion, he was successfully treated with antihistaminics.Conclusion A distant infliximab retreatment is associated with high rates of reinfusion reactions, including fever, urticaria, myalgia, arthralgia,even hypotension, dyspnea, laryngeal edema and anaphylactic shock.We recommend careful monitoring of those patients who receive infliximab retreatment, particularly after a lengthy interval.