Weanling rats were fed with a low-selenium diet (Se 0.009mg/kg, — Se group) and the diet supplemented with sodium selenite (Se 0. 232mg/kg,+ Se group) for 1, 2 and 3 months respectively. The generation rate of superoxide radical(O_2~-), activity of manganese dependent superoxide dismutase (Mn-SOD) in heart mitochondria and blood Se concentration from the rats were determined. The results showed that the mitochondrial O_2~- generation rate from — Se rats was significantly higher than those from + Se rats at 2 and 3 months. During all the feeding periods, no significant difference in mitochondrial Mn-SOD activity was found between the—Se and + Se groups,while the blood Se concentration in — Se group was significantly lower than those in + Se group at each feeding time and continually decreased in the 2 and 3 month. The results suggested that selenium could depress O_2~- generation in heart mitochondria.

Objective To investigate the effect of microbubble-enhanced non-focused ultrasound on liver uhrastructure during the treatment of hepatic trauma.Methods The model of hepatic trauma was established in 18 healthy New Zealand rabbits.The subjects were divided into trauma group,ultrasound group and ultrasound-microbubble group according to the random number table,with 6 rabbits each.Thicker region of the left hepatic lobe was treated by custom-made non-focused ultrasound for 5 min.Peak intensity (PI) was used to evaluate the blood reperfusion of the target region after treatment.Liver specimens were performed transmission electron microscope examination immediately and 24 h after treatment to analyze ultrastructure changes.Results PI ratio in ultrasound-microbubble group (15.1 ± 2.6) was significantly lower than that in trauma group (23.1 ± 1.1) and ultrasound group (23.4 ± 1.3) (P ＜ 0.05).But the difference between trauma and ultrasound groups was insignificant (P ＞ 0.05).Compared with trauma and ultrasound groups immediately after treatment,hepatic cells in ultrasoundmicrobubble group had obvious edema,sinusoids thinned,organelles arranged in disorder,mitochondrial edema was present,endothelia cells of interlobular hepatic artery,interlobular vein and bile canaliculi in the portal area damaged,and microvilli of bile canaliculi disappeared.Hepatic cells showed morphology of apoptosis 24 h after treatment.Conclusion Microbubble-enhanced non-focused ultrasound can be used to make rapid hemostasis by decreasing the blood perfusion,but it causes certain damage to the ultrastructure of hepatic cells and may induce apoptosis in the radiation zone and neighboring cells.

Objective To investigate the operative indications and operation techniques for augmentative plate fixation in treatment of femoral shaft atrophic nonunions subsequent to intramedullary fixation. Methods Twelve femoral nonunions after internal fixation with intramedullary nailing were treated with augmentative plate internal fixation and bone graft from June 1999 to June 2008. All femoral nonunions were caused by insecure fixation of the intramedullary nailing, in which a rotational instability of the fracture site was verified in all the patients during operation. Minimally invasive removal of the granulation tissue at fracture site and the sclerotic bone was dccorticated. The adequate lilac bone was tiled longitudinally on the nonunion gap and the cortical bone bed. The fixation involved the limited-contact dynamic titanium plate with 5-6 holes, 3.0 mm Kirschner wire and 4-6 double cortex cortical screw fixation.Protective weight-bearing was given after surgery and the tunction was evaluated at 1,3, 6 and 12 months with imaging. Results All patients were followed up for 7-26 months ( average 17.4 months), which showed radiological solid union (7-12 months, average 9.4 months) and clinical union (5-9 months, average 7.1 months ). The operation lasted for 50-120 minutes ( average 77.5 minutes), with blood volume of 150-350 ml ( average 252 ml). There were nine patients with bone pain, of whom the pain was relieved within one month in seven patients and three months in two. No infection, hardware loosening or breaking were found. Conclusion The plate augmentation and cancellous bone grafting leaving the nail in situ can be an effective solution for nonisthmal femoral nonunion, bone defect and failed exchange nailing.

ObjectiveTo compare the outcomes and indications between exchange nailing (EN) and augmentation plating (AP) with a nail left in situ for femoral shaft hypertrophic nonunion after femoral nailing. MethodsFrom April 1998 to June 2009, 20 patients with femoral shaft hypertrophic nonunions after femoral nailing were treated with EN (11 patients) and AP (9 patients) respectively. There were no significant differences between the two groups with respect to the patient's age, gender, associated injuries, anatomical location and type of femoral fracture. Patients were evaluated by imaging and clinical function at 1, 2, 3, 4,6, and 12 months after surgery, and then every year postoperatively, to observe the callus and the recovery condition of the affected limb function. Fisher exact test and t'-test were performed to compare the outcome and complications respectively. ResultsAn unpaired t'-test showed no significant differences with respect to follow-up time, operating time, intraoperative blood loss, postoperative drainage, length of stay, time to radiographic union, time to clinical union, and AAOS score between the two groups. The cost of hospitalizations in the EN group was higher than in the AP group(t'=16.4, P=0.013). Four nonunions in the EN group failed to achieve union, which 3 patients were subsequently treated with AP and simultaneous autogenous bone grafting and 1 patient was treated with nail dynamization. All 9 hypertrophic nonunions in the AP group obtained osseous union. Fisher exact test showed a higher nonunion rate of EN compared with AP (χ2=6.01 ,P=0.008). ConclusionEN has been an excellent choice for aseptic isthmal femoral nonunion without a large bone defect subsequent to intramedullary fracture fixation, and AP can be an effective solution in cases of nonisthmal femoral nonunion and bone defect and failed exchange nailing.

Objective To investigate effects of ACUMED self-orientated elbow plate system in treatment of comminuted distal humeral fractures (type C) in adults.Methods Thirty-two adult cases of comminuted distal humeral fractures treated by open reduction and internal fixation with parallel dual plates from May 2009 to October 2010 were enrolled in the study.There were 17 males and 15 females,at average age of 60 years (range,21-85 years).All cases were subjected to closed fractures,involving left side in 15 cases and right side in 17.Besides,two cases had associated ulnar nerve injury.According to AO classification,there were 12 cases of type C1,12 of type C2 and eight of type C3 fractures.The time from injury to operation averaged 5.6 days.Distal humeri were exposed through posterior median incision of elbow and V shape osteotomy of olecroanon.Muscular contractile and relaxant functional exercise was taken within 24 hours postoperatively.Clinical results were assessed based on Mayo elbow performance score (MEPS) and X-ray films.Results X-ray films showed that all cases obtained primary bone healing in the follow-up (mean 12 months).Three cases of type C3 fractures had heterotopic ossification.All cases had no complications like infections or implant loosening postoperatively.Range of motion in elbow flexion and extension averaged 85° (range,8°-140°).MEPS was average 90 points (range,60-100 points),including excellent outcomes in 13 cases,good in 15,fair in one and poor in three,with excellence rate of 88％.Conclusion ACUMED parallel dual plate fixation technique based on stability theory of arch structure achieves solid fixation of adult comminuted distal humeral fractures,successfully reconstructs bone structure of distal humeri,and effectively restores elbow joint function in response to early rehabilitation exercise.

Objective To compare the two different ways of right ventricular outflow tract(RVOT) reconstruction at repair of pulmonary atresia with ventricular septal defect,the direct RV-PA anastomosis and pericardial conduit to find the better way.Methods From Jun.2002 to Oct.2012,66 patients underwent pulmonary atresia with ventricular septal defect repair in our hospital,age at operation from 14 days to 272 months.Patients were divided into 2 groups according to the way of RVOT reconstruction.Group 1:31 of them,using direct RV-PA anastomasis,Group 2:35 of them,using pericardial conduit.Paired t test was used to evaluate the growth of pulmonary arteries.Chi-square test and Kaplan-Meier were used to calculate the postoperative mortality,reopemtion situation and survival time.Results There are 3 early hospital death in group 1 (9.7 ％),and 5 in group 2(14.3％),P =0.71.There is a significant difference between the two groups in restenosis rate of the RV-PA anastomasis and autologous pericardial conduit with pulmonary branch artery(Group 1:22.2％,Group 2:55.6％,P =0.01).The diameters of RV-PA anastomasis and the pulmonary artery branches in follow-up were significantly lager than the earlier diameters(P ＜ 0.05) in group 1.There is no growth on diameters of the pericardial conduit and pulmonary branches except the right pulmonary artery in follow-up in group 2.There is no significant difference between the two groups in later survival(P =0.30).Conclusion Both the direct anastomasis of RV-PA and pericardial conduit are available for RVOT reconstruction in pulmonary atresia with ventricular setal defect repair.There is lower incidence of RVOT and pulmonary stenosis and anastomosis absolutely has the ability for later growth in the former.

Objective To investigate the clinical efficacy of digital gastrointestinal machine in emergency.Methods 1600 emergency patients accepted radiography with digital gastrointestinal machine.Rusults All cases were successful in examining with digital gastrointestinal machine.Conclusion Excellent digital film can be acquired by digital gastrointestinal machine.It meets the requirements in clinical emergency diagnosis.It is easy to operate and acceptable to patients.

Objective To evaluate the right heart function with echocardiography after right ventricle-pulmonary artery (RV-PA) anastomasis for right ventricle outflow (RVOT) reconstruction in patients with different types of pulmonary atresia and ventricle septal defect(PA/VSD).Methods From Nov 2002 to Aug 2013,31 patients with PA/VSD had undergone right ventricle-pulmonary anastomasis to reconstruct RVOT for radical or palliative repair.Related echocardiography indexs including strain/rate etc.were used to evaluate the right heart function and the progress of the right heart valves regurgitation.Results There were 3 early hospital deaths.No later death during follow-up.The echocardiography suggested the pulmonary artery and tricuspid regurgitation were more serious,however,the right heart function was relatively fine.The regurgitation of tricuspid valve was positive correlation with duration of follow-up (P =0.016).Conclusion The right heart function in follow-up keeps relatively well,and tricuspid valve regurgitation needs a long-term follow-up.

Masquelet technique has become a safe and effective treatment for chronic osteomyelitis of the long limb shaft. The vast majority of osteomyelitis can be ultimately controlled, segmental bone defects repaired and limb functions restored. Accumulation of clinical applications and development of imaging technology have led to rapid progress in determining the infection scope of chronic limb osteomyelitis, precise preoperative design for repair of soft tissue defects, evaluation of bone structure stability, and use of bone grafting materials. This article reviews the progress of Masquelet technique in the treatment of chronic limb osteomyelitis from the aspects of its theoretical foundation, key operations, and selection of fixation methods, hoping to deepen the understanding of current Masquelet technique.

Objective:To characterize the geriatric osteoporotic pelvic fractures using 3-D computed tomography (CT) fracture mapping.Methods:Retrospectively analyzed were the 79 elderly patients with pelvic fracture who had been admitted to Department of Orthopaedics, The 7th Medical Center of PLA General Hospital between January 2017 and December 2021. There were 24 men and 55 women, aged from 60 to 98 years (average, 74.3 years). The CT scan data of the pelvis from all patients were imported into the software (Mimics Medical 18.0, Geomagic Studio 2014, Rhinoceros 6.0, and Matlab) to create a 3-D pelvic fracture model. The fracture pieces were imported into a standard pelvic template to obtain the morphology of the fracture lines after fitting. A map of fracture line distribution frequency and a fracture heat map were created by fitting the fracture lines of all patients into a common pelvic template.Results:Of the 79 elderly patients with pelvic fracture, 69 (87.3%) had fractures of both the anterior and the posterior rings. The fracture map and heat map of geriatric pelvic fractures showed the following: the fracture lines of the anterior ring were concentrated in the junction of the cancellous bone and cortical bone of the superior and inferior pubic rami; the fracture lines of the posterior ring were concentrated in the middle and posterior 1/3 of the ilium and in the sacral wing; the fracture frequencies incurred by the pubic bone, sacrum, and ilium were from the highest to the lowest.Conclusions:Fracture mapping can visually characterize the distribution of fracture lines of the geriatric pelvic fractures. Simultaneous fractures of the anterior and posterior rings of the pelvis are the most typical kind of pelvic fractures in the elderly. The junction of the cancellous and cortical bones of the superior and inferior pubic rami and the area surrounding the sacroiliac joint are the most frequent locations for the fractures.