BACKGROUND:In recent years,bone defect caused by tumor,trauma,infection and so on is always the troublesome problem in the orthopaedics field. Many kinds of bone graft substitute have been exploited to conquer this problem.OsteoSet,a new substitute for bone graft,with the advantage of excellent biocompatibility,degradation,bone conduction and induction of ossification,is an ideal product.OBJECTIVE:To investigate the effect of OsteoSet in repairing bone defects due to tumor.DESIGN:Retrospective study and case analysis.SETTING:Department of Orthopaedics,First Hospital of Jilin University.PARTICIPANTS: Twenty-two patients with bone defect caused by bone tumor who received operation in the Department of Orthopaedics,First Hospital, Jilin University between June 2004 and September 2006.The involved patients,14 male and 8 female,averaged 23 years old ranging from 5 to 68 years.Inclusive criteria:① Diagnosed as benign tumor in bone according to the bone tumor classification criteria instituted in China in 1983.②Had the indications of tumorectomy and bone grafting with OsteoSet substitute.③Informed consent was obtained.The position of tumor was described as 6 in shaft of humerus,2 in neck of femur, 9 in inferior segment of femor, 4 in superior segment of tibia and 1 in celcaneus respectively.METHODS:①Operation procedure:After the effective anesthesia,the tumor was exposed as usual.Then the tumor was resected as thoroughly as we could.When OsteoSet substitute in the bone defect was filled carefully in order to avoid crushing into pieces.At last the substitute should be covered with periosteum or soft tissue.②Postoperative evaluation: The area of substitute absorption was observed by X-ray examination in 4, 8, 12 and 24 weeks after oporation.Postoperatively.incision healing,pain and complications of paients were observed at 6,7,8 and 9 months.MAIN OUTCOME MEASURES: OsteoSet substitute absorption rate and new bone formation rate as well as postoperative follow-up results.RESULTS:Twenty-two patients were involved in the final analysis.①OsteoSet substitute absorption rate and new bone formation rate:The evident absorption of OsteoSet substitute could be found in the X-ray film 4 weeks after operation.At the same time,the slender bone trabecula formed and bone density ncreased.At the end of 12 weeks after operation,about 97.1 percent OsteoSet substitute was absorbed and approximate 95.3 percent new bone infiltrated the defect area. In the 6 months, the substitute absorption rate and the new bone formation rate were 99.1 percent and 98.6 percent respectively. Stable bone trabecula formed in the bone defect area and the new bone connected with the surrounding health bone naturally by remolding.②Follow-up results:All the operative incisions healed well and there were no pain and discomfort in the duration of hospital stay; All the patients had no fever, erythra or other allergic responses during the follow up;The OsteoSet substitute were absorbed well and new bone also formed well in all the cases;All the patients were satisfied with the recovery of limb function.CONCLUSION:The substitute absorption was accordance with the new bone formation.For its good absorption and new bone reconstruction,OsteoSet is an ideal substitute for bone defect caused by tumor.

Objective To discuss the etiology,clinical features,diagnosis and treatment of congenital pleural effusion in fetuses and neonates in order to improve the understanding of this disease. Methods Six neonate cases with congenital pleural effusion were retrospectively analyzed in neonates who were admitted to the Department of Neonatolo-gy of the First Affiliated Hospital of Zhengzhou University after birth and the etiology,clinical features,diagnosis and re-lated treatment were analyzed based on literature review. Results Among 6 patients with congenital pleural effusion, chylothorax was found in 3 cases,one of whom had chylothorax,chylous abdominal,21 trisomy syndrome and congenital hypothyroidism,and the etiology of the other 3 cases were unknown. Diagnosis mainly was depended on imaging and la-boratory tests. The number of nucleated cells of hydrothorax or ascites were(1 588 - 13 057)× 106 / L,mainly lympho-cytes. Protein qualitative was( + - + + + ),the chylothorax qualitative test was positive in 3 cases. The liver function showed that the total protein and albumin were decreased in varyig degrees. Conservative or surgical treatment was taken according to the situation of the patients. Among 6 patients,3 cases were cured after treatment,the others gave up treat-ment finally. Conclusions The etiology of congenital pleural effusion was different,and often associated with chromo-somal abnormalities or other malformations,ultrasonography was the main method to diagnose congenital pleural effusion and the patients should be dynamically observed or treated during the antepartum or intrapartum period. If the neonates are found to have pleural effusion in prenatal period early diagnosis and treatment is a best choice.

0.05),but those in severe hyperbilirubinemia group significantly higher(Pa

Objective To explore the early diagnostic value of the expression level of plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP)for heart failure(HF)in neonates.Methods Thirty-five neonates who were clinic diagnoses as HF newborns and 20 cases of non-HF newborns(control group)were selected,on the 2nd,the 7th day after birth,plasma NT-proBNP and CK-MB levels were measured with electrochemiluminescence method and mass method.All data were analyzed by SPSS 16.0 software.Results Compared with the control group,CK-MB and NT-proBNP were higher in the HF group before treatment(P0.05).Compared with before treatment,CK-MB and NT-proBNP were significantly lower in the HF group(P0.05),NT-proBNP level was lower in the control group(P

Objective To explore the roles of bacterial infection in the pathogenesis and progression of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Methods The clinical data of 604 patients with ALI or ARDS hospitalized from April 1991 to March 2001 were analyzed. Results (1) The cause of direct lung injury was predominantly ascribed to lung infection, whereas indirect lung injury was due to sepsis. (2) The gram positive cocci (50.76%) and gram negative bacilli (40.15%) in the isolated pathogenic bacteria from patients were approximately similar. Furthermore, Staphylococcus aureus and Pseudomonas aeruginosa were the first and second pathogenic bacteria, respectively. (3) The incidences of ALI and ARDS in infected patients significantly increased with the grade elevation of systemic inflammatory response syndrome (SIRS) ( P

ObjectiveTo explore the risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage in premature infants.MethodsA total of 304 premature infants were selected who were diagnosed as sever intracranial hemor-rhage (grade III and IV) by cranial bedside ultrasound admitted to our hospital from Jun. 2013 to Sep. 2014. According to wheth-er the obstructive hydrocephalus was followed, all infants were divided into hydrocephalus group (n=59) and non-hydrocephalus group (n=185). The risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage were analyzed and the lateral ventricle size was measured dynamically.ResultsThe univariate analysis showed the factors related with obstructive hydro-cephalus were as follows: gestational age≤32 weeks, birth weight< 1500g, severe asphyxia, cesarean section, RDS, neonatal infection, heart failure, PDA, acidosis, thrombocytopenia, coagulation abnormalities, and intracranial hemorrhage (gradeⅢ orⅣ) (allP<0.05). Multivariate logistic regression analysis showed that acidosis, thrombocytopenia, coagulation abnormalities, gesta-tional age≤ 32 weeks, severe asphyxia, intracranial hemorrhage (gradeⅢ orⅣ) were independent risk factors for obstructive hydrocephalus (OR: 1.76~20.46, allP<0.05). At each time point after birth, the ratio of posterior horn of lateral ventricle was signiifcantly higher in hydrocephalus group than that in non-hydrocephalus group (P<0.05). There were signiifcant differences in the changes of the posterior horn ratio of left or right lateral ventricle with time in hydrocephalus group (P=0.000), increasing at 14 days and reaching the peak at 28 days after birth.ConclusionsThe risk factors for obstructive hydrocephalus secondary to intracranial hemorrhage in neonates are important. Regular and dynamical monitoring of ventricle size by cranial ultrasound is needed in infants with sever intracranial hemorrhage.

Objective To evaluate the cleanliness and tolerance of different administration speed on polyethylene glycol electrolyte solution (PEG-ES) for colonoscopy preparation. Methods 97 consecutive asymptomatic individuals underwent colonoscopy and therapy were enrolled and randomly assigned into 2 groups. Subjects in group A drank 2000 ml PEG-ES (1000 ml every 10 ~ 20 min rapidly) within 1 h before colonoscopy;Subjects in group B drank 2000 ml PEG-ES (250 ml every 10 min) within 2 h before colonoscopy. The total time of drinking PEG-ES, the first defecation time and total numbers of defecation after drinking PEG-ES, score and degree of Boston bowel preparation scale (BBPS) and PEG-ES related adverse effects of the two groups were assessed and compared. Results There were no significant differences in gender, age and cecal insertion rate between group A and group B (P > 0.05). The total time of drinking PEG-ES, the first defecation time in group A were significant faster than those in group B, while total numbers of defecation was significantly more than that in group B (P < 0.05). No patients in the two groups complained PEG-ES related bellyache and vomiting, a little subjects in group B complained PEG-ES related nausea and bloating (P < 0.05), but the incidence were both less than 10.00 %. Accepting rate of colonoscopy preparation in group A was lower than that in group B, but both more than 90.00%, while accepting rate of re-colonoscopy than that in group B. BBPS score of the right half colon, transverse colon, total colon were significantly higher in group A than that in group B respectively (P < 0.05), while that of the left colon no significant differences between the two groups (P > 0.05). Conclusions Both regimens met the requirement of conventional colonoscopy and therapy, while rapid drinking PEG-ES within 1 h provides more better colonic cleansing quality for colonoscopy preparation.

Objective To investigate the effect and safety of topical tranexamic acid (TXA) plus cocktail analgesic for reducing blood loss during total knee arthroplasty (TKA).Methods A prospective case control study was made on 60 patients scheduled to undergo TKA because of knee injuries between August 2015 to June 2016.There were 13 males and 47 females,with the mean age of 65.5 years (range,51-80 years).Traumatic arthritis occurred in 44 patients and degenerative arthritis in 16 patients.The patients were assigned to separate cocktail analgesic group (Group A,n =30) and topical TXA plus cocktail analgesic group(Group B,n =30),according to the random number table.Patients in Group A received multiple-point intra-articular cocktail analgesic injection before implantation of the prosthesis in TKA.While patients in Group B received multiple-point intra-articular TXA plus cocktail analgesic injection before implantation of the prosthesis.Between-group differences were compared with respect to intraoperative blood loss,hemoglobin change (Hb),haematocrit (Hct),postoperative drainage,total blood loss,hidden blood loss,blood transfusion rate,Hospital for Special Surgery (HSS) score,incidence of deep venous thrombosis (DVT) and other complications.Results All patients were followed up for 3 months.Perioperative Hb reduction in Group B was 18.5 (13.0,26.0) g/L,less than 23.0 (21.0,35.5) g/L in Group A (P ＜ 0.05).Hct was reduced by 5.6 (4.1,7.8) ％ in Group B,while 7.2 (6.1,10.7) ％ in Group A (P ＜ 0.05).Postoperative drainage volume,total blood loss and occult blood loss in Group B were 105.0(60.0,223.8) ml,596.0(426.1,795.3) ml,422.3 (228.9,624.0) ml respectively,decreased compared to Group A [162.5 (118.8,245.0) ml,788.3 (583.0,1 082.4) ml,603.2 (435.2,884.7)ml respectively] (P ＜0.05).There were no significant differences in intraoperative blood loss,blood transfusion rate,HSS score and DVT incidence between the two groups (P ＞0.05).Conclusion Topical TXA plus cocktail analgesic can reduce blood loss during perioperative period in TKA,without increasing the risk of DVT.

Partial deletion of the long arm of chromosome 7 is a rare disease and is prone to missing the diagnosis or being misdiagnosed.Here we present a case of a 13-year-old boy that showed symptoms such as growth-retardation,moderate intellectual disability,hypotelorism,microcephaly,epicanthal folds,genu varum and lumbar vertebral cleft,but it did not show serious symptoms like cleft lip,urogenital malformation and hypotonia.He was eventually diagnosed as partial deletion of the long arm of chromosome 7 syndrome through gene analysis.Considering the rare incidence of this disease and more rarely for being hospitalized to endocrine ward due to growth retardation,this case report can provide more information for clinic diagnosis and differential diagnosis for growth retardation.

OBJECTIVE： Four different one－ week triple therapeutic schemes to eradicate Helicobacter pylori were compared by pharmacoeconomic analysis to provide a scientific method for rational assignment of our limited medical fund.METHODS： According to literature reports,892 cases of duodenal ulcer and gastritis with Helicobacter pylori were selected.These patients were randomly divided into four groups which received different one－ week triple therapeutic schemes： OMC(Omeprazole＋ Metronidazole＋ Clarithromycin),OFC(Omeprazole＋ Furazolidone＋ Clarithromycin),OFA(Omeprazole＋ Furazolidone＋ Amoxicillin)and BFC(Colloidal bismuth subcitrate＋ Furazolidone＋ Clarithromycin).The schemes were evaluated with pharmacoeconomic cost－ effectiveness analysis.RESULTS： The cost－ effectiveness ratios of OMC,OFC,OFA,BFC for gastritis or duodenal ulcer were 16.19/17.33,17.30/13.93,11.40/10.56,11.17/10.75 respectively.They changed to 16.36/17.51,17.49/14.08,8.15/7.55,11.66/11.20 by sensitivity analysis.CONCLUSION： OFA is the most effective and inexpensive one to eradicate Hp.