Objective To discuss the technique and clinical effect of infective long bone defect treated by external fixator combination of iliac bone graft with deep iliac circumflex vessels.Methods All 28 patients with posttraumatic infective long bone defect were treated by external fixator and iliac bone graft with deep iliac circumflex vessels from July, 2008 to June, 2014.The length of the bone defect was from 3 to 7 cm (averaged 5.1 cm), including tibia defect in 13 patients, femoral defect in 7, humeral defect in 4, and ulna and radius defect respectively in 2, and 17 patients also with soft tissue defect.After thorough debridement, the bone defect was fixed by the external fixator, and then VSD was applied for irrigation drainage.As fresh granulation tissue growth, iliac bone vascularized by deep iliac circumflex vessels, size from size 5.0 cm× 3.0 cm to 8.0 cm× 3.5 cm, was transplanted.As for composite defect of infective bone and soft tissue in 17 patients, 6 cases of them was repaired with the iliac flap combined free flap, three with the iliac flap combined local skin flap, 4 cases with the iliac flap doubled with both the deep and the shallow iliac circumflex vessels, 3 cases with the circumflex iliac artery chimeric perforators flap and 1 with random iliac osteocutaneous flap.Affected limb function was graded with Enneking's system.Results All transplanted vascularized iliac bone survived, postoperative infection controlled well, but there were 2 patients of iliac flap partial necrosis.After dressing exchange and reoperation, the wound all repaired again.Twenty-six patients followed from 8 to 50 months, with an average of 18 months while 2 patients lost postoperative.The osseous healing time of the iliac bone graft was an average of 6.5 months, 25 patients healed well but 1 case encouraged tibia fracture again.Appearance of the limb also recovered satisfactorily.Twenty-six patients had the average limb function restored in 89.7％.There was no obvious complication in the donor.Conclusion It is an effective technical method to treat infective long bone defect by external fixator combination of iliac bone graft with deep iliac circumflex vessels, which can not only fix and bridge bone defects and enhance bone healing, but also obliterate dead space and resist local infection by ensuring blood supply.But the method is suitable for the receipt site infection under control and the length of the long bone defect less than 10 cm.

Objective To investigate the safety of argon plasma coagulation (APC) with submucosal injection for colon polyps.Methods A total of 30 sets of fresh sigmoid colon from healthy pigs were assigned to control group to receive direct APC,and to treatment group to receive APC with submucosal injection,respectively.After same time and energy of APC,each specimen was sampled for pathological evaluation and the damage extent was determined as mucosa,submucosa (superior 1/3,middle1/3,inferior 1/3),and muscularis propria.Ten cases of colon sessile polyps with diameter of about 1-2 cm,elevated within 3mm by endoscopic ultrasonography(EUS).Direct APC or APC with submucosal injection were performed,respectively,and the difference was observed by EUS.Results In 30 cases of control group,the injury depth of 5 cases reached to the muscularis propria and of 25 cases to submucosa layer,among which 4 cases showed damage to superior submucosa 12 middle submucosa and 9 inferior submucosa.In 30 cases of treatment group,there was no damage to muscularis propria.The injury depth of 26 cases reached submucosa layer,among which 22 cases showed damage to superior submucosa,4 middle submucosa.The results showed significant difference between two groups (P ＜0.01).In patients who underwent APC with submucosal injection,EUS showed effective isolation of mucosa and muscularis propria.It confined the injury to the mucosal layer.Without treatment of submucosal injection in advance,it seemed easier to damage the submucosa and muscularis propria.Conclusion Submucosal injection can protect the colon injured by APC,and may reduce the risk of colon perforation by APC for colon polyps.

Objective To investigate the risk factors associated with feeding intolerance in very low birth weight infants (VLBWI) and to investigate the beneficial factors for preventing feeding intolerance.Methods Retrospectively analysis was carried out in 151 VLBWI cases in our hospital from January 2005 to November 2010.Logistic regression analysis was performed to find the risk factors of feeding intolerance.Results The overall rate of feeding intolerance in VLBWI was 47.7 ％ (72/151).Dysporia and infection were associated with feeding intolerance in VLBWI (Wald x2 =7.748 and 4.555,P =0.05 and 0.033 respectively).Gender,multifetation were not associated with feeding intolerance(Ps ＞0.05).Conclusion The feeding intolerance is associated with dysporia and infection in VLBWI.

Objective　To evaluate the diagnostic value of MR I、CT、DSA for cerebral arteriovenous malformation(AVM). Methods　A total of 40 case of AVM were examined with imaging methods in which 19 MRI, 30 CT and, 12 DSA. Combination of two or three kinds of eximinations were perfo rmed in 20 and 4, respectively. Results　Diagnostic accordance r ate rate of CT was 70%, sensitivity and specificity of MRI were 100% and 84% res pectiv ely, diagnostic accordance rate of DSA was 92%. Conclusion　MRI,CT,D SA can play important roles in the diagnosis of AVM. MR and DSA are superior to CT. DSA could reveal the circulation time and the stealing blood situation of AV M and thus suggests the applicability of interventional embolization therapy.

Objective:To investigate the clinical efficacy of intramedullary nailing combined with bone cement in repair of segmental bone defects after tumor resection.Methods:A retrospective analysis was conducted of the 5 patients with malignant bone tumor who had been treated at Department of Orthopaedics, Qiannan People's Hospital from April 2018 to September 2019 for remaining segmental bone defects following limb salvage surgery. They were 4 males and one female, aged from 11 to 55 years (average, 35.4 years). Their defects ranged from 6 to 21 cm (average, 12.3 cm) after tumor resection. By the Karnofsky performance score (KPS) for long-term quality of life, all of them scored less than 50 points. Of them, 3 were treated by interlocking intramedullary nails and bone cement filling, and 2 by elastic intramedullary nails and bone cement filling. In the 2 cases with defects of 21 cm and 13 cm, the fixation was assisted by a plate and an external fixator. Defect length after resection, operation time and intraoperative bleeding were recorded; the efficacy was evaluated by the Enneking functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system, visual analogue scale (VAS), and KPS.Results:All the 5 patients had uneventful surgery, with operation time ranging from 112 to 225 min (average, 154.2 min), intraoperative bleeding from 300 to 500 mL (average, 382 mL), and defect length after resection from 6 to 21 cm. The 5 patients were followed up for 6 to 28 months. Of them, 2 died of disease progression 6 and 7 months after surgery, respectively. According to the Enneking's evaluation, one patient scored 28 points, 2 patients 23 points and 2 patients 21 points, giving a high degree of satisfaction. Their VAS scores 6 months after surgery ranged from 1 to 6, averaging 3.6; their postoperative KPS scores ranged from 60 to 80, averaging 72.Conclusion:In repair of segmental bone defects after tumor resection, intramedullary nailing combined with bone cement filling can relieve pain of patients and lead to satisfactory short-term curative efficacy.

Objective To isolate and purify human coagulation factor Ⅶ from Cohn fraction Ⅲ precipitate.Methods The purification procedure of human factor Ⅶ from Cohn fraction Ⅲ precipitate involves dissolving fraction Ⅲ,absorbing factor Ⅶ onto barium citrate and eluting,ammonium sulfate fractionation and DEAE-Sepharose Fast Flow ion exchange chromatography,and Sephadex G-100 gel filtration chromatography.Results 10.1mg purified FⅦ was obtained from 400g Cohn fraction Ⅲ precipitate.The purified FⅦ has a specific clotting activity of 1775.8U/mg and the overall yield of FⅦ specific clotting activity is 17.6% of the starting material.The purity of FⅦ was judged by SDS-PAGE and there was only one protein band on the gel.Conclusion The procedure of purifying Ⅶ from Cohn fraction Ⅲprecipitate is established with satisfactory purity.

Incidence of acute closed Achilles tendon rupture is high in clinic. Accurate diagnosis of this injury depends on a combination of physical signs and imaging examinations. Although conservative and surgical interventions are common for acute closed Achilles tendon rupture, its optimal treatment remains controversial. This literature review focuses on the research progress concerning this injury so as to analyze its risk factors, diagnostic methods, treatments, early functional rehabilitation, postoperative complications and prognosis evaluation.

Objective To investigate the procedure,imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bi-tilted CT scanning.Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT).The patients and yolunteers were given bubble-making powder by mouth and placed in a supine position on the CT table.CTVG and MPR images were obtained using the virtual dissection and reform of GE.Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy.The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening,soft tissue mass,stenosis of stomach,cancerous ulcer,infiltration to adjacent tissues,and lymph node and distant metastases.In comparison with fiberoptic gastroscopy(as the gold standard),CTVG showed a diagnostic accuracy of 92.5 %,a sensitivity of 93.3 %,a specificity of 90.0 %,a positive prediction value of 96.7 %,and a negative prediction value of 81.8 %.Conclusions CTVG is a safe,reliable,non-invasive method for demonstrating the structure of normal and abnormal stomach,and is a good complementory method to conventional fiberoptic gastroscopy.

OBJECTIVETo investigate the influence of ozonated water on physical and chemical properties of vacuum sealing drainage (VSD) materials.

METHODSVSD materials (foam and sealing membrane) were immersed in 10 µg/ml ozonated water for 1 h twice daily for 8 days. The foam appearance and microscopic structure of the materials were observed, and tensile tests and Raman spectrum scan were performed assess the effect of ozonated water. Simulated VSD devices were prepared and tested for leakproofness under negative pressure after ozonated water treatment.

RESULTSzonated water treatment for 8 days caused no obvious abnormal changes in the foam appearance or microscopic structure of the materials. The maximum tensile load of foam before and after ozonated water treatment was 4.25∓0.73 kgf and 2.44∓0.19 kgf (P=0.000), the momentary distance when the foam torn before and after intervention was 92.54∓12.83 mm and 64.44∓4.60 mm, respectively (P=0.000). The corresponding results for VSD sealing membrane were 0.70∓0.58 kgf and 0.71∓0.08 kgf (P=0.698), and 99.30∓10.27 mm and 100.95∓18.22 mm (P=0.966), respectively. Raman spectroscopy revealed changes in only several wave intensities and no new chemical groups appeared within the scan range of 400-4000 cm(-1). The VSD device was well hermetic after treatment with ozonated water.

CONCLUSIONExcept for a decreased stretch resistance property of the foam, VSD materials display no obvious changes in physical and chemical characteristics after treatment with ozonated water for 8 days.

Objective To investigate the association between tumor necrosis factor-α(TNF-α)and lymphotoxin α(LTα) gene single nucleotide polymorphisms (SNPs) and susceptibility to extremity post-traumatic osteomyelitis in Chinese population.Methods We used SNaPshot genotyping method to detect genotypes of 6 TNF-α gene SNP sites (rs1799964,rs1800630,rs1799724,rs1800750,rs1800629 and rs361525) and 1 LT α gene SNP site of rs909253 in 189 patients with post-traunatic osteomyelitis and 200 healthy controls.Genetic models were applied to investigate the potential links between the above-mentioned SNPs and risks of developing post-traumatic osteomyelitis.Results Outcomes revealed that the frequency of mutant allele C of rs909253 in the patient group was statistically higher than that in healthy controls (54.23％ versus 45.00％,P =0.010,OR =1.448,95％ CI 1.092 ～ 1.921).Significant correlations were found between rs909253 and risk of developing post-traumatic osteomyelitis by recessive model (CC versus CT+TT,P=0.012,OR=1.868,95％CI1.150～3.035) and homozygote model (CCversusTT,P=0.021,OR=2.016,95％ CI 1.111～3.658).The frequency of CC (29.63％) in the patient group was higher than that in the control group (17.50％).With regard to rs1800629 site of TNF-oα gene,we only found that the frequency of mutant allele A (4.23％) in the patient group was statistically lower than that(7.75％) in the control group (P=0.040,OR=0.526,95％ CI 0.283 ～0.978).Conclusions LTαgeneSNP site rs909253 may be linked with elevated risk of developing post-traumatic osteomyelitis in Chinese population.Mutant allele C may be a risk factor and people with genotype of CC may be a group at a higher risk of developing post-traumatic osteomyelitis in China.