1.Cervical artificial disc replacement in protection of adjacent segment discs
Tao JIANG ; Xianjun REN ; Weidong WANG
Orthopedic Journal of China 2006;0(07):-
0.05).Measurement results of adjacent segment movement extention showed more significant changes in the fusion group than in the non-fusion group(P
3.Biological features of ultrasound assisted acellular spinal cord scaffold
Hong YIN ; Xianjun REN ; Tao JIANG ; Changli ZHOU ; Kaijian WANG
Chinese Journal of Trauma 2013;(3):278-283
Objective To observe three-dimensional structure and biological features of rat acellular spinal cord scaffold prepared by sonic oscillation and chemical extraction in order to offer an ideal scaffold for spinal cord tissue engineering research.Methods Rat spinal cord underwent acellular treatment with sonic oscillation and chemical extraction (Triton X-100 at volume fracture of 2% and sodium deoxycholate at volume fracture of 2%) (acellular spinal cord group).In contrast with spinal cord tissue of normal rats (control group),general morphology,histology and ultramicro three-dimensional structure of acellular spinal cord scaffold were observed and aperture size,factor of porosity,water ratio,enzymolysis ratio and stability in water solution of the scaffold were also detected.Results Acellular spinal cord group showed effective removal of original cell components with factor of porosity for (94.57 ±3.45) % and water content for (88.62 ± 1.0) %,and satisfactory three-dimensional structure with average aperture of 46 μm.Scaffold showed gradual degradation in enzymolysis solution and enzymolysis rate reached (69.03 ± 2.19)% at 20 hours.Besides,scaffold showed stepwise disintegration in double distilled water and hydrolysis rate was (62.55 ± 1.70) % at 8 days.While,normal spinal cord showed close structure,generous neurons and myelin sheath with factor of porosity for (0.04 ± 0.02) % and water content for (62.4 ± 1.5) %,and unobvious pore structure under scanning electron microscope.Normal spinal cord were degraded gradually in enzymolysis solution and enzymolysis rate was (37.62 ± 0.9)% at 20hours.In the meantime,normal spinal cord were disintegrated gradually in double distilled water and hydrolysis rate was (40.97 ± 0.81) % at 8 days.Conclusions Acellular spinal cord scaffold prepared by sonic oscillation plus chemical extraction achieves complete removal of cell components,intact extracellular matrix,and satisfactory results in three-dimensional network structures,factor of porosity and water content.Also,the scaffold meets theoretical demands of tissue-engineered spinal cord scaffold and is an ideal alterative for tissue-engineered spinal cord scaffold.
4.Correlation among plasma levels of fibrinogen, D -dimer and AT III and carotid atherosclerosis in AMI patients
Liang XU ; Jun REN ; Chaodan JIANG ; Wen WANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2016;25(6):580-584
Objective:To explore the correlation among plasma levels of fibrinogen (Fg) ,D-dimer (DD) and antithrombin III (ATIII ) and carotid atherosclerosis (CAS) in AMI patients .Methods:A total of 147 AMI patients treated in our de‐partment from Jan 2012 to Dec 2014 were enrolled as AMI group ,another 120 patients without myocardial infarction (MI) were treated as control group .According to ACS severity ,AMI group was further divided into normal group (n=22) ,mild group (n=30) ,moderate group (n=40) and severe group (n=55) .Plasma levels of Fg ,DD and ATIII ,and carotid inti‐ma-media thickness (IMT) were measured and compared among all groups .Results:Compared with control group ,there were significant rise in plasma levels of Fg [ (3.12 ± 0.87) g/L vs .(5.01 ± 1.38) g/L] ,DD [ (317 ± 50)μg/L vs .(1530 ± 218)μg/L] and carotid IMT [(0.86 ± 0.41) mm vs .(1.12 ± 0.29) mm] ,and significant reduction in plasma AT Ⅲ level [ (87 ± 18)% vs .(76 ± 19)% ] in AMI group , P<0.01 all. Compared with normal group ,there were significant rise in plasma levels of Fg and DD ,and significant reduction in plasma ATIII level in moderate group and severe group , P<0.05 or <0.01. Spearman correlation analysis indicated that plasma Fg and DD levels were significant positively correlated with CAS severity (r=0.426 ,0.535 ,P<0.01 both) ,ATIII level was significant inversely correlated with CAS severity in AMI patients ,(r= -0.438 ,P=0.005) .Multi-factor Logistic regression analysis indicated that plasma Fg and DD levels were independent risk factors for MI (OR=2.836 ,2.231 , P<0.01 both) ,and plasma ATIII level was independent protective factor for MI (OR=0.899 , P=0.014 ) .Conclusion:Plasma Fg and DD levels are independent risk factors for MI and plasma ATIII level is independent protective factor for MI .
5.Free vascularized fibular graft bridged vascular pedicle by vein transplantation for infective long bone defect recon-struction
Gaohong REN ; Guiyong JIANG ; Gang WANG ; Bin YU
Chinese Journal of Orthopaedics 2015;(8):833-841
Objective To explore the surgical method and curative effect of free vascularized fibular graft bridged vascu?lar pedicle by vein transplantation for infective long bone defect with or without soft tissue defect reconstruction. Methods From June 2008 to January 2014, 17 patients with infective long bone defect were treated, 11 male and 6 female, 1.5 to 55 years old and averaged 31.3 years. 8 cases in femur, 5 cases in tibia, 3 cases in humerus and 1 case in radius. Bone defect were 4 to 19 cm in length with an average of 9.4 cm. 8 cases with soft tissue defect, from 5.0 cm×3.0 cm to 17.0 cm×5.5 cm. Required adequate surgi?cal debridement, and vacuum sealing drainage (VSD) was used. Free vascularized fibular (skin) flap was designed and harvested . Artery and veins close to the health site were dissected, and bridged vascular pedicle of free vascularized fibular flap by autolo?gous vein transplantation with end to end anastomosis. The length free vascularized fibular graft was from 5 to 18 cm, with an aver?age of 9.6 cm. The free fibula flap ranged from 6.5 cm×4.0 cm to 18.0 cm×6.0 cm. Results All the 17 cases of fibular flap sur?vived, no vascular crisis happened. Post?operative wound primary healed in 11 cases, delayed 1 to 2 weeks to heal in 6 cases. Cal?lus was seen in the 6 to 8 weeks later. 15 cases were followed from 9 months to 6 years (averaged 30 months) while 2 cases were lost to follow?up. Bone defect primary healed in 13 cases, and the fibula graft unhealed in 2 cases, but healed again after a second operation. Fibula stress fracture occurred in one case at 7 months after grafting procedures and bone union was achieved 4 months after reapplying an external fixator. Infected bone defect healing time ranged from 4.2 to 9.8 months, averaged 5.9 months. Accord?ing to the Enneking score, 11 cases were excellent, good in 3 cases, one in fair. Excellent and Good rate was 93.3%. Conclusion Free vascularized fibular (skin) graft with vein bridged vascular pedicle can not only effectively repair infected bone and soft tissue defect, but also improve local blood supply and control infection, shorten the course of treatment, which is an effective treatment of infective long bone defects with or without soft tissue defects.
6.Design on the performance evaluation framework of district and county health system in Shanghai
Jianlin REN ; Libo JIANG ; Ying PENG ; Jianping WANG ; Kan ZHANG
Chinese Journal of Medical Science Research Management 2014;27(4):388-391
Shanghai district and county health system performance evaluation conceptual frameworkwas proposed based on health services system performance assessment frameworks raised by some countries and international organizations,and combined with Shanghai district and county health system characteristics.This framework contains two first grade indices and seven second grade indices:In the long term goals,'health','satisfaction' and 'disease risk protection' are the county's longterm effects of health system performance assessment dimensions; in the medium-term goals,the'accessibility','cost',' efficiency' and 'quality' are the county' s medium-term effects of health system performance assessment dimensions.This study aimed to evaluate Shanghai county health system's overall performance.Further study is needed in constructing its third grade indices.
7.Application of large field diffusion-weighted imaging in the detection of bone metastases of malignant tumors: comparison with bone scintigraphy
Chunyan ZHANG ; Zhuanqin REN ; Hongyue SUN ; Xiaoying WANG ; Xuexiang JIANG
Chinese Journal of Medical Imaging Technology 2009;25(7):1258-1261
Objective To evaluate large field diffusion-weighted imaging (DWI) in detection of bone metastases of malignant tumors. Methods Eighteen patients with various malignant tumors were enrolled in this study. All the patients underwent large field DWI and 99mTc-MDP bone scintigraphy within one month. Results Fifteen of 18 patients were diagnosed as bone metastases with conventional MRI; 7 of them were found more than 10 bone metastases, and 23 bone metastases were confirmed in the other 8 patients. When seven patients with multiple bone metastases (>10) were excluded, and lesions in the residual 11 patients with or without bone metastases were counted, the diagnostic sensitivity of bone metastases with large field DWI and bone scintigraphy was both 100%, and specificity were 100% and 33.33%, respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 1.00 and 0.67, respectively (P=0.04). With lesion numbers as study unit, the diagnostic sensitivity of large field DWI and bone scintigraphy were 86.96% and 78.26%, and the specificity was both 60.00%. ROC study showed the AUC of large field DWI and bone scintigraphy was 0.74, 0.69, respectively; and no statistical difference was found. Conclusion Large field DWI can be used in screening the bone metastases of malignant tumors.
8.Porto-azygous devascularization for the treatment of portal hypertension
Guang CHEN ; Jiang REN ; Guangyi WANG ; Jian SUO ; Yuquan TAN
Chinese Journal of General Surgery 1994;0(05):-
Objective To evaluate pericardial devascularization with splenectomy (PCDV) for the treatment of cirrhotic portal hypertension. Methods From January 1994 to December 2004, 177 patients were treated by PCDS, among them posthepatitic cirrhosis was identified in 170 cases, and alcoholic cirrhosis in 7. One hundred and thirty two patients were operated on electively, 25 prophylactically, and 20 emergently. Results The bleeding control rate was 95% , the overall operative mortality rate was 4. 5%. The main causes of death were upper gastrointestinal bleeding, hepatic failure and intra-abdomimal hemorrhage. The mean follow-up time was 3. 6 years. The 5-year survival rate was 90%. The 5-year recurrent bleeding rate was 5. 1% , The rate of postoperative hepatic encephalopathy was 5. 1%. Conclusions This procedure has the advantage of high successful rate of bleeding control, low complication rate, and long term survival.
9.Application of rapid sequence induce nasotracheal intubation with fiberoptic bronchoscope in patients with cervical vertebra injury
Cehua OU ; Xian JIANG ; Changhe REN ; Xiaobin WANG
Chinese Journal of Postgraduates of Medicine 2008;31(30):25-27
Objective To compare the appfication of rapid sequence induce nasotracheal intobation with awake nasotracheal intubation with fiberoptic bronchoscope (FOB) in patients with cervical vertebra injury.Methods Forty patients with cervical vertebra injury were randomly divided into group (rapid sequence induce nasotracheal intubation with FOB) and group II (awake nasotracheal intubation with FOB),20 patients in each group.Bp,HR,SpO2 before and during intubation,intubafion time and cases of re-intubation were observed.Results SpO2 maintained normal during intubation.Between group I and group II,there was no significance in intubation lime [(3.12±0.52)min and (3.34±0.65)mini and cases of re-intubafion (2 cases and 1 case) (P > 0.05 ).During intubation,MAP and HR inceased significantly in group II than those in group I (P < 0.05 ).Conclusion The application of rapid sequence induce nasotracheal intubation with FOB is better than awake nasotracheal intubation with FOB in patients with cervical vertebra injury,it is safe and valid.
10.Analysis of the UV absorbing constituents of the metabolites from UV-B tolerance bacteria and study on its anti-ultraviolet mechanism
Hongyuan WANG ; Xiaolu JIANG ; Hong REN ; Xiaoting LIANG ; Huashi GUAN
Chinese Journal of Marine Drugs 1994;0(04):-
Objective The anti-UV-B radiation mechanism of UV-B tolerance strain KFS-9 was studied from the profile of metabolites.Methods The compounds were separated by column chromatography and their structures were elucidated based on GC-MS,LC-TOF-MS,EI-MS and NMR analyses.Results Three unsaturated fatty acids(identified as 9-hexadecenoic acid,9,12-octadecadienoic acid and 11-octadecenoic acid) and 1,2-benzenedicarboxylic acid able to absorb ultraviolet were isolated from the petroleum ether extract of the fermentation liquid of Pantoea agglomerans KFS-9.Fraction(Ⅱ) was isolated from the ethyl acetate extract and was composed of 2,3-butanediol and a series of high unsaturated aroma compounds.Fraction(Ⅱ) had a wide absorption peak,and it could protect E.coli from UV-B damage in some sense.Conclusion Strain KFS-9 produced metabolites that were able to absorb UV to build a natural barrier and so improved the tolerance to UV radiation.The UV-B radiation protection test to the E.coli also showed fraction(Ⅱ) was not the only protector,and there definitely existedother materials and mechanism to protect the strain.