Objective To explore the feasibility of using human umbilical cord derived mesenchymal stem cells as seed cells to repair sciatic nerve defects of rats by tissue engineering methods. Methods Mesenchymal stem cells from human umbilical cord were cultured and induced into neuron-liked cells,which were co-cultured with acellular basal lamina tube to construct tissue engineering nerve;models of sciatic nerve defects 10 mm in length were set up with thirty healthy adult SD rats and were divided randomly into 3 groups:tissue engineering nerve group (group A, compound of human umbilical cord derived mesenchymal stem cells and acellular basal lamina tube), pure acellular basal lamina tube group (group B), and autogenous nerve bridging group (group C). Evaluation of electrophysiological and histological results was carried out 10 weeks after operation. Results The engineering nerve group had good result in nerve regeneration which was close to the effect of autogenous nerve transfer group (group A), and much better than the effect of pure acellular basal lamina tube group. Conclusion Engineering nerves from human umbilical cord derived mesenchymal stem cells can effectively repair 10 mm defects of sciatic nerve.

Objective To explore the methods of therapy in lung cancer patients with bone metastases, and evaluate the effects and side effects of Strontium-89 palliative therapy in lung cancer patients with bone metastases. Methods About 56 cases of bronchiogenic cancer patients with bone metastases who did not receive any radiotherapy, according to 1.48×10~7 Bq/person/time, using standard intravenous injection ~(89)Sr as treatment. Follow-up 6 months, assess according to the following parameters: pain and frequency of pain were given quantized value and got pain score, using T test for comparing the pain score. According to before and after treatment bone imaging showed the size of focus and change of the number, upgrade focus therapy effect. Examine (CEA) and (NSE), using T test for changes before and after treatment. Using T test for changes of LEU and platelet after treatment. Results After treatment for 6 months, for 77 % patients are alleviating pain (43/56), the pain went off of 13 patents, account for 23 percent of the total. The pain score from 7.3±3.6 before treatment decrease to 5.3±3.4 after treatment, dropping obviously. After treatment, the focus regressed in 14 cases, decreased in 5 cases, total efficiency is 34 %. Before and after treatment, CEA from (33.64±18.15)μg/L obviously decreased to (t=4.26, P<0.01) to (21.36±11.65) μg/L, NSE from (27.16±10.12) μg/L obviously decreased to (t=4.26, P<0.05) to (12.56±4.23) μg/L. After treatment, LEU and platelet decreased to the lowest, LEU decreased about 27.9 %, platelet decreased about 19.7 %, after 3 months,normal rate of blood picture is 75 %(42/56). Conclusion The method of strontium-89 palliative therapy in lung cancer patients with bone metastases is good, safe and has little side effects, it can improve the quality of patients life.

Objective To analyze the CT features of intestinal tumor obstruction, and explore its CT value.Methods CT manifestation and clinical materials of intestinal tumor obstruction proved by surgical findings or endoscopy biopsy in 35 cases were analyzed restrospectively, and compared with the results of surgery-pathology and endoscopy. Results CT findings were consistence with the results of surgery-pathology and endoscopy in 33 of 35 cases. The CT diagnostic accuracy of intestinal obstruction was 100%. And the accuracy of the cause was 94%, including colon carcinoma in 25, lyphoma in 5, gastrointestinal stromal tumor in 2, and lipoma in 3.Conclusion CT has unique advantage in examining intestinal tumor obstruction, not only for definiting the existence of the obstruction, but also locating the site of obstruction diagnosing the cause and chosing the appropriate treatment.

Objective To investigate the diagnostic Value of multi-slice spiral CT 3-Dimensional reconstruction in intestinal obstruction.Methods 28 Patients with malignant lesions of colon underwent volume scanning using multislice helical CT.Four types of reconstruction included multiple planner reconstruction(MPR),CT virtual colonoscopy(CTVC),shaded surface display(SSD)and raysum.The results were compared with those of colonoscopy and patholog.Results CT diagnostic accurate rate was 100%,and the accurate rate of the cause was 96% in intestinal obstruction,including primary or secondary neoplasms(18/28),abhesions(2/28),bowel torsion(2/28)and external or internal hernias(3/28) and gallstone ileus(3/28).Conclusion There were advantages and disadvantages in diagnosis of mechanical intestinal obstruction with MPR,CTVC,SSD and Raysum respectively.The combined use of the four post-processing technigues can be more helpful to precise localizing and qualitative diagnosis of lesions.MPR should be the optimal post-processing technigues for the diagnosis of intestinal obstruction

0.05),but the level of P- selectin in treatment group were obviously decreased compared with control group after the seventh and fourteenth day(P

Objective To evaluate the efficacy of phloroglucinol combined with dyclonine hydrochloride mucilage in preventing catheter-related bladder discomfort (CRBD)during recovery from anesthesia in patients under general anesthesia.Methods A total of 120 male patients scheduled for laparoscopic cholecystectomy under general anesthesia,aged 18-60 years,weighing 46-80 kg, ASA physical status I or II,were randomly divided into 3 groups (n=40 in each group):group of combination of phloroglucinol and dyclonine hydrochloride mucilage (group P),sufentanil group (group S)and control group (group C).After induction of general anesthesia,the patients in group P were tracheally incubated and then inj ected with 5 ml dyclonine hydrochloride mucilage per urethra.In the meantime,for patients of groups S and C,equal volume of normal saline was inj ected and paraffin oil was used to lubricate for urethral catheterization.The catheter was clamped and then reopened 30 min later.At 15 min before the end of surgery,80 mg Phloroglucinol,0.10 μg/kg sufentanil and an equal volume of normal saline were injected intravenously in group P,group S and group C,respec-tively.The catheter was removed when the patients were fully awake.The awakening time and extu-bation time were recorded.In addition,Riker sedation-agiation scale (SAS)score was documented at 5 min (T1),15 min (T2),30 min (T3),1 h (T4)and 2 h (T5)after extubation.The occurrence and severity of CRBD within 2 h after surgery,as well as occurrence of nausea and vomiting and respira- tory depression were recorded.Results Compared with group C,the SAS score at T1-T4and inci-dence and severity CRBD were decreased,whereas the emergence time and extubation time were pro-longed in group S.The SAS score at T1-T5,incidence and severity of CRBD were decreased (P<0.05),and no significant change was found in emergence time and extubation time in group P.Com-pared with group S,the SAS score at T1-T4was increased,whereas the SAS score at T5,incidence and severity of CRBD were decreased,and the emergence time and extubation time were shortened in group P (P<0.05).There was no significant difference in the incidence of nausea and vomiting,re-spiratory depression and extubation time among the three groups. Conclusion Dyclonine hydrochloride mucilage injected per urethra combined with phloroglucinolol injected intravenously at 1 5 min before the end of surgery can reduce the incidence and severity of CRBD during the recovery from anesthesia in the patients under general anesthesia.

Objective To summarize the microsurgical techniques for removal of large neoplasms located in the suprasellar,back of sellar region and anterior part of third ventricle through bilateral frontobasal interhemispheric approach.Methods Fifty-six patients with large neoplasms located in the suprasellar,back of sellar region and anterior part of third ventricle,admitted to our hospital from January 2002 to January 2013 and performed removal via bilateral frontobasal interhemispheric approach; their clinical data and treatment efficacy were analyzed retrospectively.The microsurgical techniques were summarized,and the factors affecting the prognosis were analyzed.Results Total removal of the tumors was achieved in 49 patients (88％) and subtotal removal in 7 (12％).The pituitary stalk was reserved in 47 patients (84％),severed in 4 (7％),and unidentified in 5 (9％).The bilateral olfactory nerves were successfully preserved in 50 patients (89％) and unilateral severed in 6 (11％).Visual impairment was found in 41 patients before surgery,39 of them achieved postoperative visual improvement and 2 patients had no change during the follow-up at 6 months.In our series,there were no procedure-related mortalities and bacterial meningitis.Unilateral anosmia was detected on examination in 2 patients.Minimal frontal lobe contusion developed in 2 patients but resolved within 3 weeks.Cerebrospinal fluid leakage occurred in 1 patient,which was cured for 2 week.Transient diabetus insipidus developed in 25 patients but resolved within 1 month; permanent postoperative diabetes insipidus was present in 5 patients during the follow-up at 6 months.During the follow-up of 12 months,56 patients (100％) gained Glasgow outcome scale (GOS) scores of 5,only 4 (7％) patients with tumors resected partially had tumor relapse and received surgery again.Conclusions The bilateral frontobasal interhemispheric approach is appropriate for removing tumors located in the suprasellar,back of sellar region and anterior part of third ventricle.With sufficient exposure of lesion,the important anatomic structures such as the pituitary stalk,hypothalamic structure,perforating vessels,anterior communicating complex,the visual pathway,and the olfactory nerves could be preserved effectively.The surgery via this approach can increase total removal rate of the tumors,decrease the complications and achieve a good outcome.

Objective To evaluate Evans lateral lengthening calcaneal osteotomy(E-LLCOT) in the treatment oftalocalcaneal coalitions (TCCs) with forefoot abduction deformity in the teenagers.Methods From February 2014 to August 2018,11 teenaged patients (14 feet) were treated at Department of Foot and Ankle Surgery,Zhengzhou Orthopaedics Hospital for TCCs with severe forefoot abduction deformity.They were 6 males (8 feet) and 5 females (6 feet),aged from 13 to 17 years (average,15 years).Their diseases involved bilateral feet in 3 cases and unilateral foot in 8,the left foot in 7 cases and the right in 7.All patients underwent TCCs resection followed by E-LLCOT.Their talonavicular coverage angles (TCA) and talar-second metatarsal angles (T2-MT) on the anteroposterior film and talar horizontal angles (TH) and talar-first metatarsal angles (T1-MT) on the lateral film were measured preoperatively and at the last follow-up.The foot functions were evaluated preoperatively and at the last follow-up using the ankle-hindfoot scores of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS).Results All the 11 patients were followed up for 12 to 24 months (average,16.5 months).The mean preoperative TCA (22.3°,from 20° to 26°) was improved to 10.5° (from 8° to 13°) at the last follow-up;the mean T-2MT was improved from preoperative 17.6° (from 16° to 20°) to 6.5° (from 5° to 11°) at the last follow-up;the mean TH on the lateral view was improved from preoperative 35° (from 25° to 40°) to 17.5° (from 16° to 21°) at the last follow-up;the mean T-1MT was improved from preoperative 15.5° (from 10° to 22°) to 3.5° (from 2° to 6°) at the last follow-up;the mean AOFAS score was improved from 56.5 (from 50 to 62) preoperatively to 90.6 (from 75 to 95) at the last follow-up;the mean VAS score was improved from 6.0 (from 5 to 7) preoperatively to 2 (from 0 to 3) at the last follow-up.Conclusion For TCCs with severe forefoot abduction deformity in the geenagers,E-LLCOT after TCCs resection can effectively correct deformity,relieve pain and achieve significant functional and radiographic improvements.

Objective:To analyze the therapeutic effect of ankle arthrodesis with reverse proximal humerus internal locking system plating plus cannulated screwing via the transfibular approach in the treatment of end-stage ankle arthrosis.Methods:From April 2014 to January 2018, 19 patients (19 ankles) with end-stage ankle osteoarthritis were treated at Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital by ankle arthrodesis with reverse PHILOS plating plus cannulated screwing via the transfibular approach for multi-plane fixation. They were 9 men and 10 women, aged from 36 to 65 years (average, 46.7 years). The disorder was further diagnosed as traumatic arthritis in 9 cases, as osteoarthritis in 6, as talar necrosis in 2 and as equinovarus in 2, and affected the left ankle in 11 cases and the right in 8. All cases belonged to stage Ⅲ osteoarthritis according to the Morrey-Wiedeman imaging classification. Their American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), joint fusion and complications were observed preoperatively and at the last follow-up.Results:All the 19 patients were followed up for 18 to 62 months (average, 31.5 months). Their AOFAS scores were improved from preoperative 46.3±2.1 to 81.6±0.9 at the last follow-up, and their VAS was reduced from preoperative 7.1±0.2 to 2.0±0.2 at the last follow-up, showing significant differences ( P<0.001). All their ankle joints obtained bony fusion after 9 to 14 weeks (mean, 11.5 weeks). No implant loosening or breakage was observed. All the patients were satisfied with their operative results at the last follow-up. Dorsal lateral foot numbness was observed in one patient who became asymptomatic after neurotrophic medication for 3 months. Lateral distal wound dehiscence happened during removal of stitches at 2 weeks after operation in another patient but healed after debridement. The last follow-up found subtalar joint degeneration in 2 cases and talonavicular joint degeneration in one but no clinical symptoms in the 3. Conclusion:Ankle arthrodesis with reverse PHILOS plating plus cannulated screwing via the transfibular approach is a fine treatment for end-stage ankle arthrosis, because it leads to reliable fixation, short fusion time, alleviated pain and improved ankle function.

Objective:To explore the outcome of sponge forceps assisted threading with Speedbridge technique for the treatment of acute closed Achilles tendon rupture.Methods:A retrospective case series study was conducted on 20 patients with acute closed Achilles tendon rupture treated in Zhengzhou Orthopedic Hospital from December 2019 to December 2021. There were 18 males and 2 females, with age range of 24-43 years [(29.5±7.6)years]. All patients were with unilateral injury, involving the left side in 13 patients and right side in 7. Examinations revealed a palpable defect in the Achilles tendon and positive Thompson test. A longitudinal incision was made at the medial edge of the ruptured tendon. Three nonabsorbable sutures were passed through the proximal stump with sponge forceps, bypassed the rupture site and fixed directly into the calcaneal bone. The disrupted tendon ends were aligned by the tendon-bundle technique using 4-0 absorbable sutures. The operation time and incision length were documented. The ankle joint range of motion (dorsiflexion/plantar flexion), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles tendon total rupture score (ATRS) in the affected and healthy side were compared at 3, 6 and 12 months postoperatively. The wound healing and complications were observed.Results:All patients were followed up for 12-16 months [(13.2±2.5)months]. The operation time was 40-66 minutes [(52.0±10.3)minutes], with the incision length of 3-4 cm [(3.3±0.7)cm]. In the affected side at 3 and 6 months postoperatively, the ankle joint dorsiflexion [(5.6±1.5)°, (10.5±0.2)°] and plantar flexion [(28.4±3.2)°, (33.5±1.5)°] showed statistically significant difference compared with the healthy side (all P<0.05). The ankle joint dorsiflexion [(13.9±0.7)°] and plantar flexion [(38.3±4.4)°] in the affected side were not statistically different from that of the healthy side at 12 months postoperatively (all P>0.05). The AOFAS ankle-hindfoot score was (58.3±5.4)points, (84.9±7.1)points and (91.8±6.3)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). The ATRS was (60.5±4.9)points, (85.5±9.0)points and (93.1±5.7)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). All incisions were healed primarily. No patients had wound infection, nerve injury or re-rupture. Pain at the anchor insertion site occurred in 2 patients at 1 month after operation and relieved after active functional rehabilitation at 4 months after operation. Transient pain at the Achilles tendon insertion occurred in 1 patient at 6 months after operation, and relieved after 2 weeks of oral non-steroidal anti-inflammatory drugs treatment. Conclusion:For acute closed Achilles tendon rupture, sponge forceps assisted threading with Speedbridge technique can attain short operation time, small incision and good functional recovery, with few complications.