To improve higher training quality and capacity of orthopedic postgraduates,early contact education,problem-base learning combined with co-supervisor with radiologists were engaged for orthopedic postgraduates since 2008.Effect of the practice was assessed by postgraduates one year later.Investigation revealed that practice aroused learning enthusiasm and initiative,promoted comprehensive understanding of orthopedic knowledge,set up social responsibility,and constructed innovative thinking.

BACKGROUND: Negative pressure of limbs is a convenient, safe and unwound way to treat peripheral arterial occlusion and to relieve pain.Prostaglandin E1 can directly rellax vascular smooth muscles and relieve pain on nerve.OBJECTIVE: To observe the effect of negative pressure of limbs immunologic reaction positive nerve fiber of prostaglandin E1 in sensory nerve fiber of central nervous system of dogs with peripheral arterial occlusion.DESIGN: Randomized controlled animalstudy.SETTING: Tumor Center of Zhujiang Hospital affiliated to Southern Medical University, the Third General Surgery of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Animal Laboratory of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA from April 2003 to May 2004. A total of 17 healthy adult hybrid dogs were randomly divided into three groups: treatment group (n=10),non-treatment group (n=5) and normal control group (n=2), according to randomly digital table.METHODS: Ischemic models of left hindlimb were established in treatment group and non-treatment group. Fourteen days later, dogs in treatment group were given negative pressure (-12kPa) treatment for 15 minutes. The negative pressure was done once a day for 10 successive days.However, negative pressure was not done in non-treatment group. Animals were not interfered in normal control group.MAIN OUTCOME MEASURES: Twenty-four days later, dogs in each group were anesthetized and sacrificed. L1-L5 spinal cord and ganglia of dorsal root were selected and stained with immunohistochemical method to detect average giay value of immunologic reaction positive nerve fiber of prostaglandin E 1.RESULTS: A total of 17 dogs were involved in the final analysis. Average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord were 75.23±4.3 in non-treatment group, 43.22±3.7 in treatment group and 22.00±5.8 in normal control group; average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in ganglia of dorsal root were 67.12±2.3, 40.08±3.8, 27.64±2.7, respectively.There was no significant difference among the three groups (P＜0.01).CONCLUSION: After onset of peripheral arterial occlusion, amount of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord and ganglia of dorsal root of distal limbs is increased remarkably, and this may be a kink of auto-protective mechanism of organism. Negative pressure can relieve pain of limbs and decrease damaged-stimulated transmission of peripheral arterial occlusion.

Study the immunological adjuvant function of biodegradable microspheres for DNA immunization. Empty poly(D,L-lactide-co-glycolic acid) microspheres were prepared using the water-inoil-in-water(w-o-w)technique; A plasmid DNA pRc-CMV encoding hepatitis B virus S antigen was constructed;The mixture of the microspheres and the plasmid DNA was prepared by incubation method. The mixture was administered to Balb/c mice by intramuscular injection. Result: The high antibody titer (1:1600) of intramuscular injection of the mixture of microspheres and the plasmid DNA was obtained, similar to that of intramuscular injection of the mixture of AL(OH)3 and hepatitis B virus S antigen; while intramuscular injection the plasmid DNA elicited no serum antibody respones. Conclusion: biodegradable microspheres may be used as an good adjuvant for DNA immunization.

Objective To investigate the clinical application of anti-β2 glyeoprotein Ⅰ antibodies (IgG, IgM, IgA)in systemic lupus erythematosus(SLE). Methods The anti-β2-GP Ⅰ antibodies and anti-cardiolipin antibodies(ACL) level were measured by ELISA in 100 SLE patients, 39 other rheumatoid arthri-tis patients and 30 healthy control people. Their clinical application was analyzed in SLE diagnose and thera-py. Results The level of anti-β2-GP Ⅰ (IgG, IgM, IgA)were significantly higher in SLE than that in healthy (P < 0. 01 ). Sensitivity, specificity, positive predictive value and negative predictive value were 17.2%, 95.7%, 85.0% and 44. 6%, respectively. There was a significant and positive correlation be-tween anti-β2-GP Ⅰ antibodies and ACL antibodies ( IgG, IgM, IgA) (r = 0.418, 0. 624, 0.518, 0. 583, P <0.01). In multivariate analysis the factors(anti-β2-GP Ⅰ antibodies, ACL antibodies, dsDAN, u1-RNP, Sm, SSA, SSB, Jo-1, Scl-70, P-protein, PT, APTT) associated with SLE disease activity index(SLEDAI) were anti-β2-GP Ⅰ (IgG) and dsDNA. Conclusion anti-β2-GP Ⅰ antibody has high specificity and positive predict value, also is associated with SLE's thrombosis. It has some values in the clinical application.

Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.

Objective To explore the therapeutic effects of pure collagenase injection and collagenase combined with herniation injection of ozone on the treatment of lumbar disc herniation(LDH).Methods According to the principle of randomized controlled double blind, 100 patients with LDH were divided into 2 groups:pure collagenase group and combined treatment group.Changes of NRS value and Macnab score were observed and recorded at multiple time points after operation.The difference of the effect of the two kinds of operation was analyzed.Results Among the 50 patients in the simple treatment group,3 patients were lost to follow-up.Among the 50 patients in the combined treatment group,2 patients were lost to follow-up,and open surgery in 2 patients because of poor efficacy after the injection of 3 months and 6 months respectively.By analyzing the change of NRS value and Macnab score of 2 groups patients,there was no significant difference in the short-term and long-term efficacy between the 2 groups(P>0.05);The symptoms of the 2 groups were improved after operation.The curative effect was positively correlated with the recovery time, and the difference was statistically significant (P<0.05).Conclusion The curative effect of pure collagenase injection and the combined with herniation injection of ozone are both significant, and there is no significant difference in the clinical efficacy between the 2 kinds of operations.

Objective:To explore the predictive factors of intestinal necrosis in acute mesenteric ischemia.Methods:This retrospective study enrolled 81 patients diagnosed as acute mesenteric vascular occlusive diseases in Zhongshan Hospital, Fudan University between Nov 2012 to May 2017. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis.Results:In univariate analysis, the predictive factors of intestinal necrosis were peritoneal irritation sign ( P<0.001), white blood cell count ( P<0.001), serum albumin ( P=0.028), blood creatinine ( P=0.025), serum lactic acid ( P=0.008), D-dimer ( P=0.037), intestinal pneumatosis ( P=0.017), decreased or disappeared enhanced bowel wall ( P<0.001) and bowel loop dilation>2.5 cm ( P=0.01) on CT scan. According to multivariate logistic regression analysis, white blood cells ( OR=3.60, 95% CI: 1.51-5.47, P=0.007), lactic acid ( OR=4.80, 95% CI: 1.36-9.89, P=0.032), reduced or disappeared enhanced bowel wall ( OR=10.57, 95% CI: 1.82-61.10, P=0.008) were independent predictive factors of intestinal necrosis in patients with acute mesenteric ischemia. Conclusions:The predicted risk factors for intestinal necrosis in mesenteric ischemic diseases are increased white blood cells, elevated serum lactate levels, and reduced or disappeared enhanced bowel wall on CT scan.

Objective To evaluate operative effect on internal rectal prolapse. Methods Sixty-two patients with internal rectal prolapse who underwent operation were studied by retrospectively analyzing the treatment and followed up results. Results The total success rate of surgical treatment for internal rectal prolapse is 73%. The rate of symptoms improvement as difficulty in defecation,anal aboating, incomplete defecation,asistation with fingers,and defecating dependent on laxatives were 77%,80%,71%,86%,97% respectively. Conclusion the operative indications of internal rectal prolapse should be strictly controlled. Only those who received standard conservative treatment and failed to improve should be a candidate for surgery.

Objective The existing Quality Standards for Qianliean Capsules lack the quantitation control item and therefore cannot completely reflect the quality of the preparation .This study aimed to establish the methods for qualitation and quantitation of Qianliean Capsules . Methods Thin-layer chromatography ( TLC) was used for the qualitative identification of Radix Salviae miltior-rhizae, Rhizoma curcumae, and Glycyrrhiza uralensis in Qianliean Capsules .The content of hesperidin was determined by high-per-formance liquid chromatography ( HPLC) , and the method of determination was systematically evaluated . Results TLC spots were clear with a strong specificity .The content of hesperidin showed a good linear relationship within the range of 11 .56-310 .00μg/mL (r=0.999 5), with a mean recovery rate of 99.55% and relative standard deviation of 1.93%. Conclusion The qualitation and quantitation methods we established were simple , accurate and reliable , with a good reproducibility , and can be used for the quality control of Qianliean Capsules .

For recent two decades,radiofrequency ablation technology(RFA)has made great progress in the field of the treatment for diseases for its distinguishing characteristic of microtrauma,targeted,effective and almost having no side-effect.At the very beginning,radiofrequency ablation was adopted in treating solid tumors,and since then it has been gradually practiced in treating benign diseases of solid organs such as hypersplenism,prostatic hyperplasia and widely used in almost every system of the body.Here,we review its therapic principle,types and clinical application.