BACKGROUND:Compared with hydroxyapatite materials and other nano-hydroxyapatite composites, carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composites have been significantly improved in the mechanical strength, toughness, elastic modulus and other aspects. It can be used for repairing bone defects of loading parts. OBJECTIVE:To investigate the biocompatibility of carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composites in bone tissues. METHODS:Eight Bama mini pigs were taken to establish models of thoracic vertebral defects and implanted with carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composites. At 8, 16 and 24 weeks after implantation,the animals were sacrificed, respectively, for bone mineral density detection and hematoxylin-eosin staining. Blood samples for kidney and liver function tests were taken before and 1 and 8 weeks after implantation. RESULTS AND CONCLUSION: Hematoxylin-eosin staining of bone samples showed that the materials could bond with the bone defect interface without rejection, and could induce osteogenesis of chondrocytes. At 8 weeks after surgery, the broken ends of cancelous bone closed and the composite material was wrapped by granulation tissues. At 16 weeks after surgery, granulation tissues were organized and new bone developed directly from fibroblast cels. The new bone tissues were nearly fused with the end of cancelous bone. At 24 weeks after surgery, new bone tissue became mature lamelar bone, and the end of cancelous bone was connected tightly with the composite material. Bone mineral density of the implanted vertebra showed an increase trend at 8, 16 and 24 weeks after implantation. Over time, the bone mass was increased. The liver and kidney function tests showed that there was no significant difference before and after implantation. It is preliminarily believed that the carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composite has excelent histocompatibility and bioactivity without hepatic toxicity and nephritic toxicity.

BACKGROUND:There is controversy on the treatment of old femoral neck fracture with hemiarthroplasty.
OBJECTIVE:To observe the clinical effect of cementless hemiarthroplasty in the treatment of old femoral neck fracture, and to compare with total hip arthroplasty.
METHODS:A retrospective analysis was performed on the clinical data of 23 old femoral neck fracture patients treated by artificial joint replacement from January 2009 to June 2010. Among the 23 patients, 11 cases were treated with cementless hemiarthroplasty, and 12 cases were treated with total hip arthroplasty. The time for off-bed activity, Harris score and the incidence of perioperative complications were compared between cementless total hip arthroplasty and hemiarthroplasty.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-18 months. The active straight leg raising angle, time for off-bed activity, incidence of early postoperative complications and Harris score at 1 week after treatment of the cementless hemiarthroplasty group were better than those of the total hip arthroplasty group;there were no significant differences in Harris score at 6 weeks, 3 and 6 months between two groups;the incidence of forward hip pain of the cementless hemiarthroplasty group was higher than that of the total hip arthroplasty group. So, we general y think that cementless hemiarthroplasty has better short-term effect in the treatment of old femoral neck fracture, but the long-term integrated efficacy needs to be further identified.

Objective To investigate the relationship between antipituitary antibodies (APAs) and hypopituiarism following traumatic brain injury (TBI),as well as the severity of brain injury.Methods The study included 73 patients who suffered TBI 9 to 12 months ago and were diagnosed with hypopituitarism during the follow-up.Based on their Glasgow Coma Scale (GCS) on admission they were categorized into three groups:A (3-8),B (9-12) and C (13-15).Levels of plasma pituitary hormones (GH,TT,FT3 and FSH/LH) and APAs were measured in all patients with chemiluminescence assays and ELISA,respectively.Results Patients in group A had higher levels of APAs and lower levels of hormones compared with those in group B(P＜0.001) or group C(P＜0.001),while no significant difference was found between group B and group C for levels of either APAs (P＞0.05) or hormones (P＞0.05).Levels of APAs were negatively correlated with both GH (r=-0.64071,P＜0.001) and GCS (r=-0.50132,P＜0.001).Conclusion The present investigation provides preliminary evidence that APAs may be associated with the development of TBI-induced hypopituiarism.It suggests that the severity of hypopituiarism following TBI could be predicted by measuring the level of APAs.

Objective To explore the ideal choice of feeding artery which is used for regional arterial infusion (RAI) in severe acute pancreatitis. Methods Forty-five patients with SAP were treated with RAI. The ideal feeding artery was that can supply entire pancreas according to arteriography and can maximize concentration of drug at pancreatic tissue. The pancreatic arteriography was considered as the final objective evidence for choice. Results (1)Gastroduodenal artery was chosen as feeding artery in forty-four cases, and superior mesenterlc artery was chosen in only one case because of vascular abnormity. (2)According to splenic arteriography, blood of splenic artery was supplied to spleen chiefly, and only partial tail of pancreas was applied by splenic artery. (3)According to celiac trunk arteriography, blood of celiac trunk could be supplied to entire pancreas, but a considerable proportion of the total blood was supplied to spleen through splenic artery and liver through hepatic artery proper.Therefore, the drug utilization index was lower. (4)According to gastroduodenal arteriography, blood of gastroduodenal artery could be supplied to entire pancrea, and almost all of the blood that contains drug flowed into pancreas. Therefore, the drug utilization index was higher. Conclusions Gastroduodenal artery is the ideal choice of artery which is used for regional intra-arterial infusion in sever acute pancreatitis. Pancreatic arteriography should be applied routinely when yever acute pancreatitis was treated with RAI.

Objective To investigate the role of substance P (SP) and its neurokinin-1 receptor (NK-1R) in the pathophysiologic process of Crohn′s disease. Methods In 23 surgical patients of Crohn′s disease and 24 healthy controls, reverse transcription polymerase chain reaction (RT-PCR) was used to determine the mRNA expression of NK-1R, Western blot analysis was used to determine NK-1R protein expression levels, and immunohistochemistry was used to localize expression of NK-1R. Results Compared with normal gut NK-1R mRNA and NK-1R protein in Crohn′s disease were overexpressed. In Crohn′s disease moderate to strong intestinal NK-1R immunoreactivity was found in the lamina propria mononuclear cells, lymphoid follicles, and the surface and crypt epithelium, lymphoid follicles, submucosal vessels, smooth muscle and myoenteric plexus neurones. Conclusions In cases of Crohn′s disease, overexpression of NK-1R may disturb neuropeptides loop balance, and may be involved in the pathophysiological change in this disease.

Objective To evaluate the diagnostic value of dual-source CT angiography (DSCTA) for intracranial aneurysms.Methods The data of DSCTA and digital subtraction angiography (DSA) were collected from 95 patients with subarachnoid hemorrhage (SAH).The efficacies of detection and description of morphologic features of intracranial aneurysms were analyzed retrospectively.Results A total of 117 aneurysms in 88 patients were detected with DSCTA.Two patients were suspected of having aneurysms,and no aneurysrms were detected in 5 patients.These patients were reexamined with DSA,4 were diagnosed as having aneurysm,and the aneurysms were not detected in 3 patients.DSA results were considered as gold standard,the specificity,sensitivity and accuracy of DSCTA for the detection of intracranial aneurysms were 100％,96.7％and 96.8％,respectively.The larger volume of intracranial aneurysm was,the higher the sensitivity of DSCTA diagnosis would be.Even for small aneurysms,the sensitivity of DSCTA diagnose was more than 90％.In addition,tmeasurement results of the maximum diameter and neck width of aneurysms measured by DSCTA were almost consistent with DSA.Condclusions SCTA is a non-invasive,quick,reliable,and effective method,and can provide accurate imaging information for surgery.The specificity and sensitivity of the diagnosis of aneurysms with DSCTA are almost the same with DSA.It has more advantages than DSA in the emergency operation of intracranial aneurysms.

Adenine ; analogs & derivatives ; Fanconi Syndrome ; Humans ; Organophosphonates

Objective To study the significance of the cerebrospinal fluid(CSF)lactate level in diagnosing neonatal bacterial meningitis(BM). Methods The CSF samples were collected from neonates admitted to Neonatal Ward of Children's Hospital of Fudan University between January 2014 and March 2015. CSF lactate and glucose con-centrations were measured with blood - gas analyzer. CSF and serum glucose levels were measured with glucometer. The enrolled neonates were divided into 2 groups based on CSF culture,CSF white blood cells(WBCs)and clinical presenta-tion:observation group(neonates with BM)and control group(neonates without BM). Statistical analysis of data was performed with Stata 12. 0. Results A total of 93 infants(16 assigned to observation group and 77 assigned to control group)met the inclusion criteria. Neonates in observation group had higher median CSF lactate level(4. 2 mmol/ L)and CSF lactate/ glucose ratio(L/ Gcsf)(2. 32 mmol/ L),than those in control group(1. 3 mmol/ L,0. 52),and there were significant differences(Z = - 6. 19,- 5. 92,all P ﹤ 0. 05). CSF glucose levels were lower in observation group(me-dian,1. 25 mmol/ L)than those in control group(median,2. 5 mmol/ L),and the difference was significant(Z = 4. 97, P ﹤ 0. 05);CSF/ serum glucose ratio(CSF/ Sglu)were lower in observation group(median,0. 44 vs 0. 81 in control group),and the difference was significant(Z = 4. 43,P ﹤ 0. 05). The optimal CSF lactate cutoff point of 2. 2 mmol/ L had a positive predictive value(PPV)of 72. 7% and negative predictive value(NPV)of 100. 0% for bacterial meningi-tis. The optimal L/ Gcsf cutoff point of 1. 24 had a PPV of 94. 1% and NPV of 100. 0% . The optimal CSF glucose cutoff point of 2. 0 mmol/ L had a PPV of 65. 0% and NPV of 95. 9% . The optimal CSF/ Sglu cutoff point of 0. 6 had a PPV of 60. 0% and a NPV of 96. 9% . Conclusion CSF lactate may be an excellent biomarker for early diagnosis of neo-natal BM.

Objective To explore the curative effect of transurethral resection combined with pirarubicin infusion in the treatment of superficial bladder tumor. Methods From June 2010 to June 2012 in our hospital undergoing transurethral resection after treatment combined with pirarubicin instillation for the treatment of superficial bladder tumor in 32 cases , set up in the observation group, the otherunderwent transurethral resection after treatment with mitomycin irrigation in treatment of superficial bladder tumor in 30 cases, set up as the control group,1) comparison of the observation group group and control group, operation time,postoperative indwelling catheter time, hospitalization time; 2) complications and recurrence of the two groups after treatment. Results The two groups of patientswere a successful operation , TURBT operation time was 10-65 min. Two groups of intraoperative bleeding was less , the observation group 2 cases , control grouponly only 3 cases of postoperative bleeding obvious , reimplanted resectoscope were successful hemostasis. The operation time,postoperative indwelling catheter time, hospitalization time in the observation group compared with the control group, there was no significant difference (P>0.05). After treatment, liver and kidney function damage obvious and systemic reaction was not found in the two groups of patients , the number of cases of occurrence frequent micturition, dysuria and hematuria of the observation group was significantly less than that of the control group (P<0.05), and followed up 2 years, the main inspection items for B ultrasound, CT, cystoscopy, and no case of death in both two groups, the observation group was significantly lower than that of control group, the recurrence rate of recur-rent rate, with significant difference (P<0.05). The emergence of 6 months without recurrence after operation in the two groups, the observation group 1 case, control group 5 cases of recurrent patients were appeared in 9-12 months after operation, all non recurrence in situ. Conclusion Transurethral resection combined with pirarubicin instillation for the treatment of superficial bladder tumorexact curative effect, low recurrence rate, worthy of promotion and appli-cation.

Objective To compare and analyze the effect of transperitoneal laparoscopic radical prostatectomy (TL RP) and open operation. Methods The clinical data of 80 cases of prostate cancer in our hospital were analyzed retrospec-tively, including 40 cases of laparoscopic group with transperitoneal laparoscopic radical prostatectomy, 40 cases of control group with open prostate cancer,the operation time, bleeding, the operation quantity, postoperative intestinal function recovery time, postoperative hospitalization time and complications were recorded and compared between the two groups. Results The operation time of laparoscopic group was (326.9±63.5) min, was significantly longer than the control group; the amount of bleeding in laparoscopic operation group was reached (390.2±67.8)mL, significantly less than the control group (P<0.01); the laparoscopic group postoperative intestinal function recovery time was (3.12±0.51) days, was significantly shorter than that in the control group, the hospitalization time of laparoscopic patients (8.2±1.3) days, was significantly shorter than that in control group, com pared with control group, the difference was significant (P<0.05). The incidence of postoperative complications of la paroscopic was 10.0%, significantly lower than the incidence of postoperative complications in 25.0% of control group, the difference was significant (P<0.05). Conclusion Transperitoneal laparoscopic radical prostatectomy (TLRP) and open operation are the effective methods for treating prostate cancer, but the transperitoneal laparoscopic radical prostatectomy (TLRP) has more advantages com-pared with open operation, fewer complications, and is worthy of popularization and application.