1.Percutaneous vertebroplasty for fresh osteoporotic vertebral compression fractures
Zhigang ZHAO ; Wusheng KAN ; Peng LI
Chinese Journal of Orthopaedic Trauma 2014;16(3):218-221
Objective To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) for patients with fresh osteoporotic vertebral compression fracture (OVCF).Methods From February 2010 to November 2011,103 patients with fresh OVCF were assigned to receive either PVP or conservative treatment according to their choice or the choice of surgeons.There were no significant differences between the 2 groups regarding general clinical data (P > 0.05).The pain was scored at pre-treatment,1,4,12,24 and 48 weeks post-treatment in all the patients.The vertebral re-fractures were recorded in both groups at follow-ups.The 2 groups were compared in terms of postoperative pain relief and risk of re-fracture.Results The overall pain relief at 1,4 and 12 post-treatment in the PVP group was significantly greater than in the conservative treatment group (P < 0.05).The pain relief at night at 1,4 and 12 post-treatment was significantly greater in the PVP group than in the conservative treatment group (P < 0.05).At one year post-treatment,7 vertebral re-fractures were observed in the PVP group (18.4%,7/38) and 12 ones in the conservative treatment group (20.3%,12/59),with no significant difference between the 2 groups in the risk of re-fracture (Hazard ratio =0.909,95% CI:O.36 ~ 2.29,P =0.841).Conclusion Compared with conservative treatment,PVP may significantly reduce the pain for patients with fresh OVCF but does not increase the risk of vertebral re-fracture.
2.Effect of perioperative thermal preservation on hemostatic function in elderly patients with laparoscopic rectal cancer resection
Zhiwei MO ; Xi LI ; Wusheng HUANG
Chinese Journal of Postgraduates of Medicine 2013;(18):28-31
Objective To research the effect of perioperative thermal preservation on hemostatic function in elderly patients with laparoscopic rectal cancer resection.Methods Eighty-six elderly patients with laparoscopic rectal cancer resection with ASA Ⅰ-Ⅱ were randomly divided into control group (43 patients) and test group(43 patients).Control group was given routine operation,test group was given routine operation and thermal preservation.The nose pharynx temperature was monitored and recorded respectively on preanesthesia,30,60,90 min post-anesthesia and after operation.The level of prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),platelets (PLT),D-dimer(DD),fibrinogen (FBG),yon Willebrand factor (vWF) were detected on preanesthesia,30,60,90 min post-anesthesia and 24,48 h post-operation.Results The temperature in control group on 30,60,90 min pest-anesthesia and after operation [(36.1 ± 0.2),(36.0 + 0.1),(35.7 + 0.1),(35.6 ± 0.2) ℃] was significantly lower than that on preanesthesia [(36.8 ± 0.2) ℃] and the same time in test group [(36.8 ± 0.0),(36.7 ± 0.1),(36.7 +0.2),(36.8 ±0.2) ℃] (P <0.05).The level of PT,APTT and TT in control group on 30,60,90 min post-anesthesia and after operation were significantly longer than those on preanesthesia and the same time in test group (P <0.05).The level of PLT in control group after operation and on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group(P < 0.05).The level of DD and vWF in control group on 24,48 h post-operation were significantly higher than preanesthesia and the same time in test group (P < 0.05).The level of FBG in control group on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group (P < 0.05).The hemostatic function had no significant change in test group (P >0.05).Conclusion The perioperative thermal preservation in elderly patients with laparoscopic rectal cancer resection can alleviate hemostatic function suppression and promote recovery.
3.Hyperthermia Combined with Chemotherapy for Ovarian Cancer:A Meta-analysis
Xiao GU ; Shunchao YAN ; Wusheng LI ; Li ZHAO ; Huawei ZOU
Journal of China Medical University 2015;(6):489-493
Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P<0.05). There was no significant difference in the improvement rate of life quality and the incidences of myelosuppression,severe myelosuppression,severe nausea and vomiting,severe constipation and diarrhea,liver and renal damage(P>0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.
4.Transplantation of the free anterolateral thigh flap combined with iliotibial band for reconstruction of children's soft tissue defects at foot and ankle
Rui HU ; Yijun REN ; Li YAN ; Fan LI ; Qiong HAN ; Wenjun CHENG ; Wusheng KAN
Chinese Journal of Microsurgery 2014;37(5):457-460
Objective To investigate the clinical effect of transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defects at foot and ankle and functional reconstruction.Methods From January,2008 to January,2013,25 pediatric patients with soft tissue defects at foot and ankle were transplantation of the free anterolateral thigh flap and iliotibial band.Of the 25 cases,there were 12 cases at heel,8 cases at dorsum of foot,3 cases at medial malleolus and 2 cases at external malleolus.All the cases were accompanied with different degree of fracture or dislocation,and with soft tissue defect such as achilles tendon,extensor tendon of dorsal,collateral ligament of ankle.The length of soft tissue defect which were reconstructed with iliotibial band were 3 cm to 16 cm.The causes of injury:19 cases were crushed by motorcycle or bicycle,4 cases were crushed machines,2 cases were injuryed in traffic accidents.The areas of free anterolateral thigh flaps were 8 cm × 5 cm to 18 cm × 12 cm.All the patients begined to early rehabilitative exercise under the protection of orthosis after 2 weeks of the operation.Results All cases were followed up from 6 to 24 months,averaged of 14 months.All the flaps survived,and only 2 cases with necrosis of small area in distal,and which were healed by dressing.The healing time were 12 to 24 days,and the average of 15.1 days; The surgery function were assessed according to Thermann's scale,and the results was 14 cases for excellent,9 cases was good,the general was 2 cases,and the excellent and good rate was 92%.Conclusion The transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defect at foot and ankle and functional reconstruction is a safe and effective strategy,and it has the advantages such as covering the wound at foot and ankle approvingly,reconstruction of power device once,the flap and iliotibial band were in the same wound,the trauma of doner site is small invasive,early recovery functional exercise,shorten the treatment cycle,and relieve the suffering of children.
5.Ectopic osteogenesis in vivo using bone morphogenetic protein-2 derived peptide loaded biodegradable hydrogel.
Jingjing ZHAO ; Zhenhua FANG ; Ruokun HUANG ; Kai XIAO ; Jing LI ; Ming XIE ; Wusheng KAN
Journal of Biomedical Engineering 2014;31(4):811-815
We investigated the development of an injectable, biodegradable hydrogel composite of poly(trimethylene carbonate)-F127-poly(trimethylene carbonate)(PTMC11-F127-PTMC11 )loaded with bone morphogenetic protein-2 (BMP-2) derived peptide P24 for ectopic bone formation in vivo and evaluated its release kinetics in vitro. Then we evaluated P24 peptide release kinetics from different concentration of PTMC11-F127-PTMC11 hydrogel in vitro using bicinchoninic acid (BCA)assay. P24/ PTMC11-F127-PTMC11 hydrogel was implanted into each rat's erector muscle of spine and ectopic bone formation of the implanted gel in vivo was detected by hematoxylin and eosin stain (HE). PTMC11-F127-PTMC11 hydrogel with concentration more than 20 percent showed sustained slow release for one month after the initial burst release. Bone trabeculae surround the P24/ PTMC11-F127-PTMC11 hydrogel was shown at the end of six weeks by hematoxylin and eosin stain. These results indicated that encapsulated bone morphogenetic protein (BMP-2) derived peptide P24 remained viable in vivo, thus suggesting the potential of PTMC11-F127-PT- MC11 composite hydrogels as part of a novel strategy for localized delivery of bioactive molecules.
Animals
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Biocompatible Materials
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chemistry
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Bone Morphogenetic Proteins
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pharmacology
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Bone and Bones
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drug effects
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Dioxanes
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chemistry
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Drug Delivery Systems
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Hydrogels
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chemistry
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Osteogenesis
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drug effects
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Peptides
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Prostheses and Implants
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Rats
6.Clinical Observation of Kubai Oil and Cuyu Oil for External Use by Stages for Wound Healing after Perianal Abscess Operation
China Pharmacy 2018;29(2):233-236
OBJECTIVE:To investigate therapeutic efficacy and safety of the use of Kubai oil and Cuyu oil by stages on wound healing after perianal abscess operation.METHODS:A total of 125 observation objects selected from Chengdu Third People' s Hospital during Jan.2014-Jan.2016 were randomly divided into control group (60 cases) and observation group (65 cases).Both groups received perianal abscess incision drainage or thread-drawing drainage.Control group was additionally given gentamicin gauze for dressing and other treatments after surgery based on routine treatment.Observation group was given Kubai oil gauze for dreassing in wound inflammation period,Cuyu oil gauze for dressing in granulation growth period and epithelial growth period.After 4 weeks of treatment,therapeutic efficacy,wound healing,wound pain,wound secretion and the growth of granulation tissue were compared between 2 groups.The occurrence of ADR was also recorded.RESULTS:The cure rate of observation group reached 80.0%,which was significantly higher than 63.3% of control group (P<0.05);the reduction rate of wound area was significantly higher than control group,while the carrion shedding time and wound healing time were significantly lower than control group (P<0.01 or P<0.05).The wound pain score in 2nd,4th week,the wound secretion score and granulation tissue growth score in 1st,2nd,4th week after operation were significantly lower than control group (P<0.01 or P<0.05).No significant ADR was found in 2 groups.CONCLUSIONS:For the patients underwent perianal abscess operation,the use of Kubai oil and Cuyu oil by stages can effectively improve therapeutic efficacy and wound healing,and relieve postoperative pain with good safety.
7.Transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot
Rui HU ; Yijun REN ; Li YAN ; Fan DING ; Xincheng YI ; Qiong HAN ; Wusheng KAN
Chinese Journal of Microsurgery 2016;39(1):37-40
Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot.Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap.The causes: 2 cases in traffic accident injury, 4 cases in machine injury;3 cases with traumatic defect, and septic defect in 3 patients.Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm;All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively.Results All cases were followed up 12-24 months, and average of 14 months;All the flaps survived, and the metatarsal bone and fibula healing was good visibly in half a year, The surgery function were assessed according to Maryland's scale, and the excellent were 2 and the good were 4.Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.
8.Correlation of delayed diagnosis of cerebral venous sinus thrombosis with its clinical symptoms and prognosis
Yusheng LI ; Ting HU ; Xiaoyun LIU ; Zhenhui DUAN ; Rui SUN ; Wusheng ZHU
Journal of Medical Postgraduates 2017;30(6):615-618
Objective Cerebral venous sinus thrombosis (CVST) is easily misdiagnosed for lack of specificity in its pathogenesis and clinical symptoms and characteristics.This study was to investigate the association of the clinical features of CVST with the time of diagnosis and the impact of diagnostic delay on the prognosis of the disease.Methods We retrospectively studied the clinical data about 94 cases of CVST treated in our hospital from March 2004 to August 2016.According to the interquartile-range time of diagnosis, we divided the patients into four groups, <5 d, 5-9 d, 10-16 d, and >16 d, and analyzed the correlation between the time of diagnostic delay with the clinical characteristics of the patients.The primary and secondary endpoints were the modified Rankin Scale score (mRS) ≤1 and ≤2 respectively at 3 months after discharge.Results Papilledema, isolated intracranial hypertension syndrome, and Glasgow Coma Score of 14-15 were associated with a longer diagnostic delay than seizure and hemorrhagic or infarction lesions (P<0.05).A significantly higher rate of earlier diagnosis was found in patients with lower levels of albumin and total protein, longer thrombin time, and a higher level of C-reaction protein (P<0.05).However, no significant correlation was observed between the time of diagnostic delay and the prognosis CVST.Conclusion The symptoms and laboratory indexes of the CVST patients at admission can be used as markers for the diagnosis of CVST, which may provide some new idea for its early diagnosis.
9.Preparation and ectopic osteogenesis in vivo of scaffold based on new synthetic biodegradable hydrogel loaded with synthetic BMP-2-derived peptide
Jingjing ZHAO ; Zhenhua FANG ; Ruokun HUANG ; Kai XIAO ; Jing LI ; Ming XIE ; Wusheng KAN
International Journal of Biomedical Engineering 2013;36(3):147-150,后插2
Objective To prepare P24/PTMC11-F127-PTMC11 hydrogel,to study the in vitro release profile and to observe ectopic bone formation in p24 peptide incorporated PTMC11-F127-PTMC11 hydrogel.Methods Corresponding weight powder of p24 peptide was infunded into tubes of PTMC11-F127-PTMC11 solution with concentrations of 16%,20% and 25%.Release profiles of P24 peptide in different concentration PTMC11-F127-PTMC11 hydrogel were measured in vitro by BCA assay.P24/PTMC11-F127-PTMC11 hydrogel was implanted into each rat's erector muscle of spine,and the implanted gel was detected by hematoxylin and eosin stain (HE).Results PTMC11-F127-PTMC11 hydrogel showed sustained slow release for the whole process after the initial burst release.With the increase of concentration in PTMC11-F127-PTMC.hydrogel,the initial burst release was reduced significantly.Ectopic bone formation was observed by computed tomography in p24 peptide incorporated PTMC11-F127-PTMC11 hydrogel after four weeks.Bone trabeculae surround the P24/PTMC11-F127-PTMC11 hydrogel was observed at forth week by hematoxylin and eosin stain.The bone trabeculae became thicker from sixth week.Conclusion Delayed release of peptide from the hydrogel was mainly controlled by disintegration of hydrogel and a satisfactory release profile was observed.These results suggest that the p24-loaded PTMC11-F127-PTMC11 hydrogel remmns active of p24 at the implanted site,continuously induce differentiation of osteoblast precursor cells into osteoblasts,and activate osteoblasts to promote ectopic calcification.
10.Stenting for atheros clerotic subclavian artery stenosis/occlusion A retrospective case series analysis and follow-up results
Yongkun LI ; Qin YIN ; Wusheng ZHU ; Yinzhou WANG ; Dezhi LIU ; Maogang CHEN ; Gelin XU ; Xinfeng LIU
International Journal of Cerebrovascular Diseases 2011;19(11):811-817
Objective To investigate the efficacy of endovascular stenting complicating other craniocervical artery stenosis (OCAS) in patients with atherosclerotic subclavian artery stenosis/occlusion (SASO).Methods The clinical data of receiving endovascular stenting therapy in patients with atherosclerotic SASO were analyzed retrospectively,including demographic characteristics,vascular risk factors,complicating OCAS,as well as stenting for SASO and follow-up results.Results A total of 65 patients with SASO were included in the study,47 of them were males and 18 were females (mean age of 64 ± 9 years).Forty-six patients (70.8% ) complicated OCAS.The overall technical success rate was 95.4%,in which the patients with stenosis (n =58) were 98.1% and those with complete occlusion (n =7) were 71.4%.The complications occurred in 4 patients.There were no intervention-related serious stroke and death.Mean follow-up was 24 ± 19 months,6 patients with restenosis and 10 with clinically relevant events were found.They mainly occurred in patients with OCAS.The first angioplasty patency rates were 94.5%,81.8% and 81.8%,respectively at 12 and 24 months after procedure and at the end of follow-up.The survival rates of no clinically relevant events were 92.9%,74.6% and 68.3%,respectively.Conclusions Endovascular stenting can safely and effectively treat the SASO patients complicating OCAS.Its overall clinical outcome may be affected to some extent by OCAS.