BACKGROUND: Deproteinized bone has three diamensions frame profitting bone cells to adhere to, new capillaries and interstitial cells to enter, osteoblasts to differentiate and extracellular matrix to synthesize. Calcium phosphate cement (CPC) is a new in-ceramic bone cement that can degradate, which has plasticity, no heat production, invariably mechanics intension and porosity.OBJECTIVE: To explore the ability of CPC attaching with human vascular endothelial growth factor (rhVEGF) and recombinant human bone morphogenetic protein-2 (rhBMP-2) in promoting deproteinized osteoarticular allograft to repair osteoarticular defect.DESIGN: Randomly control observation.SETTING: Department of Orthopaedics, the First Affiliated Hospital, Chongqing Medical University.MATERIALS: A total of 42 adult hybridization dogs of both genders and weighing (10±0.5) kg were provided by Animal Center of Chongqing Medical University. RhVEGF was provided by Beijing Boaosen Biotechnology Co., Ltd.; rhBMP-2 by Guangzhou Dahui Biotechnology Co., Ltd.; CPC by Shanghai Ruibang Biotechnology Co., Ltd.METHODS: The experiment was carried out in the Laboratory of Orthopaedics (Municipal Laboratory), Clinical College,Chongqing Medical University from March to September 2006. A total of 36 adult dogs were randomly divided into three groups with 12 in each group, including group A: CPC/rhVEGF/rhBMP-2/deproteinized femoral inferior extremity (DPB)osteoarticular allograft; group B: rhVEGF/rhBMP-2/DPB osteoarticular allograft; group C: simple DPB osteoarticular allograft. The experimental dogs were cut off femur by wire saw from articular surface with 30 mm, then fixed the grafts to broken ends of fractured femur with cross Kirschner wires, drawn down the proximad periosteum and sutured it. At the 4th, 8th, 12th and 16th weeks after operation, the effects were partly assessed by X-ray film examination, histologic examination as well as immunohistochemistry analysis of VEGF and BMP-2, vas capillare analysis by vaso-filling with ink, radionuclide bone imaging examination (ECT) and vitodynamic tests.MAIN OUTCOME MEASURES: At the 4th, 8th, 12th and 16th weeks after operation, the effects were partly assessed by X-ray film examination, histologic examination as well as immunohistochemistry analysis of VEGF and BMP-2, vas capillare analysis by vaso-filling with ink, radionuclide bone imaging examination (ECT) and vitodynamic tests.RESULTS: All 36 rats were involved in the final results. ① From 4th to 16th week after operation, the callus formation in group A was better than that of group B and group C by x-ray film examination. ② Image analysis system displayed that the value of area integration of optical density in group A was obviously higher than that in group B and C about VEGF at the 8th, 12th and 16th weeks, and BMP-2 at the 4th, 8th, 12th and 16th weeks. The difference had statistical significance (P＜ 0.01). ③ The new vessels of grafts in group A were more than those in group B and C, part of those inclined to mature. The difference had statistical significance (P ＜ 0.01). ④ The blood flow of operation side was higher than that of uninjured side after operation, but that in group A was significantly higher than that in group B and C. The difference had statistical significance (P＜ 0.01). ⑤ At the 16th week, the result in group A was significantly higher than that in group B and C (P＜ 0.01).CONCLUSION: The recombinant deproteinized osteoarticular materials have fairly strong ability of new bone formation and vasculogenesis, and can early achieve bone healing, repairing osteoarticular defect and become autologous tissue at last.

Objective To compare the serum microelement changes between patients aged ≥80years and adults aged ＜ 60 years,and to compare the levels of serum microelement,total protein,albumin,hemoglobin between the long term in-bed and non in-bed oldest patients.Methods Beijing Bohui BH5100 type atomic absorption spectrometer was used to determine serum microelement.Total protein,albumin,hemoglobin were also determined.Results The amounts of ferrum,zinc,calcium,copper,magnesium were (7.21 ± 1.21) mmol/L,(93.29 ± 10.96)mmol/L,(1.63 ± 0.21)mmol/L,(17.31±3.61)mmol/L,(1.49±0.20)mmol/L in people aged over 80 years,(8.91±1.25)mmol/L,(121.85±11.24)mmol/L,(1.51±0.23)mmol/L,(15.89±3.87)mmol/L,(1.51±0.21)mmol/L in people aged less than 60 years,respectively.The ratios of Ferrum deficiency were 42.9 ％,zinc deficiency 14.3％,calcium deficiency 21.4％,copper deficiency 14.3％ in oldest-old,whereas were 9.1％,13.6 ％,31.8％,27.3％ in people aged less than 60 years.The amount of ferrum was significantly lower in people aged over 80 years than in people aged less than 60 years (P＜0.01).Proportion of ferrum deficiency was higher in patients aged over 80 years (P＜0.01).The amount of calcium and copper was markedly lower in people aged less than 60 years than in people aged over 80 years (P＜0.01).The proportions of calcium,copper deficiency were higher in people aged less than 60 years (P＜0.01).The amounts of ferrum,zinc,total protein,albumin,hemoglobin of the patients aged over 80 years in long-term in-bed group were significant decreased as compared with those of people in non long-term in-bed group [(6.44±0.89)mmol/L vs.(8.16±1.16)mmol/L,(84.48±8.98)mmol/L vs.(103.62±10.31)mmol/L,(62.8±3.9)g/L vs.(66.3±1.7)g/L,(33.7±2.6)g/L vs.(36.7±l.8)g/L,(109.0±12.5)g/L vs.(132.0±5.2)g/L,all P＜0.01].The amount of calcium of people in none long-term group was much lower [(1.57±0.23)mmol/L vs.(1.71±0.19)mmol/L,P＜0.01].Ferrum,zinc,calcium and copper deficiencies were 60.9％,18.8％,13.0％,13.0％ in long-term in-bed group,21.1％,8.8％,31.6％,15.8％ in non long-term in-bed group.Proportion of ferrum deficiency was higher in long term in-bed group than non long-term in-bed group (P＜0.01).Proportion of calcium deficiency was higher in non long-term in-bed group than long-term in bed group (P＜0.01).There was no significant difference in the amount of copper between people in long term in bed group and non long-term in-bed group (P＞0.05).There was no absence of magnesium in both two groups.Conclusions There is more absence of ferrum,zinc,total protein,albumin,hemoglobin in the patients aged 80 years and over in long-term in-bed.There is more calcium and copper absence of people aged less than 60 years.So it is necessary to supply high ferrum food and nutrients in order to get well sooner,especially to patients aged over 80 years.

Objective To explore the ability of revascularization of big section deproteinized bone (DPB) allograft combining calcium phosphate cement (CPC) with recombinant human vascular endothelial growth factor (rhVEGF) and bone morphogenetic protein-2 (rhBMP-2). Methods Totally 36 adult hybrid dogs were inflicted to demi-articular defect models by exsecting 30 mm right femur inferior extremity near articular surface,and then randomly divided into 3 groups, group A, receiving material CPC/rhVEGF/rhBMP-2/DPB transplantation into the demi-articular defect, group B, material rhVEGF/rhBMP-2/DPB transplantation, and group C with simple material DPB transplantation. At 4, 8, 12 and 16 weeks after operation, vasculogenesis and new bone formation were assessed by X-ray examination, histological examination, transmission electron microscopy, vas capillare analysis by vaso-filling with ink and radionuclide bone imaging examination (ECT). Results The bone formation and vascularization was significantly superior in group A to that in group B and C. The results of vaso-filling examination with ink and arterial perfusion of ECT examination were both significantly superior to that in group B and C (P

ObjectiveTo investigate the prevalence and distribution of 16S rRNA methylase gene and research the relationship with drug resistant spectrum.And preliminary explore its role in molecular epidemiology analysis.MethodsCollected 69 clinical isolates of non repetitive ESBL-producing Klebsiella pneumoniae in our hospital from Mar to Sep 2010.Detection 16S rRNA methylation enzyme gene by PCR,and analyze ESBL genetype and integron gene of the positive strains.All PCR products were sequenced for determination.Plasmid conjugation test and plasmid elimination method to determine dissemination of 16S rRNA methylase gene.Then we used ERIC-PCR genotyping technology for the establishment of DNA fingerprinting.ResultsIn sixty-nine strains,twenty isolates were rmtB positive (28.9％),two isolates were armA positive,and two strains coproduce rmtB and armA.All positive isolates carried the CTX-M gene,detemined by sequencing,14 strains of CTX-M-14 gene,6 strains of CTX-M-15 gene,14 strains carried TEM1 gene,8 strains carried SHY gene,sequencing showed that 5 strains of SHV-12 gene,3 strains of SHV-11 gene,3 strains carried OXA-10 gene,3 strains carried VBE-1 gene.In addition,the intl gene was found in 12 isolates of 20 rmtB positive strains.All the intl gene positive strains were divided into five kinds gene cassettes,which contained drfA25,drfA1,drfA12,aadA1,aadA2,sat and blaVEB-1 genes.Respectivily,16S rRNA methylase gene positive strains were divided into five genetypes using ERIC-PCR technology.A genetype was the advantage popular clones.Conjugative plasmid and elimination test found that rmtB gene was located in a plasmid in KP5 and KP16 isolates with A genetype,and can disseminate by conjugation.ConclusionA high prevalence of 16S rRNA methylase gene-rmtB was found among clinical ESBL-producing K.pneumoniae isolates in our hospital,which could lead to resistant to almost all aminoglycoside at a high level.Both horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB gene.In addition,K.pneumoniae co-producing ESBLs,16S rRNA methylation enzymes and class Ⅰ integron existed and were spreading.

Objective To investigate molecular epidemiology and antimicrobial susceptibility of carbapenem-resistant strains of Klebsiella pneumoniae isolated from children.Methods From July 2010 to June 2011,twelve non-replicate clinical isolates of carbapenem-resistant Klebsiella pneumoniae were consecutively collected from children inpatients in the Second Hospital of Wenzhou Medical Colloge.All of the isolates were identified by the automated microbiology systems.Modified Hodge test was used to screen strains producing carbapenemases.Pulsed field gel electrophoresis(PFGE) was performed to analyze the homogeneity of genomic DNA of Klebsiella pneumoniae.KPC,IMP,GIM,SPM,SME,OXA-10,bla(s),VIM gene and integrase gene were amplified by PCR and then sequenced to cofirm the genotypes;Plasmid conjugation experiment was used to study the transfer method of bacterial resistance.Plasmid-curing test were used to initally locate the resistant genes.Results One(8.3％),5(41.7％),7(58.3％),1(8.3％),1(8.3％) and4(33.3％) of12isolates were susceptible to gentamicin,tobramycin,amikacin,ciprofloxacin,levofloxacin and trimoxazole,respectively.All isolates carried KPC-2,TEM-1 and SHV genes(six for SHV-11-like,six for SHV-12-like).Eleven of twelve isolates with KPC-2 gene carried CTX-M genes(4 for CTX-M-14-like,6 for CTX-M-15-like).Two isolates carried OXA-10 genes,and one isolates carried PER-1 gene.None of NDM-1,GIM,SPM,SIM and VIM carbapenemase genes was detected in 12 isolates.All of 12 isolates carried Int 1 genes.The plasmids of 2 isolates were transgerred into the recipients E.coli EC600.PCR and sequence analysis revealed that blaTEM-1 and blaCTX-M-15-like were co-transferred with the KPC-2 gene to the recipients.Elimination of KPC-2-encoding plasmid from Kp7 and Kp12 resulted in imipenem susceptibility in the two isolates.Amplification revealed that KPC-2 gene was lost by the plasmid-curing test.Of the 12 isolates,5 patterns were obtained by PFGE.Pattern B and C were the main drug resistant clones.Conclusion KPC-2 gene are the major carbapenemase genes in Klebsiella pneumoniae isolated from children,including ESBLs and integrase.Some resistance genes can be disseminated by plasmids.

Eight patients with chronic pancreatitis or benign pancreatic head tumors were investigate to evaluate the use of Bern procedure in duodenum-preserving pancreatic head resection.Our data indicated no periopemtive deaths and serious complications.During median follow-up of 10 monks(range,6 to 14 monks),all patients reported impmvod clinical symptoms,and those with chronic pancreatitis had weight increased by 7.9 kg(range,4 to 18 kg).Pancreatic exocfine function wag improved,although the endocrine function showed no change.The Bern procedure might be a relatively safe and effective procedure for the treatment of chronic pancreatitis or benign pancreatic head tumors.

Objective To investigate the epidemiological characteristics of COVID-19 outbreaks in Xiangyang, and to provide a scientific basis for curbing the development of the epidemic. Methods A retrospective epidemiological investigation was conducted to analyze the epidemiological characteristics of confirmed COVID-19 cases in the city from January 1 to April 30, 2020. Results Confirmed COVID-19 cases were reported throughout the city, and the epidemic situation decreased significantly after February. The median age of confirmed cases was 47 years old, and most of them were 25-65 years old (86.89%). The average interval time between first diagnosis and admission was 5.23 days, while the average interval time between diagnosis and confirmation was 1.69 days. As time went on, the time intervals between the first diagnosis and admission and between diagnosis and confirmation were significantly shortened. The higher the proportion of previous underlying diseases was, the more serious the COVID-19 infection was (χ²=44.40, P<0.05). Conclusion The infection of COVID-19 in Xiangyang is highly contagious, but the cluster epidemic was mainly mild. Novel coronavirus infection is closely related to occupational exposure, with young and middle-aged people being high-risk populations. Early diagnosis, early isolation, comprehensive treatment and active control of chronic underlying diseases are crucial to the control of COVID-19.

Acute Achilles tendon rupture is a common sports injury, is currently the best treatment for acute Achilles tendon rupture there are more controversial programs in the clinical, their treatment is divided into conservative treatment and surgical treatment. Conservative treatment for a long time, and then the higher Achilles tendon rupture rate, postoperative recovery slow. There are a number of complications traditional open surgery, and minimally invasive surgery in recent years developed a new technology that minimizes the exposure of the wound, reduce surgical trauma scope, shorten the operation time and reduce wound infection rate increasing importance in clinical practice, worthy of recommendation.

Aged ; Anesthesia ; methods ; Electrocardiography ; Heart Ventricles ; Hip Fractures ; surgery ; Humans ; Intraoperative Complications ; etiology ; Male ; Myocardial Infarction ; etiology

Objective To analyze the infection of human parvovirus B19 among women of childbearing age in Xiangyang City, and to provide a reference for pregnant women's health care. Methods A total of 303 women of childbearing age in Xiangyang City from 2018 to 2019 were selected as the research subjects. B19 virus DNA in serum of the subjects was detected by nested PCR technology. The differences in the detection rate of B19 viral DNA among normal pregnancy, abnormal pregnancy, and infertility serum were statistically analyzed. The differences in the detection rate of B19 virus DNA among women of childbearing age at different ages were compared. Results The detection rate of B19 viral DNA in all 303 women of child-bearing age was 27.72%. The detection rate of B19 virus DNA in 26-35 year old women was higher than that in other age groups. The detection rate of B19 virus DNA in abnormal pregnancy group was significantly higher than that in normal pregnancy group (P <0.05). Conclusion The detection rate of B19 virus DNA in abnormal pregnancy and infertility group was significantly higher than that in normal pregnancy group, with the detection rate of B19 virus in 26-35 year old women of childbearing age being the highest among all age groups. It is necessary to strengthen the screening of B19 virus in pregnant women of childbearing age in this region to reduce its impact on fetal abortion.