[Objective]In order to dynamically observe the ossification process by living small animal Micro-CT in a rat femur distraction osteogenesis (DO) model,the author applied a special designed external fixiator system. [Methods]A femur DO model was made on 12 SD rats.After 7 days of latency,the femurs were distracted at a speed of 0.25 mm every 12 hours for 14 days.At the first day of consolidation period,the steel external fixiators were substituted by radio-transparent polymer splint material made fixiators.At 7 and 21 days of consolidation period,two randomly selected rats were sacrificed for histological examination.The other 8 rats were selected for X-ray and living Micro-CT examination at 0,7,21,35 days of consolidation period.All animals were sacrificed at 35 days of consolidation period,5 for biomechanical test,3 for histological examination.[Results]There was no significant new bone formed in distracted zone at latency and distraction periods.The volume of distracted zone increased little in the following 5 weeks of consolidation period.Bone volume,bone mineral content,bone volume fraction,and the number of trabeculae all increased over the consolidation period,while mineral content of mineralized tissue and thickness of traleculae did not increased until 3 weeks after consolidation began.At final observation (56 days post operation),there still exist un-mineralized cartilage tissues in the central of distracted zone,and the distracted femurs had lower biomechanical property when compared with corresponding normal femurs.[Conclusion]1) Radio-transparent polymer splint is a satisfactory substitute of steel external fixator.2) Micro-CT is a useful tool for dynamical observing and evaluating bone formation status in DO model.3) The increasing of bone volume began at the end of distraction,lasting at least 5 weeks,while the remodeling of new formed bone began 3 weeks after distraction ended.The increasing and remodeling of new formed bone was not concord.This result indicates that,in order to obtain proper results,the corresponding interference should be taken at different time points.

Humans ; Male ; Mesylates ; poisoning ; Occupational Diseases ; Occupational Exposure ; adverse effects ; Young Adult

Objective To assess the efficacy of recoil of inflating syringe plunger in limiting laryngeal mask airway (LMA) cuff pressure.Methods Sixty ASA Ⅰ or Ⅱ patients aged 22-64 yr with body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were enrolled in this study.LMA Supreme (Laryngeal Mask Co.Singapore) size # 3 (for patients with body weight ≤50 kg) or # 4 (for patients with body weight ＞ 50 kg) was placed after induction of anesthesia.Correct position of LMA was confirmed by fiberoptic bronchoscopy.The LMA cuff was inflated to 60,80,100 and 120 cm H2O step by step using a 20 ml-syringe.The cuff pressure was measured with a monometer through a 3-way stopcock and maintained at each level for 10 seconds.The plunger was then allowed to recoil.The cuff pressure at the end of recoil (residual cuff pressure) was recorded.The patients were mechanically ventilated.The inspiratory pressure was limited to 30 cm H2 O.The airway pressure at which the air started to leak between LMA and larynx (leak pressure-Pleak) was recorded.Results The residual cuff pressure following the 4 inflating pressures was all ＜ 60 cm H2 O.The Pleak was ＞20 cm H2O.There was no significant difference in residual cuff pressure and Pleak between size # 3 and # 4.Conclusion Recoil of inflating syringe plunger can limit LMA pressure to safe level.

Objective To analyze the changes of Blood Cell Count and D-dimer concentration in lung cancer patients with thrombosis.Methods ①554 cases of patients with lung cancer were included between January 2012 and November 2013,75 patients with other diseases which lead to high coagulation state were excluded,blood cell count and D-dimer concentration were compared between 64 lung cancer patients were the cases with thrombosis with 415 lung cancer patients were the con-trol group without thrombosis.②Color doppler ultrasonography was taken as the golden standard,receiver operating charac-teristic curves (ROC)were drawn for indexes which had significance in method.Results ①Compared with lung cancer pa-tients without thrombosis,lung cancer patients without thrombosis had decreased red blood cell count (RBC),increased white blood cell count (WBC)and D-dimer.And there were no significant change in platelet (PLT).②The area under curve (AUC)of ROC in RBC,WBC and D-dimer were 0.662,0.637 and 0.896,respectively.By thecut-off values of RBC>4.06× 1012 L,WBC<5.37×109/L and D-dimer<4.02 mg/L,the negative predictive values of RBC,WBC and D-dimer for diagno-sis of lung cancer patient with thrombosis were 93%,93% and 96%,respectively.By the cut-off value of D-dimer>4.02 mg/L,the positive predictive value of D-dimer for diagnosis of lung cancer patient with thrombosis was 6 6%.Conclusion RBC,WBC and D-dimer were related with the progress of thrombosis in lung cancer patients.RBC,WBC and D-dimer have good negative prediction effect on lung cancer patients with thrombosis.D-dimer had positive effect for diagnosis of lung cancer with thrombosis.

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

Objective To investigate the effect of emulsified isoflurane anesthesia on the expression of hippocampal amyloid-beta protein (Aβ) and phosphorylation of Tau protein in rats.Methods Seventy-two healthy Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 3 groups:normal control group (group C,n =12),fat emulsion group (group E,n =12),and 8％ emulsified isoflurane group (group EI,n =48).30％ fat emulsion and 8％ emulsified isoflurane 0.15 ml/100 g were slowly injected via the tail vein in groups E and EI,respectively.Morris water maze test was performed 6 days before anesthesia.Twelve animals in each group were chosen at 2 h after administration (T1) in E group,at the corresponding time points in C group,or at T1 and 1,7 and 14 days after administration (T2-4) in EI group and underwent spatial probe tests,and the escape latency was measured.The rats were anesthetized with intraperitoneal 1％ pentobarbital sodium 4 g/100 g after the end of Morris water maze test.Blood samples were taken for determination of the plasma S100 protein concentration.The rats were then sacrificed and brains were removed for determination of the expression of hippocampal Aβ and phosphorylated Tau (p-Tau) protein by immunohistochemistry.Results The escape latency and swimming distance were significantly shorter on 3rd,4th and 5th days than those on 1st day of place navigation test before anethesia (P ＜ 0.01).Compared with group C,the escape latency and swimming distance were significantly prolonged and the time of staying at the original platform quadrant was shortened at T1,and the plasma S100 protein concentration was decreased at T4 in group EI (P ＜ 0.05),and no significant change was found in the each parameter of Morris water maze test,plasma S100 protein concentration,and expression of Aβ and p-Tau protein in group E (P ＞ 0.05).The escape latency and swimming distance were significantly shorter and the time of staying at the original platform quadrant was longer at T2-T4 than at T1 in group EI (P ＜ 0.05).Conclusion Emulsified isoflurane anesthesia exerts no effect on the expression of hippocampal Aβ and phosphorylation of Tau protein,indicating that hippocampal Aβ and Tau protein are not involved in emulsified isoflurane anesthesia-induced cognitive dysfunction in rats.

Objective To investigate the clinical significance of generalized epilepsy with febrile seizures plus(GEFS+ ). Methods The data of one family with GEFS+ were retrospectively analyzed by studying clinical manifestations, physical examinations, electroencephalogram(EEG), 24 hours dynamic EEG monitoring, et al. Some of the patients were examined by CT. Results Ⅳ 12, her chief complaints when admitted to hospital were frequent spasm for 3 days. She began to appear febrile seizures (FS) from 8 months after birth, and frequent generalized tonic - clonic FS appeared during that time. There were 36 people in 5 generations of the family including 14 patients (8 males and 6 females) ,aged from 4 years and 5 months to 82 years. FS presented in 8 cases (Ⅱ 2, Ⅲ1, Ⅲ4, Ⅲ6, Ⅳ1, Ⅳ11, Ⅳ17, Ⅴ2),febrile seizures plus(FS +) in 4 cases ( Ⅳ2, Ⅳ12, Ⅳ13, Ⅳ14), ES + and absence seizures in 1 case ( Ⅴ1 ), uncertain type in 1 case (Ⅰ2). The results of EEG indicated that 12 cases were normal and 4 cases with FS+ and 1 case with absence seizures had epileptic discharges. Apart form Ⅳ13, Ⅳ14 who were treated with magnesium valproate, the dosage for the other patients decreased, or medicine terminated or without medicine, and all the patients had no recurrence of seizures. The intelligence, movement development and neurological examinations of the family were all normal. Head CT scan of 3 cases were normal. Conclusions GEFS+ is autosomal dominant inheritance disease with conspicuous genetic heterogeneity and phenotypic heterogeneity. The apprehension of GEFS+ plays an important role in diagnosis and differential diagnosis of epilepsy in childhood.

Objective To evaluate the diagnostic yield and safety of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (Direct Path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation using an ultrathin bronchoscopy (UNRE) for bacterial infection located in the peripheral third of the lung field. Methods Ninety-seven patients with bacterial infection, which located in the peripheral third of the lung field on CT images, were ran-domly assigned to UNRE (n=49) or non-UNRE (NUNRE, n=48) groups, who were treated in General Hospital of Tianjin Medical University between April 1, 2014 and March 31, 2015. The TBLB guided by UNRE was performed in two groups. The diagnostic yield, safety and complication rate were compared between two groups. Moreover, the differences of autofluo-rescence intensity of alveolar macrophage in alveolar lavage fluid were compared between two groups of patients. Results The diagnostic yield was significantly higher in UNRE group than that of NUNRE group (81.6% vs 56.2%, χ2=7.313, P <0.01). The diagnostic yield was higher in UNRE group with bronchus sign compared to that of NUNRE. All patients had a mild bleeding at the time of biopsy. There were no hemoptysis, pneumothorax or other serious complications. The autofluores-cence intensity of alveolar macrophage was different in different levels of infection in patients. Conclusion The procedure of UNRE has higher diagnostic rate and fewer complications. The careful selection of suitable cases can further improve the diagnostic accuracy. The autofluorescence intensity of alveolar macrophage in alveolar lavage fluid indicates the severity of infection in patients.

ObjectiveTo investigate the effect of isoflurane anesthesia on plasma cortisol,and brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in hippocampus in rots.MethodsThirty-six adult male SD rots,aged 10 weeks,weighing 250-280 g,were randomly assigned into 6 groups:control group (group C,n =6) and O2 group (group O,n =6),isoflurane group (group Ⅰ,n =24).The rats were exposed to 2％ isoflurane for 2 h (FGF 3 L/min) in group Ⅰ.While the rats were only exposed to the pure oxygen in group O.Six rats in each group were chosen to perform Morris water maze test after inhalation of pure oxygen was stopped in group O,and at 2 h,and at 1,7 and 14 days after the end of administration in group Ⅰ.The escape latency and swimming distance in place navigation test,and the number of crossing the platform and swimming distance in spatial probe test were recorded.After water maze test was terminated at each time point,blood samples were taken from the fossa orbitalis to determine the plasma cortisol concentration and the hippocampal tissue was obtained for measurement of the contents of BDNF and NGF.ResultsCompared with group C,the number of crossing the platform was significantly decreased,the swimming distance was significantly shortened,and the plasma cortisol concentration was significantly decreased in spatial probe test in group O,and the escape latency and swimming distance were significantly prolonged at 1 day after the end of administration in plaee navigation test,and the number of crossing the platform and the content of BDNF in the hippocampal tissue were significantly decreased,and the swimming distance was significantly shortened in spatial probe test in group Ⅰ (P ＜ 0.05 or 0.01 ).Conclusion lsoflurane anesthesia exerts a transient inhibitory effect on cognitive function in the short term,and promotion of the cortisol release and synthesis of BDNF is involved in the mechanism,but not the synthesis of NGF in hippocampus in rats.