Objective To investigate the outcomes of infection mauagement after patellar fracture surgery using vacuum sealing drainage (VSD) combined with closed irrigation-suction within the articular cavity.Methods We treated 7 patients who had been inflicted by infection after patellar fracture surgery from June 2008 to March 2012.They were 5 men and 2 women,aged from 19 to 52 years (average,40.5years).There were one open aud 6 close patellar fractures.Their infections occurred 14 to 21 days (average,17.7 days) after internal fixation.One infection was superficial and 6 were deep,resulting in pyogenous arthritis of the knee.All cases were given debridement and VSD treatment and immobilized with braces.The 6 cases of deep infection were irrigated continuously with 4000 mL 0.9％ NaCl every day within the articular cavity.Direct skin suture or transplantation of local skin graft was performed after growth of fresh granulation tissue.Neer system was used to evaluate the knee functions at the last follow-up.Results After the VSD was applied for 7 to 12 days,the wound surface and knee cavity were very clean and fresh granulation tissue emerged.The wound was closed by direct suture for one superficial and one deep infection.Local skin grafts were transplanted for 5 deep infections.The infections were effectively controlled without pain,swelling or local fistula.The patients were followed up from 3 to 48 months (average,21 months).The functional outcome according to Neer' s criteria at the last follow-up was excellent in 2 cases,good in 3 and fair in 2.Conclusion In management of infection after patellar fracture surgery,VSD combined with closed irrigation-suction within the articular cavity can drain sufficiently,control infection effectively and stimulate fresh granulation growth,facilitating wound closure by direct suture or transplantation of a local skin flap.

Objective To investigate the effect of treatment with transplanted bone marrow mononuclear cells under different transplant paths on neovascularization in ischemic cerebral infarction rats. Methods The MCAO models were established by intraluminal vascular suture method. All the successful models were randomly divided into control group, intravenous transplantation group and subarachnoid transplantation group according to the random number table. The Extraction,isolation and culture of bone marrow mononuclear cells were extracted,i?solated and cultured. The models in the control group were injected 200μl PBS through the femoral vein. The mod?els in the intravenous transplantation group were injected 200μl containing 2×107 bone marrow mononuclear cells through the femoral vein. The models in the subarachnoid transplantation group were injected 200μl containing 2× 107 bone marrow mononuclear cells through the subarachnoid. The VEGF levels in cerebrospinal fluid of rats were detected using quantitative ELISA method. The vascular regenerations in the infarct area were observed by using quantitative immunofluorescence. Results After transplantation of bone marrow mononuclear cells 7 d,14 d and 28 d,the VEGF levels of rat cerebrospinal fluid in subarachnoid transplantation group were (207.4±8.9)pg/ml, (171.2±10.3)pg/ml and (143.8±13.8)pg/ml,respectively,which were all higher than the VEGF levels in intra?venous transplantation group,the differences were all statistically significant (P<0.05). After transplantation 14 d and 28 d,the BrdU?positive cells in subarachnoid transplantation group were ( 2043. 8 ± 514. 2) and ( 1834. 8 ± 307.4) ,respectively,which were higher than the intravenous transplantation group,the differences were all statisti?cally significant (P<0.05). The microvessel counts in subarachnoid transplantation group were (384.6±45.1) and (514.8±51.3),respectively,which were higher than that in the intravenous transplantation group,and the differ?ences were all statistically significant (P<0.05) . Conclusions Bone marrow mononuclear cells transplantation can increase VEGF secretion,and promote angiogenesis infarct. The effect of subarachnoid transplantation is better.

Background:Detection and removal of colorectal polyp by colonoscopy is of great importance for prevention of colorectal carcinoma. Aims:To investigate whether the clinical symptoms of patients undergoing colonoscopy may hint colorectal polyp and carcinoma,and provide reference for candidate selection in colonoscopic screening. Methods:A total of 2 366 patients undergoing colonoscopy were recruited and the history information such as symptoms at outpatient visits, site and nature of the lesions was collected for analyzing the detection rates of colorectal polyp and carcinoma and the correlations of clinical symptoms with the risk and site of the disease. Results:The overall detection rates of colorectal polyp and carcinoma were 20. 5% and 5. 4% ,respectively,in 2 366 patients. The detection rates were significantly higher in symptomatic patients than those in asymptomatic patients(24. 2% vs. 4. 5% for polyp and 6. 4% vs. 0. 9% for carcinoma,P all = 0. 000). Moreover,when patients were classified by major symptoms,the detection rate of colorectal polyp was significantly increased in patients with diarrhea(OR = 1. 213),hematochezia(OR = 2. 076),and changing of stool consistency(OR = 1. 503)(P all < 0. 05),and the detection rate of colorectal carcinoma was significantly increased in patients with abdominal pain( OR = 1. 568),hematochezia( OR = 2. 837),changing of stool consistency( OR =2. 206),and tenesmus( OR = 1. 735)( P all < 0. 05). The major symptoms being hematochezia,changing of stool consistency and tenesmus were associated with lesions locating at rectum or left hemicolon(P all < 0. 05). Conclusions:Diarrhea, hematochezia and changing of stool consistency hints risk for colorectal polyp, while abdominal pain, hematochezia,changing of stool consistency and tenesmus hints risk for colorectal carcinoma. Colonoscopy is strongly recommended for patients with these symptoms.

BACKGROUND:Sirius red is a strong acid anionic dye. Being not-easyto-fade and specific, sirius red becomes the best dye for collagen staining.Collagen is a major component of extracellular matrix and has some specific physiological functions. Through synthesis and reconstruction of collagen, bone fracture repair will be accomplished.OBJECTIVE: Picric acid-Sirius red stained slides were observed under a polarized light microscopy for evaluation the dynamic changes in the ratio of different collagen types and their distributions in bone fracture healing.DESIGN: It was a controlled observation.SETTING: It was conducted in the Department of Orthopedics, Renmin Hospital, Wuhan University; Department of Traumatic Orthopaedics, Tianjin Hospital; Department of Traumatic Orthopaedics, Jishuitan Hospital,Medical Department, Peking University; Tissue Engineering Center of Institute of Basic Medical Sciences, Academy of Military Medical Sciences of Chinese PLAMATERIALS: It was conducted at Tissue Engineering Center of Institute of Basic Medical Sciences, Academy of Military Medical Sciences of Chinese PLA from March 2002 to September 2003. Three healthy adult Chinese sheep, male and in weight from 25 to 35 g, were selected.METHODS: All the animals were anesthesized and sterilized; a transverse osteotomy of the trunk of metatarsus was performed; and the end of fracture was fixed with a six-hole Medoff sliding plate. At the post-operative month 1, 3 and 6, samples were taken from bone fractures. After decalcification with EDTA, they were stained with Picric acid-sirius red, and the types and distribution of collagens were observed under a polarized light microscopy.MAIN OUTCOME MEASURES: Types and distributions of collagens in bone lesion in different period of bone healing were investigated.RESULTS: Three sheep used in this study entered the statistical analysis.①Morphological features of various collagens under a polarized light microscopy postoperatively: Type Ⅰ collagen packed tightly, with a strong refraction and yellow, orange or red thick fibres. Type Ⅱ collagen formed a loose reticulation with fibres exhibiting different colour and a weak refraction. Thin fibres of type Ⅲ collagen with weak refraction and green colour formed a loose reticulation. ②Quantitative studies on various collagens under a polarized light microscopy postoperatively: At postoperative month 1,red or orange fibres (type Ⅰ collagen) were rarely seen in bone fracture,while green fibres (typical of type Ⅲ collagen) were dominant with a disorder pack. At postoperative month 3, red or orange fibres increased significantly and the ratio of type Ⅲ collagen reduced. The collagen fibres assembled regularly. At postoperative month 6, thick yellow-red collagen became dominant and thin green type Ⅲ collagen decreased dramatically and arranged in an obvious oblique, spiral and crossed orientations.CONCLUSION: Picric acid-sirius red stain combined with polarized light microscopy technique is not only capable of identifing type Ⅰ and type Ⅲ collagens in bone fraction, but also can reflect the morphological features,distribution and the ratio of these two type collagens. This approach has the virtues of easiness in operation, strong specificity and high sensitivity.

Objective To type Acinetobacter baumannii using infrequent restriction site PCR (IRS PCR). Methods Strain specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction sites of 15 strains of Acinetobacter baumannii were compared with the results of biotyping and antimicrobial susceptibility. Results The 15 bacteria were divided into 5 gene types with IRS PCR, but 3 with biotyping, and 4 with antimicrobial susceptibility. Conclusion IRS PCR method for typing Acinetobacter baumannii is of strong sensitivity, high recognition, good repeatability, convenient operation, and wide range of application.

The vast majority of vertebral compression fractures are caused by osteoporosis and vertebral tumor,which lead to the pain of a fracture and intervertebral height lost.In recent 20 years,the use of percutaneous vertebroplasty and percutaneous kyphoplasty,a kind of minimally invasive surgery method intended for the vertebral compression fractures,are rising up for patients with vertebral compression fractures,which can quickly relieve patients' pain and restore injured vertebral deformities.Percutaneous vertebroplasty injects bone cement into fractures through a small incision.However,percutaneous kyphoplasty injects a balloon into a fracture to make a cavity by expending and shrinking,which is filled with filler material,and then removes the balloon,and injects bone cement.This article mainly reviews development,curative effect and safety,clinical application and future aspects.of the percutaneous vertebroplasty and percutaneous kyphoplasty.

In order to study the chondrogenic phenotype differentiation of adult sheep bone marrow-derived mesenchymal stem cells (MSCs) in a defined medium as potential seed cells for cartilage tissue engineering. MSCs were isolated by density centrifugation with Percoll solution from bone marrow aspirated from sheep iliac crest. The third passage of MSCs were induced with H-DMEM containing TGF-beta3, IGF-I, Dexamethasone and VitC. The shape and ultrastructure of cells were observed, toluidine blue stain for GAG and immunohistochemistry for type II collagen were applied for chondrogenic phenotype identification. After 14 days of induction, MSCs changed from a spindle-like appearance to a polynal shape, a large amount of endoplasmic reticulum, Golgi complex and mitochondria were observed, and the differentiation of MSCs chondrogenic phenotype was verified by positive staining of toluidine blue and immunohistochemistry. MSCs derived from bone marrow can differentiate to chondrogenic phenotype when induced in vitro and can be used as optimal seed cells for cartilage tissue engineering.
Bone Marrow Cells/*cytology ; Cell Differentiation ; Cell Separation ; Cells, Cultured ; Chondrocytes/*cytology ; *Chondrogenesis ; Mesenchymal Stem Cells/*cytology ; Phenotype ; Sheep ; Tissue Engineering

Objective To evaluate the clinical effects of bladder perfusion combined with deep hyperthermia on preventing postoperative recurrence of non-muscle invasive bladder cancer.Methods Choose 98 patients with NMIBC who were treated with transurethral bladder cancer resection,and randomly divide them into two groups,research group and control group,49 cases in each.Giving MMC bladder perfusion chemotherapy to the control group,and added deep hyperthermia to the research group on the basis of bladder peffusion.Contrast the relapse rates and condition of adverse events during treatment.Resnits The relapse rates of research group when treatment was continued for 6,9,12,15,18 months were significantly lower than that of control group(4.08％ VS 10.20％,6.12％ VS 12.24％,10.20％ VS 18.37％,10.20％ VS 20.41％,14.29％ VS 24.50％,all P ＜ 0.05).No statistical significance in adverse events between each group was observed (P ＞ 0.05).Conclusion MMC bladder perfusion combined with deep hyperthermia therapy has great clinical value,as it can reduce the rates of postoperative recurrence of NMIBC,as well as not increase the AEs of bladder perfusion.

Objective To understand the abnormal status of alanine aminotransferase (ALT),fasting blood glucose (GLU),to-tal cholesterol (TC)and triglyceride (TG)in urban and rural residents,to provide the basis for making the effective prevention measures,health education and health promotion to community work more targeted and effective.Methods The data of physical ex-amination results of 4 042 residents were analyzed retrospectively,the levels and abnormal rates of ALT,TG,TC,GLU were com-pared between different gender and age.Results Among 4 042 residents,the abnormal rate of male was significant higher than that of female,but the abnormal rates of TG,TC of female were significant higher than those of male(P <0.05).The highest rates of ALT,TG,TC,GLU in male were in 20-<40 years old,40-<60 years old,60-<80 years old,≥80 years old.The highest rates of ALT,TG,TC,GLU in female were in 0-<20 years old,60 -<80 years old,≥ 80 years old,≥80years old.Conclusion The health status of urban and rural residents is not optimistic,the community intervention,health guidance should be strengthened to prevent and control the occurrence and development of diseases and improve the health level of urban and rural residents.

Objective To investigate the clinical efficacy of fixation of distal radius fracture with dorsal instability with locking compression plate (LCP) via radial approach.Methods From September 2009 to October 2012, 21 cases underwent LCP fixation of the distal radius fracture with dorsal instability via radial approach.The study included 14 males and 7 females (mean age, 54.5 years;range, 38-81 years).Twelve cases were injured in traffic accidents, 7 in falls and 2 in high falls.Fracture AO classification was type A3 in 10 cases, type C1 in 8 cases and type C2 in 3 cases.Two cases (one type A3 and one type C1) had malunion.When the lateral column, intermediate column, radial edge and dorsal plane were exposed by radial incision, LCP fixation with bone grafting was performed to restore the height of radial styloid process, ulnar deviation and palmar tilt.According to the GartlandWerley score, wrist joint function was evaluated.Results Mean duration of follow-up was 13.5 months (range, 12 to 24 months).Stage Ⅰ bone union was shown on X-rays, with the healing time of 7.5 weeks.Based on the X-rays at postoperative 6 months, 1 year and 2 years, the shortening of radial styloid process was ≤ 2 mm, mean volar tilt was 12.5°(range, 8°-17°) , mean ulnar tilt was 20.5° (range, 15°-26°), and step-off or gap of the articular surface was ≤ 2 mm.In postoperative wrist motion assay, mean volar flexion was 60°(range, 30°-70°), mean dorsal flexion was 55° (range, 30°-65°), mean radial deviation was 17°(range, 10°-20°), mean ulnar deviation was 25.5° (range, 20°-30°),pronation was 65.5° (range, 60°-70°) , and mean supination was 75.5° (range, 60°-80°).Mean grip strength was 75％ (60％-95％)of the contralateral side.Two cases suffered from pain (one complained of moderate pain and one minor pain occasionally).According to the Gartland-Werley score, 16 cases were rated excellent, 2 good, 2 fair and 1 poor, with the excellent rate of 86％.No complication was found as injury of the superficial branch of radial nerve, infection, nonunion, nail loosening, medium neuritis and tendon injury.Conclusions Lateral column, intermediate column, radial edge and dorsal plane can be shown via the radial approach.LCP fixation combined with bone grafting contributes to fracture anatomical reduction.