OBJECTIVETo compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

METHODSFrom September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.

RESULTSAll patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.

CONCLUSIONBoth of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

When we did compatibility testing, we found a case of leukemia with irregular antibody. The antibody specificity was identified as anti-Ce using panel-cell, and was IgG antibody. The anti-Ce antibody had both anti-C and anti-e activity. It is very difficult to find a Ce antigen negative blood for transfusion. The compatible donors rate is very low, only 2%-3%.

Objective To investigate the protein and mRNA expressions of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) on colons of rats with trinitrobenzene sulfonic acid (TNBS)- induced colitis,and to evaluate the effects of probiotics.Methods Thirty male Wistar rats were randomly divided into normal control group (NC group),model control group(UC group) and probiotics-treated group(PC group).The experimental colitis was induced by TNBS/ethanol enema.Rats in PC group were fed with Bifico [live probiotics of combined hifidobacterium(Bif),lactobaeillus(Lac) and enteroeoccus] by 2.2?10~9 CFU/d for 4 weeks.Inflammatory scores were studied.Expressions of protein and mRNA of TLR2 and TLR4 were measured by Western blot and real-time quantitative polymerase chain reaction (PCR),respectively.Results Inflammatory scores in NC group,UC group and PC group were 4.35?0.88,10.25?1.36 and 7.94?0.85,respectively.The inflammatory scores in PC group were decreased compared with that in UC group (P

OBJECTIVEThe study aimed to review the treatment and prognosis of acute obstruction of colorectal cancers and to compare different treatment strategies of those cancers, and to evaluate the risk factors affecting perioperative complications.

METHODSClinical data of 184 patients with acute obstruction of colorectal cancer undergone operation were analyzed retrospectively.

RESULTSA total of 184 patients with acute obstruction of colorectal cancer was collected in this study, including 58 patients with proximal and 126 patients of distal colorectal cancers. Perioperative death occurred in 2/58 patients (3.4%) with distal colorectal cancer and 6/126 cases (4.8%) of distal colorectal cancer (P > 0.05). The overall perioperative complications in the two groups were not significantly different (P = 0.794). Among the 58 patients with proximal colorectal cancer, one patient underwent colostomy, but among the 126 patients with distal colorectal cancer, 41 patients underwent colostomy, showing a significant difference between the two groups (P = 0.002). ASA scores (grade 3 - 4), elderly age (≥ 70 years) and colon perforation peritonitis were independent prognostic factors associated with perioperative mortality and morbidity. Patients in the self-expandable metallic stent (SEMS) group had a significantly shorter hospital stay (25.4 ± 8.3) d than that in the emergency surgery group (32.8 ± 16.4) d, (P = 0.039).

CONCLUSIONSEndoscopic stent implantation provides an acceptable modality of palliation for acute proximal large bowel obstruction caused by malignancies. In acute colorectal cancer obstruction, SEMS can provide a minimally invasive management compared with surgical intervention.

Acute Disease ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; complications ; diagnosis ; surgery ; Colostomy ; Endoscopy ; Female ; Humans ; Intestinal Obstruction ; etiology ; therapy ; Intestinal Perforation ; etiology ; Intraoperative Complications ; Length of Stay ; Male ; Middle Aged ; Palliative Care ; methods ; Peritonitis ; etiology ; Prognosis ; Retrospective Studies ; Risk Factors ; Stents ; Young Adult

OBJECTIVETo assess the relationships between iodine biological exposure and subclinical thyroid dysfunctions.

METHODSThe cross-sectional survey was performed to obtain the epidemiologic data of population in three communities with different iodine biological exposure: mild iodine deficiency [median urinary iodine concentration (MUI) of 50-99 microg/L], more than adequate iodine intake (MUI of 200-299 microg/L), and excessive iodine intake (MUI over 300 microg/L). Univariate and multivariate analysis (logistic regression analysis) were used to analyze the risk factors of subclinical hypothyroidism and subclinical hyperthyroidism.

RESULTSLogistic regression analysis with sex and age controlled suggested that more than adequate iodine intake (OR = 3.172, P = 0.0004) and excessive iodine intake (OR = 6.391, P = 0.0001) increased the risk of subclinical hypothyroidism, while excessive iodine intake decreased the risk of subclinical hyperthyroidism (OR = 0.218, P = 0.0001). Logistic regression analysis including interaction of iodine intake and antibodies [thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] suggested that excessive iodine intake was an independent risk factor of subclinical hypothyroidism (OR = 6.360, P = 0.0001), but independent protect factor of subclinical hyperthyroidism (OR = 0.193, P = 0.0001). More than adequate iodine intake and it's interaction with TgAb increased the risk of subclinical hypothyroidism independently, in addition, it decreased the risk of subclinical hyperthyroidism at the present of TPOAb.

CONCLUSIONBoth excessive iodine intake and more than adequate iodine intake could increase risk of subclinical hypothyroidism, supplement of iodine should be controlled to ensure MUI within the safe range.

Adult ; Autoantibodies ; blood ; China ; Cross-Sectional Studies ; Dose-Response Relationship, Drug ; Female ; Humans ; Hyperthyroidism ; chemically induced ; epidemiology ; metabolism ; Hypothyroidism ; chemically induced ; epidemiology ; metabolism ; Iodide Peroxidase ; immunology ; Iodine ; administration & dosage ; adverse effects ; urine ; Male ; Multivariate Analysis ; Risk Factors ; Surveys and Questionnaires ; Thyroglobulin ; immunology

Atomic absorption spectrometry was employed to determine the levels of 7 essential trace elements in the whole blood of 150 mainteinance hemodialysis (MHD) patients.And comparisons were made with the normal group of 200 participants in routine medical examination at the same time at our hospital.And among 7 indices,as compared with the control group,the blood levels of zinc,chromium,cobalt and manganese were significantly lower (P ＜ 0.05) while those of selenium and copper higher (P ＜ 0.05).MHD patients lacked essential trace elements to a varying extent.A clinician should pay attention to complementing essential trace elements to improve the patient's quality of life.

Objective To evaluate the therapeutic efficacy and safety of endoscopic sphincterotomy (EST) combined with large balloon dilation for bile duct stones.Methods A total of 83 patients with common bile duct stones were randomly divided into 2 groups to receive standard EST (n =41,EST group) or EST plus large balloon dilation (n =42,EPLBD group),respectively.The number of endoscopic session,operation time,rates of successful complete stone retrieval,mechanical lithotripsy,and procedure related complication were compared between the two groups.Results The rate of early procedure-related complications was similar in 2 groups (9/41 vs.7/42,P ＞0.05),including perforation ( 1/41 vs.0/42,P ＞0.05),bleeding (5/41 vs.2/42,P＞0.05) and pancreatitis (3/41 vs.5/42,P＞0.05).The rate of successful complete stone removal was also similar in 2 groups (39/41 vs.41/42,P ＞ 0.05 ).However,EST group needed more procedure time (38.8 ±4.3 min vs.29.2 ±5.3 min,P ＜0.01 ) and use of mechanical lithotripsy to achieve complete stone removal (9/41 vs.2/42,P ＜ 0.05 ).Only one patient in EPLBD group ( 1/42,2.4％ ) needed a second ERCP to clear bile duct stone,while in EST group,8 patients underwent a second procedure ( 19.5％,P ＜ 0.05 ).Conclusion For endoscopic removal of common bile duct stones,EST combined with larg4e balloon dilation is as safe and effective as EST,while easier in manipulation.

BACKGROUND:It has become a focus to look for new vertebral body fil ing materials which have the biomechanical property, biological activity and low cement leakage rate.
OBJECTIVE:To investigate the biomechanical characters and cement leakage rate of the vertebral bodies implanted with biodegradable reticulated bal oon and calcium phosphate.
METHODS:Thirty-two vertebral bodies from pigs were randomly divided to four groups. For A group, 2.5-3.0 mL polymethacrylate cement was injected into the body through a unilateral thoracic pedicle pathway;for B group, 2.5-3.0 mL calcium phosphate cement were injected by the same protocol;for C group, the biodegradable reticulated bal oons fil ed with 2.5-3.0 mL calcium phosphate cement were implanted;D group, including normal vertebral bodies, was designed as controls. Leakage of bone cement was observed in each group. The load-shift curves were recorded by an electronic universal testing machine (SCHENCK RSA-250).
RESULTS AND CONCLUSION:The stiffness and strength of A group were significantly higher than those of D group (P<0.05), and the stiffness and strength of B group were statistical y lower than those of D group (P<0.05). The stiffness and strength of C group, otherwise, were similar with those of D group (P>0.05). Cement leakage rate of C group was lower than that of A or B group (P<0.05). Vertebral bodies implanted with biodegradable reticulated bal oons may lead to similar biomechanical characters as the normal vertebral bodies and reduce the cement leakage rate.

BACKGROUND:Vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures can result in many complications, such as bone cement leakage and adjacent-level fractures.
OBJECTIVE:To verify the possibility of biodegradable mesh-like microporous polymer bal oon for the treatment of osteoporotic vertebral compression fractures.
METHODS:Biodegradable mesh-like microporous P(DLLA-CL) bal oons were fabricated by electrospinning technique. Coated bal oons with the same specification was fabricated by coating P(DLLA-CL) onto the same mould. Morphology of the bal oons was observed by scanning electron microscopy. The bal oon leakage was observed by eyes after the injection of water or cement. The initial strength and stiffness were measured by a universal testing machine. The proliferation of MC3T3-E1 cel s on the bal oons was determined by laser confocal microscope and cel counting kit-8 assays. The biodegradation of bal oons in simulated body fluid, porcine pancreatic lipase, and fresh human serum was studied by residual weighing and scanning electron microscopy observation. Burst pressure of bal oons was measured after the bal oon was placed into a hole in the vertebral bone. For the in vitro calcium release tests, the bal oons were fil ed with calcium cement, tied, placed into 6atm ultrapure water, and then the calcium concentration was regularly determined.
RESULTS AND CONCLUSION:Mesh-like microporous bal oons presented with good fiber morphology, thickness distribution, and the presence of pores;on the coated bal oon surface, there was absence of specific morphology and porosity. Compared with the coated bal oon, the mesh-like microporous bal oon showed better mechanical properties, liquid permeability and burst pressure, to prevent leakage of bone cement and promote osteoblast adhesion and proliferation. In addition, the degradation of the mesh-like microporous bal oons was more uniform and stable than the coated bal oons, which may increase the calcium concentration in the injured vertebrae and wil be beneficial to the new bone growth and fracture healing.

BACKGROUND:In vitro experiments have demonstrated that the biodegradable mesh-like microporous baloon made of macromolecular materials has obvious advantage of anti-leakage, which is capable of maintaining calcium homeostasis, has no inhibitory effects on cel growth and on microscopic interdigitation formation between new bone and bone cement. OBJECTIVE:To evaluate the therapeutic effects of biodegradable mesh-like microporous baloon with calcium bone cement on vertebral fractures based on animal experiments. METHODS:The fracture model was established in 48 New Zealand rabbits, in which a bone dril was introduced after successful puncture at sites near left low extremity of the femur. These rabbit models were randomized into two groups: experimental group with calcium phosphate bone cement and biodegradable mesh-like microporous baloon and control group only with calcium phosphate bone cement. Clinical parameters such as blood cel count, biochemistry, and CT/X ray were examined at 1, 3 and 6 months after implantation of the baloon and bone cement. After that, the specimens were fixed for pathological analysis. RESULTS AND CONCLUSION:The operation was performed under general anesthesia with no eventful infusion of bone cement. The expansion of baloon was satisfactory without definite extravasation of bone cement in the experimental group. In the control group, cement diffusion was found with pulmonary embolism occurring in three New Zealand rabbits. No statistical significance for blood cel counts and biochemistry was found between pre- and postoperation or between two groups. The materials in the two groups had favorable biocompatibility with injured bones without obvious immunological response. In the experimental group, the baloon wal was thinned and partial bone tissues grew into the cement at 1 month; at 3 months, a large amount of bone tissues grew into the cement and cement volume diminished; at 6 months, the baloon disappeared and only a smal amount of cement left in the bone tissues. In the control group, it was difficult to determine when the cement degraded. The biodegradable mesh-like microporous baloon combined with calcium bone cement is superior to bone cement alone in the management of vertebral fractures.