3.Titanium wire mesh and impact bone allograft in treating acetabular bone defects in revision total hip arthroplasty
Zhefeng CHEN ; Weimin FAN ; Qing WANG ; Weiding CUI ; Feng LIU
Chinese Journal of Orthopaedics 2016;36(23):1512-1516
Objective To investigate the method and efficacy in treating acetabular bone defects by the use of titanium wire mesh and impact bone allograft in revision total hip arthroplasty.Methods Twenty-two patients (22 hips) with acetabular bone defects in revision total hip arthroplasty were treated with wire mesh and impact bone allograft from January 2008 to December 2013.There were 7 males and 15 females in the present study.The average age of the patients at the surgery was 64.8 (37-78) years.According to Paprosky classification,there were 9 cases of type ⅡA,4 cases of ⅡB,7 cases of ⅡC and 2 cases of ⅢB.Twenty cases with aseptic loosen and 2 with periprosthetic infection were underwent revision surgery.Deep frozen cancellous bone allograft was sterilized and morselized to particles with the size of 7 to 10 mm.After removal of loosed acetabular component,the bone grafts were impacted into the acetabular defects area to restore the bone quantity.Titanium wire mesh with appropriate diameter was chosen to fix on impacted bone graft and fixed acetabulum with screws.Polyethylene cup was cemented in the mesh wire with proper position.Harris hip score system was used to evaluate the hip joint function.The AP pelvis X-ray was taken at 1 week,3 months,12 months and annually thereafter postoperatively to evaluate the rotation center,fusion of the bone graft and loosening of cup.Results All patients were followed up with the average period 5.1 years (3-7 years).The average Harris hip score before revision was 43.75±13.45,while the score was 85.33±7.84 at last follow-up (t=7.930,P=0.000).The average height of hip rotation center of surgical side was 3.49±0.77 cm before surgery,while its height at last follow-up was 2.22±0.22 cm (t=4.390,P=0.005).The distance between hip rotation center and the base of acetabulum was 3.54±0.45 cm before surgery,while its value was 3.52± 0.76 cm at last follow-up.All the bone grafts came to infusion with the average time 12 months (9-15 months).There was no case with cup migration more than 4 mm or rotation greater than 5° at last follow-up.One patient had the symptom of sciatic nerve injury.No case was with infection or dislocation.Conclusion In the treatment of acetabular bone defects,wire mesh and impact bone allograft with cemented cup in revision total hip arthroplasty can reconstruct hip rotation center and the acetabular bone quantity effectively.Satisfied early-midterm curative effects could be acquired by using this method.
4.The reason of operative death and operative risk factors in patients with esophageal cancer after esophagectomy by logistic regression model
Bin FENG ; Yaoguang JIANG ; Shizhi FAN ; Ruwen WUANG ; Qing ZENG
Journal of Third Military Medical University 2001;23(5):526-529
Objective To explore the risk factors and causes affecting the operative mortality in esophagectomy patients with esophageal can cer. Methods 1400 cases with a curative esophagectomy for neopl asm of esophagus hospitalized from Mar,1973 to June, 2000 were reviewed. There w ere 31 died within 30 d or during hospitalization after esophagectomy as a group , and 1 369 survival cases, after operation, as another group. Sixteen factors t hat may influence the operational mortality were selected. A multi-variate anal ysis of these individual variables was performed by the computer′s logistic reg ression model. Results The operative mortality was 2.2%(31/1400 ). The causes of death included respiratory complication 17 cases (including res piratory failure caused by pneumonia or atelectasis), 15 cases, and adult respir atory distress syndrome (ARDS) 2 cases, the mortality was 54.8% in the death gro up), anastomotic leak 11 cases (34.5%), Chylothorax 2 cases (6.5%) and postopera tive digestive tract hemorrhage 1 case (3.2%). The results showed that the major risk factors that affected operative mortality in cases with esophageal cancer were history of long-herm heavy smoking, duration of operation and the year of operational (P<0.05). Conclusion To minimize operative mort ality of esophagectomy, some means must be noticed, including the reinforcemen t of the perioperative care, the improvement of anastomotic methods and surgical skill, reduing operative time as p ossible, disposing pulmonary complications in time and using respirator if neces sary.
5.Two-stage exchange total hip arthroplasty for infected hip surgery
Zhefeng CHEN ; Qing WANG ; Weiding CUI ; Weimin FAN ; Feng LIU
Chinese Journal of Orthopaedics 2012;32(9):817-822
Objective To evaluate effect of two-stage exchange total hip arthroplasty (THA) using an antibiotic-loaded cement spacer in the treatment of hip infection secondary to hip surgery.Methods From January 2005 to January 2010,6 consecutive patients with infected hip secondary to hip surgery,including 2 males and 4 females,aged from 43 to 68 years (average,59.7±9.2 years) were treated with two-stage exchange THA.There were 3 cases of femoral neck fracture treated with compression screws fixation,1 case of femoral head necrosis treated with bone graft,and 2 cases of early stage femoral head necrosis treated with core decompression and local interventional therapy respectively.Debridement and insertion of antibioticloaded cement spacer was performed in the first stage.After eradication of infection,it was converted to THA in the second stage.All patients were followed up regularly.Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were tested.Harris score was used to evaluate the function of the hips.Results All patients were followed up for an average of 46 months (range,24 to 81 mouths).Five of 6 patients were successfully converted to THA after an average of 14 weeks.One patient accepted the second debridement and reinsertion of a spacer owing to the abnormal values of ESR and CRP; this case was converted to THA successfully 12 weeks after the second debridement.Harris hip score improved from preoperative 35.6±3.3 to 57.8±5.4 between the two stages and 92.3±5.7 at final follow-up.One patient suffered deep vein thrombosis in the infected extremity and pulmonary embolism.There was no reinfection after THA.Conclusion Twostage exchange THA using an antibiotic-loaded cement spacer can obtain satisfactory results for the treatment of hip infection secondary to the hip surgery.
6.Observation of experimental corneal neovascularization induced by alkali burn
lei, ZUO ; xun, XU ; ying, FAN ; feng, WANG ; qing, GU
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(06):-
Objective To induce the experimental corneal neovascularization(CRNV) by alkali burn,and explore the methods for quantitative analysis of CRNV and observation of permeability of CRNV. Methods Thirty-six C57BL/6 mice were selected and divided into experiment group(n=30) and control group(n=6).For the experiment group,alkali burn was induced by application of filter paper with 1mol/L sodium hydroxide to the cornea for 5 s.For the control group,no intervention was conducted.Areas of CRNV were measured on day 4,7,10 and 14 after alkali burn.Histological examinations of cornea were performed with HE staining on day 3, 7,10,16 and 28 after alkali burn.On day 10,endothelial cell marker CD31 was used with immunohistochemical staining for CRNV counting,and fluorescence angiography(FA) was employed to reveal the permeability of CRNV.Corneal ulceration and hyphema were observed everyday.Results CRNV developed after alkali burn,and extincted afterwards.Axenic coneal ulceration and hyphema were frequently observed,with the incidences of 6.7% and 10.0%,respectively.Histologic changes of corneal tissues at different time points could be observed with HE staining.On day 10, CRNV could be labeled and counted with immunohistochemical staining for CD31 antibody,and the permeability of CRNV could be detected by FA. ConclusionCRNV counting with immunohistochemical staining for CD31 antibody and measurement of area of CRNV are appropriate methods for quantitative analysis of CRNV.FA is an effective method in the detection of permeability of CRNV.
7.Determination of Aluminum in Floured Food by Tetra Component Complex System
Qing-Zhi GUO ; Er-Lao ZHAO ; Jian-Feng FAN ;
Journal of Environment and Health 2007;0(10):-
Objective To develop a spectrophotometry in tetra component complex system of A1-CAS-CTMAB-OP for the determination of aluminum in floured food.Methods The sample was processed by combustion and the content of aluminum in foods was determined by spectrophotometry with Al-CAS-CTMAB-OP as color system.Results A linear relationship between the aluminum content and absorbency was in the range of 0.04~0.32 ?g/ml with the regression equation equating to A =3.551 2x-0.005 34,the correlation coefficient was 0.997 6,the detection limit was 0.001 4 ?g/ml and the recovery rate was in the rang of 98.6%~ 103.2%.Conclusion This method has been applied successfully to determine the aluminum in floured food for its special features, such as simple,rapid and accuracy.
8.Reduction of Vascular Endothelial Growth Factor Expression Induced Proteinuria in Adriamycin Nephrotic Rats
qing-feng, FAN ; yan, XING ; jie, DING ; na, GUAN
Journal of Applied Clinical Pediatrics 2006;0(17):-
0.05) at any observed time points as compared with the controls.3.From day 7 after the adriamycin injection,VEGF protein reduced significantly(P
10.Mortality following simultaneous bilateral or staged bilateral total knee arthroplasty: a meta-analysis
Jun HU ; Feng LIU ; Zheng LV ; Qing WANG ; Weiding CUI ; Weimin FAN
Chinese Journal of Orthopaedics 2011;31(8):852-858
Objective To evaluate mortality associated with simultaneous bilateral or staged bilateral TKA, and better understand the risks involved in the simultaneous versus staged bilateral procedures.Methods A systematic review was conducted, following an a priori protocol, according to the methods recommended by the Cochrane Musculoskeletal Group in the Cochrane Collaboration. Eligible studies were identified in PubMed (1990-2010), OVID MEDLINE (1990-2010), and the Cochrane library, concerning postoperative complications of bilateral or staged bilateral total knee arthroplasty. All of the English-language abstracts were obtained, and retrieval words including bilateral total knee arthroplasty, staged total knee arthroplasty, and total knee arthroplasty, etc. An extensive analysis was then performed to identify articles fulfilling the inclusion criteria for the study. The details of the reported data were extracted and evaluated by two reviewers independently. Data analyses were conducted with Stata 10.0. Results Six studies met our inclusion criteria for review. The combined results showed that the prevalence of mortality[OR=2.925, 95% CI (2.352, 3.638)], mortality 30 days postoperatively[OR=5.078, 95% CI (2.192, 1 1.763)]and mortality in 70 years or older patients[OR=4.087, 95% CI (1.947, 8.582)]were statistically higher in the population that had undergone simultaneous TKA compared with staged TKA. Conclusion Compared with staged bilateral TKA, simultaneous bilateral TKA might carries a higher potential risk of postoperative mortality. Patients should be aware of this information when deciding whether to proceed with simultaneous bilateral TKA. Further well-designed and large-scale randomized controlled trials are required to confirm these findings.