OBJECTIVE: To compare the effectiveness of different puncture methods of the flexible bone cement delivery device in unilateral percutaneous curved vertebroplasty for osteoporotic vertebral upper 1/3 compression fractures. METHODS: A retrospective analysis was conducted on the clinical data of 67 patients with osteoporotic vertebral upper 1/3 compression fractures who were admitted and met the selection criteria between January 2023 and April 2024. The patients were divided into two groups based on the puncture method of the flexible bone cement delivery device: the oblique puncture group ( n=37) and the parallel puncture group ( n=30). There was no significant difference ( P>0.05) between the two groups in terms of gender, age, bone mineral density (T value), distribution of fractured vertebrae, time from injury to operation, and preoperative visual analogue scale (VAS) score for pain, Oswestry disability index (ODI), anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra. The following parameters were compared between the two groups: operation time, incidence of secondary puncture, incidence of bone cement leakage, volume of injected bone cement, bone cement distribution score, as well as VAS score, ODI, anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra at 1 day after operation and at last follow-up. RESULTS: Two cases in the oblique puncture group and 7 cases in the parallel puncture group underwent secondary puncture during operation, and the difference in the incidence of secondary puncture was significant ( P<0.05). No complications such as bone cement hypersensitivity, bone cement embolism, nerve injury, or epidural hematoma occurred in both groups. There was no significant difference in operation time, volume of injected bone cement, incidence of bone cement leakage, distribution score and rating of bone cement between the two groups ( P>0.05). All patients were followed up 6-18 months (mean, 12.0 months), and there was no significant difference in the follow-up time between the two groups ( P>0.05). No further fracture collapse or compression occurred in the fractured vertebra during follow-up. Both groups exhibited significant improvements in VAS score, ODI, anterior vertebral height, and Cobb angle of the fractured vertebra after operation compared to baseline ( P<0.05). There were also significant differences between the two time points after operation ( P<0.05). However, there was no significant difference in the above indicators between the two groups ( P>0.05). CONCLUSION For osteoporotic vertebral upper 1/3 compression fractures treated with unilateral percutaneous curved vertebroplasty, both oblique and parallel puncture methods of the flexible bone cement delivery device can effectively relieve pain, but the former is more conducive to reducing the incidence of secondary puncture.
Humans ; Bone Cements/therapeutic use* ; Fractures, Compression/surgery* ; Retrospective Studies ; Vertebroplasty/instrumentation* ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Female ; Male ; Aged ; Middle Aged ; Treatment Outcome ; Punctures/methods* ; Aged, 80 and over

Purpose: Tumor regression grade (TRG) has been widely used in gastrointestinal carcinoma to assess pathological responses to neoadjuvant chemotherapy (NCT). There are various standards without a consensus, and it is still unclear which kind of system has better predictive value. This study aims to investigate and compare the predictive ability of the Mandard and Becker TRGs in patients with locally advanced gastric cancer. Materials and Methods: A total of 290 patients with locally advanced gastric adenocarcinoma who underwent NCT and curative surgery were studied. Survival analysis for overall survival (OS) and disease-free survival (DFS) were based on the Kaplan-Meier method and Cox proportional hazards method. Predictive values of TRGs and models were assessed by time-dependent receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), nomogram, and calibration curve. Results: In multivariable analysis, the Mandard TRG was associated with OS (hazard ratio [HR], 1.806; p=0.026) and DFS (HR, 1.792; p=0.017). The Becker TRG was also related to OS (HR, 1.880; p=0.014) and DFS (HR, 1.919; p=0.006). The Mandard and Becker TRG AUCs for 5-year survival were 0.72 and 0.71, respectively. The whole models showed an increased predictive value, with AUCs of 0.85 and 0.86, respectively. There was no significant difference between the two TRGs and two models. Conclusion TRG was an independent predictor for survival, and there was no significant difference between these two systems.

Chronic osteomyelitis (COM) is an infectious disease caused by methicillin-resistant Staphylococcus aureus (MRSA),the main characteristics of COM including local dead bone formation,soft tissue infection,and repeatedly attacks.As a sensitive antibiotic,vancomycin plays an important role in the therapy of COM caused by MRSA.Currently,drug treatment is divided into systemic and topical,systemic medication is given priority to intravenous drug delivery;local drug application including local delivery device and local antibiotics lavage and regional arterial perfusion.In practice,its validity depends on whether free drug concentration of vancomycin has riched the effective concentration in the organization.Nevertheless,low concentration lead to treatment failure and even induce drug-resistance bacteria,meanwhile high concentration may cause acute renal failure.So when using vancomycin for the treatment of chronic osteomyelitis,both drug resistance and renal toxicity is as the same important as the effectiveness.Systemic administration is a targeting weak way and has many complications;topical medicate effect on the lesion can be targeted,it would be an effective way in the future treatment of COM.Different methods of delivering vancomycin have great influence on local drug concentration,which makes it become the most important factor on local drug concentration of COM.

Chronic osteomyelitis (COM) is an infectious disease caused by methicillin-resistant Staphylococcus aureus (MRSA),the main characteristics of COM including local dead bone formation,soft tissue infection,and repeatedly attacks.As a sensitive antibiotic,vancomycin plays an important role in the therapy of COM caused by MRSA.Currently,drug treatment is divided into systemic and topical,systemic medication is given priority to intravenous drug delivery;local drug application including local delivery device and local antibiotics lavage and regional arterial perfusion.In practice,its validity depends on whether free drug concentration of vancomycin has riched the effective concentration in the organization.Nevertheless,low concentration lead to treatment failure and even induce drug-resistance bacteria,meanwhile high concentration may cause acute renal failure.So when using vancomycin for the treatment of chronic osteomyelitis,both drug resistance and renal toxicity is as the same important as the effectiveness.Systemic administration is a targeting weak way and has many complications;topical medicate effect on the lesion can be targeted,it would be an effective way in the future treatment of COM.Different methods of delivering vancomycin have great influence on local drug concentration,which makes it become the most important factor on local drug concentration of COM.

BACKGROUND:The effect of dimethyl sulfoxide cryoprotectants has been got a lot of verification in the low-temperature medical applications. But there is no literature addressing microdialysis detection of dimethyl sulfoxide cryoprotectants. OBJECTIVE:To investigate the microdialysis relative recovery of different concentrations of dimethyl sulfoxide cryoprotectants used for limb reattachment. METHODS:In vitro linear probe relative recovery of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) was detected by retrodialysis gain and loss method. The correction in vivo experiment was done to estimate dimethyl sulfoxide relative recovery in rabbit amputated limbs. RESULTS AND CONCLUSION:The relative recoveries of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) were (49.49±3.56)%, (46.30±1.48)%, (52.66±2.54)%using retrodialysis gain method and (50.99±6.89)%, (43.86±1.35)%, (50.67±0.75)%using retrodialysis loss method. The average recoveries were (49.48±3.18)%and (48.51±4.03)%, respectively. There was no difference in the relative recovery of dimethyl sulfoxide detected using two methods. The change of dimethyl sulfoxide concentration could not influence the retrodialysis gain and loss method calibration results. The recovery was (15.45±4.8)%in vivo. These findings indicate that the microdialysis technology is suitable for dimethyl sulfoxide sampling in vivo that has no obvious influence on the relative recovery.

Objective To observe the contribution of acute normovolemic hemodilution ( ANH) in experiment of cryopreserved dog limb replantation.Methods Sixteen healthy Beagle dogs (male:female=1:1) were divided into two groups.Dogs in the experiment group ( Group B) received ANH in the limb replantation, and dogs in the control group ( Group A) received the same amount of lactate Ringer’ s solution intravenously during the surgical operation.We recorded and compared the hemodynamic indexes, HB, HCT, the resuscitation time, the first rising head time, the first standing time and the first eating and drinking time between the two groups.Results ( 1 ) During the operation, both PaO2 and PCO2 in the two groups were normal, as well as the breathing rate.The heart rate in the group B was lower than that in the group A.Before blood transfusion, there was no statistically significant difference in HB and HCT between the two groups, but after transfusion they were significantly higher in the group B than in the group A.(2) The resuscitation time, the first rising head time, the first standing time and the first eating and drinking time of the group B were all better than those in the group A.Conclusions In cryopreserved dog limb replantation experiments, acute normovolemic hemodilution is helpful to improve the general condition and facilitate the recovery of animals after limb replantation.

BACKGROUND:The cryopreservation of single tissue has achieved great advancement and is gradual y applied in clinics. However, the cryopreservation of complex tissue is rarely reported.
OBJECTIVE:To investigate the morphological change in rabbit limb tissue after replantation through different rewarming methods, find the best rewarming methods of compound textured blood vessels, and provide theoretical basis for the feasibility of limb replantation after long-term cryopreservation.
METHODS:Thirty New Zealand white rabbits were randomly divided into control group, slow freezing-slow thawing group, and slow freezing-rapid thawing group. The right posterior limbs of al the rabbits were cut off 1 cm above the knee joint. Except control group, the latter two groups were given limb replantation after thawing, and then the right posterior limb was again cut off after the replanted limbs were survived for 6 hours. For al groups, the histological changes and gross observation in aorta tissue were observed by light microscopy and transmission electron microscope, and the results were analyzed with statistical methods.
RESULTS AND CONCLUSION:In the slow freezing-slow thawing, slow freezing-rapid thawing groups, the pathological changes (gross specimen, light microscope, electron microscope) of rabbit limbs 6 hours after replantation were worse than those in control group. Compared with slow freezing-rapid thawing group, better integrity of endothelial cells and less damage of the organel es were found in slow freezing-slow thawing group. Through deep cryogenic freezing-thawing process, rabbit limb blood vessels can maintain the structural integrity after replantation and survived at 6 hours. Slow freezing-slow thawing is better than slow freezing-rapid thawing for the preservation of severed limbs, providing evidences for the long-term survival fol owing a deep cry ogenic treatment after the severed limb replantation.