Objective:To evaluate the clinical efficacy of a novel surgical approach of debridement, antibiotics, and implant retention (DAIR) with flap transfer, for treating chronic implant infections in bone tumor patients.Methods:A retrospective review was conducted on nine consecutive patients [6 males, 3 females; median age 35(27, 51) years, range 9-71] who underwent a modified procedure of DAIR plus flap transfer between November 2022 and January 2024. The cohort included six cases of chronic periprosthetic joint infection and three cases of chronic plate and screw infection. Tumor diagnoses included seven primary malignant tumors (osteosarcoma=5, undifferentiated pleomorphic sarcoma of bone=1, synovial sarcoma=1) and two bone metastasis of renal cell carcinoma. The procedure involved wide, radical debridement, meticulous removal of biofilm from implants and surrounding soft tissue, followed by the transfer of a well vascularized musculocutaneous flap to fully envelope the contaminated interface. Pre-operative clinicopathological data, surgical details, postoperative complications and infection recurrence were analyzed.Results:The median interval between initial implantation and debridement was 10.0(3.3, 14.8) months. Median follow-up after debridement was 15.9(15.4, 18.2) months. All nine surgeries were completed as planned: six musculocutaneous flaps, two fasciocutaneous flaps and one muscle-only flap. Implants were preserved in six patients; two required subsequent removal for recurrent infection, and one patient later underwent amputation for tumor recurrence. Infection-free implant survival at 3, 6 and 12 months was 88.9%, 87.5% and 87.5%, respectively. Major complications included one donor-site hematoma, one donor-site sensory deficit and one wound healing delay. All the complications were well management. Both reinfections occurred in proximal tibial prostheses, likely due to limited flap coverage options and local anatomical constraints.Conclusion:Although reinfections happened in two cases DAIR with flap transfer provides promising short-term infection control in patients with chronic implant-associated infections following bone tumor surgery.

Objective:To evaluate the clinical efficacy of a novel surgical approach of debridement, antibiotics, and implant retention (DAIR) with flap transfer, for treating chronic implant infections in bone tumor patients.Methods:A retrospective review was conducted on nine consecutive patients [6 males, 3 females; median age 35(27, 51) years, range 9-71] who underwent a modified procedure of DAIR plus flap transfer between November 2022 and January 2024. The cohort included six cases of chronic periprosthetic joint infection and three cases of chronic plate and screw infection. Tumor diagnoses included seven primary malignant tumors (osteosarcoma=5, undifferentiated pleomorphic sarcoma of bone=1, synovial sarcoma=1) and two bone metastasis of renal cell carcinoma. The procedure involved wide, radical debridement, meticulous removal of biofilm from implants and surrounding soft tissue, followed by the transfer of a well vascularized musculocutaneous flap to fully envelope the contaminated interface. Pre-operative clinicopathological data, surgical details, postoperative complications and infection recurrence were analyzed.Results:The median interval between initial implantation and debridement was 10.0(3.3, 14.8) months. Median follow-up after debridement was 15.9(15.4, 18.2) months. All nine surgeries were completed as planned: six musculocutaneous flaps, two fasciocutaneous flaps and one muscle-only flap. Implants were preserved in six patients; two required subsequent removal for recurrent infection, and one patient later underwent amputation for tumor recurrence. Infection-free implant survival at 3, 6 and 12 months was 88.9%, 87.5% and 87.5%, respectively. Major complications included one donor-site hematoma, one donor-site sensory deficit and one wound healing delay. All the complications were well management. Both reinfections occurred in proximal tibial prostheses, likely due to limited flap coverage options and local anatomical constraints.Conclusion:Although reinfections happened in two cases DAIR with flap transfer provides promising short-term infection control in patients with chronic implant-associated infections following bone tumor surgery.

Objective·To investigate the effect of early postoperative administration of zoledronic acid on fracture healing and functional recovery in elderly patients with osteoporotic femoral intertrochanteric fracture treated with proximal femoral nail antirotation(PFNA)surgery,and explore other potential prognostic factors.Methods·A total of 174 patients with femoral intertrochanteric fractures of 80 years old or above who underwent PFNA treatment in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January,2016 to February,2022,were divided into experimental group(n=26)and control group(n=148)according to whether they received zoledronic acid early after surgery.All patients were followed up twice at 6 weeks and 12 weeks after surgery.The patients in the experimental group were matched with the control group by propensity score matching(PSM)at a ratio of 1:3(the matching factors included age,gender,fracture type,and body mass index).General characteristics,as well as fracture healing and functional recovery at the two follow-up visits were compared between the two groups after matching.Subsequently,Logistic regression was used to explore the potential prognostic factors on fracture healing at 12 weeks after surgery.Results·PSM resulted in 25 patients in the experimental group and 65 patients in the control group,and there were no statistically significant differences in baseline characteristics between the two groups.The fracture healing rates at 6 weeks and 12 weeks after surgery in the experimental group(16.0%and 96.0%,respectively)were higher than those in the control group(1.5%and 73.8%),and the differences were statistically significant(P<0.05).Harris hip function score in the experimental group at 12 weeks was significantly higher than that of the control group(P=0.019).The results of Logistic regression analysis showed that good surgical reduction(OR=12.52,95%CI 2.67?58.74,P=0.001),early postoperative administration of zoledronic acid(OR=10.14,95%CI 1.01?102.09,P=0.049),and higher serum albumin level(OR=1.15,95%CI 1.02?1.29,P=0.025)were the favorable factors of early fracture healing,while unstable fracture(OR=0.10,95%CI 0.03?0.31,P=0.000)was the unfavorable factor.Conclusion·For elderly patients with osteoporotic intertrochanteric femoral fractures treated with PFNA surgery,early postoperative administration of zoledronic acid can promote fracture healing and lead to better functional recovery;in addition,good surgical reduction and higher serum albumin levels are favorable factors for fracture healing,whereas unstable fracture presents as a hindrance to the healing process.

BACKGROUND:The peri-implant bone absorption is closely related to the repair effect. OBJECTIVE:To compare the effects of three kinds of dental implant systems on the peri-implant bone absorption. METHODS:116 patients who underwent the dental implant systems were col ected, including 46 cases with 3I implant system, 40 cases with ITI implant system and 30 cases with BLB implant system. The peri-implant bone absorption, sulcus bleeding index and periodontal probing depth of three groups were detected at 1, 3, 6, 9 and 12 months after implantation, respectively. RESULTS AND CONCLUSION:The peri-implant bone absorption of three groups within 1 year after implantation was in a rise, and the bone absorption of BLB group was significantly higher than that of ITI and 3I groups at 3 and 12 months after implantation (P<0.05). Compared with the natural teeth, the gingival sulcus bleeding index of three groups were al increased at different time points after implantation;the gingival sulcus bleeding index of BLB group was significantly higher than that of natural teeth at 6 months after implantation (P<0.05);the gingival sulcus bleeding index of three groups were significantly higher than that of natural teeth at 9 months after implantation (P<0.05). The periodontal probing depth of three groups showed an ascending trend at 6 months after implantation;the periodontal probing depth of three groups was higher than that of natural teeth at different time points after implantation, which exhibited significant differences at 6 and 9 months after implantation (P<0.05). In conclusion, three kinds of dental implant systems exhibit differet effects on the peri-implant bone absorption, but al achieve excel ent clinical efficacies.

This study was aimed to compare the activation of daidzein and puerarin on antioxidation, NO and NOS suppression in vitro . The RAW264 . 7 cell line was used to prepare radical reaction model induced by LPS (1 μg/mL). MTT method was adopted to detect cytotoxicity of daidzein and puerarin. The DCFH-DA probe and confocal microscopy were used to examine the antioxidant ability of daidzein and puerarin. Griess reagent was adopted to test the NO level in the culture medium. And chemical colorimetry was used to detect the content in RAW264.6 cells. The results showed that daidzein and puerarin can significantly suppress the NO and T-NOS expression in RAW264.7 cells induced by LPS. It was concluded that there was no difference on the activation of antioxidant free radical between daidzein and puerarin . In this regard , daidzein can be the used as substitutes of puerarin .

Objective To determine the median effective dose (ED50 ) of ropivacaine for spinal anesthesia when combined with sufentanil in patients undergoing caesarean section. Methods Twenty-eight ASA Ⅰ or Ⅱ parturients, aged 18-40 yr, weighing 50-110 kg, undergoing cesarean section under combined spinal-epidural anesthesia, were enrolled in this study. Combined spinal-epidural anesthesia was performed at L2,3 interspace. The mixture of ropivacaine and 5 fig sufentanil was injected into the subarachnoid space over 30 s. The initial dose of ropivacaine was 11 mg. The dose was increased/decreased by 1 mg in the next patient. The ED50 and 95% confidence interval were calculated by up-and-down method. Results The ED50 of ropivacaine was 7.780 mg (95% confidence interval 6.850-8.836 mg). Conclusion When combined with sufentanil 5 μg, the ED50 of ropivacaine for spinal anesthesia is 7.780 mg in patients undergoing caesarean section.

OBJECTIVETo explore the relation between genetic polymorphisms of NQO1, GSTT1 and risks of chronic benzene poisoning (BP).

METHODSA case-control study was conducted. 152 BP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. Polymerase chain reaction (PCR), denaturing high-performance liquid chromatography(DHPLC) and sequencing were used to detect the single nucleotide polymorphisms(SNPs) of the promoter and complete coding-region of NQO1 gene. Multiple PCR was used to detect GSTT1 genotype.

RESULTSIn smoking population, there was 7.73-fold (95% CI: 1.71-34.97, P = 0.010) of risk in BP subjects carrying NQO1c. 609 T/T genotype, compared with those carrying C/C and C/T. genotype. In drinking population, the individuals carrying the 6th extron of NQO1c. 609 T/T homozygote genotype had a 11.00-fold(95% CI: 1.89-63.83, P = 0.005) risk of BP compared to those with NQO1c. 609 C/T and C/C genotypes.

CONCLUSIONThe subjects carrying NQO1c. 609 T/T genotype and together with the habit of smoking or drinking may be more susceptible to BP.

Benzene ; poisoning ; Case-Control Studies ; Ethanol ; adverse effects ; Genotype ; Glutathione Transferase ; genetics ; Humans ; NAD(P)H Dehydrogenase (Quinone) ; genetics ; Occupational Diseases ; genetics ; Occupational Exposure ; Polymorphism, Single Nucleotide ; Smoking ; adverse effects