1.IPC devices combined with anticoagulants for the prevention of deep vein thrombosis in TKA and THA patients: A prospective randomized control study
Yuchi ZHAO ; Shudong ZHANG ; Mingwei YU ; Shijun WANG ; Zhongyuan ZHAO ; Kun SONG ; Yangde LIU
Chinese Journal of Orthopaedics 2015;35(11):1091-1095
Objective To investigate the effectiveness of intermittent pneumatic compression (IPC) devices combined with anticoagulants for the prevention of deep vein thrombosis (DVT) after joint replacement surgery.Methods All of 400 patients were involved in this prospective randomized control study with 100 total knee arthroplasty (TKA) patients and 100 total hip arthroplasty (THA) patients in each group.All patients were operated under the general anesthesia.Patients in the control group received 10 mg of rivaroxaban per day beginning 6-8 hours after the surgery.Besides the prescription of rivaroxaban, IPC devices were used just after the anesthesia in the operating theater and lasted for 48 hours in the experimental group.The diagnosis of DVT in the lower extremities was made by color Duplex sonography on the second postoperative day.The incidence rate of DVT and symptomatic pulmonary embolism was recorded.The incidence rates of total DVT, proximal DVT (p-DVT, proximal to the trifurcation of the popliteal vein), distal DVT (d-DVT, in the anterior tibial vein, posterior tibial vein or peroneal vein) and intermuscular DVT were recorded.CT pulmonary angiography was used to confirm the pulmonary embolism if it was suspected.Results The incidence rates of overall, proximal, distal and intermuscular DVT were 9.5%, 0.5%, 0.5%, 8.5% in the experimental group and 30%, 0.5%, 5.5%, 24% in the control group respectively.The incidence rates of total DVT, distal DVT and intermuscular DVT were significantly lower in the experimental group.The incidence rate of DVT in TKA patients and THA patients were significantly lower in the experimental group than in the control group respectively.For patients with DVT, enoxaparin was used instead of rivaroxaban, and DVT was found disappeared by color Duplex sonography 10-12 days postoperatively.Conclusion Compared with the use of rivaroxaban alone, IPC devices combined with anticoagulants can significantly reduce the incidence rate of distal DVT and intermuscular DVT in the early postoperative period after joint replacement surgery.
2.Femoral rotation influences dynamic alignment of the lower extremity in total knee arthroplasty
Yangde LIU ; Yuchi ZHAO ; Weiguang WANG ; Shudong ZHANG
Chinese Journal of Orthopaedics 2015;35(10):1048-1054
Objective To evaluate the influences of femoral rotation on dynamic alignment of the lower extremity in TKA by computer assisted surgical technology.Methods From July 2013 to August 2013,76 consecutive patients with knee osteoarthritis undergone primary-single TKA in our hospital were enrolled,including 46 males and 30 females,aged from 64 to 78 years (average,71 years).All surgeries were completed by the same professional doctor.The PFC (fixed-bearing posterior stabilized) Sigma rotating-platform was selected for all patients,and computer navigation system (Stryker(R) Navigation System Ⅱ-Cart (Stryker corporation,Kalamazoo,Michigan,USA) was used.External rotation osteotomy of the distal femur during TKA was completed according to the pre-operative external rotation angle (ERA),intraoperative transepicondylar axis (TEA) and anteroposterior (AP) line.Passive dynamic alignment of the lower extremity during knee flexion was recorded.The variation trend of hip-knee-ankle (HKA) alignment and the influences of femoral external rotation osteotomy were analysed.Results ERA calculated by the computer navigation system according to Whiteside line,TEA and the mean of Whiteside line and TEA was 5.54°±2.86°,5.21°±2.60° and 5.34°±2.38°.Compared with the ERA measured by CT,no method was better than the other two.Postoperative deviation of HKA alignment from 0° to 90° flexion was associated with the rotational alignment of the femoral component.Trend of HKA alignment during knee flexion tended to be varus,valgus or neutral according to different angles of external rotation osteotomy of the distal femur.Conclusion The HKA alignment changes during the knee flexions.External rotation osteotomy of the distal femur played a crucial role in determining dynamic HKA alignment in TKA.
3.Preparation and property evaluation of graphene oxide based silver nanoparticles composite materials.
Yupu SHEN ; Jiantai HE ; Yangde ZHANG ; Yukun SHEN ; Longjiao ZHANG
Journal of Biomedical Engineering 2014;31(2):357-360
We prepared silver nanoparticles/polyethyleneimine-reduction graphene oxide (AgNP/rGO-PEI) composite materials, and evaluated their quality performance in our center. Firstly, we prepared AgNP/rGO-PEI, and then analysed its stability, antibacterial activity, and cellular toxicity by comparing the AgNP/rGO-PEI with the silver nanoparticles (PVP/AgNP) modified by polyvinylpyrrolidone. We found in the study that silver nanoparticles (AgNP) distributed relatively uniformly in AgNP/rGO-PEI surface, silver nanoparticles mass fraction was 4.5%, and particle size was 6-13 nm. In dark or in low illumination light intensity of 3 000 lx meter environment (lux) for 10 days, PVP/AgNP aggregation was more obvious, but the AgNP/rGO-PEI had good dispersibility and its aggregation was not obvious; AgNP/rGO-PEI had a more excellent antibacterial activity, biological compatibility and relatively low biological toxicity. It was concluded that AgNP/rGO-PEI composite materials had reliable quality and good performance, and would have broad application prospects in the future.
Anti-Bacterial Agents
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chemistry
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Graphite
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chemistry
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Light
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Nanoparticles
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chemistry
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Oxides
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chemistry
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Particle Size
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Polyethyleneimine
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chemistry
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Silver Compounds
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chemistry
4.Design of an integrative laser laryngoscope system.
Journal of Biomedical Engineering 2012;29(5):880-883
Laser technology is widely used in many medical fields such as general surgery, cardio-thoracic surgery, neurosurgery and urology. Laser has the characteristics of identical direction and high energy density, so that a laser knife leaves smooth incisions, less hemorrhage and less infection. The design presented in this paper applied the advanced laser technology in laryngoscopic operations, which increases efficiency and safety of the operation. The design included a laryngoscope, a laser-knife system host machine and a laser-knife, which were integrated in the front of the laryngoscope working terminal. Operators could choose the laser with appropriate wavelength to cut, irradiate, stop bleeding and coagulate the foreign objects or lesions of the larynx. A Chinese national patent (patent number ZL201020537693. 5) has been granted to the design.
Equipment Design
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Humans
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Laryngoscopy
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instrumentation
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Laser Therapy
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instrumentation
5.Comparative study on laparoscopy assisted radio frequency ablation and percutaneous radio frequency ablation for hepatocellular carcinoma
Chinese Journal of General Surgery 2012;27(7):564-567
Objective To evaluate laparoscopy assisted radio frequency ablation (LRFA) and percutaneous radiofrequency ablation ( PRFA ) for the treatment of hepatocellular carcinoma ( HCC ).Methods A total of 525 HCC patients were enrolled,including LRFA group of 78 cases with 106 tumor nodules,and PRFA group of 447 cases with 565 tumor nodules.Results ( 1 ) In LRFA group complete ablation rate was 97.17% (103/106); in LRFA group complete ablation rate was 93.09% (526/565)(x2 =2.523,P =0.112).(2)The 1,3,5 year overall survival rate was 96.15%,55.12% and 38.46%in LRFA group and 93.73%,48.54% and 31.54% in PRFA group respectively ( x2 =0.699,1.151,1.447 ; P =0.403,0.283,0.229 ).The 1,3,5 year disease-free survival rate was 94.87%,43.58% and 28.21% in LRFA group and 93.73%,48.54% and 31.54% in PRFA group respectively (x2 =0.915,0.303,0.174; P=0.339,0.582,0.676).The average disease-free survival time was 22.25 months in LRFA group and 21.53 months in PRFA group respectively.(3)The serious complications was 0% (0/78)in LRFA group and 1.34% ( 6/447 ) in PRFA group respectively.( 4 ) Recurrence rate was 23.07%(18/78) in LRFA group,and 34.89% (156/447) in PRFA group ( x2 =4.189,P =0.041 ).Conclusions The therapeutical effect of LRFA equals that of PRFA,while enjoying lower recurrence rate,no serious complications and higher treatment safety.
6.Design of integrative confocal-microscopic hard laryngoscope system
International Journal of Biomedical Engineering 2012;35(4):254-256
Objective The existing laryngoscope can not be used to observe the ultrastructure of cells.As a result,doctors always have to conduct biopsies on some patients who can not be diagnosed.The timeconsuming procedure of biopsy may be detrimental to the timely diagnosis and treatment.To solve this problem,we aimed to design the integrative confocal-microscopic hard laryngoscope system (ICMHL).Methods ICMHL system integrated the technique of existing laryngoscope and confocal microscopy,which allows doctors to observe the macrostructure and microstructure of lesions at the same time. Results With the effect of fluorescein sodium,ICMHL system could record the dynamic changes of cells at a rate of 30 fps,and the confocal-microscopic host machine could photograph images at a rate of 230 fps and diagnose invisible minute lesions.Conclusion ICMHL system provides a new,real-time approach for clinic biopsy.
7.Clinical value of non-invasive monitoring of cerebral hemodynamics for evaluating intracranial pressure and cerebral perfusion pressure in patients with moderate to severe traumatic brain injury
Guodong Huang ; Yangde Zhang ; Hong Zhang ; Weiping Li ; Yongzhong Gao ; Jianzhong Wang ; Taipeng Jang ; Jianjun Ding
Neurology Asia 2012;17(2):133-140
Objective: To explore the clinical value of non-invasive monitoring of cerebral hemodynamics for
evaluating intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with moderate to
severe traumatic brain injury (TBI). Methods: Transcranial Doppler (TCD) was employed to detect the
hemodynamics of bilateral middle cerebral arteries, including systolic blood fl ow velocity (Vp), diastolic
blood fl ow velocity (Vd), average fl ow velocity (Vm), pulsatility index (PI) and resistance index (RI)
in 52 patients with moderate to severe TBI. At the same time, the CPP, ICP and mean arterial blood
pressure (MABP) were monitored. The correlations between hemodynamics and MABP, ICP as well
as CPP were analyzed. Results: The PI and RI were positively related to the ICP (r=0.881, P<0.0001;
r=0.789, P<0.0001). Multiple stepwise regression analysis showed PI was closely associated with ICP
(ICP=-8.593+24.295PI; t=13.216, P<0.0001) and signifi cant correlation was also found between CPP
and PI as well as MABP (CPP=15.596-22.886PI+0.910MABP; F= 76.597, P<0.0001).
Conclusion: Non-invasive monitoring of cerebral hemodynamics by TCD can refl ect the real time
changes in the ICP and CPP and may be used as an effective tool to monitor the ICP and CPP. This
method is non-invasive, safe, cheap, repeatable and applicable in clinical practice.
8.The effect of Fe3O4 nanometer magnetic fluid induced hyperthermia on implanted liver cancer in nude mice
Jian PENG ; Qi TANG ; Yifeng PAN ; Wei CHEN ; Yuanfei HUANG ; Yangde ZHANG
Chinese Journal of General Surgery 2011;26(3):237-240
Objective To study the therapeutic effect of Fe3O4 nanometer magnetic fluid-induced hyperthermia on implanted liver cancer in nude mice under alternating magnetic field. Methods Nude mice model bearing implanted HepG2 was established. Mice were then randomly divided into 3 groups: the blank control group; the magnetic field group; nanometer magnetic fluid group. The magnetic field group were just put under the magnetic field; Nanometer magnetic fluid group received injection of PEG-PEI/Fe3O4 nanometer magnetic fluid under the alternating magnetic field. At the frequency of 40 kHz, and magnetic field of 5 kA/m, 15 minutes one day in the next 14 days. On the 7th day and the 15th day, the changes of tumor volume and weight were recorded, cell apoptosis were observed and recorded and pathological examination was done. Results On the 7th and the 15th day, in the nanometer magnetic fluid group, tumors' volume was smaller and the weight was lighter than other groups, and the tumor inhibitory rate of 54. 20% (t = 14. 506,P <0. 01 ) was significantly higher than the control group and the magnetic field group 22. 66% ( t = 7.497, P < 0. 05 ). In the control group, tumor cells grew well, high density, the nucleus engrained, the shape irregular, the nuclear fission clear; compared with the control group, in the magnetic field group, tumor cells scatter thinly, intercellular substance increases, and necrosis area formed;in the nanometer magnetic fluid group, many of tumor cells died, their cell nucleus broke up and vanished,the blood vessel reduced obviously, and the tumor cell spread thinly. Conclusions Under the alternating magnetic field, PEG-PEI/Fe3O4 nanometer magnetic fluid inhibits liver cancer growth in nude mice model of HepG2.
9.Effect of surface modification on anti-fogging and anti-reflection of optical glasses
Jian LI ; Jiayi LIU ; Yangde ZHANG
Chinese Journal of Tissue Engineering Research 2010;14(8):1418-1421
BACKGROUND: The polarity and the layer-by-layer coating method which are utilized to improve the membrane surface of optical glasses is a new focus for researching in the world. OBJECTIVE: To prepare a stable hydrophilic anti-fogging coating by surface modification. METHODS: Hydrophilic anti-fogging coatings of complexes of polyacrylic acid (PAA), cationic polyacrylamide (CPAM) and sodium silicate were fabricated by layer-by-layer coating method. Subsequently, the stable multilayer films were obtained by thermal torrefaction. Then the transmittance, hydrophlicity, and hardness were tested. RESULTS AND CONCLUSION: In the wavelength coverage of 200 nm, the transmittance of the anti-fogging coatings was above 92.9%. In the wavelength coverage of 700-800 nm, the transmittance reached 98.1%, suggesting that the membrane had the good transmittance. Water drop dispersed completely after 230 ms when it contacted with the surface of the multilayer films, suggesting that it had the good hydrophilicity. The hardness of stable films structure was 4 H. The layer-by-layer coating method was simple and favorable for preparing the anti-fogging coatings with good product properties including good stability, anti-fogging function and the improved transmittance.
10.Treatment of bronchopleural fistula using injection of fibrin sealant combined with microwave under endoscope in 8 cases
Jianming LIU ; Xinmin LIU ; Shenghua SUN ; Yangde ZHANG ; Beizhan LIU
Chinese Journal of Tissue Engineering Research 2010;14(8):1491-1494
BACKGROUND: Traditional treatment includes conservative therapy and surgical treatment on bronchial pleural fistula. With the development of endoscopic therapy, a new safe and effective method is concerned. OBJECTIVE: To summarize the therapeutic effect of treating bronchopleural fistula using bronchoscopy-guided injection of fibrin sealant combined with gelatin sponge filled and microwave following after lung resection. METHODS: Totally 8 cases of bronchial fistula patients were received injection of fibrin sealant after microwave and gelatin sponge filled by bronchoscopy, including 6 males and 2 females, mean aged 53.8 years (39-73 year-old). Cases 1 and 2 received left upper pulmonary Iobectomy, cases 3 received left lower pulmonary Iobectorny, case 4 received right lower pulmonary Iobectomy, cases 5 and 6 received right upper pulmonary Iobectomy, and the cases 7 and 8 received pneumonectomy. bronchopleuralfistula occurred after postoperative Chemotherapy in cases 4 and 8. RESULTS AND CONCLUSION: The case 8 was failed to treatment due to the large orificium fistulae (> 5 mm) and disappointed results after 6 times plugging. The other 7 patients were cured successfully. The injection time was correlated to the size of orificium fistulae, and the plugging was successful for 4 patients with less than 3 mm orificium fistulae. However, a third or fifth plugging was performed for 3 cases with 3-5 rnm orificium fistulae. No surgery-related complications occurred in all patients. Bronchoscopy guided injection of fibrin sealant combined with gelatin sponge and microwave is a safe and effective method for bronchial fistula.

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