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BACKGROUND:Percutaneous hol ow screw under X-Ray fluoroscopy has been shown to treat fracture of acetabulum of the pelvis, but the time of internal fixation was long, and the amount of radiation exposure to the patients and physicians was large. OBJECTIVE:To test the application of the ISO-C3D METHODS:Thirty-one patients with fracture of the acetabulum were treated with percutaneous hol ow screw under a fluoroscopy-based ISO-C computerized navigational system for fracture of acetabulum. 3D computerized navigational system. The interval from injury to operation was 4 to 13 days. Al patients were fol owed up for one year. RESULTS AND CONCLUSION:The average bleeding volume during operation was only 18 mL, except that the bleeding volume of only one patient, who suffered from the sacroiliacjoint injury and received open reduction and internal fixation, was up to 300 mL. The total number of screws used in the operation was 42, among which 24 were screws for acetabular anterior column fracture and 18 for posterior column fracture. Al screws were implanted once precisely. The average time of internal fixation was 59 minutes, and the mean time for fluoroscopy was 39 seconds. The 31 patients were pain-free one week after the operation and no complication (infection, vascular nerve injury or implant breakage) was noted post-operatively. When the fol ow-up ended, radiography revealed fracture union with satisfactory screw fixation (no screw breakage or loosening). According to Matta functional scoring, results were excellent in 23 cases, good in 8 cases, with an excellent and good rate of 100%. According to Majeed functional scoring, the results were excellent in 22 cases, good in 6 cases and average in 3 cases, with an excellent and good rate of 90%. These results indicated that ISO-C3D computerized navigational system can supply stable internal fixation without an increase of complication.
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Objective To compare the effect of ISO-C3D navigation and conventional C-arm fluoroscopy in iliosacral screws insertion for treatment of posterior pelvic ring injuries.Methods Sixty-five patients with posterior pelvic ring injuries managed by minimally invasive percutaneous iliosacral screws from June 2006 to January 2012 were reviewed.There were 37 males and 28 females,at age range of 18-63 years (mean 35.9 years).Pelvic fracture classification based on Tile system was type B1 in 10 cases,type B2 in 15,type B3 in nine,type C1 in 18 and type C2 in 13.Patients were divided into ISO-C3D navigation group (Group A,n =35) and C-arm fluoroscopy group (Group B,n =30) according to the difference in intraoperative fluoroscopy methods.Intraoperative fluoroscopy time,time cost in inserting a screw,patient satisfaction rate for bone reduction,bone union time and excellent-good rate of postoperative function were recorded.Results Eighty cannulated screws were inserted for the 65 patients.Average fluoroscopy time and time cost in inserting a screw were shorter in Group A than in Group B (P ＜0.01),but there was no statistical difference between the two gronps in patient satisfaction rate for bone reduction.No patient presented with infection,vascular nerve injury or other complications.Follow-up was 6-24 months (mean 12.7 months) for all the patients.Functional recovery showed no statistical difference between the two groups at postoperative 6 months.All fractures were healed and no delayed union or nonunion happened.Conclusion As compared with conventional C-arm fluoroscopy,computer-navigated surgery can reduce fluoroscopy time and improve screw insertion accuracy.
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ObjectiveTo investigate the results of open reduction with internal fixation for high anterior column fracture of acetabulum with intact true pelvic brim.MethodsFrom January 2006 to January 2010,12 patients suffered high anterior column fracture of acetabulum without involvement of true pelvic brim were identified.There were 9 males and 3 females,with the average of 35.6 years(range,29-46).The injury was caused by crush in 7 cases,smash of heavy object in 3 cases,and fall-down from height in 2 cases.These fractures were classified into three types:isolated high anterior column fracture of acetabulum without involvement of true pelvic brim,high anterior column fracture of acetabulum without involvement of true pelvic brim with posterior wall fracture of acetabulum and commminuted high anterior column fracture of acetabulum without involvement of true pelvic brim according to present and unpresent of posterior wall fracture.Five cases suffered isolated fracture and 2 cases associated smaller and nondisplacement fracture fragment of posterior wall were reduced and fixed by buttress plate of iliac crest and lag screw of anterior border of ilium through an iliofemoral approach; 4 cases with displacement posterior wall fracture of acetabulum were reduced and reconstructed by buttress plate and lag screws of through combinations of anterior and posterior approaches.One case suffered comminuted fracture were reduced and reconstructed by plates and screws of through extended iliofemoral approach.ResultsThe mean follow-up time of all patients was 26.7 months (range,14-37months).The quality of reduction was grade as anatomical in 8 patients,imperfect in 3,poor in 1 by Matta's score system.The fracture union was uneventful.There was nonunion and loss of internal fixation.At the final follow-up,the mean score was 16.8 (range,11-18),7 cases were graded as excellent,4 good,1 fair,according to modified Merle d'Aubigne and Postel score system.Heterotopic ossification and traumatic osteoarthritis were recorded in 1 patient.ConclusionGood clinical results can be achieved by anatomical reduction and rigid fixation through optimal approach.
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Objective To investigate the outcome of the urethral realignment simultaneous internal fixation in treatment of pelvic fracture associated with posterior urethral disruption. Methods The study included 33 patients with pelvic fracture associated with posterior urethral disruption treated simultaneously by urethral realignment and internal fixation from December 2003 to August 2009. According to AO classification, two patients were with type A2 fracture, six with type B1 ,seven with type B2,five with type B3 ,six with type C1 ,four with type C2 and three with type C3. All the patients were found with complete posterior urethral disruption. Primary urethral realignment combined with emergency open reduction and internal fixation of pelvic fracture were performed in 12 patients. Due to unstable condition, 21 patients underwent primary suprapubic cystostomy and external fixation, sequentially delayed urethral realignment and internal fixation.Results The mean follow-up time of all patients was 37 months ( range, 3-63 months). Of all the patients, 25 patients (76%) regained good without urethral dialation or needed only short term urethral dilatation, and eight patients (24%) suffered from urethral stricture and needed further complex surgery. The incidences of urinary incontinence and erectile dysfunction were 6%(2/33) and 18% (6/33). The erectile dysfunction of two patients was ascribed to sacral nerve injury.At the final follow-up, the mean score was 90.3 points (range, 66-100) according to the Majeed' s scoring system, which showed that the result was excellent in 24 patients, good in eight and fair in one.Conclusions Urethral realignment and simultaneous internal fixation can attain good clinical results for pelvic fracture associated with posterior urethral disruption. It takes advantages of minor surgical trauma,short treatment cycle, good outcome and low complication rate.
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<p><b>OBJECTIVE</b>To study that low-intensity microwave whether or not enhances the genotoxic effects of mitomycin C(MMC) on human lymphocytes.</p><p><b>METHODS</b>Single strand DNA breaks and chromosomal aberrations were measured by comet assay and cytokinesis-blocked micronucleus(CBMN) test in vitro when human lymphocytes were exposed to 2,450-MHz microwave (5.0 mW/cm2) alone and in combination with mitomycin C.</p><p><b>RESULTS</b>In the comet assay, the average comet lengths of microwave group[(29.1 +/- 8.1) micron in male and (25.9 +/- 7.5) micron in female] were not significantly different from those of control groups [(26.3 +/- 6.6) and (24.1 +/- 4.3) micron respectively] (P > 0.05). The average comet lengths of MMC group(0.0125, 0.0250, 0.0500, 0.1000 microgram/ml) were significantly longer than those of control groups (P < 0.01) and were increased with the dose of MMC. The average comet lengths of microwave combined with MMC (MW + MMC) also were increased with the doses of MMC and were significantly longer than those of control groups (P < 0.01). When MMC was > or = 0.0250 microgram/ml, microwave and MMC synergistically increased the single strand DNA breaks. In the micronucleus test, the average micronucleus rates of microwave groups were not higher than those of control groups (P > 0.05). The average micronucleus rates of MMC groups and MW + MMC groups were significantly higher than those of control groups (P < 0.01) when MMC was > or = 0.0500 microgram/ml. The average micronucleus rates of MW + MMC groups seemed higher than those of corresponding MMC groups, however the difference was not significant (P > 0.05).</p><p><b>CONCLUSION</b>Low-intensity(2,450-MHz) microwave did not induce DNA and chromosome damages on human lymphocytes, but enhanced the effects of DNA breaks induced by MMC.</p>
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Female , Humans , Male , Chromosome Aberrations , Comet Assay , DNA Breaks, Single-Stranded , Lymphocytes , Radiation Effects , Micronuclei, Chromosome-Defective , Microwaves , Mitomycin , ToxicityABSTRACT
Objective To observe the genetic damages relate d to occupational exposure to antineoplastic agents without special protective measures in exposed subjects.Methods The damages of DNA and chromosomes of peripheral blood lym-phocytes were determined by comet assay and cytokinesis-block micronucleus test in exposure group consisting of24nurses oc-cupationally exposed to antineoplastic agents without special protective measures and control group consisting of24female doc-tors without exposure to antineoplastic agents in oncology department in a certain hospital.Results The exposure group showed significantly higher micronucleus rate(13.25‰?5.17‰)compared with that of control group(3.79‰?2.19‰),P
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Toxicogenomics is a new undertaking in the pursuit of human genomics relevant to health risk from environmental toxicants and related stress, and also is a new scientific subdiscipline derived from a combination of the fields of toxicology and genomics. Microarray technique, i. e. gene-chip technique includes gene-chip development, pretreatment of detected samples, probe hybridization, detection data analysis. The microarray technique in toxicology mainly was applied to identification of potential hazardous substances, screening for mechanism of action, dose-response relationship assessment, identification of interaction among chemical mixtures, biomarker of exposure and biomarker of susceptibility. Microarray technique has been used to study biomarker for human bladder cancer, to study fingerprints of gene regulation associated with cadmium chloride, benzo(a) pyrene and trichloroethylene. fn this paper, a new automated and multi-applied molecular biology workstation, NanoChip biomolecular system was introduced .