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Objective To explore the clinical significance of the ratio of descending aorta diameter to ascending aorta diameter (rDA) in rapid diagnosis of Stanford B aortic dissection (AD). Methods A total of 118 patients with chest pain admitted to the emergency department from January 2013 to June 2018 in the People′s Hospital of Longhua were selected,and 42 patients with Stanford B type AD (group A) and 76 patients without AD (group B) were diagnosed by CT angiography.Eighty healthy people in the same period were selected as control group (group C). The descending aorta diameter and ascending aorta diameter were measured and rDA was calculated. The receiver operating characteristic curves were made. The sensitivity and specificity of descending aorta diameter and rDA for predicting Stanford B-type AD were analyzed. Results The descending aorta diameter, ascending aorta diameter and rDA in group A (male and female) were significantly higher than those in group C (male and female), while the descending aorta diameter and rDA in group A (male and female) were significantly higher than those in group B (male and female) (P<0.05). The sensitivity and specificity of descending aorta diameter with 30.0 mm as the cut-off point for the diagnosis of Stanford B-type AD were 92.9%(39/42),82.9%(63/76), and those of rDA with 0.8 as the cut-off point for Stanford B-type AD were 95.2%(40/42),90.8%(69/76). Conclusions The descending aorta diameter and rDA can be used as indicators for rapid diagnosis of Stanford B-type AD, and rDA is better than the diameter of descending aorta.
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Objective Iodine loading would be carried out on orthopedic titanium Kirschner-wire by electrophoretic deposition.And by this,a kind of orthopedic iodine-coated implant with antibacterial properties was supposed to be developed,that would provide a theoretical basis for the development of clinical orthopedic implants with antibacterial properties.Methods Iodine loading on the surface of titanium Kirschner-wire was carried out by electrophoretic deposition.PVP-I solution as 1 000 ppm,2 000 ppm and 4 000 ppm was prepared respectively (1 ppm=1 mg/kg=1 mg/L).Three kinds of iodine-coated orthopedic titanium Kirschner-wires with different iodine content were prepared by electrophoretic deposition at 200 V voltage for 30 min and then stoved after being washed with distilled water.The surface signs and composition structure of iodine coated titanium Kirschnerwire were studied through scanning electron microscopy (SEM) and energy dispersive spectrometer (EDS).Antibacterial experiments of Iodine coating titanium Kirschner needle were performed in vitro.Antimicrobial test:10 pieces of uncoated titanium Kirschner-wires;10 pieces of iodine-coated titanium Kirschner-wires with 1 000 ppm;10 pieces of iodine-coated titanium Kirschner-wires with 2 000 ppm;10 pieces of iodine-coated titanium wires with 4 000 ppm.Because iodine is easy to sublimate and does not withstand high temperature,all the titanium Kirschner needles are fumigated and disinfected by ethylene oxide (supported by the supply room of our hospital).Titanium wires were immersed respectively in 106 CFUJ/ml (ATCC25923) bacterial suspension of standard Staphylococcus aureus so that bacteria would be fully inoculated on the surface of the titanium wire.The sterilized titanium Kirschner needle was placed in a sterile culture cup and 30 ml suspension was added into the culture cup.The sterilized titanium Kirschner needle was completely immersed in the bacterial solutionand was kept at 37°C for 6 h before taking out.Take out the titanium Kirschner needle slowly,rinse the titanium Kirschner needle with 5 ml sterile PBS buffer,after rinsing the surface of titanium Kirschner needle,transfer the titanium Kirschner needle to the new sterile culture cup and add 5 ml sterile saline until the titanium Kirschner needle is completely immersed.Then put the titanium Kirschner needle into the ultrasonic oscillator to wash the surface of the bacteria fully.After 10 000 times dilution,100 μl was smeared on agar medium for culture (37°C) and the number of colonies was observed and counted 24 h later.Results The surface of three kinds of iodine coating titanium Kirschner-wires was covered with uniform iodized compound coating and had a brown look.The film structure was stable and there was no falling off after ultrasonic cleaning.SEM exhibited that the surface of Titanium Kirschner-wire is covered with a compact coating;the appearance structure is relatively flat and a slight collapse can be seen scattered in the surface of the wire.The results of EDS showed that the iodine content in the surface coating of 3 groups was 4.38 wt％,9.05 wt％ and 14.48 wt％.The bacteria growing on the surface of titanium needle were shaken down by ultrasonic vibration.The CFU counting was carried out after the bacterial solution being diluted,coated and cultured for 24 h.It can be seen that the antibacterial property increases continuously with the increase of iodine coating content.The antibacterial properties of iodine-coated implant which content 14.48 wt％ iodine was more than 1 orders of magnitude than the control group.The results showed that the plants coated with iodine had obvious antibacterial effect.Conclusion The iodine coated titanium wire was prepared by electrophoretic deposition,after being characterized by SEM,EDS and quantitative measurement,the successful loading of iodine was proved,the antibacterial experiment proved that the iodinecoated orthopedic titanium Kirschner-wire has a stronger antibacterial properties than the ordinary titanium Kirschner-wire under laboratory conditions.
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BACKGROUND: Resection of the nudeus pulposus is the classical treatment for intervertebral disc protrusion, except a higher recurrence rate. OBJECTIVE: To verify the feasibility of establishing an animal model of intervertebral disc degeneration by puncture and aspiration via a posterolateral approach to simulate resection of human nucleus pulposus. DESIGN, TIME AND SE'I'FING: The experiment was conducted in the animal Experimental Center of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from October 2006 to February 2007. MATERIALS: Twenty Japanese big ear rabbits were selected to establish animal models of intervertebral disc degeneration. METHODS: Some nucleus pulposus tissues were abstracted from the L1-2 and L3-4 segment of 20 rabbits by the puncture and aspiration method using a 21-gaege hypodermic needle. Histological analysis was performed at 2, 4, 8, 12 weeks after surgery, and L2-3 segment was used as control group.MAIN OUTCOME MEASURE: Histological structure of the intervertebral disc was observed by homatoxylin-eosin staining. RESULTS: Hematoxylin-eosin staining revealed a great deal of complete nudeus pulposus tissues, clear boundaries between nucleus pulposus and annulus fibrosus in the control group, and the structure of near normal annulus fibrosus was almost normal, nucleus pulposus tissue had a large number of nucleus pulposus cells. In the experimental group, the nucleus pulposus cell reduced in amount in the fourth week, the nucleus pulposus at the twelfth week were mainly full of flbroblests, while few nucleus pulposus cells were found.CONCLUSION: It is successful to establishing an animal model of intervertebral disc degeneration by puncture and aspiration via a posterolateral approach based on simulating the resection of human nucleus pulposus. This model is available for repairing intervertebrai disc degeneration using tissue engineering techniques.
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Objective To explore the clinical application of reconstruct ion interlocking nail in treating ipsilateral fractures of femoral neck and shaf t. Methods Twelve cases of ipsilateral fractures of femoral neck and shaft trea ted with reconstruction interlocking nail by static locking were reviewed. The d iaplasis of the fracture was done in a close manner or in an open manner but wit h a little incision, and the two sides of the fracture were locked with nails by a three-dimensional aim implement. Two lag screws were inserted into the femor al neck at a 15 degree dip angle. Results Eleven cases were followed up (average 12.3 months). Their long term effects were evaluated according to MaYuanzhang e valuation criteria: 5 cases gained excellent clinical results, 4 good, 2 fair; t he excellent and good rates were 81.8% (9/11). The average period of femoral n eck fracture healing was 5.2 months and that of shaft fracture healing 6.7 month s .72.7 % of the patients(8/11) showed fracture healing at one stage. There were no necrosis of femoral head, no femoral neck nonunion or malunion, or no n ail rupture. Conclusions Reconstruction interlocking nail is a principal way in treating ipsilateral fractures of femoral neck and shaft because of its effecti ve fixation and excellent clinical effect. Anatomy reduction of femoral neck and non-open reduction should be emphasized in treatment of femoral neck fractures , while close nail insertion, limited reaming and static locking should be a rou tine way in treatment of femoral shaft fractures.
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Objective To compare the results of treatment with biodegradable ligaments and metallic fixation for total acromioclavicular joint dislocation. Methods Twenty eight patients with total acromioclavicular joint dislocation were treated with two different materials, 1) by Kirschner pin and steel wire or screw and steel wire tension band (MF group,16 cases), and 2) reconstructed by artificial coracoclavicular ligament and coracoacromial ligament (BF group,12 cases). There were 17 males and 11 females. All patients had acute dislocation. The time from injury to hospital admission varied from 0-8 days (average, 1.5 days). Results All patients were availble for an average duration of follow up of 39.5 months (range,8-70 months). The results were evaluated by radiographic representations and joint function according to Lazcano's standards. In BF group, 10 patients were assesed as good and 2 as fair. In MF group, 13 patients were assesed as good, 2 as fair and 1 as poor. There were no statistic differences between these two methods. Conclusion Biodegradable ligament fixation is believed to be a good simple method for the treatment of acromioclavicular joint dislocation without the necessity of a second operation for removal of implants.