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@#This article summarizes and analyzes the reported synthetic routes of brivudine in patent and literature.2′-Deoxyuridine was employed as starting material, affording brivudine through iodization, heck coupling, hydrolysis, decarboxylation, bromination and recrystallization.After optimization of reaction conditions of each step, a synthetic route suitable for industrial production was achieved with simple synthetic process, high yield and excellent purity.
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Objective:To explore the changes in somatosensory evoked potential (SEP) in rats with spinal cord injury (SCI) and the effects of relieving spinal cord compression at different times on recovery and the evoked potential.Methods:Seventy Sprague-Dawley rats were randomly divided into a control group of 10 and an experimental group of 60. The experimental group was further divided into a mild injury group of 10, a moderate injury group of 40 and a severe injury group of 10. Spinal cord injuries with different severities were established in the experimental group using a self-made percussion device. The rats′ SEPs were measured before the injury, and 5 minutes, 1 hour, 6 hours, 3 days and 7 days afterward. Some of the rats receiving decompression treatment.Results:The more seriously the spinal cord was injured, the longer was the latency and the smaller was the amplitude. Both differences were statistically significant. Rats with longer compression time had significantly longer incubation periods and greater decreases in the amplitude. After relieving the compression, rats from whom it had been relieved earlier had quicker amplitude recovery. For rats under compression for 30 minutes, their amplitude was the lowest seven days later.Conclusions:For spinal cord injury, longer compression time can lead to more significant changes in the latency and amplitude of SEP, with the change in the amplitude more significant than that in the latency.
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BACKGROUND: With the continuous renewal and development of clinical repair techniques, the intraoperatie blood loss has been greatly reduced in the treatment of intertrochanteric fracture; however, no matter what kind of repair methods should be adopted, there are stil a large amount of perioperative hidden blood loss, however, there are few clinical reports for the reasons and related factors. OBJECTIVE: To study the correlation of perioperative hidden blood loss with gender and internal fixation methods in the surgery of elderly femoral intertrochanteric fractures.METHODS: Total y 121 patients with elderly femoral intertrochanteric fractures who received the treatment at Department of Orthopedics, Nanyang City Center Hospital from March 2010 to June 2013 were divided into two groups according to the condition and treatment wishes of patients, and were respectively treated with dynamic hip screw and proximal femoral anti-rotation intramedul ary nail internal fixation. The preoperative hidden blood loss, postoperative hidden blood loss, the total hidden blood loss, dominant blood loss and total blood loss of patients in these two groups were compared. The multiple linear regression analysis on the correlation of perioperative hidden blood loss with gender and internal fixation methods was conducted. RESULTS AND CONCLUSION: There was no significant difference in the preoperative hidden blood loss between these two groups (P > 0.05). The total blood loss, postoperative hidden blood loss and total hidden blood loss in the proximal femoral anti-rotation intramedul ary nail group were significantly higher than those in the dynamic hip screw group (P < 0.05), and the dominant blood loss was significantly lower than that in the dynamic hip screw group (P <0.05). There were significant differences in the preoperative, postoperative hidden blood loss and total hidden blood loss between males and females (P < 0.05), and above indexes in males were significantly lower than in females. The multiple linear regression analysis showed that gender and internal fixation methods were correlated with hidden blood loss (P < 0.05). These results suggest that the perioperative hidden blood loss in surgery for elderly femoral intertrochanteric fractures is closely related to gender and above indexes in internal fixation methods. The perioperative hidden blood loss of male patients is less than that of female patients, and the patients treated with proximal femoral anti-rotation intramedul ary nail fixation have more hidden blood loss than dynamic hip screw fixation.
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OBJECTIVE:To explore the effects of dehydroepiandrosterone(DHEA)combined with Meloxicam tablets on thera-peutic efficacy of osteoarthritis and biochemical indicator. METHODS:104 patients with osteoarthritis were randomly divided into ex-perimental group and control group with 52 cases in each group. Control group only received Meloxicam tablets,7.5 mg/time,bid;ex-perimental group was additionally given DHEA,25 mg/time,qd,on the basis of control group. The treatment course of 2 groups was four weeks. The clinical efficacy,VAS score before and after treatment,joint function score,levels of IL-1β and TNF-α,cartilage thickness,synovial thickness and score of liquid aggregation of joint cavity were compared between 2 groups. RESULTS:The total ef-fective rate of experimental group(86.54%)was significantly higher than that of control group(69.23%),with statistical significance (P0.05). Compared with before treatment, the thickness of the synovial membrane and the score of liquid aggregation of joint cavity significantly decreased after treatment,with statistical significance(P<0.05);the thickness of synovial membrane and the score of liquid aggregation of joint cavity in experimen-tal group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:DHEA combined with Meloxicam tablets is significant in the treatment of osteoarthritis,can significantly relief the pain and decrease the levels of serum IL-1βand TNF-α.
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Objective To investigate the effect of different pore sized hydroxyapatite for promoting bone vascularization in tissue engineering.Methods Male Wistar rats were randomly divided into three groups,named group A,B and C,which were im-planted hydroxyapatite bioceramics compositing 4 μg bone morphogenetic protein with different aperture of 200 -300,350 -450, 500-600 μm in the back subcutaneously.The size of each block was 5 mm×5 mm×1 mm in a weight about of 40.0 mg.After im-plantation,the animals were killed and the implants and the surrounding tissue were taken out at the first,second,third and forth week respectively.HE staining of histological analysis was used to detect the situation of local neovascularization.Results There was significant difference between second and third week in group A.Comparing the area of vascularization at different time points in group B and group C,there were significant difference in the comparison of intragroup (P <0.05 ).During the first week after surgery,there was only group C that had the area of vascularization.During the second and forth week after operation,the area of vascularization in group B and group C were significant higher than group A (P <0.05).The C group showed a great deal of new-born blood vessels and clear formation of bone trabeculae.Conclusion The hydroxyapatite bioceramics of 500-600 μm could better promote vascalarization of tissue engineering in bone.
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BACKGROUND:Proximal femoral locking plate and proximal femoral nail anti-rotation are the two common methods for the treatment of femoral intertrochanteric fractures in clinic. However, there were few randomized control ed trials on the comparison of both methods. Most of them are retrospective case analysis, and short of systematic evaluation. OBJECTIVE:To systematical y evaluate the clinical outcomes and safety between locking compression plate and proximal femoral nail anti-rotation for the treatment of the femoral intertrochanteric fractures. METHODS:The Cochrane Library (No.2 in 2015), PubMed(1966-01/2015-06), MEDLINE (1966-01/2015-06), EMbase (1984-01/2015-06), CNKI (1979-01/2015-06), VIP(1989-01/2015-06)and WanFang Data(1990-2015)were searched by computer. Meanwhile, relevant literature from the relevant journals and references were searched by hand. Al the randomized control ed trials concerning locking compression plate and proximal femoral nail anti-rotation for the treatment of the femoral intertrochanteric fractures were col ected. The literature was strictly filtered out according to the inclusion criteria, and was strictly evaluated for the quality. Meta-analysis on the included results was performed with RevMan5.2 software from the Cochrane col aboration. RESULTS AND CONCLUSION:There were 54 potential y relevant papers, and final y, 11 randomized control ed trials were eligible for this investigation. A total of 917 patients were included containing locking compression plate group (464 cases), proximal femoral nail anti-rotation group (453 cases). The Meta-analysis results showed that there were no significant differences in Harris scores, excel ent rate, complications, fracture healing time and hospital stays after treatment between the locking compression plate and proximal femoral nail anti-rotation groups. However, there were significant differences in the time of operation [MD=15.80,95%CI(7.57-24.04), P=0.000 2], peri-operative blood loss [MD=98.01, 95%CI(58.57-137.44),P<0.01], ambulation loading time [MD=8.07,95%CI(3.02-13.12),P=0.002], the length of incision [MD=6.90,95%CI(1.07-12.73), P=0.02] and postoperative drainage volume [MD=41.85,95%CI(23.77-59.93),P<0.01]. These results suggest that the treatment of proximal femoral nail anti-rotation had shortened the length of incision and the time of operation. The treatment of locking compression plate took more time of ambulation loading time, more peri-operative blood loss and postoperative drainage volume. Because the number of cases which this study included are few, and the fol ow-up time was shorter, we should design stricter large sample randomized control ed studies in future increase the strength of the evidence by conducting medium and long-term fol ow-up.