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Objective:To investigate the imaging characteristics on contrast-enhanced ultrasound(CEUS)of carotid plaque instability and their correlation with histopathological changes in elderly patients.Methods:Twenty-three patients undergone carotid endarterectomy(CEA)at the Department of Neurosurgery of Beijing Hospital from June 2018 to November 2020 were retrospectively enrolled, including 27 males and 5 females, aging from 60 to 87(68.1±6.3)years.They were diagnosed with moderate to severe carotid artery stenosis(50%-99%)based on digital subtraction angiography(DSA).Carotid artery CEUS was conducted before surgery, and HE staining and CD34 immunohistochemical staining were used to record histopathological scores and microvessel density(MVD)counts.Results:The mean pathological score and MVD count were 2.46±0.66 and 37.17±12.88 for 32 cases with hypoechoic patterns, 22.42±0.55 and 38.06±13.66 for 18 cases with mixed echo patterns, and 2.75±0.35 and 23.50±9.192 for 2 cases with strong echo patterns, respectively.CEUS grading was positively correlated with histopathology score and MVD count( r=0.53、0.76, all P<0.01). Conclusions:Low echo and mixed echo plaques are more unstable than strong echo plaques.CEUS can be used to comprehensively assess the vulnerability of atherosclerotic plaques and to decide the optimal surgical time for patients with carotid atherosclerotic plaque stenosis.
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Objective:To design a knowledge-based cervical cancer planning model and apply it to cases of endometrial cancer and rectal cancer in order to explore the generalization of the model.Methods:A total of 179 cases of pelvic regions with different prescribed doses of dual-arc volumetric modulated arc therapy clinical plans were collected, of which 99 cases of cervical cancer clinical plans with a prescribed dose of 50.4 Gy were used as the training set to establish the RapidPlan model, and the remaining clinical plans were divided into 4 validation groups with 20 cases in each group. The clinical plans for cervical cancer and endometrial cancer with a prescription dose of 50.4 Gy were named groups A and B, while the clinical plan for endometrial cancer and rectal cancer with a prescription dose of 45 Gy were named groups C and D. The model was used to redesign the clinical plans in the 4 groups and the automatic plans were obtained. The planning target volume (PTV) and organ at risk (OAR) dosimetry parameters were compared between automatic plans and clinical plans.Results:The conformity index (CI) of the automatic plans in the A, B, C, and D groups were equivalent to that of the clinical plans ( P>0.05). The homogeneity index (HI) and D2% of the automatic plans in groups A, B, and C were all lower than those in clinical plans(HI, Z=-3.248, -3.360, -2.329, P<0.05; D2%, Z=-2.987, -3.397, -2.442, P<0.05). The HI and D2% of the automatic plans in group D were similar those in the clinical plans ( P>0.05). While ensuring the PTV coverage, the average value of OAR dosimetry parameters in all automatic plans groups were lower than that of the clinical plans. Conclusions:The RapidPlan model established by the cervical cancer clinical plans can complete the automatic plan design for endometrial cancer and rectal cancer under different prescription doses, which preliminarily proves the possibility of the generalization of the RapidPlan model.
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The design of a conventional radiotherapy plan is a time-consuming and labor-intensive process, and relevant parameters need to be continuously adjusted in the plan optimization to identify the optimal plan. In addition, experience differences between planners, time invested in plan design, and institutional standards all affect the quality of the plan, which in turn influences clinical outcomes and patient prognosis. In recent years, automatic planning has developed rapidly, which can improve the efficiency of planning design while ensuring the quality of the plan. At present, there are several methods dedicated to the automation of radiotherapy planning design, such as the Rapid Plan and Auto-Planning functions in Eclipse and Pinnacle commercial treatment planning systems, and there are also studies applying artificial intelligence technology in dose prediction to achieve automatic planning. In this article, the research progress on automatic radiotherapy planning was reviewed, and the realization principles, clinical efficacy and existing problems of various automatic planning methods were illustrated.
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Objective:To develope a deep-learning-based auto-segmentation model to segment organs at risk (OARs) in head and neck (H&N) region and compare with atlas-based auto-segmentation software (Smart segmentation).Methods:The auto-segmentation model consisted of classification model and segmentation model based on deep learning neural network. The classification model was utilized to classify CT slices into six categories in the cranio-caudal direction, and then the CT slices corresponding to the categories for different OARs were pushed to the segmentation model respectively. The CT image data of 150 patients were used for auto-segmentation model training and building atlas library in Smart segmentation software. Another 20 patients were used as testing dataset for both auto-segmentation model and Smart segmentation software. Dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to evaluate the accuracy of two method, and auto-segmentation time cost was recorded. Paired Student′s t-test or non-parametric Wilcoxon signed-rank test was performed depending on result of normality test. Results:The DSC and HD of auto-segmentation model for brainstem, left eye, right eye, left optic nerve, right optic nerve, left temporal lobe, right temporal lobe, mandible, left parotid and right parotid were 0.88 and 4.41 mm, 0.89 and 2.00 mm, 0.89 and 2.12 mm, 0.70 and 3.00 mm, 0.80 and 2.24 mm, 0.81 and 7.98 mm, 0.84 and 8.82 mm, 0.89 and 5.57 mm, 0.70 and 11.92 mm, 0.77 and 11.27 mm respectively. The results of auto-segmentation model were better than those of Smart segmentation ( t=3.115-7.915, Z=-1.352 to -3.921, P<0.05) except left and right parotids. In addition, the speed of auto-segmentation model was 51.28% faster than that of Smart segmentation. Conclusions:In this study, the deep-learning-based auto-segmentation model demonstrated superior performance in accuracy and efficiency on segmenting OARs in H&N CT images, which was better than Smart segmentation software.
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In recent years,the application of machine learning in the field of radiotherapy has been gradually increased along with the development of big data and artificial intelligence technology.Through the training of previous plans,machine learning can predict the results of plan quality and dose verification.It can also predict the multi-leaf collimator (MLC) positioning error and linear accelerator performance.In addition,machine learning can be applied in the quality assurance of intensity-modulated radiotherapy to improve the quality and efficiency of treatment plan and implementation,increase the benefits to the patients and reduce the risk.However,there are many problems,such as difficulty in the selection,extraction and calculation of characteristic value,requirement for large training sample size and insufficient prediction accuracy,which impede its clinical translation and application.In this article,research progress on the application of machine learning in the quality assurance of IMRT was reviewed.
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OBJECTIVE： To study the improvement effect and mechanism of Chuanju zhitong capsules （CZC） on migraine model rats. METHODS： SD rats were randomly divided into normal group， model group， chemical drug positive control group （Zolmitriptan tablet， 0.004 05 g/kg）， TCM positive control group （Compound yangjiao capsule， 4.32 g/kg）， CZC high-dose， medium-dose and low-dose groups （1.6， 0.8， 0.4 g/kg）， 10 rats in each group. All rats were relevant medicine intragastrically once a day， for successive 5 days. 30 min after last medication， except for normal group， rats in other groups were given glyceryl trinitrate subcutaneously （10 mg/kg） via head and neck to induce migraine model. The behavior changes of rats were evaluated using the times of scratching head as indexes within 2 h after modeling （30 min as a period of time）. 4 h after modeling， hemorheological parameters as whole blood viscosity （low-shearing， medium-shearing， high-shearing）， plasma viscosity， erythrocyte aggregation indexes and erythrocyte rigidity indexes were determined by automatic hemorheology instrument. The levels of NO， NOS， ET-1， CGRP in serum and the levels of 5-HT， 5-HIAA， DA and NE in cerebral tissue were determined by ELISA. RESULTS： Compared with normal group， the times of scratching head was increased significantly in model group at different periods （P＜0.01）. The serum levels of NO， NOS and CGRP were increased significantly （P＜0.01）， while ET-1 level was decreased significantly （P＜0.01）. The levels of 5-HT， DA and NE in cerebral tissue were decreased significantly （P＜0.01）， while 5-HIAA level was increased significantly （P＜0.01）. Whole blood viscosity （low-shearing）， plasma viscosity， erythrocyte aggregation index and erythrocyte rigidity indexes were increased significantly （P＜0.05），plasma viscosity were decreased significantly （P＜0.05） . Compared with model group， the times of scratching head were decreased significantly in TCM positive control group （0-120 min）， TCM positive control group （60-90 min）， CZC high-dose （30-120 min） and medium-dose （60-90 min） groups （P＜0.05 or P＜0.01）. The whole blood viscosity （low-shearing） and erythrocyte aggregation indexes of TCM positive control group， CZC high-dose and medium-dose groups were decreased significantly （P＜0.05 or P＜0.01）； the serum levels of NO， NOS and CGRP in chemical drug positive control group and CZC high-dose and medium-dose groups were decreased significantly （P＜0.05 or P＜0.01）， while the serum level of ET-1 was increased significantly （P＜0.01）； the levels of 5-HT， DA and NE were increased significantly in cerebral tissue （P＜0.05 or P＜0.01）， while the level of 5-HIAA was decreased significantly （P＜0.05）. CONCLUSIONS： The improvement effect of CZC on migraine model rats is associated with decreasing the serum levels of NO， NOS and CGRP and increasing the levels of 5-HT， DA and NE in cerebral tissue.
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Machine learning has developed rapidly in recent years.Using machine learning to predict the radiotherapy outcomes and complications can more accurately evaluate the patients' conditions and take appropriate treatment measures as soon as possible.The non-dose and dose related factors generated during radiotherapy are filtered and input into the algorithm model,then corresponding prediction result can be obtained.There are many algorithm models to predict survival rate,tumor control rate and radiotherapy complications,and the predicted result are more accurate now.However,the algorithm model also has various problems,and it needs constant exploration and improvement.
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Objective To report the clinical outcomes of latissimus dorsus flap used to reconstruct severe trauma on lower leg.Methods From May 2011 to September 2016,12 patients were treated for severe trauma on lower leg at Orthopaedic Department,General Hospital of Rocket Force.They were 10 men and 2 women,aged from 22 to 54 years (average,37.5 years).According to the Gustilo classification,their open fractures were of type ⅢA in 2 cases and of type ⅢB in 10.The areas of soft tissue defect ranged from 15 cm × 8 cm to 35 cm × 12 cm.Their wounds were covered with latissimus dorsus flaps;the dorsal expansion of the ankle joint was reconstructed after their bone infection was controlled.Two flaps were anastomosed directly to the anterior tibial vessels and one flap to the femoral vessels.The other 9 flaps were anatomosed to the lateral circumflex femoral artery,bridging with the greater saphenous vein (average length:32 cm).Ten flaps were neuroanatomosed with the motor branch of common peroneal nerve and 2 with the motor branch of vastus lateralis.The therapeutic outcomes were evaluated in terms of repair of soft tissue defects,control of infection and range of active dorsal flexion of the ankle at neutral position.Results The 12 patients were followed up for an average of 3.5 years (from 1 to 6 years).All the 12 flaps survived and infections were eradicated.The fractures were healed with muscle strength of grade 3 to grade 4.Their ankle extension was reconstructed.Their limbs were preserved with satisfactory limb function.The bone exposures of 5 cm × 3 cm and 6 cm × 3 cm in area after debridement respectively in 2 cases of Gustilo type ⅢA were covered with latissimus dorsus flaps.The range of active dorsal flexion of the ankle at neutral position increased from preoperative 10.5° to postoperative 19.1° on average.Conclusion In treatment of severe trauma on lower leg,latissimus dorsus flaps can be used to repair skin wound,control infection and reconstruct ankle function simultaneously,with advantages of reduced operative procedures,a high rate of limb preservation,and better function recovery.
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Objective To evaluate the efficacy of microsurgical techniques combined with bone transportation for osteomyelitis following open fracture on the leg.Methods From April 2007 to April 2016,25 patients with osteomyelitis caused by severe open injury on the leg were treated at Orthopaedic Department,General Hospital of Rocket Force.They were 22 men and 3 women,aged from 19 to 65 years (average,36.5 years).Their open injury was located at upper tibia in 6 cases,at middle tibia in 6 and at lower tibia in 13.Eight patients received internal fixation with plate and 17 unilateral external fixation.By the Cierny-Mader classification,their chronic osteomyelitis was of type Ⅲ in 14 cases and of type Ⅳ in 11.The tibial defects after excision of infectious segment ranged fromn 5 to 14 cm in length (average,8.8 cm).After infectious tissues were removed,antibiotic bone cement chains were inserted into the defects.The open wounds were covered with microsurgical pedicled or free flaps.Bone transportation with unilateral external fixation was used to deal with the bone defects after removal of the infectious bone.Results Bone infection was controlled in the 25 patients.The rate of infection control after one debridement procedure was 76.0％ (19/25),and that after 2 debridement procedures was 24.0％ (6/25).Flap repair led to early closure of the open wounds.The successful rate of wound closure after one operative procedure was 84.0％ (21/25),and that after secondary operation was 16.0％ (6/25).Bony union of tibial defects was achieved in all the 25 patients with no recurrence of osteomyelitis.The patients were followed up for 18 to 36 months (average,24.6 months).Re-fracture happened in one case and was treated with another operation.Bone union time starting from bone transportation ranged from 8 to 18 months (average,10.5 months).Time for external fixation ranged from 12 to 20 months (average,18.4 months).Conclusion For osteomyelitis caused by severe open injury on the leg,microsurgical techniques can be used to repair open wounds and bone transportation to reconstruct bone defects after removal of infectious bone.
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AIM:To investigate whether Mycoplasma pneumoniae ( Mp)-induced interleukin-1β( IL-1β) pro-duction in RAW264.7 cells is through the activation of NLRP3 inflammasome via reactive oxygen species (ROS).ME-THODS:RAW264.7 cells were randomly divided into 3 groups.In normal group , RAW264.7 cells were treated without Mp.In model group, RAW264.7 cells were treated with 1∶10 multiplicity of infection ( MOI) of Mp.In NAC group, RAW264.7 cells were pretreated with N-acetylcysteine ( NAC) at a concentration of 5 mmol/L for 30 min before infection with Mp.The RAW264.7cells were infected with Mp (1∶10 MOI) for 4, 8, 16 and 24 h in model group and NAC group , respectively.The intracellular ROS level was analyzed by flow cytometry .The mRNA expressions of NLRP3, ASC and caspase-1 were detected by real-time PCR.The protein levels of NLRP3, ASC and caspase-1 p20 were determined by Western blot.The levels of pro-inflammatory cytokine IL-1βin the supernatant were measured by ELISA .RESULTS:Compared with normal group , the production of ROS were significantly increased at 4, 8, 16 and 24 h after infection, the mRNA expression of NLRP3, ASC and caspase-1 were increased at 8, 16 and 24 h after infection, the protein levels of NL-RP3, ASC and caspase-1 p20 were increased at 16 and 24 h after infection, and the releases of IL-1βwere increased at 24 h after infection in model group (P<0.01).Compared with the model group, the level of ROS in NAC group decreased, so as the expression of NLRP3, ASC and caspase-1 at mRNA and protein levels and the releases of IL-1βin the superna-tant at the corresponding time points .CONCLUSION:Mp may stimulate the ROS production to activate NLRP 3 inflam-masome in RAW264.7 cells.
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BACKGROUND:The effect of dimethyl sulfoxide cryoprotectants has been got a lot of verification in the low-temperature medical applications. But there is no literature addressing microdialysis detection of dimethyl sulfoxide cryoprotectants. OBJECTIVE:To investigate the microdialysis relative recovery of different concentrations of dimethyl sulfoxide cryoprotectants used for limb reattachment. METHODS:In vitro linear probe relative recovery of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) was detected by retrodialysis gain and loss method. The correction in vivo experiment was done to estimate dimethyl sulfoxide relative recovery in rabbit amputated limbs. RESULTS AND CONCLUSION:The relative recoveries of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) were (49.49±3.56)%, (46.30±1.48)%, (52.66±2.54)%using retrodialysis gain method and (50.99±6.89)%, (43.86±1.35)%, (50.67±0.75)%using retrodialysis loss method. The average recoveries were (49.48±3.18)%and (48.51±4.03)%, respectively. There was no difference in the relative recovery of dimethyl sulfoxide detected using two methods. The change of dimethyl sulfoxide concentration could not influence the retrodialysis gain and loss method calibration results. The recovery was (15.45±4.8)%in vivo. These findings indicate that the microdialysis technology is suitable for dimethyl sulfoxide sampling in vivo that has no obvious influence on the relative recovery.
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OBJECTIVE:To optimize extraction technology of polysaccharides from Stemona tuberosa so as to increase the ex-traction rate and efficiency. METHODS:Anthrone-sulfuric acid method was used for detection. With water and alkaline water (NaOH solution)as the solvent respectively,the effects of decocting method,ultrasound method and microwave method on the ex-traction rate of crude polysaccharide were observed respectively. By carrying out single factor and orthogonal tests,with the extrac-tion rate of crude polysaccharide as the index,the effects of the amount of water,NaOH solution concentration,extraction tempera-ture and extraction time on the extraction of crude polysaccharide by alkaline water ultrasound method were observed to optimize the technology parameters,and verification test was conducted. RESULTS:The alkaline water ultrasound method is superior to oth-er extraction methods,where the optimal technology parameters were as follows as 0.3 mol/L NaOH aqueous solution 30 times as much as the amount of crud drug,ultrasonic processing for 70 min at 50 ℃. The verification tests showed that the average extrac-tion rate of crude polysaccharide was 25.76%(RSD=3.51%,n=6). CONCLUSIONS:The optimal alkaline water ultrasound method can better extract crude polysaccharide from S. tuberosa.
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Objective To observe the contribution of acute normovolemic hemodilution ( ANH) in experiment of cryopreserved dog limb replantation.Methods Sixteen healthy Beagle dogs (male:female=1:1) were divided into two groups.Dogs in the experiment group ( Group B) received ANH in the limb replantation, and dogs in the control group ( Group A) received the same amount of lactate Ringer’ s solution intravenously during the surgical operation.We recorded and compared the hemodynamic indexes, HB, HCT, the resuscitation time, the first rising head time, the first standing time and the first eating and drinking time between the two groups.Results ( 1 ) During the operation, both PaO2 and PCO2 in the two groups were normal, as well as the breathing rate.The heart rate in the group B was lower than that in the group A.Before blood transfusion, there was no statistically significant difference in HB and HCT between the two groups, but after transfusion they were significantly higher in the group B than in the group A.(2) The resuscitation time, the first rising head time, the first standing time and the first eating and drinking time of the group B were all better than those in the group A.Conclusions In cryopreserved dog limb replantation experiments, acute normovolemic hemodilution is helpful to improve the general condition and facilitate the recovery of animals after limb replantation.
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Objective To observe the effects of Xianfu Wenyang Tongluo Drink (XFWYTLD) on ANCA associated antigen in rats with thromboangiitis obliterans;To discuss its mechanism. Methods Totally 72 SPF male Wistar rats were randomized into sham-operation group, model group, Mailuoning Granule group and XFWYTLD low, medium, and high dose groups. Method of femoral artery injecting sodium laurate was used to duplicate models. From the second day after modeling, the rats in sham-operation group and model group were fed with distilled water, while other groups received gavage with relevant medicine. 15 days later, the activity of MPO in serum was detected through the method of ultraviolet spectrophotometry;the protein expressions of PR3 and LAMP-2 in femoral artery and the surrounding tissues were detected through the method of immunohistochemisty. Results Compared with sham-operation group, the activity of MPO in serum and the protein expressions of PR3 and LAMP-2 in rats of model group were significantly higher;Compared with model group, the activity of MPO in serum and the protein expressions of PR3 and LAMP-2 in rats of all medication administration groups decreased, among which the XFWYTLD medium dose group showed the most obvious decrease. Conclusion XFWYTLD may lower levels of ANCA associated antigen, and further inhibit humoral immune function.
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BACKGROUND:The cryopreservation of single tissue has achieved great advancement and is gradual y applied in clinics. However, the cryopreservation of complex tissue is rarely reported. OBJECTIVE:To investigate the morphological change in rabbit limb tissue after replantation through different rewarming methods, find the best rewarming methods of compound textured blood vessels, and provide theoretical basis for the feasibility of limb replantation after long-term cryopreservation. METHODS:Thirty New Zealand white rabbits were randomly divided into control group, slow freezing-slow thawing group, and slow freezing-rapid thawing group. The right posterior limbs of al the rabbits were cut off 1 cm above the knee joint. Except control group, the latter two groups were given limb replantation after thawing, and then the right posterior limb was again cut off after the replanted limbs were survived for 6 hours. For al groups, the histological changes and gross observation in aorta tissue were observed by light microscopy and transmission electron microscope, and the results were analyzed with statistical methods. RESULTS AND CONCLUSION:In the slow freezing-slow thawing, slow freezing-rapid thawing groups, the pathological changes (gross specimen, light microscope, electron microscope) of rabbit limbs 6 hours after replantation were worse than those in control group. Compared with slow freezing-rapid thawing group, better integrity of endothelial cells and less damage of the organel es were found in slow freezing-slow thawing group. Through deep cryogenic freezing-thawing process, rabbit limb blood vessels can maintain the structural integrity after replantation and survived at 6 hours. Slow freezing-slow thawing is better than slow freezing-rapid thawing for the preservation of severed limbs, providing evidences for the long-term survival fol owing a deep cry ogenic treatment after the severed limb replantation.
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Objective To investigate the minimal and optimal concentration of ropivacain for epidural anesthesia in patients with breast cancer.Methods 103 patients with breast cancer ASA Ⅰ-Ⅱ undergoing elective radical mastectomy were conducted with epidural anesthesia.T2-3 were selected as a puncture site.A catheter was inserted into the epidural space in a cephalic direction for 3.5-4.0 cm.The concentration of ropivacain was produced by the test of up-down sequential allocation technique.20-25 ml of 0.20 ％ ropivacaine was given after a test of 0.20 ％ 5 ml ropivacaine.If the anesthesia was effective (VAS≤3),the next concentration was down 0.01％,while the VAS was more than 5,the next concentration was up 0.01％.The anesthesia effect and segments of block were measured with acupuncture.Blood pressure (NIBP),heart rates(HR),blood oxygen saturation (SPO2),blood gas and VAS were monitored during operation.Nasal catheter oxygen inhalation was used in routine method.Results The median effective concentration (EC50) of ropivacaine was 0.10 ％ determined by the formula of dixon and massey.The 95 ％ confidence intervals was 0.1022 ％-0.1065 ％.The least and the best analgesic concentration of ropivacaine for the upper thoracic epidural block was 0.14 ％ and 0.17 ％-0.18 ％ respectively.Conclusion The minimal and the optimal analgesic concentration of ropivacaine for the upper thoracic epidural block are 0.14 ％ and 0.17 ％-0.18 ％respectively,and which provides a safe and rational use of ropivacaine for the clinic.
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Objective To investigate the cause of fracture nonunion and discuss the experience of locking plates fixation combined with autoallergic cancellous bone in the management of non-infective long bone nonunion.Methods A retrospective analysis was made in 38 patients(29 males and 9 females)with fracture nonunion treated with locking plates fixation combined with autoallergic cancellous bone from August 2006 to August 2010.Of all,22 patients were treated with plates and 16 with interlocking intramedullary nails.Results All the patients were followed up for a mean of 12 months(range,6-24 months).The bone union time for all the fractures averaged 5.3 months(range,3-7 months),with no complications like implant loosening or fracture.Conclusions Iatrogenic factor is the main cause for fracture nonunion after open reduction and internal fixation of long bone fractures and the locking plates combined with autoallergic cancellous bone are a safe and effective treatment procedure.
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BACKGROUND: Some researches demonstrate that jog stress at fracture part can promote formation of callus, but molecular biological mechanism of jog stress on fracture healing is still unclear.OBJECTIVE:To study the effect of jog stress at fracture site on basic fibroblast growth factor(bFGF)at broken parts.DESIGN:Randomized controlled animal study.SETTING:Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA;Departments of Orthopaedics and Pharmacy,the First Affiliated Hospital of General Hospital of Chinese PLA.MATERIALS:The experiment was carried out in the Animal Laboratory,the First Affiliated Hospital of General Hospital of Chinese PLA and the 8th Laboratory,Academy of Military Medical Sciences of Chinese PLA from March 2003 to April 2004.A total of 72 healthy purebred New Zealand rabbits,of general grade,5-6 months old,weighing 2.5-3.0 kg,were provided by Animal Center of Academy of Military Medical Sciences of Chinese PLA.All rabbits were randomly divided into jog group and fixation group with 36 rabbits in each group.And then,every 6 rabbits in both groups were respectively observed at 6 time points,including 7,14,21,28,42 and 56 days.METHODS:All animals were anesthetized with ketamine and sumian xinji.Fixation needle was rotated into 3,3.5,5.5 and 6 cm below platform of tibia,respectively,and then external fixators were installed.Chuck which was located at 1.5 cm from internal cortical bone and 4.5 cm below platform of tibia crossly cut off tibia.Fracture space was 2.0 mm and 2.5 mm in the fixation group and jog group,respectively.Animals in the fixation group were fixed with unilateral external fixator to dissect replace fracture part.In addition,animals in the jog group cut off their bone,fixed,and moved 0.5 mm to axis along central staff of external fixator.Animals were able to freely walk and external fixator was slightly shaken based on body mass of animal.Furthermore,all animals were sacrificed at 7,14,21,28,42 and 56 days after operation.According to the center of fracture part,samples in 1 cm length were cut,divided and fixed for 12 hours.Quantitative analysis of bFGF and colorized intensity were detected with immunohistochemical stain and JVC imaging analytic system at 7,14,21,28,42 and 56 days after operation.MAIN OUTCOME MEASURES:①Detecting colored intensity of bFGF;②quantitative analysis of bFGF.RESULTS:A total of 72 rabbits were involved in the final analysis bFGF could express in interstitial cells,vascular endothelial cell,osteoblast,chondroblast and osteocyte plasma.At 14,21 and 28 days after operation,positive indexes of bFGF protein in the jog group were 1.98±0.14,2.04±0.12 and 2.13±0.17,respectively,which were obviously higher than those in fixation group(1.59±0.14,1.68±0.15,1.63±0.27,P＜0.05).CONCLUSION:Jog stress can increase numbers of bFGF at fracture part and promote fracture healing.
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@#根据弱智儿童对音乐的喜好 ,因势利导对其进行 5周集中强化的音乐训练 ,以探讨训练对弱智儿童注意短暂、兴趣易转移、纪律性差等行为的矫正 ,以及感知能力的协调、认识能力的改善等的作用。
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Objective To explore the ways of repairing the large long-bone and skin defects as single stage procedures. Methods Five clinic cases were studied, firstly, the arteriae fibularis were restructuered into one or two vaso-nasa which nourished the related fibula segments and the overlying skin, then, binding all of the fibula segments and turn it into a bulky bone with a periosteal vaso-nasa wraparound. The graft was rich in blood supply so osteogenesis activity was vigorous under the periostum, the interspace in the graft soon disappear and the graft increased in diameter gradually. Results All of the harvested skin flaps survived and the wound healed on schedule, besides, the involved fractures were union 1 year later and the grafts were strong enough for weight-bearing and walking 2 year later, Neither fracture occur nor morbidity was created at the donor site, No problem was caused at the ankle. Conclusions It's appropriate way to repair large long-bone and skin defects with a vascularized fibula segments complex transfer incorporationg the overlying skin that was supplied via the same peroneal vessel pedicle.