Clinical application of a new deformity correction device based on Ilizarov technique for flexion and extension contracture of elbow / 医用生物力学

Objective To design a new correction device for elbow deformity with active orthopedic force based on Ilizarov technique, and discuss its curative effect on elbow orthotics in clinic. Methods A total of 44 patients with elbow joint dysfunction were randomly divided into treatment group (n=22) and control group (n=22), and treated with new deformity orthotic device and continuous positive motion, respectively. The functional recovery of the elbow joint for patients in two groups was evaluated after 3-month treatment. Results The range of motion (ROM) of elbow flexion-extension in treatment group was significantly larger than that in control group, and the effective rate for treatment group and control group was 90.91% and 81.82%, respectively. Conclusions The use of such correction device for elbow deformity showed good curative effect for treating elbow joint dysfunction, which is worth popularization and application in clinic．

Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

OBJECTIVE: We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. MATERIALS AND METHODS: Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. RESULTS: All the lesions were located in the cortex and their mean size was 1.3 +/- 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. CONCLUSION: Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

Retrospective analysis of 100 patients managed by extracorporeal membrane oxygenation / 中华外科杂志

<p><b>OBJECTIVE</b>To describe the experience with extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support of 100 patients.</p><p><b>METHODS</b>Retrospective analysis of the medical files of 100 patients submitted to the implant of extracorporeal membrane oxygenation system for cardiorespiratory assistance of acute and refractory cardiogenic shock from December 2004 to September 2008. There were 67 males and 33 females, age ranged from 5 d to 76 years with a mean of (28+/-26) years, body mass ranged from 3.8 to 100.0 kg with a mean of (42+/-30) kg. The inter-surface of the ECMO equipment system was completely coated by heparin-coating technique. All patients were applied veno-artery ECMO and activated clotting time was maintained between 120 and 180 s and heparin usage dose was 5 to 20 Uxkg(-1)xh(-1). Mean blood flow was 40 to 220 mlxkg(-1)min(-1) during ECMO assistant period.</p><p><b>RESULTS</b>The shortest ECMO time was 12 to 504 h with a mean of (119+/-80) h. Sixty-one patients (61.0%) weaned off successfully from ECMO, 55 of them (90.2%) were discharged and 6 died of post-operative complications. Thirty-nine patients could not weaned off from ECMO. Total survival discharge rate was 55.0%. Mean aortic pressure before ECMO in survived patients was significantly higher than that of dead patients (P=0.038). Lactic acid concentration of artery blood before ECMO in survived patients was significantly lower than that of dead patients (P=0.005).</p><p><b>CONCLUSIONS</b>ECMO is an effective mechanical assistant therapy method for cardiac and pulmonary failure after cardiac surgery. Earlier usage of ECMO for heart lung failure patient and avoiding the main organs from un-recovery trauma are key success.</p>

Effects of taurine on early changes of excitatory amino acids in rabbit brain due to deep hypothermic circulatory arrest / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effects of taurine (Tau) on early changes of excitatory amino acids (EAA) in hippocampus rabbit brain due to deep hypothermic circulatory arrest (DHCA).</p><p><b>METHODS</b>Sixteen New Zealand rabbits were randomly allocated into 2 groups: Tau 150 mg/kg group (group I, n = 8), control group (group II, n = 8). Cardiac pulmonary bypass (CPB) was set up after cerebral microdialysis model was established. High performance liquid chromatography was employed to monitor the continuous changes of glutamic acid (Glu), aspartic acid (Asp), Tau and glycine (Gly) in the hippocampus CA1 region at anaesthesia periods, CPB stage, pre 30 minutes in DHCA, post 30 minutes in DHCA, pre 30 minutes in rewarming, post 30 minutes in rewarming.</p><p><b>RESULTS</b>The increase of Glu in group II was (5.1 +/- 1.5) and (4.1 +/- 1.4) times higher than that at anaesthesia periods (t = 3.74, 5.45, P < 0.01), and the increase of Glu in group I was (2.1 +/- 1.5) and (1.1 +/- 0.4) times than that at anaesthesia periods at pre 30 minutes and post 30 minutes rewarming stage respectively. Rising of Gly in group II was 6.7 (3.6, 13.6) times than that at anaesthesia periods (T = 75.00, P < 0.05), the rising of Gly in group I was 4.2 (3.8, 11.5) times at post 30 minutes in DHCA. Rising of Tau in group I was 6.9 (3.0, 14.2) and 10.6 (2.8, 22.5) times than that at anaesthesia periods (T = 75.00, P < 0.05 and T = 90.00, P < 0.05) and rising of Tau in group II was 4.0 (3.0, 5.7) and 3.2 (1.2, 7.6) times than that at anaesthesia periods at post 30 minutes in DHCA and pre 30 minutes rewarming stage respectively. Asp was no evident change at every periods.</p><p><b>CONCLUSION</b>DHCA might increase the excitatory amino acids in the early phases of circulatory restoration. Exterior Tau 150 mg/kg could inhibit release of EAA.</p>