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Objective To investigate the feasibility and accuracy of a patient-special template for antegrade pubic branch screwing and sacroiliac screwing which is 3D printed and based on the external fixation for treatment of pelvic fractures.Methods From January to April 2017,5 patients with Tile B fracture of the pelvis were treated by external fixation for damage control and closed reduction of the fracture at the first stage.They were 4 males and one female,aged from 42 to 65 years(average,54.8 years).By the Tile classification,there were one case of type B1 and 4 cases of type B2.After the CT scan data following external fixation were reconstructed and the screw trajectories were designed in 3D format,an individual template for the pelvic model was 3D printed.After the feasibility was confirmed by the preoperative operation,the patient-special template was used to insert antegrade pubic branch screws and sacroiliac screws in the surgery.The accuracy and safety of the actual screwing aided by the template were evaluated by comparing postoperative CT scans and preplanned trajectories of the screws.Results The individualized 3D printing templates based on external fixation led to precise screw placements into the superior ramus of the pubis and the sacroiliac joint.All the patient-special templates matched the external fixation well.Screw placement time ranged frown 5.1 to 17.5 min,averaging 10.3 min.The fluoroscopy frequency ranged from 6 to 16 times,averaging 9 times.The wound healed primarily.There was no damnage to the vessels or nerves.Verification of preoperative and postoperative CT scans showed an axial displacement deviation of 1.60 + 0.21 mm and an angle deviation of 2.0° ± 0.3°.The screws were basically in the bone channel without penetrating the cortex of important parts.Conclusion In the treatment of pelvic fractures,a patient-special screw template 3D printed based on external fixation can help accurate and safe insertion of the screws in a minimally invasive manner,significantly reducing the operation time and radiation exposure.
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Objective To evaluate the clinical efficacy of staged treatment of complex tibial plateau fractures with temporary transarticular external fixation and delayed plate fixation.Methods Enrolled in this study were 44 cases of complex tibial plateau fracture who had been treated from January 2011 to January 2014.Temporary transarticular external fixation and delayed plate fixation was adopted in 22 patients (observation group),involving 14 men and 8 women with an average age of 45.5 ± 11.4 years,and 10 left sides and 12 right sides.By the Schatzker classification,13 cases were type Ⅴ and 9 type Ⅵ.Calcaneal traction and plate fixation was adopted in the other 22 patients (control group),involving 13 men and 9 women with an average age of 43.8 ± 10.4 years,and 8 left sides and 14 right sides.By the Schatzker classification,12 cases were type Ⅴ and l0 type Ⅵ.The 2 groups were evaluated by the time from hospitalization to plate fixation,operation time,intra-operative bleeding volume,hospitalization time,healing time,complications and Hospital for Special Surgery (HSS) scoring at the final follow-ups.The 2 groups were compatible with no significant differences regarding the preoperative general data (P ＞ 0.05).Results The 44 patients were followed up for 12 to 30 months (mean,18.6 months).There were significant differences between the 2 groups in the time from hospitalization to plate fixation,operation time,intra-operative bleeding volume and hospitalization time (P ＜ 0.05).There was also a significant difference in the complications rate (4.5％ (1/22) for the observation group versus 27.3％ (6/22) for the control group) (P ＜ 0.05),but there was no significant difference in the good to excellent rate by HSS scoring [86.3％ (19/22) versus 81.8％ (18/22)] (P ＞ 0.05).Conclusions Although both methods can treat complex tibial plateau fractures,temporary transarticular external fixation and delayed plate fixation may be preferable because it can lead to decreased hospitalization time,less intra-operative bleeding volume,fewer surgical complications and good functional recovery of the knee.
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Objective To test the effect of bone marrow mesenehymal stem cells (MSCs) transplantation on oxidative stress and the development of pulmonary emphysema in rats. Methods SD rats (n=26) were randomly divided into three groups:normal control group (group A, n=8),emphysema group (group B, n=8) and emphysema+MSCs transplantation group (group C, n=10).Rat models of emphysema was established by exposing rats to cigarette smoking for 14 weeks. Then rats of group C received MSCs transplantation. At the 14th and 28th days after 4 course of MSCs transplantations, one rat in group C was sacrificed at each time point and their lungs were preserved in frozen sections. Survival of MSCs in the lung tissues were observed by fluorescence microscopy. Eight weeks after transplantations, lung sections were stained by hematoxylin and eo?sin (HE) to observe the morphological alterations.Mean linear intercept (MLI) and mean alveolar numbers (MAN) were also measured. Serum and lung malondialdehyde (MDA) levels and superoxide dismutase (SOD) activity were also examined. Re?sults At the 14th day and 28th day after transplantations of MSCs, MSCs successfully localized to lung and survived in rat models of emphysema. Emphysematous changes of lung tissues were observed in both group B and group C. MLI was higher while MAN was lower in group B and C than those in group A (P<0.05). MLI and MDA levels in serum and lung were high?er while MAN level and SOD activity were lower in group B than those in group C (P<0.05).MDA levels in serum and lung was higher while SOD activity was lower in group B and C than those in group A (P<0.05). Conclusion MSCs transplanta?tions can effectively alleviates pulmonary emphysema in rat models which might through reducing oxidative stress .
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Objective To evaluate the effect of dorsal dual-plate fixation for unstable distal radius fractures.Methods Twenty-two cases of unstable distal radius fractures undergone dorsal fixation with a 2.4 mm plate from June 2010 to June 2012 were enrolled.There were 16 males and 6 females with mean age of 54.5 years (range,22-75 years).According to the AO fracture classification,there were 12 cases of type B2,6 type C1 and 4 type C2.Five cases had autologous or allogeneic bone grafting.Results Mean period of follow-up was 14 months (range,5-30 months).According to Gartland-Werley score,the result was excellent in 13 cases,good in 5 cases and fair in 4 cases,with the excellent and good rate of 82％.Volar inclination [(11.07 ± 1.77) °],ulnar declination [(22.30 ± 3.13) °],and radial height [(11.40 ±1.51) °] showed statistical differences from that [(-1.50 ± 7.59) °,(11.90 ± 3.87) °,and (5.20 ±1.55) ° respectively] before operation (P ＜ 0.05).Conclusions Dorsal dual-plate fixation can be a reliable and effective technique for AO-B2 shear fractures with intact volar-cortex and dorsal criticallycomminuted fractures of the distal radius.Active bone grafting should be performed for bone defection to promote bone healing.
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Objetive To investigate a method of collecting lung cancer cells with bronchofibroscopic biopsy for primary culture and to improve the success rate of primary culture. Methods Thirty lung cancer specimens were obtained through bronchoscopic biopsy for primary culture. The correlation of cancer morphology under bronchofi-broscopy and success rate of primary culture was analyzed. Results Among the lung cancer specimens obtained through bronchoscopic biopsy, primary culture was successful in 17 of 30 cases (56.67%) . The success rate of cauliflower-like tumor mass under bronchofibroscopy was 84.62% (11/13) . The success rate of infiltrating tumor mass under bronchial mucosa with luminal stenosis with or without cristate were 66.67% (2/3) and 37.5%(3/8), respectively. The primary culture of a globular and stiff tumor mass was successful only 1 in 6 cases (16.67%) .Conclusions The primary culture of lung cancer cells obtained from bronchofibroscopic biopsy is simple and effective with a total success rate of 56.67%. Furthermore, the success rate of primary culture is signifi-cantly correlated with the cancer morphology under bronchofibroscopy.
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Objective As we know more about CVA and examination methods are becoming more popular,the number of patients diagnosed as CVA is increasing year after year.So it is necessary that we should find more clinical characteristic and therapy for CVA.Methods 155 CVA patients have been observed for 2 years and the results of bronchial methacholine chloride provocation test before and after the observation were analyzed.Results 30% of the patients werent analyzed because they did not take the drugs regularly.The result showed that the CVA male vs female was 1 ∶4,the average age was(40?7.2)years.20 patients developed typical asthma(12.94%).After 2 years,70% of the patients had positive results of the bronchial methacholine chloride provocation.Methacholine chloride concentration was negatively related to hyperresponsiveness of bronchus.FEV_1% was negatively related to the state of asthmatic degree.Conclusions The CVA was incident to the young and the middle-age females,often with an obvious inducement.The female prognosis was worse than that of the male.Generally speaking,the prognosis was good if patients took medicine regularly.Patientscompliance was the essence of the prevention and the cure.Young females who had chronic cough indicate CVA.The concentration of methacholine chloride and FEV_1% were effective indexes when we estimated the state and prognosis of CVA.In most CVA patients,the hyperresponsiveness stayed for a long time,which may be one of the most dangerous risks.We should keep on observing and treating those patients.
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Objective To study the diagnostic value of flexible bronchoscope in location and causes of atelectasis.Methods Flexible bronchoscopy examination was carried out on seventy-nine cases of apneumatosis to observe lobar bronchus and segmental bronchus.Lung biopsy and bronchoalveolar lavage were carried out.Results Thirty-two cases were lung cancer,covering 40.5%.Seven cases were pulmonary tuberculosis,covering 8.8%.Thirty-eight cases were inflammation,covering 48.1%.Two cases had foreign matter,covering 2.5%.Conclusions Flexible bronchoscopy is of important clinical value in the location,diagnosis and treatment of atelectasis.