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Objective To evaluate the advantage of 3D printing technique in treatment of complicated ace-tabula fracture,we compared the early clinical outcomes of surgical treatment for complex acetabula fracture with traditional surgery(group A)and that assisted by 3D printing technique(group B).Methods A prospective anal-ysis of 35 complicated acetabula fractures was performed at our department,13 patients cured assisted with 3D printing technique. The other 22 patients performed traditional surgery. Surgical trauma,systematic inflammation, immediate reduction effect were evaluated by Matta image assessment standard,and rehabilitation functional status evaluated by Harris score system and Merled' Aubigne and Postel Grading standard. Results There were signifi-cant differences between the two groups regarding intraoperative blood loss,postoperative drainage,operation time (P<0.05),and group B was superior to group A.C reactive protein,leucocyte and creatine kinase MM in periph-eral blood in group A were much higher than those in group B at 24 hours postoperatively(P<0.01).The result of reduction of fracture is poor in group A,but excellent rate of reduction is about 84% in group B. The result of Merled' Aubigne and Postel scores grading was superior in group B(P = 0.013). The excellent and good rate of Harris function score in B group was significantly higher than that in group A(P=0.027).Conclusion The treat-ment of complicated acetabula fracture assisted by 3D printing is excellent in short-term follow up,achieving good reduction with limited trauma,long-term prognosis needs to be further followed up.
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Aim To observe the effect of pyrimidine dithiocarbamate (PDTC) on the variance of disc morphology and the expressions of TNF-α, MMP-9 in the cervical disc in cervical dynamic equilibrium rat models, and to investigate the roles of PDTC in the process of intervertebral disc degeneration and the mechanism involved.Methods Fifty-four SD rats were divided into three groups randomly, then the dynamic equilibrium rat model was established by cutting the nuchal superficial and deep muscle of the rats.The dynamic equilibrium rats with PDTC solution intraperitoneal injection after operations were defined as PDTC group (group A), the models with saline intraperitoneal injection after operations as saline group (group B), the rats of fake operation with saline intraperitoneal injection as blank group (group C), and the animals were sacrificed in batches 10 weeks, 12 weeks, 16 weeks respectively after operation.The C5, C6 vertebrae and C5/6 discs were harvested, and the disc morphology was observed.TNF-α, MMP-9 mRNA expressions were detected by q-PCR and protein expression was observed by Western blot.Results Compared with the saline group, the morphology of disc in PDTC group was destructed slightly and fiber ring arranged orderly.TNF-α, MMP-9 gene and protein expressions had no obvious changes (P>0.05) in blank group (group C) at each time point.The expressions of IL-6, MMP-9 mRNA increased with time in group B, but the amount increased fast firstly, and slow lately, reaching peak in 12 weeks.The expression of TNF-α, MMP-9 protein became steady in group B from 10 weeks compared with other time points(P>0.05).TNF-α, MMP-9 genes and proteins expression decreased obviously in PDTC group (group A) compared with saline group (group B) (P<0.01) at each time point, but higher than blank group C(P<0.01) at each time point.Conclusions TNF-α and MMP-9 are important inflammatory factors involved in rat cervical disc degeneration, PDTC relieves the degeneration of rat cervical disc by reducing the expression of TNF-α and MMP-9 via disturbing the NF-κB signal pathway probably, and PDTC may become potential medicine for disc degeneration.
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Objective To explore the effectiveness of our self-designed 3D printing relay template in the treatment of malunion of irregular intra-articular ankle fractures.Methods From October 2013 to October 2015,our self-designed 3D printing relay template was used in 14 patients with severe malunion of intra-articular ankle fracture to assist their intra-articular osteotomy.They were 10 males and 4 females,with an average age of 40.5 years (from 34 to 59 years).Thin slice CT scan was preformed preoperatively for all the ankles involved.The computer fictitious tibial and fibular models for location and osteotomy navigation templates were acquired from the data of CT scan after processing,design and reconstruction by software.After the navigation templates which fit the size of solid ankle were printed by a 3D printer,they were sterilized and reserved.The guide plates were used in turn during operation.The irregular malunited bone blocks in the posterior malleolus were completely resected along the osteotomy template.After fracture reduction,the bone blocks were stabilized with internal fixation.Fracture union time was recorded.Scores of visual analogue scale (VAS),American Orthopaedic Foot and Ankle Society (AOFAS) and the short form-36 (SF-36),ankle ROM and complications were also recorded at the final follow-ups.Results The 14 patients obtained an average follow-up of 28.6 months (from 14 to 35 months).Bony union was achieved after an average of 3.7months (from 3 to 6 months).At the final follow-ups,on average,VAS score (2.2 ± O.8),AOFAS ankle and hindfoot score (81.1 ± 6.8),SF-36 score (82.5 ± 5.2),dorsal extension (27.5 ° ± 2.5°),and plantar flexion (24.2° ±6.3°) were significantly improved compared with the preoperative values (6.3 ± 1.8,43.1 ± 12.0,37.6 ± 9.9,14.1° ± 3.8° and 14.4° ± 3.9°,respectively) (P ＜ 0.05).No implant failure,soft tissue complications or post-traumatic arthritis occurred during the follow-up.Conclusion Since our self-designed 3D printing relay templates for osteotomy can accurately position the fracture lines of the distal tibia via limited incision and invasion,they help a lot in precise osteotomy and anatomical reduction of malunited intra-articular ankle fracture,preventing incidence of traumatic arthritis.
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Objective To observe the clinical efficacy of the combination of western medicine with acupuncture for treatment of polycystic ovary syndrome (PCOS) of infertility.Methods Totally 120 PCOS patients were randomly divided into western medicine group and acupuncture group, 60 cases in each group. All patients took Diane-35, and with whom resistant to insulin were added with Metformin. At the meantime patients increased the amount of exercise with adjustment and control of everyday diet. After three periods, the western medicine group used the method of Clomifene Citrate with Chorionic Gonadotropin to help ovulation induction. The acupuncture group used the method of acupoint selection including invigorating spleen and kidney with adjusting qi and blood to promote ovulation. The level of FSH, LH, FINS, E2 and T of the two groups were observed before and after treatment.Results After treatment, the levels of T, FINS, LH and BMI in the two groups decreased, with statistical significance (P<0.05). The levels of T and BMI in the acupuncture group were lower than the western medicine group after the treatment, with statistical significance (P<0.05). The total efficiency, gestation number, number of high-quality follicle, and basal body temperature of acupuncture group were all higher than the western medicine group, with statistical significance (P<0.05).Conclusion The combination of western medicine with acupuncture for treatment of PCOS of infertility has confirmed efficacy.
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[Objective] To compare the expression of matrix metalloproteinase 2(MMP-2)and matrix metalloproteinase 9(MMP-9)induced by alumina and ultra-high-molecular-weight polyethylene(UHMWPE)wear particles,and investigate the role of MMP-2 and MMP-9 in the mechanism of the periprosthetic osteolysis induced by wear debris during aseptic loosening.[Methods]Seventy-two Kunmin mice were divided into 3 groups(24 per group)in a murine air pouch model of inflammation.The air pouches were injected with 3ml of suspension containing 1?108 /ml alumina particles in group A,while UHMWPE particles in group B,and control pouches received 3ml of sterile PBS.All animals were sacrificed at 3、7、14 days after injection.Histological changes and cell counting were assessed by light microscope.RT-PCR and immunohistochemistry method were applied to detect the gene and protein expression of MMP-2 and MMP-9 in the pouches.[Results]Increased cell infiltration and MMP-2,MMP-9 mRNA and immunoreactivity expression were detected in group A and B,and compared to control group,cell number and gene and protein expression of MMP-2 and MMP-9 in group A and B was significantly higher(P