TiRobot-assisted biplane double-supported screw fixation for femoral neck fractures in middle-aged and young patients / 中华创伤骨科杂志

Objective:To investigate the efficacy of biplane double-supported screw fixation in the treatment of femoral neck fractures in the middle-aged and young patients with the assistance of TiRobot.Methods:A retrospective analysis was conducted of the 28 young and middle-aged patients with femoral neck fracture who had been treated by biplane double-supported screw fixation at Department of Traumatic Orthopaedics, Puren Hospital from January 2021 to January 2022. According to the intraoperative use of TiRobot-assistance in the nail placement, they were divided into 2 even groups ( n=14). In the observation group where a TiRobot was used to assist nail placement, there were 6 males and 8 females, with an age of (44.1±8.7) years. In the control group where nail placement was monitored by conventional C-arm fluoroscopy, there were 7 males and 7 females, with an age of (48.8±8.0) years. The 2 groups were compared in terms of operation time, intraoperative fluoroscopy times, intraoperative blood loss, hospitalization time, fracture healing time, postoperative complications and hip function 6 months after operation. Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The operation time, intraoperative fluoroscopy times, intraoperative blood loss and hospitalization time in the observation group were significantly less than those in the control group [(66.5±3.7) min versus (77.1±3.9) min, (12.8±1.6) times versus (18.7±2.5) times, 3.5 (2.8, 4.0) mL versus 26.0 (24.0, 27.3) mL, (9.4±1.2) d versus (11.3±1.2) d] ( P< 0.05). During the follow-up period, the fractures healed well in both groups with no obvious complications. The fracture healing time in the observation group was (6.1±1.2) months, insignificantly shorter than that in the control group [(6.3±1.1) months] ( P>0.5). The Harris hip score 6 months after operation in the observation group (92.6±2.7) was significantly higher than that in the control group (90.6±1.9) ( P< 0.05). Conclusions:In the treatment of young and middle-aged patients with femoral neck fracture, the biplane double-supported screw fixation assisted by a TiRobot can shorten operation time and hospitalization time, and reduce the intraoperative fluoroscopy times and intraoperative blood loss for the patients, more conducive to the functional recovery of the hip joint, leading to better surgical efficacy than the nail placement monitored by conventional C-arm fluoroscopy.

Screening for tuberculosis in health examination participants and clinical study on the spontaneous occurrence of tuberculosis in the populations with strong positive reaction to tuberculin skin test in ten years / 中华健康管理学杂志

Objective To analyze the results of screening for tuberculosis (TB) in health examination participants and study the spontaneous occurrence of TB in the subjects with strong positive reaction to tuberculin skin test (TST) in ten years. Method Totally 12 598 health examination participants without past TB history were selected, of whom 8 896 were college students, 2 496 migrant workers and 1 206 had close contacts with active TB patients. They were screened by TST with strong positive reaction. All of subjects with TST strong positive results received chest X-ray examination and sputum acid-fast bacteria detection. The subjects diagnosed to have TB were given regularly anti-tuberculosis drugs treatment and followed up for ten years. The 429 subjects without TB and no isoniazid preventive treatment were chosen to be followed up for ten years and spontaneous occurrence of TB in first three years and the fourth to tenth years respectively, as well as the recurrence of TB for the patients who received anti-tuberculosis regimen were recorded. Result Thirty-seven cases were diagnosed as TB by TST screening, and the total detection rate was 0.29% (37/12 598). Among them 11 were college students (0.12%, 11/8 896), 12 were migrant workers (0.48%, 12/2 496) and 14 were close contacts (1.16%, 14/1 206) respectively. The detection rates were different among the three groups (χ2=31.40, P=0.000). Among 897 strong positive subjects, the strong positive rate was 7.12%(897/12 598), 316 were college students (3.55%, 316/8 896), 388 migrants workers (15.54%, 388/2 496), and 193 close contacts (16.00%, 193/1 206) respectively. There was significant difference in strong positive rate among the three groups (χ2=583.04, P=0.000), and the strong positive rate of college students was lower compared with that of the migrant workers and the close contacts (χ2=483.51 and 344.11, P<0.01). In ten years, 54 subjects were diagnosed as TB in 429 subjects with strong positive reaction to TST, the spontaneous cumulative incidence rate was 12.58% (54/429). Among them, the cumulative morbidity rate was 9.21%(14/152) in college students, 9.58%(18/188) in migrant workers and 24.72%(22/89) in close contacts respectively. The spontaneous morbidity rate of close contacts was higher than that of college students and migrant workers(χ2=10.63 and 11.21, P<0.001); 75 were lost in 398 participants, the dropout rate was 18.84%(75/398). In first three years of follow-up, 31 were diagnosed TB in 429 participants, the cumulative incidence rate was 7.23% (31/429). Of them 9 were college students (5.92%, 9/152), 10 migrant workers (5.32%, 10/188) and 12 close contacts (13.48%, 12/89) respectively (χ2=6.60, P=0.037). In the fourth to tenth years of follow-up, 23 were diagnosed TB in 398 participants, the cumulative incidence rate was 5.78% (23/398), which was not significantly different compared with the cumulative incidence rate of the first three years (χ2=2.50, P=0.37). Tirty-seven patients received standard anti-tuberculosis drug therapy for one year, no one of them had recurrence at ten-year follow-up. Conclusion The migrant workers and close contacts are the high-risk populations for TB. All of them with strong positive response to TST results are susceptible to TB. So regular physical examination is recommended for them and health management should be strengthened.

Clinical features and therapy of fournier's gangrene / 中华消化外科杂志

Objective To investigate the clinical features and therapy of fournier's gangrene.Methods The clinical data of 12 patients with fournier's gangrene who were treated at the Third Affiliated Hospital of Nanjing University of Chinese Medicine from January 2010 to February 2012 were retrospectively analyzed.Eleven patients had perianal abscess and 1 patient had perianal foreign body,most of the patients were presented with perianal pain,fever (＞ 38.5 ℃) and tachycardia.The mean interval between the onset of symptoms and admission to the hospital was 8 days (range,3-20 dyas).Seven patients were complicated with diabetes.Only 2 patients were administered hypoglycemic agents,but the effects were poor.Six patients were complicated with hypertension.One patient had the history of resection of sigmoid colon cancer 2 months before operation.Debridement and drainage were applied to all the patients after examination.Antimicrobial therapy applied to all the patients according to the results of drug sensitivity test.The incisions were washed by hydrogen peroxide solution postoperatively.Redebridement was applied if the disease was progressed.All patients were followed up via out-patient examination and phone call till June 2012.Results Results of clinical features:Perianal tissues necrotized,with the color of black.The scrotum or labia majora of 8 patients were invaded by the necrotic tissues.Results of laboratory test:the white blood cell count was (3.8-27.6) × 109/L,the white blood cell count of 6 patients was above 10 × 109/L,3 was above 20 × 109/L.The ratio of neutrophil granulocytes was 0.61-0.93.Four patients received single debridement,5 received redebridement,and 3 patients received debridement for more than 2 times.Two patients had sapremia and infectious shock,and they received treatment for 3 days and 4 days at the intensive care unit.Results of bacterial culture:6 patients were infected by the escherichia coli,4 by klebsiella pnenmoniae,and 1 by pseudomonas aeruginosa.The mean duration of hospital stay was (25± 14)days (range,1-49 days).All patients were followed up for 4-29 months,1 patient was discharged at postoperative day 2,and the prognosis of the 11 patients was good,no mortality was observed.Conclusions The clinical features of fournier's gangrene include severe pain and rapid spread of infections caused by necrosis of perianal subcutaneous tissues.Diabetes might be the risk factor of fournier's gangrene.Early diagnosis and prompt and aggressive surgical debridement are critical for improving survival.

Identification of Euryales Semen and Its Closely Related Species Using ITS2 Barcode / 世界科学技术-中医药现代化

Objective: To identify Euryales Semen and its closely related species using the ITS2 barcode. Method:The total genomic DNAs were extracted from twenty samples of Euryales Semen and its closely related species. The ITS2 regions of the samples were amplified and bidirectional sequenced. Obtained sequences were submitted to the GenBank with Sequin 12.3. ITS2 sequences of 102 samples belonging to thirty species were downloaded from GenBank. The 122 ITS2 sequences were aligned and the genetic distances were analyzed with MEGA 5.1. Identification analyses were performed using BLAST1 and nearest distance methods, and were presented intuitively by constructing neighbor-joining (NJ) tree. Result: The length of ITS2 region of Euryales Semen was 214 bp, which was only one haplotype. There was significant divergence of the ITS2 regions among the samples. The NJ tree showed that Euryales Semen could be obviously differed from its closely related species, which had good 408 monophyly. Conclusion: ITS2 regions as a DNA barcode can stably and accurately distinguish Euryales Semen from its closely related species and also provide a new technique to ensure clinical safety in utilization of tradi-tional Chinese medicines. The new exploration could broaden the application of DNA barcoding technology in identification of Traditional Chinese Medicine.

Using sternocleidomastoid-clavicle myocutaneous flap to reconstruct compound operative defect of oral carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the sternocleidomastoid-clavicle myocutaneous flap (SCMCP) for repairing the compound operative defect after oral carcinoma resection, to observe its clinical effect, prognosis and advantages of SCMCP, and to develop a new operative method that implantation of dental implant can be performed simultaneously.</p><p><b>METHODS</b>Sixteen patients underwent reconstruction with SCMCP after oral carcinoma resection and neck dissection during 2007 to 2009. Four of them (25.00%) underwent simultaneously implantation of dental implants in the clavicular flaps.</p><p><b>RESULTS</b>None of these patients died postoperatively during the follow-up until now. One patient (6.25%) with buccal cancer encountered local recurrence resulting in reoperation, and the flap grows well up to now. A part of the skin paddle underwent necrosis in two patients (12.50%), local fluidity was found in 2 patients (12.50%), fracture of clavicle occurred during the operation in one patient (6.25%). All the patients had good pronunciation and oral diet with no difficulty.</p><p><b>CONCLUSION</b>SCMCP is easy to survive, simple to perform, the clavicular figure and function won't be destroyed significantly. SCMCP is a good operative method to repair the compound operative defect after oral carcinoma resection.</p>

Study on nano-hydroxyapatite/type I collagen artificial bone scaffold structure and osteogenic ability in vivo / 生物医学工程学杂志

This study was aimed to develop nano-hydroxyapatite/type I collagen artificial bone scaffold and investigate its structure, osteogenic ability and biocompatibility in vivo. According to biomimetic and self-organization mechanism, nano-hydroxyapatite/type I collagen artificial bone scaffold was developed with nano-hydroxyapatite and pure type I collagen. General observation, scanning electron microscope, porosity measurement and X-ray diffraction were used to analyze the scaffold. In vivo test, the model of rabbit skull with two defects was created, the scaffold was embedded in one defect, and another defect served as vacuity control. The in vivo study involved 12 rabbits. At 2, 4, 8 and 12 weeks, the rabbits were sacrificed in sequence and specimens were obtained for histological observation. Nano-hydroxyapatite/type I collagen artificial bone scaffold was similar to sponge under microscope, the pore size was 100-300 microm, the average ratio of porosity was 92.6%, and the inner structure was homothetic to the natural bone. No acute or chronic immunologic rejection was observed in vivo. The rabbit skull defect was repaired by nano-hydroxyapatite/type I collagen artificial bone scaffolds completely in 12 weeks. Nano-hydroxyapatite/type I collagen artificial bone scaffold structure was homothetic to natural bone structure, and had excellent osteogenic ability, biocompatibility, osteogenesis and suitable degradation.