RESUMO
Infection of intracellular pathogens remains a serious challenge for clinical anti-infective treatment. The most commonly used strategy for the treatment of intracellular bacteria is long-term use of antimicrobials at high concentration,which not only brings se-rious side effects to patients,but also causes great economic pressure to the whole society. Thus,the development of new strategies to better kill intracellular bacteria by the antimicrobials which showed good bactericidal effect in in vitro experiments is extremely impor-tant. With appropriate carriers to embed or encapsulate drugs can better control drugs' pharmacokinetic behavior resulting in effective bioavailability increase of antimicrobials. The current studies on targeted drug delivery systems for anti-intracellular bacteria were re-viewed in the paper.
RESUMO
<p><b>OBJECTIVE</b>To investigate the effect of augmentative locking compression plate combined with bone graft in treating aseptic femoral shaft nonunion after intramedullary nailing.</p><p><b>METHODS</b>Twenty-one cases with aseptic femoral shaft nonunion after intramedullary nailing from January 2007 to January 2013 were treated,including 18 males and 3 females with a mean age of 37.7 years (ranged from 23 to 64 years). The mean period of nonunion after surgery was 23.9 months (ranged from 9 to 62 months). According to Weber-Cech classification,10 of those 21 cases were hypertrophic nonunion,7 were atrophic, and 4 had oligotrophic fracture nonunion. All patients retained the original intramedullary nail, and applied with augmentation plating of 6 to 8 holes locking compression plate, unicortical fixation with 2 to 3 locking screws in the proximal or distal end, with simultaneous autologous iliac bone grafting. After treatment,all patients were allowed to partial weight-bearing until full weight-bearing according to the radiological results. All patients were followed up and were evaluated with clinical and imaging results.</p><p><b>RESULTS</b>All patients were followed up from 8 to 24 months, averaged (13.5±3.5) months,which showed clinical union at 4 to 8 months, averaged (6.0±1.0) months and radiological solid union at 7 to 12 months, averaged (9.1±1.5) months. No such complications as infection,hardware loosening or breaking were found.</p><p><b>CONCLUSION</b>Augmentative locking compression plate(LCP) combined with bone graft for aseptic femoral shaft nonunion after intramedullary nail has a satisfied clinical efficacy. It's an useful and simple method.</p>