Effect of folic acid coated-crosslinked urethane-doped polyester elastomer nerve conduit on promoting the repair of long distance peripheral nerve injury in rats / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effect of folic acid coated-crosslinked urethane-doped polyester elastomer (fCUPE) nerve conduit in repairing long distance peripheral nerve injury.@*METHODS@#Thirty-six 3-month-old male Sprague Dawley rats weighing 180-220 g were randomly assigned to 3 groups, each consisting of 12 rats: CUPE nerve conduit transplantation group (group A), fCUPE nerve conduit transplantation group (group B), and autologous nerve transplantation group (group C), the contralateral healthy limb of group C served as the control group (group D). A 20-mm-long sciatic nerve defect model was established in rats, and corresponding materials were used to repair the nerve defect according to the group. The sciatic function index (SFI) of groups A-C was calculated using the Bain formula at 1, 2, and 3 months after operation. The nerve conduction velocity (NCV) of the affected side in groups A-D was assessed using neuroelectrophysiological techniques. At 3 months after operation, the regenerated nerve tissue was collected from groups A-C for S-100 immunohistochemical staining and Schwann cell count in groups A and B to compare the level of nerve repair and regeneration in each group.@*RESULTS@#At 3 months after operation, the nerve conduits in all groups partially degraded. There was no significant adhesion between the nerve and the conduit and the surrounding tissues, the conduit was well connected with the distal and proximal nerves, and the nerve-like tissues in the conduit could be observed when the nerve conduit stents were cut off. SFI in group A was significantly higher than that in group C at each time point after operation and was significantly higher than that in group B at 2 and 3 months after operation ( P<0.05). There was no significant difference in SFI between groups B and C at each time point after operation ( P>0.05). NCV in group A was significantly slower than that in the other 3 groups at each time point after operation ( P<0.05). The NCV of groups B and C were slower than that of group D, but the difference was significant only at 1 month after operation ( P<0.05). There was no significant difference between groups B and C at each time point after operation ( P>0.05). Immunohistochemical staining showed that the nerve tissue of group A had an abnormal cavo-like structure, light tissue staining, and many non-Schwann cells. In group B, a large quantity of normal neural structures was observed, the staining was deeper than that in group A, and the distribution of dedifferentiated Schwann cells was obvious. In group C, the nerve bundles were arranged neatly, and the tissue staining was the deepest. The number of Schwann cells in group B was (727.50±57.60) cells/mm 2, which was significantly more than that in group A [(298.33±153.12) cells/mm 2] ( t=6.139, P<0.001).@*CONCLUSION@#The fCUPE nerve conduit is effective in repairing long-distance sciatic nerve defects and is comparable to autologous nerve grafts. It has the potential to be used as a substitute material for peripheral nerve defect transplantation.

Analysis on setbacks found in hospital ethics review / 中华医院管理杂志

Given the rapid progress in recent years,hospital ethics review remains a weak link.This study started from the nature and role of the hospital ethics committee to probe into setbacks found in hospital ethics review practice.Viewpoints in the paper covered the access system,review system,training system,and the conflicts of interest between researchers and subjects,in an effort to further improve the quality of ethic review,and to better protect the rights and interests of subjects.

Choice fusion therapy of PUMC Ⅱ d_2 adolescent idiopathic scoliosis A finite element analysis of optimal fusion segment / 中国组织工程研究

BACKGROUND:At present,experimental animal models of primate idiopathic scoliosis with erect feet have not been established.With rapid development of computer and imaging,we can use computer software to simulate models of human idiopathic scoliosis,and do relevant biomechanical analysis and provide instructions for clinical surgery operation.OBJECTIVE:To research the best surgical fusion level for the adolescent idiopathic scoliosis (AIS) of PUMC Ⅱ d_2 with the finite element model (FEM).DESIGN,TIME AND SETTING:The compadson observation was performed at the Department of Orthopedics,Beijing Union Hospital from May 2007 to May 2008.PARTICIPANTS:One female patient with PUMC Ⅱ d_2 scoliosis (double curve malformation) was included.METHODS:FEM (T5-S) of PUMC Ⅱ d_2 idiopathic scoliosis was used to simulate upper thoracic curve,lower lumbar curve and double curve fusion manners.Hollow lateral curvature pedicle of vertebral arch received 50,100,150 N load.Displacement of T_5 and T_(11) on upper sagittal plane (displacement of Z axis positive value on upper sagittal plane,displacement of negative value on lower sagittal plane) and their difference value were compared.T_5 displacement represented outcomes of double curve orthopaedics.T_(11) displacement represented outcomes of lower lumbar curve orthopaedics.Their difference value (T5-T11) represented outcomes of upper thoracic curve orthopaedics.MAIN OUTCOME MEASURES:Different fusion segments and displacement of T_5 and T_(11) under different orthopedic forces were measured.RESULTS:In PUMC Ⅱ d_2 lateral curvature,T_5 displacement on Z axis:fusion displacement of double curves was greater compared with upper curve alone or lower curve alone (P < 0.01 ).Difference of T_5-T_(11) displacement:double curves orthopaedics > upper thoracic curve orthopaedics alone > lower lumbar curve orthopaedics alone (P < 0.01).Displacement of T_(11) on Z axis:double curves orthopaedics > lower lumbar curve orthopaedics alone > upper thoracic curve orthopaedics alone (P < 0.01).CONCLUSION:Fusing two curves would get the best effect on the AIS of PUMC Ⅱ d_2 compared with upper curve alone or lower curve fusion alone.Effects of 3 kinds of load on correction of upper thoracic curve:double curve orthopaedics < upper thoracic curve orthopaedics alone > lower lumbar curve orthopaedics alone.Effect of 3 kinds of load on correction of lower lumbar curve orthopaedics alone:double curve orthopaedics > lower lumbar curve orthopaedics alone > upper thoracic curve orthopaedics alone.Three-dimensional finite element analysis is an effective method to analyze biomechanics of scoliosis deformity correction and provides a virtual non-invasive verification manner,and can optimize surgery scheme.

Comparison of Wrist Joint Imagings Taken with Different Angles / 中国康复理论与实践

@#ObjectiveTo compare the effect of imagings taken with different angles to observe relationship of wrist joint and distal screws.Methods29 patients with the distal radius fractures were performed operatively with the open reduction and internal fixation. The standard antero-posterior and lateral imagings of the wrist joint were taken during operation, and two different angle imagings of the wrist joint were also taken meantime in all 29 patients.ResultsScrews were found to penetrate into the joint in antero-posterior imagings of 23 cases and standard lateral imagings of 25 cases. However, no screws were found to penetrate into the joint in two different angle imagings.ConclusionTwo different angle imagings can fully show the articular surface of distal radius without screws.