Longitudinal study on the trajectory and influencing factors of cancer-related fatigue in patients with lung cancer during perioperative period / 中国实用护理杂志

Objective:To explore the changing track of cancer-related fatigue in patients with lung cancer during perioperative period and analyze its influencing factors.Methods:From December 2020 to May 2021, 162 eligible patients with lung cancer were selected in the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital by convenient sampling method. Mental resilience and social support were investigated before operation (T0);and cancer-related fatigue was investigated before operation (T0),3 days after operation (T1), 1 week after operation (T2), 2 weeks after operation (T3) and 1 month after operation (T4), and Latent Class Growth Model was used to identify the track categories. Logistic regression analysis was used to analyze the influencing factors.Results:Three cancer-related fatigue tracks were fitted in this study, which were no fatigue group (31.7%), increased fatigue group (36.0%) and sustained fatigue group (32.3%). Univariate analysis showed that smoking history ( χ2=14.83, P<0.05), BMI ( χ2=29.67, P<0.05), hemoglobin count ( F=4.57, P<0.05), mental resilience ( F=35.53, P<0.05), social support ( F=47.53, P<0.05) were related to the track category of cancer-related fatigue. Logistic regression analysis showed that smoking history, over weight/obesity, resilience and social support were the predictors of cancer-related fatigue locus ( P<0.05). Conclusions:Perioperative cancer-related fatigue of patients with lung cancer has different change trajectories, patients with higher BMI and lower resilience are more likely to have a tendency of persistent fatigue. Patients with smoking history and lower social support are more likely to have an upward trend of fatigue. For this kind of lung cancer patients, medical staff should take timely and effective intervention measures to improve their cancer-related fatigue.

Current situation and analysis of influencing factors of telephone cardiopulmonary resuscitation in China / 中华急诊医学杂志

Objective:To investigate the current situation of telephone cardiopulmonary resuscitation (T-CPR) in China, and analyze the reasons for the low implementation rate of T-CPR.Methods:This was a multicenter cross-sectional survey. Twenty cities were selected from six geographical regions of China by convenient sampling method. Anonymous online electronic questionnaires were sent to emergency medical service staffs in each city. All respondents were divided into the routine T-CPR group and control group. Student's t test and Chi-square test were used to analyze the difference between groups. Multivariate logistic regression was used to analyze the influencing factors of T-CPR. Results:⑴A total of 1 191 questionnaires were collected. 80.94% of respondents knew T-CPR. Nine hundred and sixty respondents, who knew T-CPR and completed the questionnaires, were included in the study, and were divided into the routine T-CPR group ( n=401) and control group ( n=559). Nine hundred and thirty-nine (97.81%) responders believed that T-CPR should be implemented for cardiac arrest patients that could be confirmed by telephone.⑵Four hundred and one (41.77%) responders routinely implemented T-CPR. Among them, 237 (24.68%) responders always did and 164 (17.08%) responders often did. ⑶Multivariate logistic regression analysis showed that male ( OR=1.787, 95% CI: 1.235-2.587, P=0.002), age ( OR=1.025, 95% CI: 1.004-1.047, P=0.020), clinical medicine background ( OR=2.926, 95% CI: 1.387-6.171, P =0.005), dispatcher ( OR=5.305, 95% CI: 3.463-8.126, P<0.01), using medical priority dispatch system (MPDS) system ( OR=1.941, 95% CI: 1.418-2.656, P<0.01), and T-CPR policy or procedure ( OR=3.879, 95% CI: 2.652-5.674, P<0.01) were favorable factors for T-CPR. ⑷The top three reasons for implementing T-CPR in the routine T-CPR group were that they had received T-CPR training (67.08%), believed that T-CPR could improve survival rate (63.59%), and had standard T-CPR process (63.09%). The top three reasons for not implementing T-CPR in the control group were that worrying about bystander compliance (42.04%), worrying about the quality of bystander cardiopulmonary resuscitation (CPR) (38.28%), and worrying about medical dispute (36.14%). Conclusions:The awareness and implementation of T-CPR among emergency medical service staffs need to be improved. The implementation of T-CPR depend on telephone dispatchers with clinical medicine background, clear T-CPR policy, standardized operation procedure, and professional assistant tools. To improve the public's awareness of cardiac arrest and cardiopulmonary resuscitation, and to improve the supporting legal system are also conducive to the implementation of T-CPR.

Analysis of family cluster infection with Novel Coronavirus Pneumonia / 中华急诊医学杂志

Objective@#To explore the regularity and characteristics of the transmission of Novel Coronavirus Pneumonia(NCP) in crowd, for provide a reference for pre-hospital first aid to identify and screen NCP and close contact, at the same time to improve protection awareness and reduce infection rates.@*Method@#Retrospective analysis about the cases of familial aggregation transferred by Beijing Emergency Medical Center between January 20 and February 10, 2020,collect relevant information,including basic information,contact history,symptoms and signs, clinical outcome, etc.@*Results@#The mean incubation period of familial cluster cases was 5.6d,mean time from onset of symptoms to first visit was 1.8d;Among the 5 family cluster cases, 4 had fever,mean body temperature 38ºC, the Sp02 averaged 96%; Among the 5 family cluster cases, 4 had cough, 2 had fatigue, and 1 had dyspnea.@*Conclusion@#People are susceptible to infection to NCP,it spreads easily between close contacts, effective isolation is the focus of prevention and control among family members, it is also one of the difficulties of prevention and control.

Cognitive survey of telephone cardiopulmonary resuscitation among emergency personnel / 中华急诊医学杂志

Objectives To investigate the cognition of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) among emergency medical system(EMS) personnel and compare the cognition of TCPR among EMS personnel in different economic status,and to understand the current situation of TCPR cognition of EMS personnel in China.Methods This study is a multicenter crosssectional survey.The method of multi-level convenient sampling was adopted,and the test reliability and split half reliability of the questionnaire was tested.Questionnaire survey and data collection were conducted from December 2018 to June 2019.The ethical approval number is M2018264.SPSS 20.0 was used for analysis.x2 test was used to analyze the differences between groups.Results A total of 1191 electronic questionnaires were collected.Of them,80.94％ respondents knew TCPR,97.82％ respondents thought that TCPR should be implemented in cardiac arrest,36.62％ respondents thought that bystander cardiopulmonary resuscitation quality monitoring was needed in TCPR,and TCPR training courses were set up in the emergency department which recruited 25.83％ respondents.Emergency personnel in developed areas had a better understanding of the criteria for judging patients' breathlessness (11.69％ vs 7.89％,P=0.048),of TCPR need ncluding guidance of chest compression (92.45％ vs 87.49％,P=0.012) and of bystander cardiopulmonary resuscitation (BCPR) quality monitoring including the frequency of artificial respiration (84.42％ vs 74.87％,P=0.029) than those in underdeveloped areas,but there was no significant difference in other indicators (P＞0.05).Conclusions TCPR knowledge of EMS personnel in China is unsatisfactory.Further training is needed to improve their understanding of the criteria for judging cardiac arrest in out-of-hospital cardiac arrest patients via telephone,TCPR content and bystander cardiopulmonary resuscitation quality monitoring.There is difference in TCPR knowledge between the EMS personnel in developed and undeveloped areas in China.

The Prognostic Significance of Notch1 and Fatty Acid Binding Protein 7 (FABP7) Expression in Resected Tracheobronchial Adenoid Cystic Carcinoma: A Multicenter Retrospective Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Adenoid cystic carcinoma (ACC) of the trachea and bronchus is a rare tumor. Although MYB-NFIB oncogene fusion and Notch1 mutation have been identified in ACC, little is known about the expression and clinical significance of Notch1 and its target gene fatty acid binding protein 7 (FABP7) in tracheobronchial ACC. MATERIALS AND METHODS: Primary tracheobronchial ACC that were resected between 1998 and 2014 were identified through the pathology and oncology database from five thoracic oncology centers in China. A tissue array was constructed from the patients’ samples and the expressions of Notch1 and FABP7 were evaluated by immunohistochemistry. The association between the expression of both markers and survival was determined. RESULTS: Overexpression of Notch1 and FABP7, detected in 37.8% and 38.3% of 368 patients with tracheobronchial ACC, respectively, was an independent prognostic indicator for recurrencefree survival (RFS) by multivariable Cox proportional hazard model (p=0.032 and p=0.048, respectively). Overexpression of Notch1, but not of FABP7, predicted overall survival (OS) (p=0.018). When categorized into four groups according to coexpression of Notch1 and FABP7, patients with overexpression of both Notch1 and FABP7 belonged to the group with the shortest RFS and OS (p=0.01 and p=0.048, respectively). CONCLUSION: Expression of Notch1 and FABP7, and coexpression of Notch1 and FABP7, is strongly associated with poor survival in resected tracheobronchial ACC. These data are consistent with the hypothesis that poor differentiation of tracheobronchial ACC correlates with the activation of Notch signaling.

Relationship between body position and reduction in cephalomedullary nailing for femoral in-tertrochanteric fractures / 中华创伤骨科杂志

Objective To investigate the relationship between body position and fracture reduction in cephalomedullary nailing for femoral intertrochanteric fractures. Methods Included in this analysis were 368 femoral intertrochanteric fractures undergoing cephalomedullary nailing from January 2010 to De-cember 2015. They were 191 men and 177 women, aged from 42 to 102 years ( average, 73. 1 ± 11. 0 years ) . By AO classification, there were 105 cases of type 31-A1, 131 ones of 31-A2, and 132 ones of type 31-A3. Supine position A ( contralateral hip and knee flexed at 90 degrees ) was applied in 99 cases, supine position B ( contralateral limb supine straight and abduction ) in 178 cases, and lateral position in 91 cases. The 3 groups were compared in terms of reduction quality, fluoroscopy time, fluoroscopy frequency, operative time, and Harris hp score at 6 months after operation. Results Reduction quality: supine position A group ( 97. 8％) > supine position B group ( 87. 9％) > lateral position group ( 72. 5％) . Fluoroscopy time: lat-eral position group ( 34. 4 ± 5. 8 min ) > supine position A group ( 29. 4 ± 6. 4 min ) > supine position B group ( 27. 1 ± 5. 2 min ) . Fluoroscopy frequency: lateral position group ( 15. 5 ± 5. 0 times ) > supine posi-tion A group ( 14. 0 ± 3. 4 times ) > supine position B group ( 11. 2 ± 2. 9 times ) . The above differences were significant between any 2 groups ( P <0. 05 ) . Operation time: lateral position group ( 59. 0 ± 10. 7 min ) >supine position A group ( 58. 4 ± 11. 2 min ) > supine position B group ( 51. 2 ± 8. 7 min ) . There were sig-nificant differences between supine position B group and either of the other 2 groups ( P < 0. 05 ) . There were no significant differences among the 3 groups in the Harris hp score at 6 months after operation ( P >0. 05 ) . Conclusion In cephalomedullary nailing for patients with femoral intertrochanteric fracture, the position of contralateral limb supine straight and abduction can benefit fracture reduction, affect anteroposterior and lateral fluoroscopy the least, provide convenience for surgical maneuver and thus shorten surgical time.

Clinicopathological characteristics of papillary thyroid microcarcinoma and risk factors for central lymph node metastasis / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) and risk factors for central lymph node metastasis(CLNM) in PTMC.@*Methods@#The data of 900 patients with PTMC initially treated in our hospital from January 2004 to December 2015 were retrospectively analyzed. Chi-square test and Logistic regression analysis were performed to determine the risk factors for CLNM.@*Results@#CLNM affected 162 (22.9%) of 707 patients treated with central lymph node dissection. Age, maximum tumor size, multifocality, bilaterality, and extracapsular spread (ECS) were significantly correlated with CLNM (all P<0.01). Age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread were independently correlated with CLNM.@*Conclusion@#A prophylactic central lymph node dissection should be considered in PTMC patients with age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread.

Analysis of 737 patients in IAAF world championships Beijing 2015 / 中华急诊医学杂志

Objective To analyze the 2015 IAAF World Athletics Championships victim of disease type and composition,investigate medical emergency services for major international sporting events.Methods The 2015 IAAF World Athletics Championships in Medical Encounter Forms records in 737 cases during the game (2015-8-21 to 2015-8-30) were retrospectively reviewed and analyzed.Results Total of 737 patients during the match,trauma 259 cases (35.1％),respiratory diseases 196 cases (26.6％),digestive diseases 77 cases (10.4％),heat-related illnesses 41 cases (5.6％).Athletes 170 cases (23.1％),174 cases of staff (23.6％),139 cases of the IAAF family members (18.9％),136 cases of spectators (18.4％),members of the media 56 cases (7.6％).Conclusions 2015 IAAF World Athletics Championships type of disease the treatment of patients with the most common sports injury,followed by respiratory diseases and common diseases in summer heat-related illnesses.Clinic staff personnel structure the most common,followed by extended family members as well as the IAAF athletes and spectators.Major sports events should develop reasonable security programs for priority diseases and key customer base,and to ensure a smooth operation.

"Lessons and illuminations of Tianjin port ""8 · 12"" explosion hazard" / 中华急诊医学杂志

Objective To explore how to improve the capability of emergency rescue to cope with the explosion of hazardous chemicals through analyzing the rescue process of Tianjin port 8 · 12 explosion hazard.Methods The process of explosion emergency rescue on the hazardous chemicals warehouse of Ruihai company in Tianjin Port on the evening of August 12,2015,were analyzed,summarize the experience and lessons.Results There were some shortcomings on field assessment,safety zoning,EMSS,treatment in hospital,personal protection equipment and public knowledge on hazardous chemicals explosion in Tianjin port 8.12 explosion hazard.we should learn from the lessons,to provide reference for the future similar rescue.Conclusions The ability of emergency rescue team to deal with the major hazardous chemicals explosion should further improve,to protect the safety of society and health of common people.

Change of drug resistance in 420 strains of clinically isolated Enterococcus bacteria / 国际检验医学杂志

Objective To study the clinical isolation situation of Enterococcus bacteria and the drug resistance change to provide the basis for guiding clinical rational drug use and controlling infection.Methods The clinical specimens in our hospital from Janu-ary 2008 to June 2013 were performed the routine bacterial culture,identification and drug sensitivity test.The WHONET 5.6 soft-ware was used to analyze the distribution of the clinical Enterococcus bacteria l isolates in various samples and the departments and the drug resistance change during this period.Results Total 420 strains of Enterococcus bacteria were isolated during this period, including 288 strains of E.faecium(68.6%),128 strains of E.faecalis(30.5%),3 strains of E.gallinarum(0.7%)and 1 strain of E.casseliflavus(0.2%).The Enterococcus bacteria isolates were mainly distributed in urine(60.5%),wound secretion(20.0%) and blood(13.6%).The large changes occurred in the strains and drug-resistance of isolated Enterococcus bacteria during this peri-od.The proportion of E.faecium maintained about 65% every year.The proportion of E.faecalis was about 35%.The resistance rate of E.faecium to ampicillin,penicillin and nitrofurantoin was significantly higher than that of E.faecalis .Its resistance rates to penicillin,tetracycline,nitrofurantoin,high concentration gentamycin,high concentration streptomycin,ciprofloxacin and ampicillin were close to or over 70%.Total 3 strains of vancomycin-resistant E.faecium were isolated,including 2 strains in 2008 and 1 strain in 2009.Total 13 strains of vancomycin-intermediate E.faecalis were isolated,including 1 strain in 2008,5 strains in 2009 and 7 strains in 2010.Conclusion The drug resistance of Enterococcus bacteria is very serious and the drug resistance of different strains is different.The clinical anti-infection should rationally select the antibacterial drugs for increasing the curative effects according to the in vitro susceptibility of the isolated strains to the bacterial drugs.

Association between meteorological factors and the incidence of acute cardiovascular disease / 中华急诊医学杂志

Objective To investigate the correlation between meteorological factors and the incidence of acute cardiovascular disease.Methods The number of calls for ambulance in case of cardiovascular disease between 2006 to 2010 was obtained from Beijing 120 emergency center and the data of meteorological factor during for the same period from Beijing Meteorological professional were collected,and then the impact of the weather factors of different seasons of weather factors on the incidence of cardiovascular disease was ere analyzed by time-stratified case-crossover design.Results The average daily incidence cases of cardiovascular disease in four seasons average daily were 5.61,4.55,5.05 and 6.03 respectively.The association between temperature Temperature and the incidence of acute cardiovascular disease was were non-linear relationship changes in spring and autumn seasons.Atmosphere Air pressure and the incidence were negatively correlated in the winter.The relative humidity of airand the incidence were related in the spring,summer,autumn.Wind and the incidence were related in the spring,summer,but negative correlation in the autumn,winter.Conclusions The incidences of acute cardiovascular disease are higher more in winter and spring than in summer and autumn.The incidences of cardiovascular disease are related with temperature,relative humidity,wind speed and other meteorological factors.,The influence of meteorological factors on the incidence of the disease delays to occur after changes in weather.

Epidemiological study of road traffic injuries in Beijing: a report of 990 cases / 中华创伤杂志

ObjectiveTo investigate the epidemiological features and risk factors of road traffic injury in Beijing.MethodsData of road traffic injuries of Beijing Changping Hospital in 2010 was collected for statistical analysis of the epidemiological features. ResultsA total of 990 cases of road traffic injuries were treated in Beijing Changping Hospital in 2010,with a male/female ratio of 2.57:1 and at average age of 45 yeats.There were 21 cases aged ＜ 18 years,703 cases aged 18-55 years and 266 cases aged ≥56 years.Self-employed individuals and fanning production staffs were the risky population that were easily subjected to road traffic injuries.Summer and autumn were the accident-prone seasons.The most common injury site was the lower limbs,next with the neck and head.The hospital stay was mainly in a range of 5-10 days (12.8 days on average).ConclusionsMale self-employed individuals and agricultural producers are the high-risk groups of road traffie accidents in the area,where shows a high occurrence of road traffic accidents in the summer and autumn.Thereby,traffic safety education and prevention-control measures based on these characteristics should be carried out to effectively reduce the number and severity of the local traffic injuries.

"Characteristics of adolescent (0-25 years) traffic injuries from Beijing ""120"" Emergency Center" / 中华创伤杂志

Objective To analyze the injury characteristics in 2004-2009 road traffic accidents (RTAS) of 0-25 years old adolescents treated in Beijing 120 Emergency Center so as to provide scientific basis for making effective measures in prevention and control of RTAs. Methods The data of all the adolescents with traffic injuries treated in Beijing 120 Medical Emergency Center were collected for a retrospective analysis on sex,age,traffic injury time,wound regions,injury characteristics and death condition of the injured adolescents. Results( 1 ) There were 17 232 injuries and 259 deaths according to the traffic reports from 2004 to 2009. Among the total injury cases,there were 4 229 cases of 0-25 years old adolescents (24.5％),at (20.13 ± 4.43 ) years of age.The injury number showed a significant rising trend with the increase of age and the injury number of 20 years old group were obvious more than that of other age groups.(2) There were 2 252 males and 1 677 females,with ratio of males to females for 1.5:1 ( P ＜ 0.05 ).( 3 ) Total number of patients was decreased yearly.The high incidence of adolescent RTAs could be seen in September,October and May in one year; Friday,Saturday and Sunday in one week; and between 8:00 am and 11:00 pm in one day.The low incidence of adolescent RTAs could be seen in Tuesday in one week,and 3:00-6:00 am in one day (P ＜0.05).(4) Cases of limb and arthrosis wounds (53.4％) were more than those of head and neck wounds (35％).Most of the cases were pedestrians (49.1％ ).(5) There were 38 deaths,including 28 males and 10 females,at ageof (19.29 ± 5.30) years.The death were mainly resulted from craniocerebral injuries (87％),which mainly concentrated in July ( 13.2％ ) and August ( 15.8％ ). Conclusions The present condition ofadolescent traffic injuries is not good enough.We should strengthen traffic security education,increase executive powers in the traffic rush and promote cooperation and communication in pre-hospital emergency,as may be beneficial for decreasing adolescent RTA.

Effect of mild hypothermia on the expression of hypoxia-inducible factor-1a and glucose transporter-1 in a rat model of chronic cerebral ischemia-reperfusion / 中华麻醉学杂志

Objective To investigate the effect of mild hypothermia on the expression of hypoxia-inducible factor-1α (HIF-1α) and glucose transporter-1 (GLUT-1) in a rat model of chronic cerebral ischemia-reperfusion.Methods Thirty-six female SD rats weighing 170-210 g were randomly divided into 3 groups (n = 12 each):sham operation group (group S), normal body temperature group (group NT ) and mild hypothermia group (group MH). Arterio-venous fistula was established by end-to-end anastomosis between the right common carotid artery and right external jugular vein for 6 weeks followed by reperfusion. In group MH, mild hypothermia was induced at the initiation of reperfusion and the rectal temperature was reduced to 31.5-32.5 ℃. In group S and NT, the rectal temperature was maintained at 37-38 ℃. Six rats in each group were sacrificed at 3 and 48 h of reperfusion. The brains were immediately removed for determination of the expression of HIF-1α, GLUT-1, HIF-1α mRNA and GLUT-1 mRNA and microscopic examination. Results Compared with group S, the expression of HIF-1α and HIF-1α mRNA at 3 and 48 h of reperfusion and GLUT-1 mRNA at 3 h of reperfusion was up-regulated, while the expression of GLUT-1 and GLUT-1 mRNA at 48 h of reperfusion was down-regulated in group NT (P ＜ 0.05).Compared with group NT, the expression of HIF-1α and HIF-1α mRNA at 48 h of reperfusion and HIF-1α mRNA and GLUT-1 mRNA at 3 h of reperfusion was down-regulated, while the expression of GLUT-1 and GLUT-1 mRNA at 48 h of reperfusion was up-regulated in group MH (P ＜ 0.05).Microscopic examination showed that the injury to the ultrastructure of blood-brain barrier was significantly attenuated in group MH compared with group NT. Conclusion Mild hypothermia can attenuate chronic ischemia-reperfusion injury by down-regulating the expression of HIF-1α and up-regulating the expression of GLUT-1.

Building and operation of medical rescue and assurance systems for Beijing Olympic Games / 中华医院管理杂志

An insight of the building and operation of the medical rescue and assurance system for Beijing Olympic Games will help identify effective practices for design and implementation of medical rescue plans in large-scale activities held in cities. Practice-proven: large-scale activities call for systems designed in view of characteristics of medical assurance tasks of such events, and such systems must be improved all the way. Keys to operations of Olympic venues in the run-up period are setup of medical services, development of general medical procedures, management of medical teams in venues, and design of medical rescue flows. Focuses of venue operations during the games are reporting of medical information from the venues, seamless interconnection between venues and medical organizations in the city, and crisis management for medical operations on the venues.

Human resources integration within medical service teams for Beijing 2008 Olympic Games and Paralympic Games / 中华医院管理杂志

Building of medical teams was a basic preparation for Beijing 2008 Olympic Games and Paralympic Games as well. In this consideration, the Beijing Organizing Committee for the Olympic Games (BOCOG) and Beijing Health Bureau developed a complete set of mechanism to integrate human resources, coveting standards development, selection, training and testing for members of medical teams. This ensures the success of medical services delivery and provides medical services delivery of subsequent Large-scale activities with valuable experiences as well

Emergency medical service for the Beijing Olympic Games and its outcome / 中华医院管理杂志

Emergency Medical Service (EMS) of Beijing Olympic Games needs to cover not only all the venues of the Olympic and Paralympic Games, but also emergency medical service for citizens at large and other emergency events. To this end, Beijing Emergency Medical Center made efficient preparations for the Olympic Games, namely upgraded dispatch system, first-aid stations, ambulances and equipment, and volunteer recruitment among others. Thanks to such efforts made, the EMS successfully served the Beijing Olympic Games and citizens at large. Furthermore, the Beijing Olympic Games promoted the development of the Beijing EMS system.

Design and fabrication of poly DL-lactic acid biodegradable fusion cage of the lumbar vertebrae / 中国组织工程研究

BACKGROUND:Metal vertebral fusion cage can induce some disadvantages and pseudoarticulation formation such as stress dodge,fusion cage subsidence,bone resorption,prolapse and bone collapse.Biodegradable absorbing material-made vertebral fusion cage can avoid disadvantages mentioned above.There are no studies on correlation of material function to design of absorbing fusion cage of lumbar vertebrae.OBJECTIVE:To design and fabricate the poly DL-lactic acid biodegradable fusion cage of lumbar vertebrae,and to analyze the material characteristics.DESIGN,TIME AND SETTING:The material in vivo experiment was performed at the Chengdu Institute of Organic Chemistry of Chinese Academy of Sciences from January 2003 to December 2006.MATERIALS:Twenty dogs aged 12 months were obtained from Animal Laboratory of West China,Sichuan University.Poly DL-lactic acid biodegradable fusion cage of lumbar vertebrae was produced by the Chengdu Institute of Organic Chemistry of Chinese Academy of Sciences.METHODS:According to the anatomical characters and measured data of lumbar intervertebral disc,we designed the poly DL-lactic acid biodegradable fusion cage of lumbar vertebrae.The rectangle cage consists of two styles:23 mm and 25 mm,13 mm in width,and 9,10,11 and 12 in depth(anterior wall).The depth was small half-moon shape from anterior to posterior,and the posterior wall was thinner than anterior wall about 1.5mm to accord with the shape of intervertebral discs.The depth of four walls of the fusion cage was 2.5 mm,with several 1-mm diameter holes on bilateral walls.The posterior wall had 3.5-mm diameter spiral hole,which was used for connecting with the implanted tool.Using precise shaping processing craft,the produce process was DL-lactic acid→raw material storage→lactide preparation→lactide purification→polymerization→drying package→product.After general anesthesia,bilateral thighs were incised in 20 dogs,and then a fusion cage was implanted into each dog to detect compressive strength and viscosity in the process of biodegradation.MAIN OUTCOME MEASURES:Preparation of fusion cage;compressive strength and viscosity in the process of biodegradation in vivo.RESULTS:The size of the products is 23 mm?13 mm?10 mm and the appearance of the products were saw tooth shape,which could prevent the slide,enhance the solid strength between fusion cage and the surface of vertebra.Small holes on the bilateral wall were beneficial for vascular growth and nutrient fluid exchange,resulting in bony fusion.Compressive strength and viscosity decreased at 3,6 and 9 months after implantation(r=0.961,P=0.009),but compressive strength and viscosity were good at 12 months(163 MPa and 0.66 dl/g).CONCLUSION:Poly DL-lactic acid biodegradable fusion cage has a big loading implanted bone mass and high stability.The integrity and supportive effect of the fusion cage can meet the requirement of bony fusion.