Objective To investigate the effects of carboxymethylchitosan- carboxymethylcellulose (CMCH-CMC) film on the adhesion and heal ing of colonic anastomosis. Methods Sixty-four healthy adult male SD rats was randomly divided into control group and experimental group (n=32). The model of colonic anastomosis was made according to Buckenmaier’ smethod in all rats. The experimental group was treated by wrapping anastomosis with CMCH-CMC film (3 cm × 2 cm) and the control group was not treated. At 7 days and 14 days after operation, the adhesion formation of colonic anastomosis was observed, the tensile strength of the anstomosis was assessed and compared with 6 normal rats, and the hydroxyprol ine (HP) content of the anastomotsis was detected. Results There were 3 deaths in the experimental group and 2 deaths in the control group. The adhesive scores of the experimental group on the 7th and 14th postoperative day [(0.50 ± 0.16) points and (0.45 ± 0.14) points, (Plt; 0.05)] were significantly lower than those of the control group [(1.67 ± 0.15) points and (2.29 ± 0.18) points, (P lt; 0.05)], (Plt; 0.01). Tensile strength were more marked on the 14th postoperative day than on the 7th postoperative day in the control group (Plt; 0.05), but there was no significant difference between the 7th day and the 14th day in the experimental group. The tensile strength of thecontrol group and the experimental group on the 14th postoperative day [(178.36 ± 20.10) and (172.74 ± 22.18) mmHg] were respectively higher than those on the 7th postoperative day [(138.67 ± 16.65) and (130.81 ± 18.38) mmHg] (Plt; 0.01). The tensile strength of the control group and the experimental group on the 7th postoperative day were respectively significantly lower than that of the normal rats (P lt; 0.01). The level of HP in the anastomosis was significantly higher on the 7th postoperative day in the experimental group [(84.47 ± 11.87) μg/mg dried weight] than that of the control group [(55.47 ± 12.89) μg/mg dried weight), (Plt; 0.05)], but there was no significant difference between the experimental group and the control group on the 14th postoperative day [(146.07 ± 14.81) μg/mg dried weight, (137.14 ± 16.81) μg/mg dried weight, (P gt; 0.05)]. Conclusion The CMCH-CMC film can decrease adhesion the formation of colonic anastomosis, but does not interfere with the heal ing of colonic anastomosis.
【Abstract】 Objective To investigate the early effectiveness of the Discover cervical artificial disc replacement in treating cervical spondylosis. Methods Qualified for the selective standard, 24 patients with cervical spondylosis were treated between March 2010 and March 2011. Of 24 patients, 13 patients underwent anterior cervical decompression and fusion (ACDF) (ACDF group, between March 2010 and September 2010) and 11 patients underwent Discover cervical artificial disc replacement (CADR group, between September 2010 and March 2011). There was no significant difference in gender, age, disease duration, lesions typing, and affected segments between 2 groups (P gt; 0.05). The operative time, blood loss, and complications were recorded. Japanese Orthopaedic Association (JOA) scores, Neck Disability Index (NDI) scores, and Odom’s scores were used to evaluate the postoperative effectiveness. In CADR group, the cervical range of motion (ROM) in all directions, and prosthesis eccentricity were measured before and after operation. Results Symptoms disappeared and no complication occurred after operation in the patients of 2 groups. The patients were followed up 12 to 18 months (mean, 15.3 months) in ACDF group and 6 to 12 months (mean, 9.6 months) in CADR group. The NDI scores in CADR group were significantly higher than those in ACDF group at 1, 3, and 6 months (P lt; 0.05), but no significant difference was observed in JOA score improvement rate between 2 groups (P gt; 0.05). According to Odom’s score at last follow-up, the results were excellent in 6 cases, good in 4 cases, and fair in 3 cases with an excellent and good rate of 76.92% in ACDF group, and were excellent in 9 cases, good in 1 case, and poor in 1 case with an excellent and good rate of 90.91% in CADR group, showing no significant difference (χ2=3.000, P=0.223). The patients in CADR group had significant limit of cervical joint ROM in flexion and extension and right bending at 1 month (P lt; 0.05), but cervical joint ROM restored after 3 months. The ROMs of left bending at 3 months and 6 months were bigger than preoperative value (P lt; 0.05). Meanwhile, ROM in left bending were bigger than that in right bending in replaced segment and upper segment (P lt; 0.05), and the ROM difference between left bending and right bending in upper segment was 2 times higher than that in the replaced segment; a marked linear correlation (P lt; 0.05) existed between the ROM difference and prosthesis eccentricity, and prosthesis bias had bigger ROM in lateral bending. Conclusion Discover cervical artificial disc replacement for treatment of cervical spondylosis can provide a good effectiveness and cervical postoperative movement function. As a new prosthesis, it has some merits such as simple operative steps and less complications.
Objective To investigate the cl inical appl ication of self-setting CPC loading rhBMP-2 for repair of bone defects and to evaluate the cl inical effect and safety. Methods From June 2006 to September 2007, 112 bone defects patients were treated by CPC loading rhBMP-2 (rhBMP-2/CPC group) or CPC (control group). The range of bone defect was from1 cm × 1 cm × 1 cm to 4 cm × 3 cm × 3 cm. In the control group, 63 patients included 31 males and 32 females, aging from 17 to 70 years with an average of 47.4 years. The bone defects were located as follows: calcaneus in 19 patients, tibial plateau in 20 patients, proximal humerus in 8 patients, distal radius in 9 patients and thoracolumbar vertebrae in 7 patients. In the rhBMP-2/CPC group, 49 patients included 31 males and 18 females, aging from 16 to 68 years with an average of 45.6 years. The bone defects were located as follows: calcaneus in 11 patients, tibial plateau in 16 patients, proximal humerus in 7 patients, distal radius in 2 patients, distal tibia in 2 patients and thoracolumbar vertebrae in 11 patients. All defects were repaired with rhBMP-2/CPC (2-5 g) and CPC (2-50 g) in the rhBMP-2/CPC group and the control group, respectively. Results A total of 108 patients got primary heal ing after operation. Incisions oozing l ight yellow fluids were found in 4 patients (control group in 1, rhBMP-2/CPC group in 3), and then healed through dressing changes and taking glucocorticoid. There were no allergic or toxic reaction, no rush or high fever, no fluctuation of hepatic and renal function, blood routine, CRP and urine routine. All patients were followed up for 12 to 24 months (mean 13.2 months). The X-ray examination showed that the implanted material was firmly bonded to the bone at the interface and the anatomic contour of the bone at the sites of defects was successfully restored, and no ablation occurred. All patients got bone union after 3 months of operation. The movement and function of flexion and extension of affected l imbs recovered to the normal level. Conclusion Repairing bone defects with rhBMP-2/CPC is safe and effective. Using rhBMP-2/CPC is a promising therapy to deal with bone defects.
目的 探讨影响岩斜区脑膜瘤（PCM）预后的相关因素。 方法 回顾分析解放军452医院2005年9月－2009年6月及四川大学华西医院1999年9月－2009年2月110例患者的临床资料及随访结果，通过单因素生存分析及Cox比例风险模型分析探讨影响PCM预后的相关因素。 结果 单因素生存分析发现8种相关因素影响PCM患者的预后，但Cox多因素分析仅发现脑干T2像高信号（OR=5.54，P=0.012）、肿瘤侵入脑干（OR=5.10，P=0.034）、病理高级别（OR=4.03，P=0.011）这3种因素有统计学意义。 结论 脑干T2像高信号、肿瘤侵入脑干、病理高级别可影响岩斜区脑膜瘤患者的预后。