ObjectiveTo design the channels of parallel screws and cross screws for fixation of symphysis pubis diastasis through a small sample anatomic study on pubic symphysis and its neighbor structures so as to provide anatomical basis for minimally invasive fixation of symphysis pubis diastasis. MethodsEight cadaveric pelvic specimens (6 men and 2 women) were transected along L5 and the proximal 1/3 of bilateral thighs, with intact lumbar spines. The spermatic cord, womb round ligament, and corona mortis were dissected; the distance to the ipsilateral pubic tubercle was measured and subsequently the distance between pubic tubercles, the height of pubic symphysis, the diameter of outer edge of pubic tubercle, the thickness of pubic symphysis and 2 cm outside the pubic symphysis (upper, central, and lower 1/3 thickness of pubic symphysis) were measured to provide anatomical basis for the design of channels of parallel screws and cross screws. ResultsParallel screw fixation: the entry point of first screw was on the outer edge of pubic tubercle, and its exit point was on the outer edge of contralateral pubic tubercle; a cannulated screw with a diameter of 4.5 mm or 6.5 mm can be suitable for this channel. The entry point of second screw was 20 mm outside the pubic symphysis and 23 mm beneath the pubic symphysis, and its exit point was symmetrical with entry point; a cannulated screw with a diameter of 4.5 mm can be appropriate for the second channel. The direction of two screws was perpendicular to the pubic symphysis. Cross screw fixation: the entry point of cross screws was on one side of the pubic tubercle, and its exit point was 20 mm outside the contralateral pubic symphysis and 23 mm beneath the contralateral pubic symphysis; two cannulated screws with a diameter of 4.5 mm can be chosen for cross screws channels. The direction of two cross screws was intersected with the horizontal line of two pubic tubercles at an angle of 25° respectively; besides, two cross screws formed an anteversion angle and retroversion angle of 5-10° with pubic body plane, respectively. ConclusionThe channels of parallel screws and cross screws are feasible for fixation of symphysis pubis diastasis by analyzing the anatomical data of the pubic symphysis and its neighbor structures, but further biomechanical research is need to confirm the stability of two fixation methods.
ObjectiveTo summarize the progress in treatment of pubic symphysis diastasis. MethodsRelated literature concerning treatment of pubic symphysis diastasis was extensively reviewed and comprehensively analyzed in terms of anatomy, biomechanics, and treatment. ResultsThere are many fixation methods for treatment of pubic symphysis diastasis, which aims at restoring the stability of the anterior pelvic ring. External fixator is often used as a temporary fixation; tension band wire has been abandoned due to its poor biomechanical stability; screw loosening and plate breakage often appears when a single reconstruction plate is used; box plate significantly increases the biomechanical stability of anterior pelvic ring but it leads to a considerable surgical trauma; locking plate has been used for pubic symphysis diastasis recently, especially for osteoporotic fractures; percutaneous cannulated screw has the advantages of less trauma, less bleeding, and good stability, so it is good choice for treatment of pubic symphysis diastasis. ConclusionThere is no uniform standards about the treatment of pubic symphysis diastasis, but the minimally invasive treatment is an undeniable trend. Percutaneous cannulated screw has achieved satisfactory effectiveness, however, its biomechanical stability and anatomic channels need to be further studied.
ObjectiveTo investigate the guidance of preoperative nutritional risk screening in perioperative nutrition support for colon cancer, in order to provide evidence for the rationally clinical application of nutrition support. MethodsNutritional risk screening was carried out in 95 hospitalized patients with colon cancer who were treated in the Liao He Oil Center Hospital from Jul. 2012 to Jul. 2014, with the nutritional risk screening 2002 score summary table. Patients were divided into nutritional risk group and non-nutritional risk group according to the screening results, and postoperative bowel function recovery and nutritional indicators were compared between patients who received perioperative nutrition support according to the screening results and those who did not. ResultsThere were 29 patients received perioperative nutrition support among 53 patients at nutritional risk and 19 patients received perioperative nutrition support among 42 patients without nutritional risk. Among 53 patients at nutritional risk, the time to first flatus, time to first defecation, hospital stay, postoperative complications rate, and postoperative recurrence/metastasis rate of patients who received perioperative nutrition support were shorter or lower than those of patients who didn't receive perioperative nutrition support (P<0.05), but there was no significant difference in mortality (P≥0.05); in addition, the levels of albumin, prealbumin, and transferring on 7-day after surgery were all higher in patients received perioperative nutrition support (P<0.05). Among 42 patients without nutritional risk, there was no significant difference in time to first flatus, time to first defecation, hospital stay, postoperative complications rate, postoperative recurrence/metastasis rate, and levels of albumin, prealbumin, and transferring on 1- and 7-day after surgery between patients received perioperative nutrition support and those who did not (P>0.05). ConclusionsIt is important to evaluate the nutritional risk in hospitalized patients with colon cancer. Nutritional support is benefical to the patients with nutritional risk, but it isn't necessary to patients without nutritional risk.
ObjectiveTo investigate the biological characteristics of bone marrow mesenchymal stem cells (BMSCs) in microenvironment of premature senescence of nucleus pulposus cells (NPCs) so as to lay a foundation for the repair of intervertebral disc degeneration by BMSCs transplantation. MethodsHuman degenerative nucleus pulposus and normal bone marrow were collected, and then NPCs and BMSCs were isolated, cultured, and identified. The 3rd passage BMSCs and the 1st passage NPCs with premature senescence were co-cultured without contact in the Transwell culture system. NPCs to BMSCs ratio was 75%:25% (group A), 50%:50% (group B), and 0:100% (group C). The morphological changes of BMSCs were observed by inverted phase contrast microscopy and transmission electron microscopy. At 3 and 6 days after co-culture, cell counting kit 8 was used to detect cell viability, flow cytometry was used to observe the cell cycle and detect DNA metabolism after BrdU labeling. Cell senescence was also evaluated by detecting senescence associated β-galactosidase (SA-β-gal) activity. ResultsThe typical morphology of cell senescence was seen in groups A and B, especially in group A. At 3 and 6 days after co-culture, the cell survival rate of group A was significantly lower than that of group B (P<0.05). At 3 days after co-culture, the proportion of cells in G1 phase in group A was significantly higher than that in groups B and C (P<0.05), the proportion of cells in S phase in group A was significantly lower than that in groups B and C (P<0.05). At 6 days, the proportion of cells in G1 phase in group A was about 81.0%, and the proportion of cells in S phase and G2 phase decreased, showing significant difference when compared with groups B and C (P<0.05); the proportion of cells in G1 phase in group B was about 74.4%, showing significant difference when compared with group C (P<0.05). BrdU content in group A was significantly lower than that in groups B and C at 3 and 6 days after co-culture (P<0.05), but no significant difference was found between groups B and C at 3 days (P>0.05); Brdu content in group B was also significantly reduced when compared with group C (P<0.05) at 6 days. At 6 days, SA-β-gal activity was significantly increased in groups A and B, and significant difference was shown in SA-β-gal positive cell number between groups (P <0.05). ConclusionPremature senescence of NPCs can down-regulate the proliferation capacity of co-cultured BMSCs by the paracrine effect. The greater proportion of NPCs with premature senescence is, the earlier senescence of BMSCs will be induced.