Objective To review progress of clinical application ofmorselized bone and to investigate relative exploration on it.Methods The recent articles on morselized bone in the field of clinicand experimental research were extensively reviewed, and relative examination of morselized bone referring to method and mechanism were investigated carefully.Results Morselized bone worked well clinically, especially inrevision ofartificial total hip joint, and it was proved effective with lots of advantages.Conclusion Morselized bone functions well clinically. Although its mechanism requires a further research, it still has a promising value in clinical application.
Local hypothermia as a preventive method to reperfusion injury of skeletal muscles was studied. Sixteen Japanese rabbits were divided into four groups at random. Before the tourniquet was inflated, a cold gel pack was applied to the right hind leg of each rabbit for 15 minutes to produce local hypothermic condition, without application of tourniquet the left hind limb was under local hypothermic condition as a control. The duration of tourniquet ischemia was 4 hours, and then reperfusion for one and two hours in the A and B groups respectively; in the C and D groups the duration of ischemia was 5 hours, and reperfusion for one and two hours, respectively. The muscle temperature averaged 16.6 degrees C with a needle thermocouple in the hind limb under local hypothermia. The serum K+, LA, SOD, LPO were determined from bilateral femoral veins, and electron and light microscopic studies of sural muscles were done in the post-reperfusion period. It was found that the K+, LA, LPO were lower than that of the control groups (P lt; 0.01), but SOD was higher than that of the control group (P lt; 0.01). Electron and light microscopic studies showed sight but reversible damage of muscular structure with the possibility of in the hypothermic groups cell regeneration. Basing on this experimental results, this method was applied in 45 cases reparative and reconstructive surgery of limbs. The duration of application of tourniquet averaged 2 hours and 57 minutes, the longest being 4 hours and 31 minutes, when the muscle temperature had reduced to 22.4 degrees C. There were no postoperative complications associated with this technique. Local hypothermia appeared to be a safe and effective method of decreasing the reperfusion damage after ischemia.
【Abstract】 Objective To review the progress of autologous fat grafting of the face and outline different arguments in this field. Methods Recent literature concerning autologous fat grafting of the face was reviewed and analyzed. Results The applications and techniques for autologous fat grafting have been matured increasingly. It not only can adjust the proportion of facial contours, restore tissue volume, but also can improve the local skin texture. Reliable clinical results have achieved in facial augmentation and rejuvenation. Although there are arguments about donor site, harvesting technique, processing technique, and grafting technique, the basic principle is the same. Conclusion From the perspective of evidence-based medicine, clinicians are rich in clinical experience, but objective evidence is insufficient. So further researches should be carried to look for scientific evidences.
OBJECTIVE: To sum up the clinical results of bio-derived bone transplantation in orthopedics with tissue engineering technique. METHODS: From January 2000 to May 2002, 52 cases with various types of bone defect were treated with tissue engineered bone, which was constructed in vitro by allogeneous osteoblasts from periosteum (1 x 10(6)/ml) with bio-derived bone scaffold following 3 to 7 days co-culture. Among them, there were 7 cases of bone cyst, 22 cases of non-union or malunion of old fracture, 15 cases of fresh comminuted fracture of bone defect, 4 cases of spinal fracture and posterior route spinal fusion, 3 cases of bone implant of alveolar bone, 1 case of fusion of tarsotarsal joint. The total weight of tissue engineered bone was 349 g in all the cases, averaged 6.7 g in each case. RESULTS: All the cases were followed up after operation, averaged in 18.5 months. The wound in all the case healed by first intention, but 1 case with second intention. Bone union was completed within 3 to 4.5 months in 50 cases, but 2 cases of delayed union. Six cases were performed analysis of CD3, CD4, CD8, ICAM-1 and VCAM-1 before and after operation, and no obvious abnormities were observed. CONCLUSION: Bio-derived tissue engineered bone has good osteogenesis. No obvious rejection and other complications are observed in the clinical application.
Objective To investigate the anatomic variations of the perforator vessels of anterolateral thigh (ALT) flap and the clinical indications. Methods From March 1985 to August 2004, the anterolateral thigh flapgraft was performed in 112 patients. The clinical data were analyzed. There were 67 males and 45 females, aging from 5 to 65 years with an average of 38.5 years. According to recipient site condition, four methods of flap harvesting were as follows:① 78 received free fasciocutaneous flaps;② 22 received free adipofascial flaps;③ 5 received pedicled island fasciocutaneous flaps; ④ 7 received pedicled reverse-flow island fasciocutaneous flaps. Facial, neck, breast, extremityjoint, plantar, and perineum defects were repaired and the effectiveness and donor site morbidity were evaluated. Results The blood supply of ALT flap came from the descending branch or transverse branch of the lateral circumflex femoralartery. The skin vessels were found to be septocutaneous perforators in 33% of flaps and to be musculocutaneous perforators in 77% of flaps. Of 112 flaps, 107 survived completely, the survival rate was 95.6% with little donor site morbidity. Conclusion ALT flap is a versatile softtissue flap. If refined to perforator flap, it can achieve better results in reconstructing defect and minimizing donor-site morbidity.
OBJECTIVE To review the physiological function of sodium hyaluronate in joints and its clinical applications. METHODS Many literatures were reviewed and analysed on therapeutic mechanism and the application foreground of sodium hyaluronate. RESULTS Extrinsic sodium hyaluronate plays an important role in improving synovial fluid and protecting cartilages as well as suppressing inflammation, so it is used in the treatment of joint diseases such as knee osteoarthritis, rheumatoid arthritis or temporomandibular osteoarthritis. CONCLUSION Sodium hyaluronate possesses a good applied prospect in joint diseases.
Objective To evaluate the clinical effect of percutaneous laser disc decompression (PLDD) in the treatment of cervical disc herniation. Methods From March 2003 to December 2005, 47 patients with cervical disc herniation(96 cervical disc) were treated with PLDD. There were 25 males and 22 females with an average age of 56 years, ranging from 37 to72 years. The lesion were located at the levels of C3,4 in 20 discs, C4,5 in 27 discs, C5,6 in 31 discs, C6,7 in 18 discs. The laser fiber was introduced into the center of the herniated disc space by percutaneous puncture from anterior neck surface under fluoroscopic guidance. Laser reduced the intradisc pressure through the vaporization of disc nucleu. The adopted laser was semiconducted with a wavelength of 810 nm. Each laser output power was15 W with 1 s emission and 2 s interval. The total laser output power was decided depending on the degenerative degree of the disc and the reactive process of heat, ranging from 300 to 1 000 J.Results Of 47 patients,42 were followed up for 3 to 31 months (mean 13 months). The clinical evaluation was classified as excellent in 18 cases (42.9%), good in 14 cases (33.3%), fair in 6 cases (14.3%) and poor in 4 cases (9.5%). The general response rate was 90.5%. The excellent and good rate was 76.2%. No complications occurred. Conclusion PLDD can relieve the symptoms and signs of patients suffering from cervical disc herniation with less complication. The manipulation of PLDD is easy, safe and mini-invasive.
ObjectiveTo study the clinical application of enteral microecopharmaceutics immunonutrition in the peroperation of colorectal cancer. MethodsLiteratures about enteral microecopharmaceutics immunonutrition published in China and abroad were collected and reviewed. ResultsEarly clinical application of enteral microecopharmaceutics immunonutrition in the perioperation can greatly improve the nutritional status of patients with colorectal cancer, increase the patients' immune function, reconstruct the intestinal flora, and reduce the incidence of complications. ConclusionsThe clinical application of enteral microecopharmaceutics immunonutrition in the perioperation of colorectal cancer can obviously improve patients' nutritional status and immune function, reduce the stress response, and improve its prognosis, but the use of best dose still need further study.
With the development of three-dimensional (3D) printing technology, more and more researches have focused on its application in the region of intervertebral fusion materials; the prospects are worth looking forward to. This article reviews the researches about 3D printing technology in spinal implants, and summarizes the materials and printing technology applied in the field of spinal interbody fusion, and the shortcomings in the current research and application. With the rapid development of 3D printing technology and new materials, more and more 3D printing spinal interbodies will be developed and used clinically.
In order to solve the defect of blood vessel in tissue transplantation and complicated palmar amputation, bridge by "Y" type vein had been used from Jan. 1990 to Jul. 1996. Twenty-three cases were treated. In this series, there were 16 males and 7 females, with ages ranged from 10 to 42 years old. Six cases were the defect of lower legs anterior skin and tibia, 3 cases were the femur fracture with injury of femoral artery and tissue’s defect, 2 cases were defect of five fingers, 12 cases were complicated palmar amputation. RESULT: 15 cases with tissue transplantation and 12 cases with limb replantation were all survival without infection or necrosis. After the following-up for 3 years (ranged from 1 to 5 years), the function of injured limbs were satisfactory, 19 patients had resumed their original work. So, to bridge by "Y" type vein is a good method for repairing the defect of blood vessels in tissue transplantation and complicated palmar amputation, but skilled microsurgery technique is required.