Objective To explore the clinical application of allogeneic bone transplantation. Methods Related literatures on clinical application of various allograft bone materials of the past 5 years were extensively reviewed. Results The allografts could be processed into various kinds of transplanting materials, such as small blocks, large segments, morselised or granular material, and bone ring, so that they could be applied to bone defect filling, prosthesis revision, limb preservation after tumor resection, and joint fusion. All these applications ended up with good clinical results. However, complications resulted in thestructural transplantation of large block bones could be overlooked. Conclusion The main advantage of bone allograft is that it can be integrated with host bone and be remodelled, so as to reconstruct bone structure and function. How to accelerate their integration and remodelling while exerting normal functions is the problem that requires solution.
Objective To review and evaluate the extensive and further research and the application of the collagenbased biomaterials in the field of clinical medicine. Methods The clinical research and application of collagen-based biomaterials were comprehensively reviewed and evaluated on the basis of the up-to-date publications and our practical experiences in their studies and manufacturing. Results The following five aspects concerned with the collagen-based biomaterials were evaluated: biological property, quality control, formulation of substrate and clinical application, immunogenicity and clinical side effect, and potential of the market development. Conclusion Collgen-based biomaterials have a great potential and market space in their clinical application.
Heart failure is a great threat to human health. When conventional drug treatments have limitations and transplantation confronts problems of immunoreaction and lacking donors, the ventricular assist device (VAD) has irreplaceable importance. The VAD substitutes total or part of the heart as a blood pump by using mechanical or biologicmechanical method. Since its clinical application from the 1960s, after a long time of research and application practice, it has been applied to postoperative cardiovascular recovery, heart transplantation and replacement, myocardiac recovery and permanent therapy for heart failure. In the future, VAD will develop toward such characteristics as miniaturization, high efficiency, low noise, low power consumption, fewer complications, wireless energy transmission and easy implantation, which will surely make it one of the major treatments for heart failure. This article will have a comprehensive review on the development of VAD, its clinical application, current problems and future development direction of VAD.
OBJECTIVE: To investigate the feasibility of segmentation of latissimus dorsi on the basis of anatomy and electrophysiology. METHODS: Ten cadaveric latissimus dorsi was dissected according to the blood supply, nerve innervation. Electromyelogram (EMG) of latissimus dorsi of 13 healthy persons was recorded with superficial electrode plate in the motion of shoulder joint. The results of record were managed with statistic methods. Ten patients(including reconstruction of breast and repair of scar on elbow joint and on chest wall) were treated with the lateral inferior myocutaneous island flap. RESULTS: According to the medial and lateral vasculonervous branches, latissimus dorsi can be divided into the medial superior and lateral inferior segments. The clinical application of the segment achieved good results in reconstructing breast and in repairing scars on elbow and on chest wall. CONCLUSION: Latissimus dorsi can be divided into two segments and applied separately. The lateral inferior segment is more useful in shoulder motion.
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.
Objective To evaluate the value of 16slice spiral computed tomography (SCT) and its threedimensional reconstruction in diagnosis of aortic dissection (AD). Methods Fortyfive cases with AD underwent 16slice SCT, performed with unenhanced, contrastenhanced scanning and threedimensional reconstructions. Emphasis was placed on the true and false lumen, intimal flap, the entry and reentry tear and the involvement of branches of AD. Eleven cases were confimed by operation. Results True and false lumen and intimal flap of AD could be shown in all 45 cases (100%), the entry and reentry tears were revealed in 44 cases (97.8%) and 33 cases (73.3%), respectively. The right common iliac arteries were most easily involved by AD, 21 cases (46.7%). The thrombi in false lumen were shown in 29 cases (64.4%). Compared with surgery, the location and size of initial entry sites of 11 cases were consistent with the former. Conclusion 16slice SCT can exactly and completely diagnose AD, and provide detailed imaging information for clinical therapy. It’s very important for the selection of treatment methods and the observation of curative effect of patients.
The intensive care unit (ICU) is a highly equipment-intensive area with a wide variety of medical devices, and the accuracy and timeliness of medical equipment data collection are highly demanded. The integration of the Internet of Things (IoT) into ICU medical devices is of great significance for enhancing the quality of medical care and nursing, as well as for the advancement of digital and intelligent ICUs. This study focuses on the construction of the IOT for ICU medical devices and proposes innovative solutions, including the overall architecture design, devices connection, data collection, data standardization, platform construction and application implementation. The overall architecture was designed according to the perception layer, network layer, platform layer and application layer; three modes of device connection and data acquisition were proposed; data standardization based on Integrating the Healthcare Enterprise-Patient Care Device (IHE-PCD) was proposed. This study was practically verified in the Chinese People’s Liberation Army General Hospital, a total of 122 devices in four ICU wards were connected to the IoT, storing 21.76 billion data items, with a data volume of 12.5 TB, which solved the problem of difficult systematic medical equipment data collection and data integration in ICUs. The remarkable results achieved proved the feasibility and reliability of this study. The research results of this paper provide a solution reference for the construction of hospital ICU IoT, offer more abundant data for medical big data analysis research, which can support the improvement of ICU medical services and promote the development of ICU to digitalization and intelligence.
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 summarize the progress and clinical application of portal vein embolization (PVE). MethodsDomestic and international publications about the PVE were retrieved and reviewed. ResultsPVE could effectively increase the perioperative security when selected at the appropriate time during liver resection surgery. However, there were some disputes on the best choice of the PVE in material, the use of dosage, and the clinical operation method. ConclusionsPVE as a method to induce liver to compensation, has a prominent role in increasing liver subtotal security, and improving the survival rate of patients. But it needs to be researched further to improve technique to promote future liver remnant hyperplasia compensatory faster and better.