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Chinese medical journal 04/2013; 126(8):1598-9. · 0.86 Impact Factor
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Pei Xun Zhang,
Yu Hui Kou,
Na Han,
Yu Dang,
Feng Xue,
Tian Bing Wang,
Hai Lin Xu,
Jian Hai Chen,
Ming Yang,
Hao Lu,
Xiao Feng Yin,
Lu Bai, Yan Hua Wang,
Shuai An,
Dian Ying Zhang,
Zhong Guo Fu,
Bao Guo Jiang
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ABSTRACT: To observe the clinical effect of biodegradable conduit small gap tublization to repair peripheral nerve injury.
In the study, 30 cases of fresh peripheral nerve injury in the upper extremities were recruited. After formally informed and obtaining the consent, the recruited patients were divided into the degradable chitin conduit tublization group (experimental group: 15 cases) and traditional epineurial neurorrhaphy group (control group: 15 cases). Their nerve functional recovery conditions were clinically observed according to the standard score methods provided by SHEN Ning-jiang and British Medical Research Council. The excellent and good rates of the overall nerve functional recovery were calculated. The electrophysiologic study was carried out after 6 months.
Of the total 30 cases, 28 were followed up, and there were 14 cases in the degradable chitin conduit tublization group and traditional epineurial neurorrhaphy group. The operation procedure was very simple, and the mean suture time [(8.0±0.8) min] was 20% shorter than that of the traditional epineurial neurorrhaphy group [(10.0±0.6) min]. All the wounds in the degradable chitin conduit tublization group healed as expected without rejection, hypersensitive reaction or anomalous draining. Electrophysiology examination results after 6 months displayed that the sensory nerves conduction velocity recovery rate was 77.37% of the normal value, and motor nerve conduction velocity recovery rate was 70.09% in the degradable chitin conduit tublization group. The sensory nerves conduction velocity recovery rate was 61.69% of the normal value, and motor nerve conduction velocity recovery rate was 56.15% in the traditional epineurial neurorrhaphy group. The exact propability methods was applied in the comparison of sensory and motor nerve conduction velocity recovery rate, and there was no statistically significant of two groups(sensory nerve conduction velocity recovery rate P=0.678;motor nerve conduction velocity recovery rate P=0.695). The combinated functional recovery excellent and good rates after repair in the degradable chitin conduit tublization group were 78.57%, while 28.57% in the traditional epineurial neurorrhaphy group. The Fisher's exact probabilistic method was applied in the comparison of combinated functional recovery excellent and good rates, and there was statistically significant of two groups(P=0.021).
The operation procedure of the degradable chitin conduit tublization is very simple and the clinical recovery effect is much better than that of the traditional epineurial neurorrhaphy. The biodegradable conduit small gap tublization methods to repair peripheral nerve injury has the possibility to substitute the traditional epineurial neurorrhaphy.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 12/2012; 44(6):842-6.
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ABSTRACT: Objective: To evaluate the effect of autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone cement on the repair of tibial plateau defect in rabbits. Methods: We used autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone cement to repair tibial plateau defect in rabbits. Gross and histologic observations, X-ray examination, and biomechanical test were conducted at 1, 2, 4, 8 weeks after operation. Results: X-ray examination found that the bone density was evidently reduced in calcium sulfate group at 8 weeks after operation; there were no marked changes in other groups. The maximal load measurements showed that autograft and allograft groups were greater than calcium sulfate and calcium phosphate groups at 1 and 2 weeks after operation. However at 4 and 8 weeks after operation, no significant difference was found among the four groups. In autograft and allograft groups, there was no significant difference in biomechanical intensity at 2, 4, and 8 weeks, but it was significantly higher than that at 1 week. In calcium sulfate and calcium phosphate groups, the outcome was ranked in descending order as 1 week less than 2 week less than 4 week equal to 8 week. Histologic examination found a great amount of new bones at 8 week in both autograft and allograft groups. In calcium sulfate group, calcium sulfate was almost absorbed and there were numerous bone trabeculations. There was a large amount of unabsorbed calcium phosphate in calcium phosphate group. Conclusion: At 1-2 weeks postoperatively, the biomechanical intensity is higher in autograft and allograft groups than calcium sulfate and calcium phosphate groups, but after 4-8 weeks, there is no significant difference among groups. At 1-2 weeks, the biomechanical intensity in all groups is increased, but at 4-8 weeks, there is no significant increase. The rates of absorption and bone formation are quicker in calcium sulfate group than calcium phosphate group.
Chinese Journal of Traumatology (English Edition) 10/2012; 15(5):268-72.
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ABSTRACT: To analyze the characteristics and laws of road traffic accidents in Beijing, and provide some accident-prevention measures.
The data from Beijing Emergency Medical Center were managed by computer,then the descriptive statistical analyses were made.
(1) A total of 2 984 traffic accidents with relatively complete information were recorded in our research,in which 42 people were led to death and 2 942 injured. Most of the casualties were male. The ages of the injured segments were mainly between 18 to 59 years.(2) The number of the injured in accidents between the motor vehicles was the largest, which was 1 883; The deaths caused by accidents between the motor vehicles and pedestrians were the most, with the number of 26;Major vicious accidents were mainly caused by accidents between the motor vehicles and the number was 11.(3) In one day accidents mainly happened at 8:00-10:00 ,and 14:00-18:00.(4) The most common injuries were the head and face injuries, with the number of 921, followed by multi-site combined injuries with the number of 761, and lower limb injuries, with the number of 541.(5) Human factors were the main causes of accidents, followed by vehicle factors.
The illegal driving and walking through the pedestrian lane were the main causes of car accidents. Strengthening traffic safety education of the public, especially of the floating population, rigorous training of drivers for traffic rules and regulations, enhancing the public awareness of road safety, and improving the road traffic management and control measures were the main measures to prevent and control traffic injuries.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 10/2011; 43(5):735-8.
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ABSTRACT: To analyze the time distributions of traffic accidents happening in different age groups in Beijing from 2004 to 2008, and to provide information on the prevention and rescue.
The traffic injury cases recorded by Beijing Emergency Medical Center from 2004 to 2008 were analyzed, and the data were separated by age: the youth (0-17 years old), the adult (18-64 years old) and the senior adult (above 65 years old). The constituent ratios of hours and months were calculated to describe the states and time distributions of all the cases.
The high peaks of accidents for the youth group occurred in the periods 7:00 to 8:00 (6.77%, 39) and 16:00 to 18:00 (10.38%, 60;10.73%, 62), and for the senior adult group appeared in the period 9:00 to 11:00 (11.19%, 151; 11.04%, 149). The adult group showed a stable trend during the period 8:00 to 24:00. The amount of traffic injury happening in these three groups had the same status monthly, which turned out that most traffic accidents happened in October for all the groups (12.11%, 70; 10.38%, 1 257; 12.30%, 166), and February had the smallest number (4.15%, 24; 5.28%, 640; 5.26%, 71).
The time distributions of traffic injury within these three groups do not show the same situation daily but do monthly. The emergency treatment team and traffic control personnel should pay attention to this and have special protocol for different cases to increase the efficiency of the prehospital rescue.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 10/2011; 43(5):739-42.
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ABSTRACT: This study aims to estimate the effects of using a portion of a nerve trunk to repair itself and the injured nerve simultaneously. Proximal 1/2 median nerve served as donor nerve to repair the distal 1/2 median and whole ulnar nerve. Four months postoperation, the number of myelinated axons and nerve conduction velocities of the distal half median and ulnar nerve were (2033 ± 135 and 24.6 ± 5.3 m/s) and (1138 ± 228 and 30.3 ± 7.2 m/s). It suggests that using a portion of a nearby nerve truck to reconstruct itself and the injured nerve simultaneously is a practical method for severe peripheral nerve injury.
Artificial Cells Blood Substitutes and Biotechnology (formerly known as Artificial Cells Blood Substitutes and Immobilization Bi 05/2011; 39(5):304-9. · 0.94 Impact Factor
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ABSTRACT: This study aims to estimate the effects of using one donor nerve to repair the injured nerve and itself simultaneously by biodegradable chitin conduit. Proximal median nerve served as donor nerve to repair the distal median and whole ulnar nerve. Four months postoperation, the number of myelinated axons and nerve conduction velocities of the distal median and ulnar nerve were (2085 ± 215 and 24.4 ± 5.9 m/s), and (1193 ± 102 and 30.7 ± 11.2 m/s). Recovery of the tetanic muscle forces of the reinvervated muscles were also observed. It suggests that Dor to Dor+Rec neurorrhaphy is a practical method for severe peripheral nerve injury.
Artificial Cells Blood Substitutes and Biotechnology (formerly known as Artificial Cells Blood Substitutes and Immobilization Bi 01/2011; 39(2):110-5. · 0.94 Impact Factor
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ABSTRACT: Sacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the sacral plexus injury have similar clinical symptoms and signs. Since lack of specific imaging technique in the diagnosis of sacral nerve injury, especially on multi-segment, multi-site, how to determine the preoperative location and extent of the sacral nerve injury accurately becomes a concern of the general orthopaedic and images practitioners. This study was conducted to gain an insight into the overall anatomical features of the sacral nerve (SN) on the same slice in high resolution computed tomography (HRCT) reconstruction and to determine the value of this information for the clinical diagnosis of related diseases.
Fifty healthy volunteers and 30 patients (40 sides) with SN lesions confirmed by surgery were scanned using a 16-slice helical CT scanner (Light Speed, GE, USA). Among the patients, 6 with intervertebral disk hernia (6 sides), 8 with spinal stenosis (12 sides), 11 with pelvic trauma (14 sides), 4 with pelvic malignancies (6 sides), and 1 with sacral vertebral tuberculosis (2 sides). The SN multiplanar reconstruction was performed using a UNIX-based SCD4.1 workstation where the image was set on the same slice. All images were stored in the Digital Imaging and Communications in Medicine format. The display of nerves in different sections was analyzed using a five-graded scale with coordinate curves of each individual score. The overall anatomic features visible on the slice were analyzed and the abnormalities of the lesions were studied.
The image of the same slice clearly revealed the shape, running direction, thickness, tension and adjacent anatomy of the S1-S4 nerves. The rank of display rates in different sections was: outward-rotated oblique sagittal > outward-rotated oblique coronal > oblique coronal plane > coronal > sagittal > transverse section. The S5 nerve was partially displayed from the starting point to the segment around the posterior sacral foramen. The overall anatomy of the triangular sacral plexus was only revealed in the oblique outward-rotated sagittal section, while 100% of its individual rami, as well as two or three of the adjacent rami, were displayed from their starting points to the anterior border of the piriformis. The abnormalities included 39 sides of morphological change (97.5%), 38 sides of compression (95.0%), 35 sides of adhesion (87.5%), 32 sides of displacement (80.0%), 34 sides of shrinkage (85.0%), 6 sides of thickening (15.0%), and 2 sides of abruption (5.0%).
The 16-slice CT multiplanar reconstruction was able to reveal the overall anatomic features of the SN on the same slice. The section of reconstruction was a crucial factor in determining the display capability of various sacral nerves. This technology was valuable in the diagnosis and management of related diseases.
Chinese medical journal 11/2010; 123(21):3015-9. · 0.86 Impact Factor
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ABSTRACT: To investigate the impact of different section injury on the median nerve during peripheral nerve regeneration.
18 New-Zealand rabbits were divided into 3 groups. We took the proximal, intermediate and distal nerve segment as donor nerve, the restore ratio of the number of donator fibers to recipient fibers is 1:4. We took the corresponding right side nerve as control, the restore ratio of the number of donator fibers to recipient fibers is 1:1. We then observed the general condition of regenerated nerve, counted the number of regenerated fibers, measured its conduction of velocity and wet weights of musculus flexor digitorum sublimis 3 months after operation.
The numbers of recipient fiber of 3 different groups were as follows: group I: 1747 +/- 375, group I: 1785 +/- 442, group III: 1863 +/- 321; Control goup I: 2234 +/- 364, control group II: 2319 +/- 237, control group III: 2346 +/- 308. The results of conduction of velocity were: group I: 19.5 m/s, group II: 19.9 m/s, group III: 21.3 m/s; Control group I: 57.1 +/- 3.7 m/s, control group I: 56.4 +/- 2.5 m/s, control group III: 56.8 +/- 2.3 m/s. The results of wet weights of musculus flexor digitorum sublines were as follows: group I: 1.7247 +/- 0.0891 g, group II:1.7239 +/- 0.0903 g, group III: 1.7253 +/- 0.0798 g. Control group I: 2.0448 +/- 0.1013 g, control group II: 2.0433 +/- 0.0861 g, control group III: 2.0456 +/- 0.0947 g.
The amplification phenomenon exist in every group, the amplified ratio augment according to the distance of the site from neuron, but the conduction of velocity is decreased gradually . The wet weights of musculus flexor digitorum sublines has no significant difference between 3 groups.
Zhonghua yi xue za zhi 06/2009; 89(23):1645-9.
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ABSTRACT: To identify the overall anatomical characteristics and the clinical value of the lumbar nerves under CT multiplanar reconstruction.
Fifty normal subjects and 30 patients with LN diseases (51 sides) were selected, including 10 patients with lumber intervertebral disk hernia, eight patients with spinal stenosis, 5 patients with spondylolisthesis, 1 patient with tethered cord syndrome, 1 patient with lumbar scoliosis, and 5 patients with spinal trauma The 16-slice helical CT (Light Speed, GE Company) was used for scanning the lumbar vertebra with multiplanar reconstruction in Workstation (ADW4.1) with UNIX System in DICOM format. The image was set on the same slice for the overall anatomy and manifestations of the lesions.
The same-slice imaging showed the strip-like LN slightly lower than the surrounding muscle in density. Each LN went out of the dural sac at an acute angle. The course of the lumbar plexus and its major branches, including the obturator nerve, femoral nerve and reproductive nerve, and their relations to the adjacent structures were clearly revealed. The percentage of the segments displayed was well associated with the reconstruction angle, with the order being oblique coronal > outward-rotated oblique coronal > oblique sagittal > coronal > sagittal section. The major manifestations of abnormal LN included compression and displacement (50 sides, 98.0%), morphological changes (49 sides, 96.1%), adhesion (41 sides, 80.4%).
The CT multiplanar reconstruction is ideal for the imaging of the overall size, shape, running and tension of the LN root; it is valuable in clinical diagnosis.
Zhonghua wai ke za zhi [Chinese journal of surgery] 06/2009; 47(11):853-6.
