Objective To sum up the diagnosis, treatment, and prevention of postoperative complications of carotid body tumor. Methods The clinical data of 27 patients (30 aneurysms) with carotid body tumor who treated in our hospital from June 2005 to June 2016 were analyzed retrospectively. Results Of the 27 patients, 24 patients had unilateral lesions and 3 patients had bilateral lesions, with a total of 30 aneurysms. Three patients received color Doppler ultrasound, 18 patients received computed tomography angiography, 3 patients received magnetic resonance angiography, and 6 patients received digital subtraction angiography. According to Shamblin classification: 10 aneurysms belonged to typeⅠ, 16 aneurysms belonged to typeⅡ, 4 aneurysms belonged to type Ⅲ. Twenty aneurysms were treated with simple stripping, 6 aneurysms were treated with tumor resection and external carotid artery resection, 2 aneurysms were resected by resection, partial carotid artery resection plus external-internal carotid artery anastomosis, 2 aneurysms were resected by resection, resection of internal carotid artery, external carotid artery, and common carotid artery, as well as internal carotid artery-common carotid artery bypass. All patients underwent a successful operation with no death. After surgery,1 patient suffered from hemiplegia, 2 patients suffered from hoarseness, and 1 patient suffered from cough. Of the 27 patients, 24 patients were followed-up from 3 months to 4 years, with a median time of 2.3 years. During the follow-up procedure, the 1 patient with hemiplegic recovered to more than three levels of muscle strength after 6 months after rehabilitation, the 2 patients with hoarseness and 1 patient with cough returned to normal after 2 months after symptomatic treatment. There was no recurrence during follow-up procedure, and no other complications occurred. Conclusion Computed tomography angiography and magnetic resonance angiography are propitious to the definitive diagnosis of carotid body tumor, and actively surgical treatment should be performed once diagnosis of carotid body tumor.
Objective To investigate the biomechanics of a novel injectable calcium phosphate cement (CPC) composited by poly (lactic-co-glycolic acid) (PLGA) combined with double-screw fixation in repairing Schatzker II type tibial plateau fracture, so as to provide the mechanical basis for the clinical minimally invasive treatment. Methods Ten matched pairs of proximal tibia specimens were harvested from 10 elderly cadavers to prepare Schatzker II type tibial plateau fracture model. Fracture was fixed by forcing injection of CPC (experimental group) or autologous cancellous bone (control group) combined with double-screw fixation. The samples underwent axial compression on MTS 858 material testing machine to measure the load-displacement, the maximum load, and compressive stiffness. Results The novel CPC had good injectable property at room temperature, which could fill in bone defect fully and permeated into the surrounding cancellous bone. The average bone mineral density of tibial metaphysis was (0.639 ± 0.081) g/cm2 in the experimental group and (0.668 ± 0.083) g/ cm2 in the control group, showing no significant difference (t=1.012, P=0.331). The maximum load in the experimental group [(4 101 ± 813) N] was significantly higher than that in the control group [(692 ± 138) N] (t=3.932, P=0.001). The compressive stiffness was (1 363 ± 362) N/mm in the experimental group and was (223 ± 54) N/mm in the control group, showing significant difference (t=3.023, P=0.013). Conclusion The novel CPC can effectively restore the biomechanical properties of tibilal plateau in repairing Schatzker II type tibial plateau fracture by means of forcing injection combining with double-screw fixation. It could be used as an effective bone substitute in the clinical application.
Objective To develop a kind of biological artificial knee joint prosthesis with stereo mesh surface for rabbit, to observe its function after being implanted into rabbit knee joint and to evaluate its biomechanical property.Methods Thirty adult New Zealand rabbits were randomized into experimental and control groups (n=15), total left knee arthroplasty was performed in both groups, no patella replacement was performed. Biological artificial knee joint prosthesis with stereo mesh surface was self-designed. The adjacent 4/5 surface of femur and tibia stem of the prosthesis was covered by stainlesssteel stereo mesh, the inner surface of femur condyles and tibia plateau was welded with two layers of stainless steel stereo mesh, then the prosthesis underwent biological fixation in the experimental group. Meanwhile, prosthesis having smooth marrow internal stem, femoral condyle and tibial plateau internal surface and sharing the same shape and size with the experimental group were prepared and fixed with bone cement in the control group. The postoperative general condition of animal was observed. At 1, 3 and 6 months after operation, the rabbits were killed for gross observation, X-ray examination was conducted to observe the fixation condition of prosthesis and heal ing condition, the range of motion (ROM) of knee joints was tested, biomechanics test was carried out and the maximum shear strength of prosthesis bone interface was calculated. Results In each group, there was 1 rabbit died and new one was added during the second experiment. The others survived till the end of the experiment and crawled normally 7 days after operation. For the excellent and good rate concerning the recovery of ROM of the knee joint at 1, 3 and 6 months after operation, the experimental group was 60%, 80% and 80%, respectively, and the control group was 60%, 80% and 60%, respectively, indicating there were no significant differences between two groups (P gt; 0.05). For the experimental group, the gross observation showed large quantities of bone reconstruction, X-ray films indicated the prosthesis fitted well, with sol id fixation and without dislocation and lossening；while for the control group, the gross observation showed no bone reconstruction, X-ray films displayed the location of prosthesis was good, with sol id fixation and without dislocation and loosening. Radiolucent zone around the femur prosthesis and stress shileding occured 6 months after operation. For the maximum shear strength, the experimental group was less than the control group at 1 month after operation; and it was higher than the control group at 3 and 6 months after operation, indicating there were significant differences betweentwo groups (P lt; 0.01). Conclusion The fixation strength of the biological artificial knee joint prosthesis with stereo meshsurface is better than that of the bone cement prosthesis in rabbits at 3 and 6 months after operation.