New method of local adjuvant therapy with bicarbonate Ringer’s solution for tumoral calcinosis: A case report

BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of hydroxyapatite,which is highly infilt-rative to tissues,thus making complete resection difficult.An adjuvant method to remove or resolve the residual crystals during the operation is necessary.CASE SUMMARY A bicarbonate Ringer’s solution with bicarbonate ions(28 mEq/L)was used as the adjuvant.After resecting calcium phosphate deposits of tumoral calcinosis as much as possible,while filling with the solution,residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field.A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders,bilateral hip joints,and the right foot.A shoulder lesion was resected,but the calcification remained and early re-deposition was observed.Considering the difficulty of a complete rection,we devised a bicarbonate dissolution method and excised the foot lesion.After resection of the calcified material,the residual calcified material was washed away with bicarbonate Ringer’s solution.CONCLUSION The bicarbonate dissolution method is a new,simple,and effective treatment for tumoral calcinosis in hemodialysis patients.

Evaluation of electrochemical impedance and biocorrosion characteristics of as-cast and T4 heat treated AZ91 Mg-alloys in Ringer’s solution

The present study aims at understanding the electrochemical impedance and biocorrosion characteristics of AZ91 Mg-alloy in Ringer’s solution.As-cast AZ91 Mg-alloy was subjected to T4 heat treatment in a way to homogenize its microstructure by dissolving most of theβ-Mg 17 Al 12 phase at the vicinity of grain boundaries.The electrochemical impedance and biocorrosion performances of these two different microstructures(as-cast and T4 heat treated AZ91 Mg-alloys)in Ringer solution were evaluated by electrochemical impendence spectroscopy,potentiodynamic polarization and weight loss method.EIS spectra showed that both microstructures exhibit similar dynamic response as a function of the immersion time;however,the value of impedance and maximum phase angle are about 50%higher in as-cast AZ91 Mg-alloy as compared to that of homogenized AZ91 Mg-alloy.Weight loss measurement indicated that corrosion resistance of as-cast AZ91 was significantly better than that of homogenized AZ91.Microstructural and XRD analysis revealed that as-cast AZ91 contains a passive film of MgCO_(3)and CaCO_(3)precipitates with near spherical morphologies,whereas homogenized AZ91 comprised mainly unstable Mg(OH)_(2)film featured by irregular plate-like morphologies.

Dynamics of vascular volume and hemodilution of lactated Ringer’s solution in patients during induction of general and epidural anesthesia

Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v. infusion of 1000 ml of lactated Ringer＇s solution over 60 min was studied in patients undergoing general （n=31） and epidural （n= 22） anesthesia. Heart rate, arterial blood pressure and hemoglobin （Hb） concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results： General anesthesia caused the greater decrease of mean arterial blood pressure （MAP） （mean 15% versus 9%; P〈0.01） and thereby followed by a more pronounced plasma dilution, blood volume expansion （VE） and blood volume expansion efficiency （VEE）. A strong linear correlation between hemodilution and the reduction in MAP （r=-0.50;P〈0.01） was found. At the end of infusion, patients undergoing general anesthesia retained 47% （SD 19%） of the infused fluid in the circulation, while epidural anesthesia retained 29% （SD 13%） （P〈0.001）. Correspondingly, a fewer urine output （mean 89 ml versus 156 ml; P〈0.05） and extravascular expansion （454 ml versus 551 ml; P〈0.05） were found during general anesthesia. Conclusion： We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.

Effect of Ringer's Solution on Wear and Friction of Stainless Steel 316L after Plasma Electrolytic Nitrocarburising at Low Voltages

A plasma electrolytic nitrocarburising （PEN/C） process was performed on stainless steel 316L to improve the surface properties for using as medical implants. A bath was optimised to reduce the required voltage to 150 volts. Aqueous urea-based solutions with 10% NH4Cl were prepared with slightly different amounts of Na2CO3 to optimise the electrolyte composition. The surface and the cross-section morphologies were studied by scanning electron microscopy. The microstructure and the chemical composition of samples were investigated by X-ray diffraction （XRD） and energy dispersive X-ray （EDX） techniques. The microstructure of the outer layer of the coatings was found to be a complex oxide containing Cr and Fe. The wear properties of the samples were examined by using a pin on disk wear test with Ringer＇s solution and were compared with their wear properties in the ambient atmosphere. The Ringe（s solution acted as a lubricant, reducing friction coefficient. Hardness and roughness were also studied. The bath with the composition of 10% NH4CI and 3% Na2CO3 exhibited the best tribological properties. The results showed that the tribological properties of treated samples were improved and the wear mechanism was abrasion of the pin.

Influence of heat treatment on microstructure and electrochemical behaviors of Mg-Zn binary alloys prepared by gas-phase alloying technique

Mg-Zn binary alloys fabricated by the gas-phase alloying technique under vacuum condition were investigated in the state of initial state and after heat treatment for the microstructure and electrochemical behaviors.Different from the traditional Mg-Zn alloys preparation methods,alloys prepared by gas-phase alloying have a large number of intermetallic compounds,such as MgZn,Mg7Zn3 and MgZn2.After solution treatment,the boundary of the eutectic disappeared and the size ofα-Mg increased from 100μm to 150μm.At the same time,the value of the resistance of charge transfer increased,which indicates that the resistance of the charge transfer and the corrosion resistance of the alloys increased.After artificial aging treatment,the distribution ofα-Mg was more uniform and its size was reduced to about 50μm,and there was new eutectic structure formed.The newly formed eutectic structure forms galvanic cells with the alloy matrix,which makes the corrosion resistance of the alloy weaken.