Objective To evaluate the clinical results of an anatomical reconstruction technique for the lateral ligaments with semitendinosus autografts in treatment of chronic lateral ankle instability.Methods From October 2008 to October 2009, 16 patients with lateral instability of the ankle underwent surgery using the proposed methods. They were 8 men and 8 women, with a mean age of 28.2 years (range,19 to 47 years) . Nine patients received only the anterior talofibular ligament reconstruction. Seven patients received both the anterior talofibular ligament and the calcaneofibular ligament reconstruction. Standard stress radiographs under anesthesia were taken to determine which ligament would be reconstructed. The semitendinosus autografts were secured to the fibular insertion site with suture anchors and to the talar or calcaneus insertion site with interference screws. The American Orthopaedic Foot and Ankle Society (AOFAS) scores and standard stress radiographs were used to assess the patients preoperation and at the last follow-up.Results We had a mean follow-up of 12. 1 months (range, 6 to 18 months). In the 16 patients, the average preoperative AOFAS score was 70. 50 ± 3.98, and the final average AOFAS score increased to 93.06 ± 4. 78 ( t = - 24. 010, P = 0. 000). Their average anterior drawer sign improved from 8. 75 ± 3.38 mm to 3.51 ±1.63 mm ( t = 7. 028, P = 0. 000). In the 7 patients who had received both lateral ligaments reconstruction,their average talar tilt improved from 16. 18° ± 7.30° to 5.57° ± 2. 99° ( t = 5. 661, P = 0. 001 ). No significant complications were found in all but one patient who had a 10° limitation of dorsal flexion of the ankle.Conclusions Our short-term results reveal that anatomical reconstruction of the ligaments with chronic lateral ankle instability using the above-mentioned methods may be effective and have the advantages of precise anatomical reconstruction, firm fixation of the grafts, mini-invasive procedure for the fibular skeletal structure and peroneal tendons, and saving the length of grafts.

Acupuncture ; Acupuncture Points ; Animals ; Brain ; physiopathology ; Electroacupuncture ; Humans ; Magnetic Resonance Imaging ; Pain ; physiopathology ; Pain Management

Objective:To observe the efficacys and side effects of gefitinib(Iressa)and docetaxel(aisu)as the second-line treatment for advanced non-small cell lung cancer(NSCLC)patients.Methods:A total of 98 patients with advanced non-small cell lung cancer who had failed to previous fimt-line chemotherapy were randomly divided into two groups:gefitinib group and docetaxel group.In the gefitinib group,50 patients took Iressa 250 mg once daily until disease progression or intolerable toxicity occurred.In the docetaxel group,58 patients were treated with aisu 75mg/m~2 i.v.in 60 minutes in day 1.The regimen was repeated every 21 days for at least 2 consecutive cycles.They were assessed on the basis of RECIST evaluation standard of therapeutic effect for solid tumor.Results:In the gefitinib group,the response rate was 22.4%(11/49),the clinical benefit rate was 55.1%(27/49),median survival time was 7.1 months and 1-year survival rate was 35.9%.In the docetaxel group,the response rate,clinical benefit rate,median survival time and 1-year survival rate were 18.8%(9/48),50.0%(24/48),6.9months and 31.5%,respectively(P>0.05).The incidences of Ⅰ～Ⅳ degree and Ⅲ～Ⅳ degree rash were 51.0%and 10.2%in the gefitinib group,significantly lower than those in the docetaxel group (P=0.0000 and P=0.0296).The incidence of Ⅰ～Ⅳ degree diarrhea was significantly higher in the gefitinib group than that in the docetaxel group(P<0.01).The incidence of leukopenia was significantly higher in the docetaxel group than that in the gefitinib group(P=0.0000).The incidences of thrombocytopenia and anemia of Ⅰ～Ⅳ degree were also higher in the docetaxel group (P=0.0000 and P=0.0266).The improvement rate of quality of life was higher in the gefitinib group (P<0.05).Conclusion:Gefitinib has a similar anti-tumor effect as docetaxel on advanced NSCLC patients who have failed to previous fimt-line chemotherapy.Gefitnib can achieve higher improvement rate of quality of life in advanced NSCLC patients,with a lower incidence of toxicity.

Objective To study the effect of specific hammerhead ribozyme (Rz) to hepatitis C virus (HCV) in vitro. Methods Rz 1 Rz 2 were designed to cleavage at 5′-NCR nucleotide positions under 136～160 and 313～337, Rz 3 was designed to cleavage at C region nucleotide position under 373～388. As a control, cleavage deficient Rzm that have A→G point mutations in the catalytic loop of the hammerhead domain. 32P-labeled transcript of target HCV RNA was incubated with gel-purified Rz ( Rz 1, Rz 2, Rz 3 and Rzm ) respectively at different concentration based on specified condition and autoradiographed after denaturing gel-electrophoresis. Results Except Rzm, Rz 1 Rz 2 Rz 3 were active at 37 ℃ and more so at higher concentration, and more so with cleavage site nearly to the HCV initial code. Conclusions The HCV specific hammerhead ribozyme can be designed in vitro, further study about cleavage in vitro and in vivo will continue.

Objective To investigate the relationship between 5 ,10-methylenetetrahydrofolate reductase (MTHFR) gene C677T locus polymorphism and unexplained adverse pregnancy.Methods Three hundreds and twenty pregnant women with unknown ad-verse pregnancy ≥ 2 times in the infertility department ,and obstetrics and gynecology department of our hospital from June 2014 to May 2016 were selected as the case group and 388 healthy non-abortion parous women were taken as the control group.The MTH-FR gene C677T locus polymorphism in the two groups was analyzed by using gene chip method.The differences in genotype and al-lele frequency distribution were compared between the two groups ,and the relationship between unexplained adverse pregnancy and MTHFR C677T locus polymorphism was analyzed.Results The frequency distribution of MTHFR genotype C677T C/C had sta-tistically significant difference between the case group and control group (P<0.05 ,OR=0.284).The frequency distribution of gen-otype C/T had no statistical difference between the case group and control group (P=0.400 ,OR=1.140).The frequency distribu-tion of genotype T/T had statistical difference between the case group and control group (P<0.05 ,OR=7.672).The frequency distribution of allele C and T had statistical difference between the case group and control group ( P< 0.05 ,OR= 0.304 ). Conclusion The high expression of MTHFR C677T genotype T/T may be a risk factor of unknown adverse pregnancy in child-bearing age women.

Objective To compare traditional arthroscopic reconstruction of anterior cruciate ligament (ACL) and the arthroscopic ACL reconstruction assisted by fluoroscopy-based navigation system in accuracy and reproducibility of the tunnel placement. Methods Fluoroscopy-based navigation system was used in 40 cases of arthroscopic ACL reconstruction from December 2005 to March 2006. Another 40 cases of traditional arthroscopic ACL reconstruction performed between June 2005 and March 2006 were used as control. The positions of the femoral and tibial tunnels were measured on their radiograms and compared statistically. Results The femoral tunnel position measurements averaged 62. 3%?5. 6% (52% - 73% ) in navigation-assisted ACL reconstruction, and 56. 6%?7. 3% (46% - 77% ) in the traditional arthroscopic operation. The tibial tunnel position measurements averaged 45.4%?3. 8% (37%-53% ) in the navigation-assisted ACL reconstruction, and 41. 1%?6. 0% (25% - 54% ) in the traditional arthroscopic operation. The differences were statistically significant ( P

AIM To establish an HPLC method for the simuhaneous content determination of five flavonoids in Duchesnea indica (Andr.) Focke at five picking time (April,May,June,July and August).METHODS The analysis of D.indica methanol extract was performed on a 25 ℃ thermostatic Agilent ZORBAX SB-C18 column (250 mm×4.6 mm,5 μm),the mobile phase comprising of acetointrile-0.1％ methanoic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 350 nm.RESULTS Rutin,hyperoside,isoquercitrin,celereoin and kaempferol showed good linear relationships within their own ranges (R2 ≥0.998 6),whose average recoveries were 97.1％-101.5％ with the RSDs of 1.37％-2.37％.The contents of five constituents in samples at different picking time exhibited obvious differences,among which lutin and hyperoside contents were the highest in June,isoquercitrin content was the highest in July,and celereoin and kaempferol contents were the highest in August.CONCLUSION The suitable picking time of D.indica is June and July.

Congresses as Topic ; Humans ; Otorhinolaryngologic Surgical Procedures

Objective To investigate the effect of ulinastatin on postoperative cardiac troponin I ( cTnI) in patients underwent carotid endarterectomy ( CEA) under general anesthesia. Methods Forty patients with severe symptomatic carotid artery stenosis underwent unilateral CEA under general anesthesia from January 2011 to March 2012 were divided into either a ulinastatin group or a control group according to a random number table ( n=20 in each group) . Patients in the ulinastatin group received 500 000 U of ulinastatin via veins before induction of anesthesia. The patients in the control group were given the same amount of isotonic saline. The serum concentrations of cardiac troponin I ( cTnI ) were detected before surgery and at day 1,2,and 3 after procedure. Myocardial injury was defined as the cTnI peak concentration>0. 04μg/L . Results The levels of serum cTnI before procedure and at day 1,2,and 3 after procedure in the ulinastatin group were median (M) 0. 00 (0. 00-0. 03) μg/L,0. 07 (0. 00-1. 45) μg/L,0. 01 (0. 00-1. 21)μg/L,and 0. 05 (0. 00-0. 89)μg/L,respectively;those in the control group were 0. 00 (0. 00-0. 01)μg/L,0. 00 (0. 00-1. 42)μg/L,0. 00 (0. 00-1. 39)μg/L,and 0. 00 (0. 00-1. 24)μg/L, respectively. At day 1 after procedure,6 patients ( 30%) in the control group and 11 ( 55%) in the ulinastatin group occurred myocardial injury. There was no significant difference between the two groups (P<0. 05). In all the patients with the increased cTnI levels,the peak cTnI occurred at the first day after procedure,however,they did not reach the level ( >1. 5μg/L) of indicating patients occurring myocardial infarction. Conclusion Ulinastatin may not decrease the postoperative serum cTnI levels in CEA patients under general anesthesia. For whether to the CEA patients have myocardial protective effect,more samples are needed to be confirmed.

Objective To describe a minimal invasional surgical procedure for the treatment of avulsion fracture of tibial intercondylar eminence. Methods From July 1999 to December 2000, 26 cases of avulsion fracture of tibial intercondylar eminence were treated. With the arthroscope, reduction and absorbable suture fixation of anterior cruciate ligament or the avulsion fracture were performed. Taking the advantage of ACL－ aimer, bone tunnels, through which the suture can be pulled out and tied outside the joint, could be accurately produced. Results Twenty-two patients were available for 2－ 17 months(mean 10.5 months) follow-up. Seventeen patients gained normal range of motion, 5 have limited flexion but exceeded 90 degrees. X－ ray demonstrated bone union in all the cases and anatomical reduction obtained in 21 cases. Conclusion Arthroscopically guided operation, gives less trauma, and is a simple and effective method for the avulsion fracture of the tibial intercondylar eminence.