4.Measurement of the bone mineral density in the tunnel region during the anterior cruciate ligament reconstruction
Kai TIE ; Liaobin CHEN ; Hua WANG ; Xin WANG
Chinese Journal of Orthopaedics 2012;32(2):123-127
Objective To compare the bone mineral density of the regions of femoral and tibial tunnels for anterior cruciate ligament(ACL)reconstruction in order to provide reference for the choice of optimal screw diameter for interference fixation.Methods Thirty healthy volunteers aged from 18 to 35 years were enrolled in our study,and the dual-energy X-ray absorptiometry(DEXA)was used to measure the bone mineral density of femoral and tibial tunnel regions of the right knee.All the right knees of the volunteers were also scanned by spiral CT and three-dimensional reconstruction technique was utilized to determine the circular sections that pass through the longitudinal axis of the femoral and tibial tunnels separately.The CT gray scale values of the Sections were measured.From August to October 2010,9 patients who had been diagnosed as ACL rupture underwent the operation of ACL reconstruction,and cylindrical cancellous bone peg was removed from the femoral and tibial tunnel respectively during the operation.Volumetric bone mineral density of the bone pegs were measured by using a standardized immersion technique according to Archimedes’ principle.Results Measured by DEXA,bone density of the femoral tunnel region arid tibial tunnel region were(1.162±0.034)g/cm2 and(0.814±0.038)g/cm2 respectively.The difference was significant between the femoral and tibial tunnel region(t=9.11,P=0.000).The CT gray scale value of the section for femoral tunnel region was(211.7±11.5)Hu,while that of the tibial tunnel region was(104.9±7.4)Hu.There was statistically significant difference between them(t=10.15,P=0.000).The volumetric bone mineral density of the bone peg from femoral tunnel and tibial tunnel were(2.80±0.88)g/cm3 and(1.88±0.59)g/cm3 respectively.The difference was statistically significant(t=4.32,P=0.002).Conclusion For ACL reconstruction,bone mineral density of femoral tunnel region is higher than that of the tibial tunnel.
5.Clinical application of twice fluid - gas exchange in vitrectomy
Ai-Min, YAN ; Feng-Hua, CHEN ; Kai, PENG
International Eye Science 2016;16(6):1113-1115
?AIM: To observed the clinical effect of twice fluid-gas exchange in vitrectomy for retinal detachment at the equator.?METHODS: The retrospective analysis of the 74 cases (74 eyes) with retinal detachment at the equator from January 2014 to September 2015 were reviewed. All these patients were performed standard three channel 23G vitrectomy under a wide angle lens, in which, the 37 cases ( 37 eyes ) were randomly selected and performed single fluid-gas exchange, and the other 37 cases ( 37 eyes) were performed twice fluid-gas exchange. The intraoperative surgical complications and the postoperative success rate of retinal reposition in 1wk, 1, 3mo after surgery of the two group patients were observed.? RESULTS: The intraoperative surgical complication rates of the twice fluid-gas exchange group were less than that of the single fluid-gas exchange group. The postoperative success rate of retinal reposition in the twice fluid-gas exchange group significantly increased in 1wk and 1mo after surgery, and the difference was statistically significant (P<0. 05). But the postoperative success rate of retinal reposition in 3mo after surgery had no significant difference (P>0. 05).?CONCLUSION:The twice fluid-gas exchange operation was simple and it was beneficial for beginners to master. The incomplete drainage of the single fluid-gas exchange and the pore drainage in the posterior pole or in the peripheral part of the retina were avoided during the surgery. The intraoperative surgical complication rates were reduced and the postoperative success rate of retinal reposition were improved. This operation method had great application value in clinic.
6.Wolffian Adnexal Tumor:Report of One Case.
Zhi-Qiang WANG ; Jin-Yun KAI ; Hua-Ying CHEN
Acta Academiae Medicinae Sinicae 2020;42(4):570-572
This article reports a patient who suffered from Wolffian adnexal tumor.We also briefly elucidate the pathogenesis,clinicopathological features,diagnosis,differentiation,and treatment of Wolffian adnexal tumor,with an attempt to increase the awareness of the disease and reduce misdiagnosis.
Adenoma
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Adnexal Diseases
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Female
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Humans
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Immunohistochemistry
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Wolffian Ducts
7.Minimal invasive elastic intramedullary nails and external fixation for treatment of comminuted closed fracture of tibia-fibula shaft.
Yang YU ; Wei-kai CHEN ; Wei CUI ; Yi-fei ZHOU ; Hua CHEN ; Lei YANG
China Journal of Orthopaedics and Traumatology 2015;28(5):412-416
OBJECTIVETo investigate the clinical results of external fixation and AO titanium elastic intramedullary nailing for treatment of tibia-fibula comminuted closed fractures.
METHODSFrom June 2010 to June 2012,58 patients with tibia-fibula comminuted closed fractures were treated with external fixation and AO titanium elastic intramedullary nailing, including 31 males and 27 females with an average age of 38.5 years old ranging from 21 to 57 years old. According to the system of AO Classification, the fractures were classified as type B1 in 9 cases,type B2 in 7 cases, type B3 in 10 cases, type Cl in 14 cases, type C2 in 12 cases,and type C3 in 6 cases. According to the system of Winquist-Hanson,the fractures' comminuted were classified as grade 1 in 23 cases, grade 2 in 17 cases, grade 3 in 12 cases, and grade 4 in 6 cases. According to the system of Johner-Wruhs, clinical results were compared between different type and grade groups by the time of last followed-up.
RESULTSAll 58 patients were followed up with an average time of 6.8 months (ranged from 18 to 36 weeks). All fractures had clinical healing with an average time of 28 weeks (ranged from 24 to 32 weeks). The total rate of good to excellent results was 91.4%. The rate of good to excellent in the group of grade 1 was higher than that of other grades. The complication rates and fracture healing time would increase respectively with higher Winquist-Hanson's grade. The complication rates in the group of type C3 was higher than that of other types, but the rate of good to excellent was lower than that of other types. The complication rates in the group of type B1 was lower than that of other types,but the rate of good to excellent was higher than that of other types.
CONCLUSIONMinimal invasiveusing AO titanium elastic intramedullary nailing combined with external fixation for treatment of tibia-fibula fractures especially for the multiple-segment,long spiral mild-to-moderate comminuted with hidden fracture can get satisfactory reduction and reliable fixation,it conformes to the principle of BO completely, protects the fracture end blood supply,reduces the external fixation time, has less skin soft tissue complications, postoperative function recovered satisfactorily.
Adult ; Bone Nails ; Bone Plates ; External Fixators ; Female ; Fibula ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Closed ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tibia ; injuries ; surgery ; Young Adult
8.Changes of P_(300) and Mismatch Negativity in the Treatment of First Episode Depression
hui, SU ; kai-da, JIANG ; fei-ying, LOU ; xing-shi, CHEN ; jian-hua, LIANG
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(04):-
Objective To study P300 of the first episode depression and mismatch negativity(MMN) changes after antidepressant treatment. Methods Sixty-four patients with first episode depression were evaluated by HAMD 17, and P300 and MMN tests were performed at the baseline and week 12. The cognitive potentials were compared with those of control group(N=36). Results Compared with the control group, depressive patients had longer latency of P300 and MMN,lower amplitude of P300 and MMN before treatment (P
9.A comparative study on accommodative microfluctuation between emmetropic and myopic school-aged children
Kai, DIAO ; Jing-jing, XU ; Zhi-li, ZHENG ; Jin-hua, BAO ; Hao, CHEN
Chinese Journal of Experimental Ophthalmology 2013;(6):555-558
Background The incidence of myopia is increase.Some researches documented that formation of myopia is closely related with weakness of the accommodative response,enhancement of accommodative lag and accommodative microfluctuations in short-distance use of eyes.However,there still is controversy.Objective This study sought to compare the accommodative microfluctuations among emmetropic and myopic school-aged children at reading,and to discuss its potential relationship with the onset and development of myopia.Methods A casecontrolled study was designed.Eighty-nine children aged 8-12 years old were recruited in this study,including 47emmetropic children and 42 myopic children.Refractive error were checked by subjective refraction in phoropters and binocular vision and stereopsis were examined in all the subjects.A Grand Seiko WAM5500 auto-refractor was used to measure the accommodative responses and accommodative microfluctuations with different stimulus in 40 cm and 25 cm.The differences in accommodative response and accommodative microfluctuations at 25 cm and 40 cm reading distance were compared between the emmetropic children and myopic children using independent sample t test,and change of accommodative microfluctuations in myopic children at 25 cm and 40 cm reading distance was evaluated by paired t test.Results When the reading distance was 25 cm and 40 cm,the accommodative responses of emmetropes were (2.67 ±0.31) D and (1.70 ±0.23) D,and they were higher than (2.31 ± 0.33) D and (1.49 ±0.24) D of myopes,showing significant differences (t =5.330,P =0.000; t =4.140,P =0.000).Accommodative microfluctuation of myopes was(0.35 ±0.16)D in 25 cm reading distance and that of emmtropes was(0.26±0.08)D,with significant difference between them (t =3.180,P =0.002).However,there was not significant difference in accommodative microfluctuation at 40 cm reading distance between the myopic children and emmtropie children [(0.27±0.10) D vs.(0.24±0.09) D] (P=0.220).In myopic children,the accommodative microfluctuation at 25 cm reading distance was(0.35±0.16) D,showing a much increase than(0.27±0.10) D at 40 cm reading distance(t=3.850,P =0.000),but an insignificant difference in the accommodative mierofluctuations was seen between the 25 cm and 40 cm reading distance in the emmetropic children (P =0.145).Conclusions With the increased accommodative stimulus,myopic children present lower accommodative responses and larger accommodative microfluctuations.
10.Change of vascular endothelial growth inhibitor in serum and vitreous of diabetic retinopathy patients
Qing-zhong, CHEN ; Jing-kai, ZHANG ; Li-ming, HUANG ; Hua, YAN
Chinese Journal of Experimental Ophthalmology 2013;31(12):1163-1168
Background Diabetic retinopathy (DR) leads to blindness because of the retinal angiogenesis caused by the ischemia of retina.Vascular endothelial growth inhibitor (VEGI) is a recently identified anti-angiogenic cytokine,which can suppress endothelial cell proliferation and angiogenesis.Objective The aim of this study was to detect the change of serum and vitreous VEGI/TL1A and its relative cytokines in patients with DR.Methods A non-randomized controlled clinical trial was performed.Fifty-five DR patients were enrolled in Tianjin Medical University General Hospital from November 2012 to March 2013 with the informed consent.The patients were divided into non-proliferative DR (NPDR) group (20 cases) and PDR group (35 cases).Eleven cataract patients served as normal control group,and 15 patients with diabetic mellitus (DM) were included as DM group.The demography was matched among the groups,but the course of DM and the blood glucose level were elevated in the PDR group and the DM group compared with DR group (all at P<0.05).We collected the serum of all the patients above.Another 23 PDR patients (25 eyes) were enrolled in Tianjin Medical University General Hospital from November 2012 to March 2013 with the informed consent and served as PDR group,healthy corpse's eyes (n=7) as control group,the patients were assigned to the retinal photocoagulation group,surgery group and photocoagulation +surgery group according to different treatment procedures.Vitreous samples were collected during the progress of vitrectomy.TL1A/VEGI 251,VEGF,TNF-α,IL-1β and NF-κB p65 concentrations in the serum and vitreous specimens were detected using ELISA.The differences of serum and vitreous TL1A/VEGI 251,VEGF,TNF-α,IL-1β and NF-κB p65 in various groups were statistically analyzed by ANOVA and independent sample t test,respectively.The correlation between TL1A/VEGI 251 and VEGF,TNF-α,IL-1β,NF-κB p65 were calculated by Pearson correlation analysis.Results TL1A/VEGI 251 concentration was elevated in the DM group,NPDR group and PDR group compared with the normal control group,with significant difference among the 4 group (F =27.431,P =0.009),and TL1A/VEGI 251 concentration was higher in the PDR group than that in the DM group or the NPDR group (P<0.05).VEGF,TNF-α,IL-1 β and NF-κB p65 concentrations in serum were increased in the PDR group in comparison with the DM group,NPDR group and the normal control group (P<0.05).However,no significant difference among the DM group,NPDR group and the normal control group (P>0.05).Serum TL1A/VEGI 251 concentration was significant correlated with VEGF,TNF-α,IL-1β and NF-κB p65 concentration (r=0.951,0.951,0.851,0.944,all at P<0.01).Vitreous TL1A/VEGI 251,VEGF,TNF-α,IL-1 β concentrations were ascended in the PDR group compared with the normal control group (P =0.024,0.001,0.000,0.037),but there was no significantly difference in vitreous NF-κB p65 concentration between the two groups (P =0.073).Vitreous TL1A/VEGI 251 concentrations declined in the retinal photocoagulation group and the surgery group compared with the normal group (all at P< 0.05),and significant positive correlations were found between vitreous TL1A/VEGI 251 concentration and VEGF or TNF-α concentration (r =0.675,0.950,P < 0.01) ;while Pearson correlation coefficient was not statistically significant between vitreous TL1A/VEGI 251 concentration and IL-1β or NF-κB p65 concentration (r=0.233,0.318,P>0.05).Conclusions VEGI is involved in the pathogenesis of DR,and it interacts with VEGF,TNF-α,IL-1β and NF-κB to affect the development of DR.These results provide a new clue for the further study of DR.