Cholangitis, Sclerosing ; complications ; Histiocytosis, Langerhans-Cell ; etiology ; Humans

OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

BACKGROUND:Nano-size inorganic filling greatly improves mechanic characteristic of composite resin.However,its effects on pulp tissue remain unclear.OBJECTIVE:To evaluate the biocompatibility of FiltekTM Z350 nano-composite resin on dog pulp tissue by means of histology observation.DESIGN,TIME AND SETTING:Randomized control animal experiment was performed at the animal experiment center of Fuzhou General Hospital,Nanjing Military Area Command of Chinese PLA from April 2007 to April 2008.MATERIALS:Sixty healthy teeth from three adult male beagle dogs were recruited in this study.METHODS:Buccal Class V deep cavities were prepared in beagle dogs,which were then divided into four groups at random.FiltekTM Z350 resin,Dyract AP compomer and TPH resin were used to restore the cavities in three testing groups and glass ionomer cement was used as control.All cavities were treated with Clearfil SE BOND before filling.Intact healthy teeth were used as blank control.MAIN OUTCOME MEASURES:The pulp condition of each tooth was studied histologically.The remaining dentine thickness of each cavity was measured.RESULTS:After 7 days,mild inflammatory response was observed in most of the specimens.After 30 and 90 days,normal histological characteristics were observed in almost all specimens except TPH resin group.The histological structure disturbance of dentin cell layer emerged in some specimens of TPH group,which was higher than other testing groups(P 0.05).CONCLUSION:FiltekTM Z350 nano-composite resin has similar biocompatibility as Dyract AP compomer and glass ionomer cement,better than TPH resin.

Objective To increase the preoperative diagnosis rate,reform the operation and improve the prognosis in children with ganglio -nauroma.Methods Clinical data of 20 children with ganglioneuroma hospitalized in Tongji hospital of Huazhong university of science and technology from Nov.1986 to May.2006 were reviewed(male 9,female 11).The biological,clinical and pathological characteristics of patients were analyzed.Results Among these 20 patients,15 cases were discovered to have no clinical symtom.The B ultrasound showed low-echo in all 16 cases.Under CT scan,20 cases showed low to moderate density shadows,and the distinct enhancement in these tumors was noted with enhanced CT scan.Fourteen cases undergoing MRI all showed low signals in T1W1 and inhomogeneous high signals in T2W1.All patients underwent surgical operations,completely removed in 14 cases,partly in 4 cases, and biopsy was performed only in 2 cases.Fifteen cases were followed up from 7 months to 6 years,tumor recurrence happened only in 1 case.Conclusions Ganglioneuroma is mostly found in chest-abdominal sympathetic chain,it grows up slowly and seems to be innocent.The imaging data of B ultrasound,CT and MRI can give helpful information in the diagnosis of ganglioneuroma.We shall pay attention to the choice of incision and avoidance of injuring the important blood vessels during the operation.Children who have neuroblastoma cells should receive prophylactic chemoprophylaxis treatment and the result of long-time follow up is satisfactory.

Objective To compare the clinical efficacy of percutaneous kyphoplasty (PKP) by balloon dilatation between unipedicular and bilateral pedicle approach for the treatment of osteoporotic vertebral compression fractures (OVCF). Methods From January 2012 to March 2014, 56 patients with single-level or double- level OVCF were randomly divided into two groups. 29 patients with 33 vertebral bodies were performed by PKP through unipedicular approach and 27 patients with 31 vertebral bodies through bipedicular approach , used PMMA bone cement filling vertebral. The clinical data of patients were prospectively analyzed and the clinical efficacy was compared between two groups. Results The VAS scores, Beck value, Cobb angle and ODI scores after operation improved in both groups (P < 0.01),but there were no significant difference between two groups(P > 0.05). The operative time, X-ray exposure time and volume of bone cement in unilateral group were less than that of bilateral group(P < 0.01). There were no significant difference in the incidence of bone cement leakage ,the pain relief and the incidence of complications between two groups (P > 0.05). Conclusion Both unipedicular and biopedicular PKP are significant improvement for the OVCF, vertebral strengthen showed similar efficacy, but the former has easy operation procedure, can shorten operative time and reduce X-ray exposure time and less volume of bone cement.

OBJECTIVETo investigate the efficacy of Ilizarov fixator on cicatricial foot drop after burn.

METHODSSix patients with cicatricial foot drop after burn were treated with Ilizarov fixator during June 2004 approximately October 2007, the fixator was set on the leg and foot by fixed bone needles. Nuts on the threaded rod were turned from 3 post operation day, 2 approximately 4 rounds per time and 4 times per day in the first week, then 1 approximately 2 rounds per time and 4 times a day, which corrected the deformity of talipes equinus by shortening or lengthening the thread rod in the front and at the back. Ankle joint was maintained in neutral position for 2 approximately 3 months after effective correction. Weight carrying for patients was increased gradually after removal of fixator. Ankle joint was maintained in neutral position with fixator at least three months. Patients were followed up 5 approximately 10 months.

RESULTSAnkle joints from all patients were restored to neutral position after application with fixator for 4 approximately 6 weeks. All patients achieved 0 degrees dorsiflexion in weight carrying for whole planta pedis after use of fixator for 12 approximately 15 weeks with good locomotion function.

CONCLUSIONIlizarov fixator is safe and mini-injury, which is an effective method for treatment of cicatricial foot drop.

Adolescent ; Adult ; Burns ; complications ; surgery ; Child ; Cicatrix ; etiology ; surgery ; Clubfoot ; etiology ; surgery ; Contracture ; etiology ; surgery ; External Fixators ; Female ; Foot Deformities, Acquired ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

The aim of this paper is to clarify the mineral origin of traditional Chinese medicine (TCM) Yangqishi and Yinqishi and guide identification of the both, by X-ray diffraction (XRD) Fourier patterns. Morphological identification and conventional physical and chemical analysis wee used to identify 22 batches of Yangqishi and Yinqishi. It used XRD Fourier patterns which has been collected from sample powders to analyze phase composition. It has been found experimentally that the mineral origin of Yinqishi is Talc schist and the mineral origin of Yangqishi is tremolite and actinolite. The results also showed that the method using XRD can get not only an accurate but also rapid identification of Yangqishi and Yinqishi. There are many differences in medicinal properties, efficacy, indications and composition of Yangqishi and Yinqishi, so be careful not to mix them up.
Asbestos, Amphibole ; chemistry ; Drugs, Chinese Herbal ; chemistry ; X-Ray Diffraction

Objective To evaluate the effect of discussion-based teaching pattern in clinical noviciate of general surgery. Methods Two hundred and ten students majoring in clinical medicine were randomly divided into the trial group and the control group during clinical noviciate of general surgery.There were 105 students in each group. The discussion-based teaching pattern and traditional teaching pattern were performed in the trial and control groups,respectively. After the clinical novici-ate of general surgery was completed,the teaching effects of both groups were evaluated by the exam-ination performance analyses and the questionnaire-based survey. Student's t-test andχ22 test were used in statistical analysis. Reults The rate of satisfaction with the teaching pattern was 88.6%in the trial group and 70.5%in control group(P<0.05). The mean scores in the trial group and control group were 80.3±9.2 and 74.5±11.3,respectively (P<0.05). The pass rate of examination in the trial group and control group were 97.1% and 88.6%,respectively (P<0.05). The excellence rate in the examination was 24.8%in the trial group and 12.4%in control group (P<0.05). The overwhelming majority of stu-dents in the trial group thought that the discussion-based teaching pattern had more advantages in im-proving students' learning initiative and enthusiasm,ability to analyze and solve problems,etc.,acord-ing to the questionnaire-based survey. Conclusions Discussion-based teaching is an effective teach-ing pattern and superior to the traditional teaching pattern.

Objective To establish the reference intervals of hemoglobin A 1c( HbA1c ) and fasting plasma glucose ( FPG ) in the first and second trimester of pregnancy in Chongqing , and to evaluate the viability of the combination of HbA 1c and FPG in screening gestational diabetes mellitus (GDM).Methods The study retrospectively selected the pregnant women seen at the Department of Obstetrics and Gynecology in Daping Hospital between September 2014 and August 2015.The results of FPG during 10-13 pregnant weeks and 75 g oral glucose tolerance test ( OGTT ) and HbA1c during 24-28 pregnant weeks were available.Totally 185 cases were assigned into GDM group , and 269 cases were assigned into normal group based on the American Diabetes Association ( ADA) guidelines.Reference intervals of HbA 1c and FPG in normal pregnant woman were developed .The difference of HbA 1c , FPG and OGTT results between two groups was analyzed.T-student test, NcMemar test,signed rank sum test, ROC curve were used for statistical analysis.Results The reference intervals of HbA 1c and FPG in first and second trimester were 4.58%-5.52%,4.21-5.49 mmol/L and 4.03-5.08 mmol/L.The FPG level in first and second trimester and HbA 1c level in GDM group vs normal group were(5.06 ±0.37) vs(4.85 ±0.32)mmol/L(t=6.569,P=0.000), 5.23(5.11,5.4) vs 4.74(4.54,4.91) mmol/L(z=-14.31,P=0.000)and 5.3(5.1,5.4)% vs 5.2(5.0, 5.3)%( z=-5.79,P=0.000) respectively.The area under receiver operating characteristic curve ( ROC) of HbA1c , and FPG in first and second trimester was 0.655, 0.659 and 0.890 respectively.When the cut-off value of HbA1c was 5.35%, the AUC of the combination of HbA 1c and FPG in second trimester was 0.898, the sensitivity was 0.838,and the specificity was 0.859.The kappa coefficient for identifying GDM between OGTT and the combined method was 0.692(P=0.000).Conclusion HbA1c combined with FPG is of some value in screening GDM.

Objective To investigate the causes of re-fractures of non fracture vertebral body after percutaneous kyphoplasty (PKP).Methods 512 patients (618 vertebral bodies) treated with PKP because of osteoporosis VCFs were recruited from June 2010 to June 2014.There were 107 males (121 vertebral bodies) and 405 females (497 vertebral bodies) with the mean age of 70.38±7.59 years old (51 to 91 years).There were 406 single segment fracture and 106 double segment fractures cases,and the fracture segments were T4 to L5.The T value of the patients' bone mineral density (BMD) was from-1.0 to-5.2 SD.The clinic characteristics of all the patients including age,sex,body weight,body height,body mass index (BMI),BMD score of the spine,volume of bone cement,restoration rate of anterior/middle vertebral height,postoperative complications (pulmonary embolism,bone cement leakage,nerve injury),and treated vertebral level were analyzed.Results 52 patients (10.16％,52/512) experienced refractures of non fracture vertebral body after kyphoplasty,and 4 experienced re-fracture of the fracture vertebral body after kyphoplasty.The average age of the 52 patients was 71.88±7.74 years old,meanwhile,the ratio of female was 94.23％ (49/52),the mean T value of BMD-4.03±0.60 SD,the ratio of initial double segment fractures 51.92％ (27/52).In addition,among the 456 cases with no fracture,the average age was 70.21±7.56 years,the ratio of female was 77.19％ (352/456);the mean T value of BMD was-2.89±0.55 SD;the ratio of initial double segment fractures was 17.32％(79/456).The data above (age,T value of BMD and initial double segment fractures) were all with statistical significant differences.Whereas the BMI,volume of bone cement,intervertebral disc leakage and restoration rate of anterior/middle vertebral height had no significant difference between the two groups.Furthermore,in the re-fracture of non fracture vertebral body group,32 cases (61.54％,32/52) were nonadjacent fractures,and 20 (38.46％,20/52) were adjacent fractures.Conclusion Osteoporosis degree,female and initial double segment fractures were major risk factors in the development of re-fracture of non fracture vertebral body after PKP.