Objective To evaluate the results of patients with intercondylar fracture treated with open reduction and internal fixation. Methods Forty- one patients with complete clinical data treated operatively during 1989－ 1998 were followed up for an average of 40 months. They were evaluated with modified Cassebaum rating system. The relationship between final result and the period from injury to operation, fracture pattern, operative approach, the time of initiation of exercise after operation were analyzed respectively. Results One nonunion occurred. 13 rated as excellent, 15 as good, 10 as fair,and 3 as poor. Conclusion The degree of comminution and displacement of fracture hinders the final result. Early operation, with osteotomy of the olecranon, anatomical reduction, rigid fixation and early exercise are the key factors that can improve the final result.

Objective To evaluate the choice of operative method, timing of surgery and the outcome of tibia Pilon fracture. Methods Thirty one patients with unilateral tibia Pilon fracture operatively treated between 1993 and 1998 were followed up. The average age was 39.4 years(range from 15 to 64 years). The average period between injury and surgery was 7.2 days. According to the R?edi Allgwer classification, there were 3 cases of type Ⅰfracture, 14 cases type Ⅱfracture and 14 cases type Ⅲfracture. During operation, 13 patients had the fractures reduced and internal fixation was done with the cloverleaf plate, 15 patients had limited open reduction and internal fixation coupled with external fixation, which included 5 patients with the external fixation apparatus and 10 patients with plaster splint, in the remaining 3 cases, the fibular fractures were fixed with plate and tibia fractures were immobilizated with external fixation apparatus. The average period of follow up of these 31 patients was 30.2 months. Results According to Mazurs criterion, the result of the treatment was evaluated as excellent in 25 patients, good in 5 patients and fair in 1 patient. No poor result was found. Complications included wound dehiscence in 3 cases, infection in 2 cases, delayed union of fracture 1 cases and late degenerative changes of the ankle joint in 8 cases. Conclusion In order to get a satisfactory result it is important to have the right choice and timing of surgery and correct method of fixation in tibia Pilon fractures.

Objective To review our experience of surgical treatment for postinfarction ventricular septal defect. Methods From 1990 to 2004, 22 patients with postinfarction ventricular septal defect underwent surgical treatment. There were 15 males and 7 females with a mean age of (62.2?7.3) years (from 52 years to 72 years),19 had anterior ventricular septal defect and 3 had posterior VSD, and there were 18 cases with left ventricular aneurysm.10 patients also had introaortic balloon pumping in the early experience. In all the patients cardiac function were in NYHA class III～IV. Results There were 8 operative deaths (35%). There were 7 operative deaths before 1999 and 1 case after 1999. The other patients are clinically asymptomatic after surgery, and the cardiac function is in NYHA class I～II. Conclusion Postinfarction ventricular septal defect is an infrequent but serious complication of myocardial infarction. Surgery is the best way to treat this condition. A coronary angiography should be performed in all patients who can be stabilized hemodynamically and myocardial revascularization should be performed in patients with significant coronary artery stenosis.

ObjectiveTo evaluate and compare long-term clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with remnant preservation versus remnant resection.MethodsFrom October 1999 to May 2005,standard ACL reconstruction with autogenous quadrupled hamstring tendons under arthroscopy using remnant resection with transtibial techniques was conducted in 87 patients.From June 2005 to May 2010,ACL reconstruction with autogenous quadrupled hamstring tendons using outside-in bone tunnel establishment and remnant preservation was performed in 221 patients.Only the patients who underwent simple ACL reconstruction together with more than three years follow-up records were enrolled in the study,including 66 patients in remnant preservation group and 39in remnant resection group.ResultsPatients of both groups were all followed up for 36-60 months,which showed insignificant difference between groups ( P ＞ 0.05).Compared with the preoperative data,the latest follow up data demonstrated satisfactory outcomes in both groups.The two groups showed no significant differences regarding the preoperative data including age and gender distribution,average time from injury to surgery,joint instability extent and functional score of the affected knee ( P ＞ 0.05 ).There was no statistical difference in regards of the thigh muscle atrophy and Lachman test between groups ( P ＞0.05).However,the remnant preservation group was superior to the remnant resection group in aspects of the range of motion of the affected knee,Lysholm score,stability in anterior drawer test,stability in pivot shift test and international knee documentation committee (IKDC) grade ( all P ＜ 0.05 ). ConclusionCompared with standard ACL reconstruction using remnant resection with transtibial techniques,the ACL reconstruction using outside-in bone tunnel establishment and remnant preservation has better longterm clinical outcomes including stability and function of the affected knee.

The paper analyzes different expressions of indirectly associated strong-weak connection in the process of biomedical literature knowledge discovery,defines the effect and function of strong-weak connection on literature knowledge discovery,and indicates that the accuracy rate of the discovery of potential connection through strong connection is obviously higher than the accuracy rate obtained through weak connection,and strong connection can serve as an important factor for improving the application effect of literature knowledge discovery.

OBJECTIVETo evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot.

METHODSSeven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old. The history of diabetics was from 6 to 15 years. X-ray and CT were used to evaluate fractures healing,and AOFAS was applied to estimate recovery of joint function.

RESULTSAll patients were followed up from 12 to 24 months with an average of 19 months. All incisions were healed at stage I . No infection, loosening and breakage of internal fixation, bone nonunion were found after operation. According to postoperative X-ray and CT results, the time of fracture healing ranged from 10 to 20 weeks with an average of 16 weeks. Six feet got excellent results, 2 good and 1 moderate based on AOFAS scoring.

CONCLUSIONTarsometatarsal joint dislocations secondary to diabetic charcot foot treated with plate on the metatarsal side could obtain stable fixation and got satisfied early clinical results.

Adult ; Bone Plates ; Diabetes Complications ; surgery ; Diabetes Mellitus, Type 2 ; complications ; Female ; Foot Diseases ; etiology ; surgery ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Tarsal Joints ; surgery

Successful pain management of perioperative shoulder arthroscopy may allow patients to go home earlier, improve the quality of life in perioperative period, and facilitate rehabilitation. A comprehensive method to perioperative pain control has three stages including preoperative, intraoperative and postoperative phase. Successful pain reduction should begin preoperatively because of an excellent communication between patient and physician, moreover, preoperative analgesia also should be administered. Intraoperative efforts should include local wound infiltration and the administration of anesthetic medication intra-articularly. Postoperative management should include oral analgesics, constant infusion devices, Patient Controlled Analgesia (PCA), sedative-hypnotic drug, continuous cryotherapy and vicarious treatment.
Acupuncture Analgesia ; Analgesia ; methods ; Analgesia, Patient-Controlled ; Arthroscopy ; Humans ; Pain, Postoperative ; therapy ; Perioperative Period ; Shoulder Joint ; surgery ; Transcutaneous Electric Nerve Stimulation

Objective To evaluate the effects of electroacupuncture (EA) at the Baihui (DU 20) and Dazhui (Bill) points on brain derived neurotrophic factor (BDNF) around the area of cerebral infarction and evaluate the relation between learning and memory ability and BDNF. Methods Forty-eight male adult Wistar rats were divided randomly and equally into EA and control groups. The EA group was sub-divided into 1 week, 2 weeks and 3weeks sub-groups. EA was started 24 h after establishing a model of ischemic brain injury and continued for one, two or three weeks. The control group was reared conventionally and was not given any treatment. Morris' water maze test was used to evaluate the rats' learning and memory ability. The expression of BDNF in the CA3 region of the hippo campus was detected using immunohistochemical techniques. Results Learning and memory in the EA groups were better than in the control group, and spatial probe ability was also significantly better. Positive expression of BDNF was detected in the hippocampal CA3 region of the EA group rats, and it was significantly greater than that in the control group. Conclusion Learning and memory after cerebral infarction can be affected by EA at the Baihui and Dazhui points. The effect might be related with increased BDNF expression in the hippocampal CA3 region.

Objective To evaluate long-term efficacy of microwave hyperthermia combined with chemoradiotherapy for nasopharyngeal carcinoma (NPC) with cervical lymph node metastasis. Methods A total of 154 patients with stage N2 or N3 NPC ('92 staging system) were randomized into two groups:microwave hyperthermia combined with chemoradiotherapy (Group A, 76 cases) and chemoradiotherapy alone (Group B, 78 cases). Both of the two groups received 1 -2 cycles of chemotherapy of cisplatin and 5-fluorouracil, followed by conventional radiotherapy of 70 - 78 Gy in 35 - 39 fraction to the nasopharynx and 68 -72 Gy in 34 - 36 fractions to the neck. Group A received microwave hyperthermia to the metastatic cervical nodes at the beginning of radiotherapy. The hyperthermia was given as 45 min every time, twice a week for 8 - 14 times totally. Results The 5-year complete response rates of cervical lymph nodes in group A and B were 97% and 77% (x2 = 14. 24,P<0. 01). The distant metastasis rates in the two groups were 37% and 44% (x2 = 0. 73, P > 0. 05). The disease-free survival rates were 51% and 21% (x2 = 15.91, P <0. 01). The 5-year overall survival rates were 59% and 41%, respectively (x2 = 5.09, P < 0. 05).Conclusions For patients with stage N2 or N3 NPC, microwave hyperthermia combined with chemoradiotherapy can improve the complete response, disease-free survival and overall survival.

Aged ; Angioplasty, Balloon ; Coronary Vessel Anomalies ; complications ; therapy ; Humans ; Male ; Middle Aged ; Mobility Limitation ; Stents