1.Causes analysis and management of postoperative complications after femoral fractures treated with interlocking intramedullary nails
Shujin WANG ; Jianhong CHEN ; Xiding QIU
Orthopedic Journal of China 2006;0(20):-
[Objective]To investigate the causes and treatment methods of postoperative complications of femoral fractures treated with interlocking intramedullary nails.[Method]A total of 243 cases of femoral fractures from Jan 1999 to Dec 2004 were treated with interlocking intramedullary nails.There were 14 cases having complications,delayed union in 1,nonunion in 3,nailing failure in 6(locking scerw loosen in 4,locking scerw folding in 1,locking scerw breakage in 2),nail breakage in 1,re-fracture in 1 and knee ankylosis in 1.Two cases with delayed union to convert the fixation from statictody namicin time;3 cases with nonunion were treated with bone grafting.Breakage nail and re-fractuer cases were treated with enlarging intramedullary tunels,exchanging nails and bone grafting.One of locking scerw loosen were treated with exchanging nails and bone grafting.Knee ankylosis were treated with quadriceps plasty.[Result]Through treatment,the delayed union and the nonunion were all healed and got recovery of knee function.[Conclusion]Though it has certain complications,the interlocking intramedullary nails used for femoral fractures have more advantages than other internal fixations.It needs to take valid measures to reach a satisfying result when complication appears.
2.Delay in Diagnosis of Spontaneous Dual Arteriovenous Fistulas : Correlative Factors and Influence on Outcome
Wenjin SHANG ; Hongbing CHEN ; Liming SHU ; Shujin TANG ; Hua HONG
Journal of Sun Yat-sen University(Medical Sciences) 2017;38(3):427-432
[Objective] To study the factors relative to the delayed diagnosis of spontaneous dual arteriovenous fistulas (DAVF) and its influence on the prognosis.[Methods] We included 102 continuous patients diagnosed DAVF in the First Affiliated Hospital of Sun Yat-sen University,and analyzed the correlative factors and impact on outcome of diagnostic delay.Outcome was whether symptoms were non-improvement,improvement or restoration at discharge.[Results] Median delay from onset to diagnosis was 3 months (interquartile range,1 to 6).Compared with patients diagnosed carlier(diagnose time≤3 months),patients diagnosed later (diagnose time > 3 months) had a lower frequency of headache (P =0.012),ptosis (P =0.035) and parenchymal lesions (P =0.001),a higher frequency of conjunctival congestion (P =0.004),tinnitus (P =0.021),visual dysfunction (P < 0.001),isolated visual dysfunction (P =0.007) and delayed imaging scan (P < 0.001),a higher frequency of endovascular treatment,and a lower frequency of improvement or restoration at discharge (P =0.033),in which patients with visual dysfunction had a lower frequency of improvement or restoration than those without visual dysfunction (P =0.023).Compared to those with visual dysfunction and other symptoms,patients with isolated visual dysfunction had a higher frequency of onset with paroxysmal blurring or blinding (P < 0.001),two eyes involved (P < 0.001) and more severe visual loss (P =0.057),a higher frequency of draining into transversesigmoid sinus (P < 0.001) instead of cavernous sinus (P < 0.001),and suffered intracranial hypertension all (median intracranial pressure,405 mmH2O;interquartile range,370 ~ 512 mmH2O).However,no statistically significant differences were found in the frequency of improvement or restoration at discharge between two groups (P =0.739).[Conclusion] Diagnostic delay was considerable in this cohort and was associated with outcome,especially in patients with visual dysfunction.
3.Biomechanical properties of a novel automatic anti-rotation posterior atlantoaxial internal fixation system: a finite element analysis
Min YANG ; Xiangyang MA ; Jincheng YANG ; Shujin CHEN ; Xiaobao ZOU
Chinese Journal of Tissue Engineering Research 2017;21(19):3031-3037
BACKGROUND: Atlantoaxial posterior approach is currently the main surgical treatment for atlantoaxial instability and/or dislocation, but the shape of rod in normal screw-rod device system is cylindrical. To obtain satisfactory reduction of atlantoaxis, the rod will be pre-bent obviously before fixation; however, the cylindrical rod will be rotated when tighten the nuts. Extra devices will be required to adjust and maintain the direction of the rod, thereafter, the surgical field will be blocked by the device, and spinal injury will occur once the devices are not held tightly. While the novel automatic anti-rotation rod has the function of anti-rotation during nut-tightening process, and also holds all the advantages of normal rod. Further research should be performed for the differences in biomechanical characteristics between two methods.OBJECTIVE: To investigate the biomechanical properties of the novel automatic anti-rotation rod for internal fixation system of atlantoaxial posterior approach based on three-dimensional finite-analysis model of upper cervical spine.METHODS: The three-dimensional finite element model of upper cervical spine with internal rod fixation system was developed. The biomechanical characteristics of the internal fixation system were analyzed. RESULTS AND CONCLUSION: The traditional and novel three-dimensional finite element model with realistic and geometric similarity contained 198330 elements, 964747 nodes and 246788 elements, 996069 nodes,correspondingly. There was no obvious stress concentration in both two systems, stress was concentrated mainly in the screw-bone and screw-rod interfaces. The stress values of the novel system were higher than those of the traditional system, but the maximum Von Misses Stress of two systems was lower than the yield (795-827 MPa ) and ultimate (860-896 MPa) strength of titanium alloys. These results show that the design of the novel automatic anti-rotation rod-screw fixation system has matched the biomechanical requirements for new internal fixation instruments, and is one safe, effective and practical device for atlantoaxial posterior procedure showing promising application prospect.
4.Comparison of two surgical approaches in treatment of calcaneal fracture
Hongming ZHENG ; Shujin WANG ; Zhijun CHEN ; Shuhua WU ; Danhui KONG
Chinese Journal of Postgraduates of Medicine 2017;40(8):693-696
Objective To compare sinus tarsi approach(STA) and extensile L shape approach (ELA) in the surgical treatment of calcaneal fractures. Methods A total of 51 cases of calcaneal fractures treated from May 2014 to December 2016 were enrolled. Twenty of them were performed ORIF via the sinus tarsi approach, while the other 31 cases were performed ORIF via lateral extensile L shape approach. X-ray films were taken postoperatively to record the changes of B?hler angle and Gissane angle. The AOFAS, VAS and SF-36 scores were adopted to assess the therapeutic effect. Results The average follow-up period of STA group was 15.5 months. And patients in ELA group were followed up for an average period of 18.4 months. All the fractures in the series had a boney union at or before the final follow-up. The final correction of B?hler angle (34.60 ± 2.91)° , and Gissane angle (114.45 ± 2.91)° was significantly increased in the STA group; and the final correction of B?hler angle (33.55 ± 2.73)° , and Gissane angle (112.81 ± 4.15)° was also significantly increased in the ELA group; while there was no significant difference between the two groups. The final AOFAS scores , VAS scores and SF-36 scores of the STA were (83.56 ± 7.13), (1.78 ± 0.89), (88.95 ± 4.31) scores, while those in ELA group were (81.91 ± 9.89), (2.01 ± 1.33) and (86.65 ± 4.95) scores. There was no significant difference between the two groups (P>0.05). No wound problem happened in STA group, but there were 2 cases who had wound complications in ELA group. Conclusions No significant difference is found between the two groups in the short-term efficacy of the treatment for calaneal fracture. However, STA has the advantages of lower soft tissue complication rate.
5.Evaluation of Comprehensive Benefit of Hospital Pharmacy Department with Comprehensive Index Method
Jin YUAN ; Xin CHEN ; Bo JI ; Shujin ZHAO
China Pharmacy 1991;0(05):-
OBJECTIVE: To discuss the evaluation of comprehensive benefit of hospital pharmacy department with comprehensive index method. METHODS: Suitable evaluation indexes on social effects and economic returns were respectively selected to be assigned with weight numbers by analytic hierarchy process, and the comprehensive benefits of pharmacy department in our hospital during the period from 2002 to 2004 were evaluated. RESULTS: The index values of social effects, economic returns and comprehensive benefits increased year by year, which was in line with the objective actuality. CONCLUSION: It is feasible to evaluate comprehensive benefit of hospital pharmacy department with comprehensive index method.
6.Surgical treatment of the complex fractures of the tibial plateau
Shujin WANG ; Xiding QIU ; Jianhong CHEN ; Yunlong LI ;
Chinese Journal of Orthopaedic Trauma 2002;0(03):-
Objective To study surgical treatment of complex fractures of the tibial plateau. Methods Forty eight cases of complex fractures of the tibial plateau were treated with internal fixation from January 1997 to December 2001. According to Schatzker classification, 12 cases were type Ⅲ, 9 cases type Ⅳ, 14 cases type Ⅴand 13 cases type Ⅵ. They were treated with open reduction and internal fixation with buttress plates and allograft implantation for defective fractures. Results Forty six cases of the forty eight were followed up for 1 to 4 years. The excellent and good rate was 77%. Conclusion The complex fractures of the tibia plateau should be treated surgically, and the operation procedures should be varied according to the fracture types.
7.Investigation on randomization quality of RCT in published medical periodicals of China
Qiang LI ; Yu CHEN ; Shujin WU ; Guanhui DU ; Bing CHEN ; Ning YUAN ; Jiawei CHEN
Chinese Journal of Medical Science Research Management 2008;21(6):339-342
Objective To explore the quality of randomization of RCT in medical periodicals of China.Methods We designed a table of quality evaluation of RCT.and then randomly chose 137 articles entitled with "random control",which were published in 1995,2000,and 2005.Results Of the 137 articles,103 meet the requirement of this research.Of the 103 articles,99 didn't include the details of randomization (96.1%),100 didn't present the sampling methods(97.1%).Articles published in 1995 totally didnt include the introduction of randomized sampling And grouping methods, but the situation got beuer in 2000 and 2005.There was 63.1% included clear description of diagnostic criteria.Of remaining of 36.9%, 23.3% included either in drawing or excluding criteria,50.5% included both, and 26.2%included none,For grouping,69.9% included the introduction of the baseline of each group, and 30.1%didn't.Conclusions There were some problems in the RCT,such as lack of rigorous in randomization, incomplete in diagnostic,in drawing,and excluding criteria,and lack of clear introduction of the baseline.which revealed there were still much work needed to be done to improve the clinical research level in our country.
8.Molecular Characterization of the Duck Enteritis Virus UL4 Gene
Huaqi PAN ; Nan WANG ; Li LIU ; Lei LIU ; Jiangchun HU ; Puyan CHEN ; Shujin WANG ; Ruibing CAO
Virologica Sinica 2009;24(3):171-178
Duck enteritis virus (DEV) is a herpesvirus that causes an acute, contagious and fatal disease. In the present article, the DEV UL4 gene was cloned and sequenced from a vaccine virus. A degenerate oligonucleotide primer for the consensus site of herpesvirus UL3 gene and a specific primer located in UL5 were used in the polymerase chain reaction (PCR) to amplify a DNA product 2 086 bp in size. DNA sequence analysis revealed that a 714 bp open reading frame (ORF) of DEV encoding a 237 amino acid polypeptide is homologous to the family of herpesvirus UL4 proteins and therefore has been characterized as a DEV UL4 gene. Alignment of the DEV UL4 protein sequence with those of other alphaherpesviruses showed that 10 amino acid residues are completely conserved. Phylogenetic tree analysis showed that the seventeen alphaherpesviruses viruses analyzed were classified into four large groups, and the duck enteritis virus branched separately, closely related to the Mardiviruses group comprising Gallid herpesvirus 2 (GaHV-2), Gallid herpesvirus 3 (GaHV-3) and Meleagrid herpesvirus 1 (MeHV-1). The present study showed that the evolutionary relationship of the UL4 protein could be used for classification of alphaherpesviruses.
9.Hygroscopicity of Dry Extract Powder of Hericium Erinaceus and Eathworm Biotransformation
Yuanyuan LIU ; Daijun ZHOU ; Shujin HE ; Guangyu CHEN ; Qiang LI ; Qun HE
China Pharmacist 2017;20(3):413-416
Objective:To confirm the relative humidity conditions of preparation of Hericium Erinaceus and Lumbricus ( HD) bio-transformation and the longest operation time under the conditions through the study on hygroscopicity of dry extract powder. Methods:The solution was prepared respectively in the environment with various humidity, and the moisture absorption rate and critical relative humidity ( CRH) of dry extract powder of HD biotransformation were measured, and then the mathematical model was built and the curves of moisture percentage vs relative humidity was drawn. The parameters of moisture absorption rate, and the relative humidity and operation time with the moisture percentage up to 5% were calculated. The analytic geometry and linear regression method were used to calculate CRH, so as to determine the air humidity control range and the conditions for the production and storage process. Results:The moisture absorption of HD dry extract powder could reach 5% when exposed to the air respectively with the relative humidity of 66. 0%, 80. 8%, 88. 2% and 99. 0% for 7. 088, 3. 953, 2. 892 and 0. 661 h. When the moisture percentage reached 5%, the rela-tive humidity and the shortest time was 50. 84% and 9. 937 h, respectively. The CRH of the dry extract powder of HD biotransforma-tion was 68. 12%. Conclusion:When the dry extract powder of HD biotransformation is under preparation, the relative humidity of en-vironment should be controlled below 50. 84% with the operation time shorter than 9. 937 h, or the relative humidity is controlled below 68. 12% with the operation time shorter than 6. 810 h. Under the above conditions, the moisture absorption rate of HD dry extract pow-der can be controlled below 5%, which does not affect the preparation.
10.Clinical and imaging characteristics in cryptogenic ischaemic stroke with right-to-left shunt
Shujin TANG ; Yuhua FAN ; Hongbing CHEN ; Wenjin SHANG ; Jingjing LI ; Jinsheng ZENG
Chinese Journal of Nervous and Mental Diseases 2016;42(5):267-271
Objective To investigate the clinical and imaging characteristics in cryptogenic stroke with right-to-left shunt (RLS). Methods Fifty-two patients with cryptogenic ischaemic stroke were included in the study and divided into two groups according to transcranial Doppler (TCD) bubble test: RLS group (twenty-five patients) and non-RLS group (twenty-seven patients). The demographic data, traditional risk factors of stroke and characteristics of le?sion patterns were compared between two subgroups. Results There was no significant difference between the groups in age or sex ratio. The percentage of patients with no risk factors was significantly higher in RLS group than non-RLS group (44%vs. 14.8%, P=0.015). The lesion was more frequently observed in the vertebrobasilar artery territory in RLS group (56%vs. 14.8%, P<0.01). However, there was no other significant difference in lesion patterns, such as infarct size, single/multiple lesions, superficially/deeply located between these two groups(P>0.05). Conclusions Vertebrobasilar Stroke without traditional cerebrovascular risk factors is more likely to be RLS-associated, which requires an advanced TCD bubble test to find the potential cause of stroke.