OBJECTIVETo retrospectively analyze therapy comparison between hinged external fixator combining with internal fixation, soft tissue repair and plaster fixation after routine surgery for terrible triad of the elbow.

METHODSFrom January 2003 to June 2011,26 patients with terrible triad of the elbow (posterior dislocation associated with fracture of both the radial head and the ulnar coronoid process) were treated respectively by unilateral hinged external fixator and plaster fixation. Fourteen patients were treated with external fixator combining with internal fixation, soft tissue repair and reconstruction, including 8 males and 6 females,ranging in age from 20 to 62 years with an average of (33.60 +/- 8.53) years. The mean time of fixation was 7.5 weeks (ranged, 6 to 8 weeks), and forearm rotation exercise was performed after the first day of operation, elbow flexion and extension activities after 4 to 6 days. Twelve patients were treated with plaster external fixation combining with open reduction and internal fixation,including 8 males and 4 females,ranging in age from 21 to 63 years with an average of (34.80 +/- 7.41) years. The mean time of plaster fixation was 30.4 days, and functional exercise was carried out after 4 to 6 weeks of plaster removal. JOA assessment score were used to evaluate the elbow joint function.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 36 months,with an average of 18.6 months. The mean time of fracture healing was (8.6 +/- 3.1) weeks in plaster group and (9.0 +/- 2.7) weeks in fixator group, with no statistical difference between the two groups (t =1.47, P > 0.05). The function and are of motion in plaster group and fixator group showed significant difference. While the pain, articular instability and deformity showed no statistical difference. The total assessment score between two groups indicated markedly difference (t = -2.66, P < 0.01).

CONCLUSIONHinged external fixator can enhance lateral stability of elbows,benefit the reduction of fracture dislocation, guarantee early and safe functional exercise, prevent elbow stiffness, and reduce heterotopic ossification. In treating terrible triad of the elbow, the hinged external fixator is superior to other therapies with respect of improving the function of elbow joint.

Adult ; Case-Control Studies ; Elbow Joint ; diagnostic imaging ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the synergistic effects of electroacupuncture on the treatment of knee osteoarthritis after arthroscopic debridement.

METHODSFrom May 2008 to July 2010, 78 patients with knee osteoarthritis were randomly divided into two groups. There were 42 patients in the experimental group, including 16 males and 26 females, ranging in age from 41 to 63 years, with an average of (53.62 +/- 6.53) years; the disease course ranged from 8 to 24 months, with an average of (10.35 +/- 6.42) months. The patients were treated with arthroscopic debridement combined with electroacupuncture after operation. There were 36 patients in the control group, including 14 males and 22 females, ranging in age from 40 to 62 years, with an average of (54.34 +/- 7.67) years; the disease course ranged from 6 to 25 months, with an average of (11.94 +/- 5.13) months. Those patients were treated only with arthroscopic debridment. All the patients performed isometric quadriceps femoris contraction exercise and knee flexion and extension activities after operation. The visual analog scale(VAS) score and Lysholm knee score were used to evaluate the therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 30 months, with an average of 15.6 months. At the final follow-up, VAS score was significantly decreased, and the Lysholm score, except for the item demanding for support, significantly increased, compared with those before surgery respectively in both groups. There was significant difference in VAS score between two groups after treatment. As to Lysholm score, there were significant differences in limp, pain, swelling, stair activity and squat, but there were no significant differences in items of interlocking and instability between two groups after treatment.

CONCLUSIONElectroacupuncture can effectively improve the clinical symptoms and knee joint's motor function of knee joints in patients with knee osteoarthritis, as well as the synergistic effects on the treatment of knee osteoarthritis after arthroscopic debridement, leading to a much better long-term therapeutic effect with respect of improving the function of knee joint. This therapy, combined with traditional Chinese medicine and Western Medicine,is worth of clinical application in the treatment of knee osteoarthritis.

Adult ; Aged ; Arthroscopy ; Case-Control Studies ; Combined Modality Therapy ; Debridement ; Electroacupuncture ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; therapy ; Treatment Outcome

Objective To investigate the clinical characteristics,treatment options and prognosis of duplex kidneys in children.Methods Data were retrospectively collected from all patients who were hospitalized at Shengjing Hospital Affiliated to China Medical University from January 2008 to May 201 5.The surgery to retain moie-ty nephron was performed in 30 cases:1 2 cases underwent non common sheath ureter reimplantation,4 cases of the patients had common sheath ureter reimplantation,1 2 patients underwent transurethral resection of the cyst,1 case of them had pyeloureterostomy,and the other patients underwent lower -pole pyeloplasty.Removal of renal moiety was performed in 52 cases:43 patients underwent upper -pole heminephrectomy,8 patients underwent upper pole hemi-nephrectomy and lower -pole ureter reimplantation,and 1 case of the patients had upper -pole heminephrectomy and lower -pole ureteroplasty.Results A total of 54 cases were followed up,the follow -up rate reached 65.9%,the follow -up time lasting 2 months to 4 years,with an average time of 9.53 months.All clinical symptoms disappeared after remove moiety operation.There were small ureteral cysts but compared with the preoperative condition,the symp-toms reduced significantly in 4 cases.All clinical symptoms disappeared in patients whose nephron was retained after operation,and hydronephrosis was alleviated.De novo 2 degree of vesicoureteral reflux was found in 3 out of 1 2 pa-tients who underwent transurethral puncture of the cyst.Conclusions The clinical manifestations of duplex kidney have some characteristics which include recurrent urinary tract infection,normal intermittent voiding urine dripping, abdominal pain,urethral orifice mass,abdominal mass and aggravation of hydronephrosis.Duplex kidney is often asso-ciated with cardiac malformation and cryptorchidism.The preoperative testicular examination and echocardiography should be performed.The choice of operation depends on the clinical manifestation,auxiliary examination results and comprehensive analysis.The prognosis of duplex kidney is well,but patients need to be further followed up af-ter operation.

Congenital hydronephrosis is the main cause of childhood chronic renal disease and renal failure,which is also one of the most common anomalies in pediatric urology division.Although the operation is performed to treat obstruction,the renal function of patients get worse and worse,postoperatively.Up to date,there are lots of controversies in evaluation of hydronephrosis and treatment at prenatal and postnatal.According to recent articles,the recent examinations,evaluation system,follow-up and treatment strategies of hydronephrosis are introduced.

Recently studies have shown that ketamine given to patients under mechanical ventilation and background anesthetics without adversely altering cerebral hemodynamics. More studies have also shown ketamine has neuroprotective effects. The main mechanisms may involve changing the expression of apoptosis-regulating proteins, inhibiting the toxicibility of excitatory amino acid and decreasing Ca2+ influx by blockade of NMDA receptors activation. It can also inhibit proinflammatory cytokine production induced by tissue ischemia and affect the protein kinase phosphorylations related to cerebral ischemia, etc..

Objective To explore the preventive and therapeutic effects of diminazene (DIZE) on pulmonary arterial hypertension (PAH) in rats.Methods Left pulmonary lobectomy combined with injection of monocrotaline was used to establish a rat model of pulmonary arterial hypertension.One hundred adult male Wistar rats were randomly divided into blank control group (group A,n=20),DIZE control group (group B,n=20),PAH model group (group C,n=20),PAH model plus DIZE group (group D,n=20) and PAH model plus DIZE and C-16 group (group E,n=20).Angiotensin-converting enzyme 2 (ACE2),IL-6 and IL-8 levels were determined by fluorescence resonance energy transfer (FRET) and enzyme linked immunosorbent assay (ELISA),and the mean pulmonary arterial pressure (mPAP) and right ventricular hypertrophy index (RVHI) were measured.The wall thickness (WT) and intimal hyperplasia score were calculated,and the pulmonary vascular lesions were analyzed using elastic fiber staining.Results RVHI,ACE2 enzyme activity and WT in the group A were significantly different from those of the groups C,D and E (P<0.05).Those of the group D and E were significantly different (P<0.05).The five groups showed significant differences in the overall analysis of each index (P<0.05).Conclusions Diminazene can increase the ACE2 enzyme activity,and decrease the mPAP,RVHI and WT,while reducing the pulmonary arterial medial hypertrophy,and inhibit intimal hyperplasia of pulmonary arterioles.The results of this study provide an experimental basis for the use of diminazene in the treatment of human pulmonary hypertension.

As one of the most major disease,malignant tumor is harmful to human health.Althought it' s exact pathogenesis is still not clear,it is certainly that the formation of cancer is typical of containing many factors and having gone through many steps.Resulting from the abnormal activation of a series of proto-oncogene as well as the inactivation caused by many anti-oncogene mutation,some signal pathways work abnormally.In recent years,the study of Hedgehog ( Hh),as the signal pathway,shows that Hh encodes a series of secreted signaling protein,having an important effect on the differentiation and proliferation of cells in the process of embryogenesis.The occurrence of abnormal activation of Hh signaling pathway plays a significant role in the process of tumorigenesis.Signal paths of Hh signaling protein include as much as following at least:patched(Ptch),smoothened (Smo),fused (Fu),suppressor of fused (SuFu),costaⅠ-2 (Cos)-2 and cubitus interruptus (Ci) and so on.In this paper,the function of Hh genetic family and the mechanism of its relation to many kinds of human cancers will be givien a brief overview.

Objective To evaluate therapeutic effect and safety of hysteroscope operation in treating hysteromyoma. Methods 146 patients were subjected to transcervical resection of myoma (TCRM), curative effects were evaluated as satisfaction or dis-satisfaction according to the degree of bleeding control, the rate of growth of myoma and the need of subsequent surgery. Results The total satisfactory rate is 95%. and satisfactory rate of type 0 and Ⅰ reached 100%. There was no complication in all patients. Conclusion TCRM is the best choice in treating submucous myoma. The results of surgery were satisfactory to intramural myoma if gasp the indictions. Selecting proper indications for operation, B ultrasonic monitoring severity are important for ensuring the operation effect and safety.

Objective To evaluate the clinical value of the quantitative detection of plasma 1,3-β-D-glucan in penicilliposis marneffei. Methods The 1,3-β-D-glucan concentrations were detected by using a G test. Results In 60 New Zealand rabbits infected by Penicillium marneffei,the levels of 1,3-β-D-glucan were positively correlated with infectious severity. The sensitivity, specificity, positive predictive rate and negative predictive rate were 88.3%、100%、 100% and 58.8% respectively,which were significantly higher than those of the control group(P <0.01 ).Conclusion The quantitative method for the detection of 1,3-β-D-glucan in plasma was simple,sensitive and reliable, and could be used as the assisting diagnosis of penicilliposis marneffei at early stage.

Objective To discuss the value of emergency bedside ultrasound in diagnose of blunt abdominal injury. Methods Portable ultrasound was used in 184 patients with blunt abdominal trauma in emergency department. The abnormal changes of the sound and image of the abdomen were observed,paying equal attention to free intraperitoneal fluid and gas. Results The emergency bedside ultrasound identified 169 (91.8%) patients with blunt abdominal injury, of whom 149 patients (95.5%) with single-organ injury and 20 patients (71.4%) with multi-organ injury. There were 21 patients missed diagnosis and three misdiagnosed, with rate of missed diagnosis and misdiagnosis of 13%. Surgical treatment was performed in 119 patients and conservative treatment in 65, which were proved by CT/MRI examination or clinic conservative treatment. Conclusion Emergency bedside ultrasound can provide fast and credible diagnostic information for blunt abdominal trauma, with high diagnosis accordance rate.