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

OBJECTIVETo evaluate the clinical results of dorsal approach and Weil osteotomy in treating the injury of the plantar plate in second metatarsophalangeal joint.

METHODSEight feet with plantar plate tear in five cases were treated by plantar plate repairment through dorsal approach and Weil osteotomy from June 2012 to December 2013. The mean age of the patients was 52 years old. All the patients were followed up for 6 to 12 months. American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) were used to evaluate the clinical effect.

RESULTSThe second metatarsophalangeal joint stability recovered and the pain released in all patients. Postoperative VAS was lower and AOFAS was higher than preoperative.

CONCLUSIONCombined dorsal approach and Weil osteotomy can effectively release the pian of plantar plate, stabilize the metatarsophalangeal joint, decrease the incidence rate of postoperative subluxation and anchylosis in treating plantar plate tears in the second metatarsophalangeal joint.

Female ; Humans ; Joint Instability ; surgery ; Metatarsophalangeal Joint ; injuries ; surgery ; Middle Aged ; Osteotomy ; methods ; Plantar Plate ; injuries

OBJECTIVE:To study the decoction rate changes of 4 active ingredients in the volatile oil of Curcuma phaeocaulis before and after combined with Sparganium stoloniferum,and provide reference for showing the compatibility mechanism of C. pha-eocaulis and S. stoloniferum. METHODS:HPLC was used to simultaneously determine the contents of 4 active ingredients(curdi-one,curcumol,germacrone and β-elemene) in the volatile oil of C. phaeocaulis after C. phaeocaulis single decoction and com-bined decoction with S. stoloniferum. And the fried rates of each ingredient were compared. RESULTS:Compared with C. phaeo-caulis single decoction,there was significant difference in the fried amounts of curdione,curcumol,germacrone in the volatile oil after combined decoction(P<0.05)and no significant difference in fried rate ofβ-elemene(P>0.05). CONCLUSIONS:The com-bined decoction of C. phaeocaulis and S. stoloniferum can effectively improve the dissolution of curdione,curcumol,germacrone in the volatile oil. It may be the reason for the enhancement of efficacy after compatibility.

OBJECTIVE:To study the preventive and therapeutic effect and its mechanism of medicine pair decoction liquid of Curcuma phaeocaulis-Sparganium stoloniferum on rats with uterine myoma. METHODS:Rats were randomly divided into normal group,model group,positive group(mifepristone,2.25 mg/kg)and medicine pair decoction liquid group(C. phaeocaulis-S. stolon-iferum decoction liquid,6.0 g/kg),10 in each group. Except for the normal group,rats in other groups were injected Estradiol ben-zoate injection (0.5 mg/kg) intramuscularly every Monday,Wednesday and Friday,for 12 weeks. From the 13th week,rats in modeling group were added Progesterone injection(5 mg/kg)intramuscularly as well as relevant medicines intragastrically,once a day,until the 16th week. After administration,uterine coefficient of rats was detected. HE staining was used to observe the patho-logical changes of uterus and determine the thickness of smooth muscle;immunohistochemical staining was adopted to detect the transforming growth factor β3 (TGF-β3),matrix metalloproteinase 11 (MMP-11) protein expressions in uterus tissue of rats. RE-SULTS:Compared with normal group,uterine coefficient was increased in model group,pathological changes were obvious in uterus,thickness of smooth muscle was increased,TGF-β3 and MMP-11 protein expressions were enhanced(P<0.05 or P<0.01). Compared with model group,above-mentioned changes were improved significantly in positive group and medicine pair decoction liquid groups(P<0.05 or P<0.01). CONCLUSIONS:Medicine pair decoction liquid of C. phaeocaulis-S. stoloniferum shows cer-tain preventive and therapeutic effect on rats with uterine myoma. The mechanism may be associated with downregulating the TGF-β3,MMP-11 protein expressions in uterus tissue.

OBJECTIVETo investigate the expression profile of interleuki-1β (IL-1β) in rat myocardium at different time points during hypoxia/reoxygenation(H/R)transition.

METHODSThe isolated Langendorff perfused rat heart model was established.Forty SD rats were randomly divided into sham group (A group) and hypoxia/reoxygenation group (H/R group). The H/R group rats were subdivided into H/R 0.5 h group(B group), H/R 1 h group(C group), H/R 2 h group(D group)according to reoxygenation time. The left ventricular development pressure(LVDP), maximal rates of increase/decrease of the left ventricular pressure(±dp/dtmax) were continuously recorded. The concentration of interleukin-1β(IL-lβ) and creatine kinase-MB (CK-MB) in myocardium was measured by ELISA. The mRNA expression of IL-lβ in myocardium was determined by RT-PCR. Microstructure of myocardium was observed under light microscopy.

RESULTSThe value of LVDP and ±dp/dtmax in hypoxia/reoxygenation group rat were significantly lower than that in sham group(P < 0.05). The expression of IL-lβ and CK-MB at protein level and the expression of IL-1β at mRNA level in hypoxia /reoxygenation group were higher than that in sham group(P < 0. 05). There were significant differences of the above parameters among H/R 0.5 h, 1 h, 2 h group(P <0.05). The concentration of IL-1β and CK-MB, the mRNA expression of IL-1β were higher in H/R 2 h group than that of other groups(P < 0.05).

CONCLUSIONThe high expression of IL-Iβ in myocardium after myocardial hypoxia /reoxygenation in rats might lead to. ischemia/reperfusion injury.

Animals ; Creatine Kinase, MB Form ; metabolism ; Disease Models, Animal ; Hypoxia ; metabolism ; pathology ; Interleukin-1beta ; metabolism ; Myocardial Ischemia ; metabolism ; Myocardium ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVESignificant cardiac dysfunction has been found in children with severe hand-foot-mouth disease and heart failure is the major cause of death in these patients. Evaluation of cardiac function is essential for the treatment of severe cases. This study evaluated the clinical value of cardiac output monitoring in children with severe hand-foot-mouth disease.

METHODSA total of 107 children with severe hand-foot-mouth disease admitted to the pediatric intensive care unit from April 2011 to September 2011 were enrolled and divided into three groups by clinical stage: 73 cases in stage 2, 23 cases in stage 3 and 11 cases in stage 4. Cardiac output and stroke volume were measured by ultrasonic cardiac output monitors (USCOM). Ninety-five children received MRI scanning and were grouped according to the results of MRI: 41 cases (medulla oblongata involvements in 9 cases) in abnormal MRI group and 54 cases in normal MRI group. Cardiac output was compared between the children in different clinical stages and between different MRI results.

RESULTSCompared with children in clinical stages 2 and 3, cardiac output in children in clinical stage 4 decreased significantly (P<0.05). There was no differences in cardiac output between the normal and abnormal MRI groups, however cardiac output was significantly lower in children with medulla oblongata involvement than in those with other involvements and normal MRI.

CONCLUSIONSSignificant decrease in cardiac output suggests critical conditions and medulla oblongata cardiovascular center involvement in children with severe hand-foot-mouth disease. Dynamic measurement of cardiac output is valuable for treatment of the disease.

Cardiac Output ; physiology ; Child ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; physiopathology ; therapy ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Monitoring, Physiologic

OBJECTIVETo study the assessment and management for abdominal aortic aneurysm (AAA)'s special distal landing zones in endovascular repair (EVAR).

METHODSThe clinic data of 66 AAA patients with complicated distal landing zones From January 2007 to December 2010 was retrospectively analyzed. There were 45 male and 21 female patients, aged from 53 to 87 years with a mean of 62 years. All patients underwent the CT angiography examination (1 to 2 mm interval) to obtain the necessary anatomical data. In this group, there were 20 cases with type I and IIA lesions, including 10 cases with narrow common iliac arteries/external iliac arteries (> 50%), 6 cases with seriously distorted common iliac arteries/external iliac arteries, 4 cases with the characters of the above, 16 cases with bilateral common iliac aneurysms, 46 cases with bilateral common iliac aneurysms combined internal iliac aneurysms (unilateral 32 cases, bilateral 14 cases). The vascular stent-grafts' usage was as follow: Metronic 46 cases, COOK 14 cases, Microport 4 cases, Lifetech 2 cases.

RESULTSThe mean operative time was 90 min. There were significant stent-graft shortening in 22 cases (33.3%), type II endoleak in 18 cases (27.3%), type III endoleak in 5 cases (7.6%), iliac stents' stenosis (> 50%) in 2 cases (3.0%), type II combined with type III endoleak in 5 cases (7.6%), iliac stents' stenosis combined with type III endoleak in 4 cases (6.1%). Patients were followed for a mean of 22 months (range from 3 to 36 months), during the time of follow-up, the following conditions were observed: stent-graft displacement (to the remote < 10 mm) in 2 cases (3.0%), iliac stents restenosis (> 50%) 2 cases, type II endoleak healed in 18 cases (18/23, 78.3%), and no type III endoleak remained. The fatality rate was 3.0% (2/66).

CONCLUSIONSSpecial distal landing zones increased the operative complication rate in EVAR. Being familiar with the features of stent-graft and appropriate use of various surgical management can increase the success ratio of EVAR.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

OBJECTIVETo evaluate the effect of importing triamcinolone acetonide into hypertrophic scars with skin roller needles.

METHODSThirty-two cases with burn hypertrophic scar were treated. The skin roller needles were moved back and forth on the hypertrophic scars with triamcinolone acetonide dropping on the scar surface at the same time. So the triamcinolone acetonide could be imported into the scar through needles and needle holes. The effect was evaluated as cured, effective, and no effect. The Vancouver scaring criteria and visual analogue scale was used to assess the scar color, thickness, texture and feeling before and after treatment, as well as at the untreated scar area (control).

RESULTSThirty-two cases were treated 1-3 times, including 28 cases with cured result and 4 cases with effective result. The total effective rate was 100%. The scar color, thickness, texture and feeling was significantly different between the scar before and after treatment, or between the treated and untreated scar (P < 0.05).

CONCLUSIONSImporting triamcinolone acetonide into hypertrophic scars with skin roller needles is effective. It is a new method for the treatment of large hypertrophic scar with medicine.

Burns ; complications ; Cicatrix, Hypertrophic ; drug therapy ; etiology ; Humans ; Injections, Intralesional ; instrumentation ; Needles ; Treatment Outcome ; Triamcinolone Acetonide ; administration & dosage

OBJECTIVETo study the expression of carbonic anhydrase (CA) IX and its significance in molecular subtyping of breast carcinomas. METHODL MaxVision immunohistochemical staining was used to examine the expression of ER, PR, HER2, CK5/6, EGFR, and CA IX in 117 cases of breast invasive ductal carcinomas.

RESULTSThe patients' age ranged from 25 to 71 years (mean 49.6 years). All the 117 cases were subclassified into five subtypes, with 66 (56.4%) luminal A, 6(5.1%) luminal B, 10 (8.6%) HER2 positive, 20 (17.1%) basal-like, and 15 (12.8%) unclassified tumors. The expression of CA IX in luminal A and basal-like breast cancers was 13.6% (9/66) and 8/20, respectively, with a significant difference (P < 0.05). Among the luminal A cancers, the expression of CA IX in tumors > 2 cm (7/27, 25.9%) was significantly (P < 0.05) higher than that of tumors ≤ 2 cm (2/39, 5.1%). The expression of CA IX in grade 3 invasive ductal carcinoma (18/50, 36.0%) was significantly higher than that in grade 1 (2/21, 9.5%) and 2 (7/46, 15.2%) tumors (both P = 0.006). In CA IX-negative of invasive ductal carcinoma, the expression of ER and PR was 61.1% (55/90) and 55.6% (50/90), respectively; whereas in CA IX-positive cancers, the expression of ER and PR was 37.0% (10/27) and 29.6% (8/27), respectively. The expression of hormone receptors in CA IX-negative tumors was significantly higher than that in CA IX-positive tumors (for both ER and PR, P < 0.05).

CONCLUSIONSThe expression of CA IX correlates not only with molecular subtypes of breast cancer, but also with the grading, hormone receptors and diameter of mammary invasive ductal carcinoma. CA IX is a relative independent marker of poor prognosis in breast cancer.

Adult ; Aged ; Antigens, Neoplasm ; metabolism ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; classification ; metabolism ; pathology ; Carbonic Anhydrase IX ; Carbonic Anhydrases ; metabolism ; Carcinoma, Ductal, Breast ; classification ; metabolism ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Grading ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Tumor Burden

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; surgery ; Alkaline Phosphatase ; metabolism ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Endodermal Sinus Tumor ; metabolism ; pathology ; surgery ; Female ; GPI-Linked Proteins ; metabolism ; Glypicans ; metabolism ; Humans ; Isoenzymes ; metabolism ; Keratin-7 ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; secondary ; Middle Aged ; Mucin-1 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; alpha-Fetoproteins ; metabolism