OBJECTIVETo investigate the therapeutic effects of manipulative reduction for calcaneal fractures.

METHODSFrom January 2009 to June 2012, 53 cases (60 affected feet) of Sanders type I-IV calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of (33.5 +/- 1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling, ache and activity limitation in evidence, some feet were wide flat deformity, the cortical bone was broken in the imaging examination. All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus.

RESULTSAll cases were followed up at 12 months after treatment, 13 feet got excellent curative effect, 34 good, 11 moderate and 2 poor.

CONCLUSIONManipulative reduction for Sanders type I-IV calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy, but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; External Fixators ; Female ; Fractures, Bone ; rehabilitation ; surgery ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Splints

Background Femtosecond laser in situ keratomileusis (LASIK) inevitably injury keratocytes and corneal nerve fibers.The research report about postoperative morphological changes of corneal nerve regeneration and keratocytes in femtosecond LASIK is still rare.Objective The aim of this study was to observe the kinetic changes of keratocytes and corneal nerve in corneal flap after femtosecond LASIK.Method Femtosecond laser manufacture corneal flap of LASIK surgery was performed on 60 eyes of 30 patients with refractive error using both femtosecond laser system and excimer laser treatment system.The repair of corneal wound was examined by slit lamp microscope,and the morphology of keratocytes and corneal nerve were observed with confocal microscope 1 week,1month,3 months after surgery,respectively.Results No haze or flap folds were found under the slit lamp microscope from 1 week through 3 months after operation.One week after surgery,the corneal stromal cells at the interface of the corneal flap appeared to be a mild activation status in 42 eyes (70％),but the activated cells gradually reduced with lapse of time.Three months after surgery,mild activation state still was found in 7 eyes (12％).One week after surgery,independent,short (＜50 μm),curved subbasal nerve fibers were exhibited in 7 eyes (12％),and curved filamentous nerve fibers were discovered in 48 eyes (80％) one month after surgery.The nerve fiber length of subbasal nerve was ＞200 μm in 27 eyes (45％) and classes beaded structure appeared 3 months after operation but were still different with preoperative subbasal nerve fibers.One week after the operation,filaments or discontinuous nerve fibers could been seen in 46 eyes (77％) at theinterface,and long nerve fibers or filamentous nerves were visible around the terminal or periphery of nerve fibers in 49 eyes (82％) one month after surgery,and long nerve fibers or filaments of nerve fibers were visible in 57 eyes (95％) 3 months after the surgery.Conclusions Femtosecond LASIK cause wound reaction at cellular level.Corneal nerve fibers recover with the extension of time,but there are still some morphological differences 3 months after surgery from preoperation.

OBJECTIVETo explore the therapeutic effects and complications of manipulative reduction and hard paper splints in treating forearm double fracture.

METHODSFrom November 2005 to December 2010,38 patients with forearm double fracture were treated with manipulative reduction and hard paper splints immobilization, including 26 males and 12 females, aged from 18 to 66 years (averaged 28 years). The time from injury to manipulation was 20 min to 2 d with an average of 8 hours. Before treatment, the patients manifested swelling, pain, deformity,abnormal activity of injured limbs, dysfunction of elbow and wrist extension-flexion and forearm supination-pronation; X-rays showed fractures occurred in radius and ulna. Fracture healing, flexion function of elbow and wrist, supination-pronation function of forearm were used to evaluated the therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 3 to 8 months,with a mean of 5.7 months. According to Anderson grade criterion of forearm fractures, 33 cases were excellent and fracture healing, which loss of elbow or wrist flexion and extension ranging <10% and forearm rotation <25%; 5 cases were good and fracture healing,which loss of elbow or wrist flexion and extension ranging <20% and forearm rotation loss <50%; there was no dissatisfactory or failure cases.

CONCLUSIONThis method makes the fixation firmly, safely and utility, prevents the sore of pressing and necrosis, and worths further clinical applications.

Adolescent ; Adult ; Aged ; External Fixators ; Female ; Forearm Injuries ; therapy ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Splints

OBJECTIVETo explore clinical effects of manipulative reduction with minimally invasive percutaneous plate osteosynthesis in treating distal tibiofibular fractures.

METHODSFrom 2009 to 2011, 60 patients with distal tibiofibular fractures were treated by manipulative reduction with minimally invasive percutaneous plate osteosynthesis. Among them, there were 32 males and 28 females aged from 14 to 70 years old with an average of 41.22 +/- 2.06. According to AO classification of fractures,5 cases were type A1, 22 cases were type A2,21 cases were type A3 and 12 cases were type C1. Operation time, blood loss,time of callus and fracture healing were observed, Mazur scoring of ankle joint were used to evaluate therapeutic.

RESULTSFifty-eight incisions were healed at stage I ,and 2 cases were infected at distal tibial. Operation time was with an average of (62.34 +/- 5.66) min ranged 45 to 90 min;blood loss was 30 to 150 ml with an average of (80.57 +/- 5.59) ml;formation of callus appeared from 4 to 12 weeks,with an average of (8.24 +/- 2.06) weeks, and fracture healing time was from 3 to 6 months, with an average of (4.50 +/- 1.13) months. According to Mazur scoring of ankle joint 40 cases got excellent results, 18 good, and 2 fair.

CONCLUSIONManipulative reduction with minimally invasive percutaneous plate osteosynthesis can obtain reliable fixation. It is a good choice of treating distal tibiofibular fractures by protecting blood supply of fractures.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective To explore the influence of Multi-slice spiral CT combined with plasma carbohydrate antigen 199 (CA199) ,carbohydrate antigen 242 (CA242) ,carbohydrate antigen 50 (CA50) levels detection on diagnostic accuracy of pancreatic cancer .Methods 77 cases of patients with pancreatic lesion treated in our hospital were studied ,and all were confirmed by surgery ,there were 48 cases of pancreatic carcinoma ,29 cases of pancreatic benign diseases .All the patients were undergoing CT testing .Plasma CA199 ,CA50 and CA242 levels were detected by using Radioimmunoassay method ,and plasma CA199 ,CA50 ,CA242 levels ,CT test re-sults ,and the efficacy of single test diagnosis were contrasted .Results After CT diagnosis ,there were 8 cases positive in the benign group ,39 cases positive in the pancreatic cancer group ,with the overall positive rate of 61 .04%,and the coincidence rate was 77 .92% when compared with the operation and pathological results . Plasma CA199 ,CA50 and CA242 in the pancreatic cancer group were higher than those in the benign group , the difference was statistically significant (P＜0 .05) .Surgical pathological diagnosis was as the gold stand-ard ,the coincidence rate of CA199 was 75 .32% in the highest ,and the coincidence rate of CA242 was 45 .75%in the lowest .Compared with those in the single plasma CA199 ,CA50 ,CA242 detection ,the accuracy and sen-sitivity of combined diagnosis ,and missed diagnosis rate decreased ,the difference was statistically significant (P＜0 .05) .Those were slightly higher than those of CT detection ,but without statistically significant differ-ence (P＞0 .05) .There was no significant difference in specificity and misdiagnosis rate among different diag- nostic ways (P＞0 .05) .Conclusion The accuracy and sensitivity of multi-slice spiral CT is higher in diagnosis of pancreatic cancer ,but combined detection of plasma CA199 ,CA50 and CA242 can further improve diagnosis efficiency ,and provide a reference for clinical treatment of pancreatic cancer .

OBJECTIVETo discuss the method, the advantages and disadvantages of endoscopic thyroidectomy.

METHODSEndoscopic thyroidectomy via areola of breasts approach was performed in 150 patients, including 41 cases of thyroid adenoma, 64 cases of nodular goiter, 40 cases of Graves' disease, and 5 cases of thyroid carcinoma.

RESULTSThe endoscopic thyroidectomy was successfully carried out in 144 cases, including tumor dissection in 32 cases, one lobe partial thyroidectomy in 54 cases, two lobe partial thyroidectomy in 19 cases, subtotal thyroidectomy in 37 cases of Graves' disease, and radical thyroidectomy in 2 cases of thyroid carcinoma. The operative time length ranged from 50 to 270 min (mean 80 min). There were no complications such as damage to recurrent laryngeal nerve or parathyroid glands. Postoperative hospital stay ranged from 3 to 7 days (mean 4 days). The post-operative following-up for 1 approximately 13 months indicated that all the patients were satisfied with the cosmetic results and the same curative effects as conventional surgery were obtained. However, the operations were converted into open surgery in 6 cases.

CONCLUSIONSEndoscopic thyroidectomy is a safe and effective method of thyroid surgery. Since all the minimal incisions are on concealed parts of the body, the obvious cosmetic effect of this method is guaranteed.

Adolescent ; Adult ; Endoscopy ; Female ; Follow-Up Studies ; Graves Disease ; surgery ; Humans ; Male ; Thyroidectomy ; methods ; Treatment Outcome

OBJECTIVE: To explore clinical efficicacy of closed manipulative reduction and external fixation with cardboard splint in treating Monteggia fracture. METHODS: Fifty-eight children with Monteggia fracture were underwent closed manipulative reduction and external fixation with cardboard splint from January 2010 to Junuary 2018. Among them, including 37 males and 21 females, aged from 3.5 to 12 years old with an average of (8.48±2.29) years old;the courses of disease ranged from 0.5 hours to 9 days with an average of (4.21±1.46) days. Broberg and Morrey scores before treatment, 1, 3 and 6 months after treatment were used to evaluate clinical effects. RESULTS: All children were followed up from 1 to 6 months with an average of (3.35±2.12) months. Broberg and Morrey score (7.24±2.81) before treatment, (32.06 ±8.33) at 1 month after treatment, (73.18±5.56) at 3 months after treatment and (95.87±6.75) at 6 months after treatment; there were statistical differences at each time points after treatment with before treatment ( CONCLUSION Treatment of Monteggia fractures with closed manipulative reduction and external fixation with cardboard splint could reach integration of motion and quietness, also could remove external fixation at early stage, and get obvious short-term and medium-term therapeutic results.
Child ; Child, Preschool ; External Fixators ; Female ; Fracture Fixation ; Fracture Fixation, Internal ; Humans ; Male ; Monteggia's Fracture/surgery* ; Reconstructive Surgical Procedures ; Splints ; Treatment Outcome

OBJECTIVETo evaluate the feasibility of kidney biopsy by transgastric and transvesical combined approach in the porcine model.

METHODSFive female pigs (20 to 30 kg) were included in this study. All procedures were performed with pigs under general anesthesia. The transvesical access was established by the ureteroscope. Then monitored by ureteroscopy, the transgastric access was established by a needle knife with cautery. The puncture dilation was performed with balloon through the gastroscope. The vesical hole was enlarged with the dilator of ureteroscope sheath. The kidney biopsy was finished by the scissor from the transvesical access and the grasping forcep from the work channel of gastroscope.

RESULTSAmong five cases the procedure were successful in three cases with 380 min, 180 min, 78 min respectively. Establishment of transvesical and transgastric accesses took place without complications. The exposure and biopsy of the kidney were easily achieved during operation. The transgastric and transvesical access were not closed in the end.

CONCLUSIONSThis new method is a technically feasible procedure in a porcine model. But the safety and the clinical future of it needs more study.

Animals ; Biopsy, Needle ; methods ; Female ; Gastroscopy ; Kidney ; pathology ; Swine ; Ureteroscopy

OBJECTIVETo evaluate the feasibility of no antibiotic administration to prevent infection during the perioperative period of percutaneous intradiscal ozone-injection for treatment of lumbar disc herniation.

METHODSSeventy-two patients with lumbar disc herniation but normal body temperature as well as normal results of three routine tests (blood, urine, stool) and C-reactive protein (CRP) level were randomly divided into two groups. The patients in prophylaxis group were given cephalothin V(2.0 g) intravenous 30 min before the operation, and the control group did not use any antibiotics. All the patients were injected with 6-10 ml ozone (40 microg/ml) for medical use into the discs with 21G needles under fluoroscopic guidance, followed by 10 ml ozone into the paravertebral space. Three days later the general examinations and CRP measurement were repeated.

RESULTSNo infection was found in these patients, nor were any significant differences noted in the results of the examinations between the two groups after controlling in patients with above-normal white blood cell count, neutrophil percentage and CRP level.

CONCLUSIONProphylaxis antibiotics is not necessary during the perioperative period of percutaneous intradiscal ozone injection for lumbar disc herniation.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Cefazolin ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Injections, Intralesional ; Intervertebral Disc Displacement ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Oxygen ; administration & dosage ; Ozone ; administration & dosage ; Perioperative Care ; Radiography

Based on standard carotid endarterectomy, we performed modified carotid endarterectomy in two cases of carotid artery stenosis by changing the direction of the carotid artery incision to avoid restenosis of the internal carotid artery without using a patch. The two patients recovered smoothly without any complications. Compared with eversion or patch endarterectomy, this modified carotid endarterectomy avoids restenosis of the carotid artery and shortens operation time.