OBJECTIVETo study clinical effects of the over-articular external fixator combined with limited internal fixation for the treatment of Pilon fractures caused by high energy.

METHODSFrom September 2003 to April 2011, 36 patients with Pilon fractures caused by high energy were treated with the over-articular external fixator combined with limited internal fixator. There were 25 males and 11 females, ranging in age from 16 to 72 years old,with an average of 38 years old. The diagnoses of all patients were determined by conventional X-ray examination or three-dimensional spiral CT examination. The AOFAS scoring criteria was used to evaluate the therapeutic effects. The patients with comminuted fractures were treated with screw or Kirschner wire fixation without uncovering periost so as to enhance stability between fracture end and bone blocks,followed by the fixation with over-articular external fixators.

RESULTSAll the patients were followed up, and the duration ranged from 4 to 27 months, with an average of 13 months. Thirty-two patients got wound healing at the first stage. And the bone union duration ranged from 2 to 6 months, with a mean of 3 months. According to the AOFAS ankle-hindfoot subjective scoring standard, 13 patients got an excellent result, 20 good and 3 fair, with an score of 88.2 +/- 3.6. Twelve patients had infections at pinhole, 5 patients had pinhole pain. One patient had the fixator broken induced by over loading, who was cured after treatment. There were no complications such as nerve or vascular injuries, or osteomyelitis.

CONCLUSIONThe over-articular external fixation combined with limited internal fixation for the treatment of Pilon fractures caused by high energy is an ideal method, which has such advantages as reliable fixation, simple operation, coincidence with principles of biomechanical fixation, and benefit for fracture healing.

Adolescent ; Adult ; Aged ; Ankle Injuries ; diagnostic imaging ; surgery ; Ankle Joint ; diagnostic imaging ; surgery ; External Fixators ; Female ; Fracture Fixation ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

OBJECTIVETo explore methods and clinical effects of composite external fixtor in treating adult patients with unstable middle 1/3 of clavicular fractures.

METHODSFrom March 2008 to March 2011,36 patients with unstable middle 1/3 of clavicular fractures were treated with composite external fixtor. There were 24 males and 12 females, aged from 18 to 55 years old with an average of 43 years old. Twenty cases on the left side and 16 cases on the right side. Time from injury to operation was 2 to 6 days (averaged 3.5 days). According to Robinson classification, there were 7 cases with type 2A2, 18 cases with type 2B1, and 11 cases with type 2B2. No vessels and nerve damage occurred before opreation. The clinical effects were evaluated according to Neer scoring.

RESULTSAll cases were followed up from 6 to 12 months with an average of 8 months. The mean Neer score was 88.3 +/- 6.2, which included pain 31.6 +/- 3.2, functional score 25.7 +/- 2.2, range of motion score 21.1 +/- 1.7, and anatomy score 8.8 +/- 0.8. There were 22 cases in excellent, good in 13, fair in 1. Two cases occurred pin tract infection.

CONCLUSIONComposite external fixtor is an optional method in treating unstable middle 1/3 of clavicular fracture, and can obtain a good clinical effects.

Adolescent ; Adult ; Bone Nails ; Clavicle ; injuries ; surgery ; External Fixators ; Female ; Fracture Fixation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

Objective To observe the treatment effects of the ultrashort wave diathermy on gentamycin-in- duced acute renal injury of rats.Methods Eighteen Sgrague-Dawley rats were randomly divided into a normal group(6 rats),a model group(6 rats)and a treatment group(6 rats),the treatment group was treated with ultra- short wave diathermy once a day for a total of 20 days.The observed indexes were NAG,RBP,?_1-MG,?_2-MG in the urine of rats;the SCr,BUN in the blood of rats were also tested and the pathological changes of the renal ob- served.Results The pathological injuries of those in the ultrashort wave treatment group was slighter than the con- trol group;the NAG,RBP,?_1-MG,?_1-MG in the urine and the SCr,BUN in the blood of treatment group were low- er than those of the model group(P

The nitrite-reducing activity of aerobic denitrifying bacterial strain N6-1 was studied. It showed that the nitrite-reducing activity reached the highest at 30℃, 120 r/min, pH 8.5 and C/N ratio 12, using CH3COONa and NaNO2 as the sole carbon source and nitrogen source, respectively. When the initial NaNO2 concentration was 2 g/L, NO2--N was reduced completely after 20 hours cultivation with the reducing rate of 20.3 mg/L?h. There would be no effect on its nitrite-reducing activity in the present of 1.5% NaCl or 1% peptone. The cell concentration could reach 1.2?1011 CFU/mL after 24 hours cultivation in 10 L fermentor.

Objective To establish the anti-infective tissue engineered bones (TEBs) and evaluate the anti-infective and osteogenic effects of the infection-prevention TEBs on femoral large bone defects in goats.Methods Based on the controlledrelease antibiotic system fibrin gel-coated vancomycin alginate beads (FG-Vanco-AB),the infection-prevention TEBs were established and evaluated.They were transplanted into the critical-size defects in the right femurs of goats.TEBs without the controlled-release antibiotic system were used as controls and transplanted into the left femoral defects.The breakpoint sensitivity of vancomycin (5 mg/mL) for S.aureus was used as a standard concentration.Postoperatively,the vancomycin concentrations in the lesion site,in the adjacent site and in the circulation,as well as the anti-infective effects of the infection-prevention TEBs were evaluated by High-performance liquid chromatography (HPLC).Bone hcaling was assessed by histology,CT and ECT.The results were used to evaluate the osteogenic effect of the infection-prevention TEBs.Results Results from ESM,CLSM and in vivo tracing showed that the in vitro and in vivo survival conditions of seeded cells were analogous to those of TEBs.The effective concentration (over the bactericidal concentration) of vancomycin in bilateral defects and in blood lasted for 28 days,2 days and 7 days,respectively.The concentration of vancomycin in the femur decreased gradually from the grafted site to both ends.At 28 and 56 days postoperatively,the ECT results showed no significant difference between the right and left femurs.CT and histology demonstrated that at 14,28 and 112 days after surgery,bone defects in the bilateral femurs were repaired synchronously,and were completely covered by new bone tissue after 112 days.Conclusion The anti-infective TEBs were successfully established.FG-Vanco -AB in the transplanted sites provided the local bone tissues with anti-infective capability whilst not interfered the process of bone reconstnction and wound healing.

Objective To observe the long term effects of arthroscopic knee debridement and reconstructing operation for treating osteoarthritis in patients with Kaschin-Beck disease. Methods Thirty-one cases of patients with Kaschin-Beck disease were followed for 6 years after operation of articular clearing by arthroscope. Index of pain, symptoms of self-evaluation, range of motion, walking distance, standing test by affected leg when bending at 30° or 60° were recorded and compared with the preoperative results. Results Twenty-four cases were followed up for 6 years. Six years after operation the pain index(3.38 ± 2.87) was dramatically decreased compared to that before operation (6.88 ± 1.45, t = 5.30, P ＜ 0.05). Patients symptoms markedly improved by subjective self-evaluation was 70.83% (17/24), the effective rate was 100% (24/24). The number of cases that could stand up when leg bending at 30° or 60° were 21,18 cases, respectively, compared with that of preoperative of 14, 11 cases, respectively, the difference was statistically significant(x2 = 5.17,4.27, all P ＜ 0.05). Six years after operation the walking distance(3 cases ＜ 1 km, 11 cases 1 - 5 km and 10 cases ＞ 5 km) were greatly improved compared to the results before operation (12 cases ＜ 1 km, 9 cases 1 - 5 km and 3 cases ＞ 5 km, U = 2.88, P ＜0.05). Six years after operation the knee activity[(132.25 ± 14.52)°] remained at the same level, compared with that of preoperative [(131 .58 ± 14.68) °], the difference was not statistically significant (t = 0.16, P ＞ 0.05) .Conclusions The method of arthroscopic joint debridement to cure Kaschin-Beck disease knee osteoarthritis can significantly reduce pain, improve function and walking distance, with more stable long-term satisfactory outcome.

Objective: The Penn Alcohol Craving Scale (PACS) is a five-item, single-dimension questionnaire that is used to measure a patient’s alcohol craving. We sought to develop the Chinese version of the PACS (PACS-C) and assess its reliability and validity. Methods: A total of 160 Taiwanese patients with alcohol use disorder were enrolled in this study. The internal consistency and concurrent validity of the PASC-C with the visual analogue scale (VAS) for craving, the Yale–Brown Obsessive Compulsive Scale for heavy drinking (YBOCS-hd), and the Severity of Alcohol Dependence Questionnaire (SADQ) were assessed. The test–retest reliability of the PASC-C was evaluated 1 day after the baseline measurements. Confirmatory factor analysis (CFA) was performed to examine the psychometric properties of the PACS-C. Results: The PACS-C exhibited good internal consistency (Cronbach’s α=0.95) and test–retest reliability (r=0.97). This scale showed high correlations with the VAS (r=0.81) and YBOCS-hd (r=0.81 and 0.79 for the obsession and compulsion subscales, respectively), and moderate correlation with the SADQ-C (r=0.47). Furthermore, CFA results revealed that the PACS-C had good fit indices under various models. Conclusion The PACS-C appears to be a reliable and valid tool for assessing alcohol craving in patients with alcohol use disorder in Taiwan.

Adult ; Diagnosis, Differential ; Female ; Humans ; Ovarian Neoplasms ; pathology ; Sertoli-Leydig Cell Tumor ; pathology

OBJECTIVE: An automatic detection tool was created for examining health-related webpage quality we went further by examining its feasibility and performance. METHODS: We developed an automatic detection system to auto-assess the authorship quality indicator of an health-related information webpage for governmental websites in Taiwan. The system was integrated with the Chinese word segmentation system developed by the Academia Sinica in Taiwan and the SVM(light), which serve as an SVM (Support Vector Machine) Classifiers and a method of information extraction and identification. The system was coded in Visual Basic 6.0, using SQL 2000. RESULTS: We developed the first Chinese automatic webpage classification and information identifier to evaluate the quality of web information. The sensitivity and specificity of the classifier on the training set of webpages were both as high as 100% and only one health webpage in the test set was misclassified, due to the fact that it contained both health and non-health information content. The sensitivity of our authorship identifier is 75.3%, with a specificity of 87.9%. CONCLUSION: The technical feasibility of auto-assessment for the quality of health information on the web is acceptable. Although it is not sufficient to assure the total quality of web contents, it is good enough to be used to support the entire quality assurance program.
Asian Continental Ancestry Group ; Authorship ; Humans ; Quality Indicators, Health Care ; Sensitivity and Specificity ; Taiwan

Splenic hilar lymph node (LN) should be removed in a D2 lymph node dissection for the advanced proximal gastric cancer. After improving the surgical technology and renewing treatment concepts, spleen-preserving splenic hilar LN dissection has been accepted by more and more surgeons. Because the anatomy position of spleen is very deep, and the splenic vessel is various, laparoscopic spleen-preserving splenic hilar LN dissection may be more difficult. In order to do better in laparoscopic spleen-preserving splenic hilar LN dissection, surgeons should choose the suitable patients; take reasonable surgical approach and surgical steps. Moreover, knowing the anatomy variance well of splenic vessel is also very important too.
Humans ; Laparoscopy ; methods ; Lymph Node Excision ; methods ; Spleen ; surgery ; Stomach Neoplasms ; surgery