Objective To evaluate the clinical results of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP)lesions in patients with recurrent shoulder dislocations.Methods Between May 2011 and January 2015,we reviewed 15 cases with combined Bankart and SLAP lesions with recurrent shoulder dislocations who underwent arthroscopic repair.Their average age during surgery was 24.2 years (ranging from 16 to 38 years).During the operation,we began by repairing the unstable SLAP lesion with absorbable suture anchors before we repaired Bankart lesion from the inferior to superior.Fifteen patients in the control group had isolated Bankart lesions without SLAP lesions and underwent arthroscopic repair.Their mean age was 24.6 years (ranging from 18 to 35 years).The preoperative and postoperative results were analyzed by Visual Analogue Scale (VAS)for pain,the range of motion,American Shoulder and Elbow Surgeon (ASES)and Rowe Shoulder Scores Systems.We compared the results with the isolated Bankart lesion. Results For patients who underwent arthroscopic repair of combined Bankart and SLAP lesions,the mean postoperative follow-up period was 15 months (ranging from 13 to 28 months),vs 22 months (ranging from 21 to 34 months)in the control group.VAS for pain was decreased from preoperative 4.9 to postoperative 1.9 (P <0.05).Mean ASES and Rowe Shoulder Scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1,respectively (P <0.05). Recurrent dislocation was not observed until the last follow-up and anterior instability in two groups was not noted during the physical examination.Compared with the isolated Bankart lesion group,no statistical significance was found in the ASES score,Rowe Shoulder Score,or VAS for pain (P >0.05 ).Anterior flexion,abduction,and internal rotation of the affected shoulder during the last follow-up were normal after surgery.Conclusion For recurrent dislocation of the shoulder with combined Bankart and SLAP lesion,arthroscopic repair using absorbable suture anchors can achieve favorable clinical results.It can effectively restore shoulder function.

Objective To explore the variance of plasma brain natriuretic peptide (BNP) concentrations in the aged patients after noncardiac surgery and its significance. Methods 101 patients undergoing elective noncardiac surgery were divided into two groups based on the BNP concentrations before surgery: group A: BNP≤100 ng/L，n=61; group B: BNP>100 ng/L，n=40. The BNP concentrations before and after noncardiac surgery and the incidence of cardiac events in both groups were compared. Results There was no significant difference （P>0.05） of BNP concentrations before and after noncardiac surgery in group A, which were (58.2±28.7) ng/L and (53.7±25.9) ng/L respectively, but was significant difference （P<0.05） in group B, which were (147.3±72.1) ng/L and (341.5±92.4) ng/L respectively. There was significant difference （P<0.05） between group A, in which no patient happened cardiac event, and group B, in which 14 patients happened. Conclusion The plasma BNP concentration would be increased significantly in the aged patients with a BNP concentration>100 ng/L before surgery, which may cause more cardiac events.

OBJECTIVETo evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation.

METHODSAnterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels.

RESULTSThis technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%.

CONCLUSIONSPCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

Adult ; Bone Plates ; Cervical Vertebrae ; Equipment Design ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Orthopedic Procedures

Objective:To examine the value of serum protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) detection in the early diagnosis and surveillance of hepatocellular carcinoma (HCC).Methods:The clinical data of 215 patients with HCC admitted to Department of Hepatobiliary-Pancreatic Surgery of China-Japan Union Hospital of Jilin University from October 2017 to May 2018 were analyzed retrospectively. There were 172 males and 43 females, aged of (59.0±9.3) years old (range 34 to 86 years old). In addition, there were 85 non HCC patients were enrolled in the control group, 42 males and 43 females, aged (54.2±11.3) years old (range 22 to 80 years old). The blood sample of 3 ml was drawn from the elbow vein at 6∶00 am on the next day of admission, and then was kept in low temperature away from light, and sent for PIVKA-Ⅱ detection on the same day. The positive value of AFP was ≥20 μg/L and PIVKA-Ⅱ was ≥32 AU/L. The data were analyzed statistically by χ 2 test, t test or rank sum test. The correlation between AFP, PIVKA-Ⅱ and tumor maximum diameter was analyzed by linear regression. Results:The sensitivity of PIVKA-Ⅱ detection only for the diagnosis of HCC in all stages was significantly higher than AFP or equivalent to AFP, the overall sensitivity of PIVKA-Ⅱ and AFP was 85.1% and 52.1%, respectively. But the specificity of PIVKA-Ⅱ was lower than that of AFP, they were 78.8% and 96.5%, respectively. In particularly, in the earlier stage of HCC (Ⅰa) , the sensitivity of PIVAK-Ⅱ to HCC was 64.5%, while the AFP was only 26.3%. Combined detection of PIVKA-Ⅱ and AFP significantly improved the diagnostic rate of HCC to 88.4%, and the specificity to 76.5%. Moreover, there was a positive correlation between PIVKA-Ⅱ level and the maximum tumor diameter ( r2=0.587, P<0.05), but there was no correlation between the AFP level and the maximum tumor diameter ( r2=0.296, P>0.05). The positive rate of PIVKA-Ⅱ in the diagnosis of HCC with vascular invasion was also significantly higher than that of AFP ( P<0.01) . Conclusions:PIVKA-Ⅱ can be used as a serological marker for HCC screening and diagnosis. In particular, PIVKA-Ⅱ detection was significantly sensitive than AFP in the earlier stage of HCC. Combined detection of PIVKA-Ⅱ and AFP can effectively improve the diagnostic rate of HCC in all stages. The significant elevation of PIVKA-Ⅱ is also helpful to determine the tumor aggressiveness, vascular invasion and prognosis of HCC patients.

Objective:To examine the value of serum protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) detection in the early diagnosis and surveillance of hepatocellular carcinoma (HCC).Methods:The clinical data of 215 patients with HCC admitted to Department of Hepatobiliary-Pancreatic Surgery of China-Japan Union Hospital of Jilin University from October 2017 to May 2018 were analyzed retrospectively. There were 172 males and 43 females, aged of (59.0±9.3) years old (range 34 to 86 years old). In addition, there were 85 non HCC patients were enrolled in the control group, 42 males and 43 females, aged (54.2±11.3) years old (range 22 to 80 years old). The blood sample of 3 ml was drawn from the elbow vein at 6∶00 am on the next day of admission, and then was kept in low temperature away from light, and sent for PIVKA-Ⅱ detection on the same day. The positive value of AFP was ≥20 μg/L and PIVKA-Ⅱ was ≥32 AU/L. The data were analyzed statistically by χ 2 test, t test or rank sum test. The correlation between AFP, PIVKA-Ⅱ and tumor maximum diameter was analyzed by linear regression. Results:The sensitivity of PIVKA-Ⅱ detection only for the diagnosis of HCC in all stages was significantly higher than AFP or equivalent to AFP, the overall sensitivity of PIVKA-Ⅱ and AFP was 85.1% and 52.1%, respectively. But the specificity of PIVKA-Ⅱ was lower than that of AFP, they were 78.8% and 96.5%, respectively. In particularly, in the earlier stage of HCC (Ⅰa) , the sensitivity of PIVAK-Ⅱ to HCC was 64.5%, while the AFP was only 26.3%. Combined detection of PIVKA-Ⅱ and AFP significantly improved the diagnostic rate of HCC to 88.4%, and the specificity to 76.5%. Moreover, there was a positive correlation between PIVKA-Ⅱ level and the maximum tumor diameter ( r2=0.587, P<0.05), but there was no correlation between the AFP level and the maximum tumor diameter ( r2=0.296, P>0.05). The positive rate of PIVKA-Ⅱ in the diagnosis of HCC with vascular invasion was also significantly higher than that of AFP ( P<0.01) . Conclusions:PIVKA-Ⅱ can be used as a serological marker for HCC screening and diagnosis. In particular, PIVKA-Ⅱ detection was significantly sensitive than AFP in the earlier stage of HCC. Combined detection of PIVKA-Ⅱ and AFP can effectively improve the diagnostic rate of HCC in all stages. The significant elevation of PIVKA-Ⅱ is also helpful to determine the tumor aggressiveness, vascular invasion and prognosis of HCC patients.