OBJECTIVETo study the effectiveness of pie-crusting technique in improving the stiff knee.

METHODSFrom February 2012 to December 2013, 13 patients with stiff knee were reviewed retrospectively. There were 6 males and 7 females, ranging in age from 39 to 70 years old (averaged, 55.6 years old). Of the 13 cases, 8 patients had stiffness following fracture (comminuted tibial plateau fracture in 4, femoral supracondylar fracture in 3 and patellar fracture in 1), 5 patients had TKA-related stiffness.

RESULTSA follow-up lasted 8 to 12 months (mean 10 months)in 13 cases. The mean maximum flexion increased from (37 ± 6)° preoperatively to (52 ± 7)° after arthrolysis, and (108 ± 7)° after pie-crusting. At the final follow-up, mean maximum flexion was (105 ± 6)°. According to Judet evaluation system, 10 patients got an excellent result and 3 good. No major complications, such as extensor lag, skin necrosis, deep infection, dislocation of the patella or recurrent stiffness were found.

CONCLUSIONThe percutaneous technique of pie-crusting is a simple, minimally invasive and effective treatment for knee stiffness.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Joint Diseases ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Treatment Outcome

Objective To assess the image findings of femoroacetabular impingement (FAI).Methods Image findings of 9 patients with surgically proved femoroacetabular impingement were retrospectively reviewed for characteristic image findings of FAL All 9 patients underwent X-ray examinations and MRI of affected hip, and 1 patient underwent MR arthrography (MRA) additionally. Results X-ray examinations of all 9 patients showed bump at femoral head-neck junction or overcoverage of the acetabula.MRI showed various degrees of injury of anterosuperior labrum in all 9 patients. The injuries were stage Ⅰ A in2 cases, stage Ⅰ B in3, stage ⅡA in2, and stage ⅡB in 2. MRA of the case showed tears of anterosuperior labrum, with contrast media entering into the teared labrum. There were sclerosis and cystic degeneration of subchondral bone of femoral head in 2 cases, and these findings were confirmed as cartilage delamination by surgery. Conclusions MRI can display the injures of labrum and articular cartilage, which is helpful to the early diagnosis of FAI.

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

OBJECTIVE:To optimize the water-extraction technology of Compound kuhuang formulation. METHODS:The wa-ter-extraction technology of Compound kuhuang formulation was optimized by orthogonal design,with the total contents of matrine and oxymatrine,the total content of prim-O-glucosylcimifugin and 5-O-methylvisamminol,the content of berberine hydrochloride and extract yield,and with the extraction time,amount of water(3 reflux extractions)and soaking time as the factors;and verifi-cation tests were conducted. RESULTS:The extraction time had significant effect on comprehensive evaluation value (P<0.05). The optimal water-extraction technology was as follows as extraction time of 120 min,water amount of 8,6,and 6 times as the amount of herbs,and soaking time of 20 min. In verification tests,the average total content of matrine and oxymatrine was 3.152 6 mg/g(RSD=1.03%,n=3),that of prim-O-glucosylcimifugin and 5-O-methylvisamminol was 4.977 2 mg/g(RSD=2.27%,n=3),the average content of berberine hydrochloride was 3.345 0 mg/g (RSD=1.19%,n=3) and the average extract yield was 49.23%(RSD=2.43%,n=3). CONCLUSIONS:The optimal water-extraction technology of Compound kuhuang formulation is stable and feasible.

Background and purpose:The quality of life and psychological status of the advanced cancer patients has been widely valued. This study aimed to analyze the psychological status of the advanced cancer patients and its influence factors.Methods:The patients who were hospitalized in the palliative care department of Fudan University Cancer Center from Sep. 2011 to Mar. 2013 were included in this study. Self-rating anxiety scale(SAS), self-rating depression scale (SDS), EORTC QLQ-C30, social support revalued scale and symptom checklist 90 (SCL-90) were recorded and analyzed.Results:Fifty-six patients were included in this study, 18 were depression and 24 were anxiety while 16 of them were depression together with anxiety. The patients were divided into 2 groups according to their psychological status. There’s no signiifcant difference between the age and the social support between the two groups, while the mental disorders group have lower scores on body function, role function, emotional function and social function. The mental disorders were positive correlated with the symptoms score while negative correlated with the quality of life.Conclusion:There’s a high ratio of mental disorders in advanced cancer patients, the symptom scores and quality of life are related to mental disorders. We should pay more attention to the patients who were suffered more from the illness or had lower QOL scores.

Objective:To compare the steam distillation( SD) and supercritical CO2 ( SFE-CO2 ) method in the extraction of vola-tile constituents from such 3 traditional Chinese drugs as cnidium monnieri, radix sileris and atractylodes lancea in compound Kuhuang prescription. Methods:Essential oil was extracted from the 3 traditional Chinese drugs by SD and SFE-CO2 method, respectively. The components were identified by GC-MS, and their relative contents were calculated with peak area normalization method. Results:To-tally 36 components were isolated and identified using SD extraction and 31 components were identified using SFE-CO2 extraction, a-mong them, 22 components were the same and their relative molecular weight mainly concentrated within 200-230. Conclusion: SFE-CO2 method can extract effective components from the 3 traditional Chinese drugs in compound Kuhuang prescription with higher selec-tivity, which is the more suitable extraction method for essential oil from the prescription.

Objective To observe the therapeutic effects of Liuwei Shunji Capsule on survival state, visceral hypersensitivity, the content of 5-HT of model rats with liver depression and spleen deficiency-type irritable bowel syndrome (IBS), and explore its mechanism.Methods SD rats were randomly divided into normal group, model group, pinaverium bromide group and Liuwei Shunji Capsule of high, medium and low dose groups. Senna with restraint stress was used in duplicating liver depression and spleen deficiency-type IBS model. From the second day after the model was established, each drug treatment group was administered with corresponding drugs once a day for two weeks. The effects of Liuwei Shunji Capsule on survival state, visceral hypersensitivity, the content of 5-HT in serum and hypothalamus were observed.Results Compared with model group, Liuwei Shunji Capsule could raise weight growth rate of model rats with liver depression and spleen deficiency-type IBS (P<0.05), improve their diarrhea, fatigue demeanor, fur quality, irritability and other symptoms, significantly decrease their visceral hypersensitivity, the content of 5-HT in serum and hypothalamus (P<0.01).Conclusion Liuwei Shunji Capsule can effectively improve survival state and intestinal disorders of rats with liver depression and spleen deficiency-type IBS, and the mechanism of treatment could be realized through regulating 5-HT level.

Objective To investigate the normal range of the femoral neck α-angle in normal Chinese adults and classify the morphology of the anterior femoral head-neck junction on CT-based images. Methods Six hundred and fifty-two adult patients (Bilateral: 459 patients, unilateral:193 patients) with the total of 1111 hips (552 left; 559 right, and 654 male; 457 female) without known diseases affecting the proximal femur or symptoms of femoroacetabular impingement (FAI) underwent 64-slice CT scanning for medical purpose with the hip included in the scan range. The volume CT data was used for further analysis in this study. Oblique sagittal plane images paralleling to the axis of the femoral neck were reconstructed with the volume CT data, the image through the middle of the femoral neck was chosen to measure α-angle with AutoCAD2006 software. The morphology of the anterior femoral head-neck junction was classified. Analysis of variance and t-test were performed with SPSS 15.0. Results The mean value of α-angle of all 1111 hips was 38. 2° ±5.3°. The normal range of α-angle in Chinese adults was 28°to 49°.The mean value of left and right α-angles were 38. 0° ±5. 3°and 38.4° ±5. 3° ,respectively, and there was no statistically significant difference between both sides (t = - 1. 231 ,P ＞ 0. 05 ). Males have greater α-angles than females 39. 2° ±5. 8 vs 36. 8° ±4. 1°, with t = -8. 180, P ＜0. 01. There was no statistically significant differences of the α-angles of the seven age groups (F = 1. 765, P ＞ 0. 05 ). In all 1111 proximal femora, 168 were classified as concave type, accounting for 15. 1%, with a mean α-angle of 31.2° ±2. 0°,726 were smooth type, accounting for 65.4%, with a mean α-angle of 37.4° ± 2. 4°, and 217 were flat type, accounting for 19.5%, with a mean α-angle of 46. 4° ±3. 8°. The differences of the α-angles of the three groups reached statistical significance ( F = 1636. 107, P ＜ 0. 01 ). Conclusions The morphology of anterior femoral head-neck junction can be classified into three types: concave type (type Ⅰ ), smooth type (type Ⅱ ) and flat type (type Ⅲ ). This classification could directly reflect α-angle, which helps to recognize the variation of the offset of anterior femoral head-neck junction. This study offers basic data for the diagnosis of FAI.

Objective　To evaluate the methods of surgical treatment for tumors of brain stem and their curative effects. Methods: 25 cases of tumors of brain stem were analysed retrospectively. Results: There were 18 cases of astrocytomas, 2 cases of cavernous angioma, 1 cases of hemangioblastoma, 1 cases of dermoid cyst, 1 cases of syringopontia, 1 cases of inflammatory granuloma accompanied with hecrosis and 1 cases of AVM of brain stem in 25 cases. Four patients died after operation. Conclusion: Extrinsic tumors of brain stem could be resected totally or subtotally, resulting in good outcome.

OBJECTIVETo evaluate the reliability and diagnosis accuracy of 5 special tests used for the diagnosis of subacromial impingement syndrome (SAIS).

METHODSA prospective blinded cohort study was taken,in which 105 patients with shoulder pain were reviewed. All the patients took 5 special syndrome tests including Neer syndrome, Hawkins-Kennedy syndrome, painful arc empty can test and external rotation resistance test, also underwent arthroscopic surgical examination. The Nikolaus's criterion was regarded as a golden standard for SAIS. Data accuracy analysis was calculated through a receiver operating characteristic (ROC) curve, sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (-LR). The binary Logistic regression analysis was used to find out the best test combination for ruling in or out SAIS. The interrater reliability was assessed by the Kappa coefficient and percent agreement.

RESULTSThe ROC analysis indicated a significant area under the curve (AUC) (AUC=0.62 to 0.73, P<0.05) for all tests except the Hawkins-Kennedy. Tests with a +LR greater or equal to 2.0 were the painful arc,empty can,external rotation resistance, Tests with a-LR less than 0.5 were Neer,painful are ,external rotation resistance. The regression analysis found the painful arc, empty can and external rotation resistance made the best combination for diagnosis SAIS,while the painful are and external rotation resistance made the best combination for ruling out SAIS. The difference of ROC analysis was significant with a cut-off of 3 positive tests out of 5 tests. All tests had moderate to good agreement (Kappa=0.42 to 0.71).

CONCLUSIONThe single test of painful arc, empty can and external rotation resistance, as well as 3 or more positive tests of the 5 tests can help confirm the diagnosis of SAIS, while the single test of Neer, painful arc and external rotation resistance are help rule out the diagnisis of SAIS. The tests of painful arc, empty can and ex ternal rotation resistance are the best combination for the diagnosis of SAIS (when 2 or more are positive), while the tests of painful arc and external rotation resistance are the best combination for ruling out SAIS (when both are negative)

Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Physical Examination ; methods ; Prospective Studies ; Reproducibility of Results ; Shoulder Impingement Syndrome ; diagnosis