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

Dendritic Cell Sarcoma, Interdigitating ; Humans ; Lymph Nodes ; Male ; Middle Aged

OBJECTIVETo study the scientific evidence of the traditional preparation of Dachengqi: "Boiling Aurantii Immaturus and Magnoliae Officinalis first, and then adding Rhei to decoct together. Discarding the dregs, adding Natrii Sulfas into the decoction and drinking the upper solution when the Natrii Sulfas has dissolved completely".

METHODThe concentrations of free and combined anthraquinonoids(emodin, rhein, chrysophanol, physcion) in different decoctions were determined with HPLC method respectively.

RESULTWhen Natrii Sulfas, Aurantii Immaturus and Magnolias Officinalis are decocted with Rhei in different schemes, the concentrations of anthraquinonoids were changed regularly.

CONCLUSIONThe scientific evidence of traditional preparation method greatly increased the concentrations of the active components in Dachengqi.

Anthraquinones ; analysis ; Citrus ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; Emodin ; analogs & derivatives ; analysis ; Hot Temperature ; Magnolia ; chemistry ; Materia Medica ; chemistry ; Plant Extracts ; chemistry ; Plants, Medicinal ; chemistry ; Rheum ; chemistry ; Sulfates ; Time Factors

Adult ; Antidepressive Agents ; therapeutic use ; Depression ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; drug therapy ; psychology ; Female ; Gastric Emptying ; drug effects ; Gastrointestinal Agents ; therapeutic use ; Gastrointestinal Motility ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy ; Powders

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia in singapore. We describe a cohort of multi-ethnic Asian patients with AF, with the aim to evaluate anticoagulation use and to identify factors predictive of stroke, bleeding and all-cause mortality. Materials and Methods: this was a single centre, retrospective cohort study. All patients with an admission diagnosis of AF between 1 January 2000 and 31 December 2010 were identified. Of these patients, those who had follow-up data up to 31 December 2012 were included in the study. results: there were 1095 eligible patients. the mean age was 67±14 years, mean cHADs2 score was 2±1 and mean HAs-bLED score 2±1. Of the 1095 patients, 657 (62.0%) had a cHADs2 score ≥ 2 but only 215 (32.7%) were eventually prescribed warfarin. Patients not on warfarin were older (p<0.0001) and were more likely females (p<0.0001). Among patients not on warfarin, 52% had HAs-bLED score ≤3. Multivariate analysis revealed that warfarin use and high HAs-bLED score were associated with increased bleeding risk. Age, Indian ethnicity and cHADs2 score were predictive of ischemic stroke. All-cause mortality was significantly related to age, presence of heart failure and HAs-bLED score. conclusions: Anticoagulation management of AF patients remains inadequate. Objective assessment of bleeding risks should be performed before withholding anticoagulation.

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

Objective To study the effects of recombinant ciliary neurotrophic factor(CNTF) on expression of growth related proteins in related neurons after sciatic nerve repair in rats. Methods After a segment of the sciatic nerve of the rat was removed, the distal and proximal ends were sutured into a recombinant CNTF-containing silicone tube. Growth associated protein 43 ( GAP-43 ) and somatostatin (SOM) in the L4 spinal cord, L4 or L5 spinal ganglia were examined and measured by immunohistochemistry and in situ hybridization using computerized image processing system. Results An increase in the GAP-43 immunoreactivity in the large, medium neurons of spinal anterolateral nucleus was more significant in the CNTF-treated group compared with those in the 0.9% saline (SAL) -treated group, while a decrease in SOM mRNA hybridization signals in those neurons were more significant in the CNTF-treated group. There were no significant differences in the aforementioned immunoreactivity and hybridization signals of spinal ganglia between the CNTF-treated group and the SAL-treated group. Conclusion The results suggest that recombinant CNTF administration up-regulate GAP-43 expression and down-regulate SOM mRNA expression in the related motor neurons, but not sensory neurons, after reconnection of transected sciatic nerve.

BACKGROUNDEdaravone had been validated to effectively protect against ischemic injuries. In this study, we investigated the protective effect of edaravone by observing the effects on anti-apoptosis, regulation of Bcl-2/Bax protein expression and recovering from damage to mitochondria after OGD (oxygen-glucose deprivation)-reperfusion.

METHODSViability of PC12 cells which were injured at different time of OGD injury, was quantified by measuring MTT (2-(4,5-dimethylthia-zol-2-yl)-2,5-diphenyltetrazolium bromide) staining. In addition, PC12 cells' viability was also quantified after their preincubation in different concentration of edaravone for 30 min followed by (OGD). Furthermore, apoptotic population of PC12 cells that reinsulted from OGD-reperfusion with or without preincubation with edaravone was determined by flow cytometer analysis, electron microscope and Hoechst/PI staining. Finally, change of Bcl-2/Bax protein expression was detected by Western blot.

RESULTS(1) The viability of PC12 cells decreased with time (1 - 12 h) after OGD. We regarded the model of OGD 2 h, then replacing DMEM (Dulbecco's Modified Eagle's Medium) for another 24 h as an OGD-reperfusion in this research. Furthermore, most PC12 cells were in the state of apoptosis after OGD-reperfusion. (2) The viability of PC12 cells preincubated with edaravone at high concentrations (1, 0.1, 0.01 micromol/L) increased significantly with edaravone protecting PC12 cells from apoptosis after OGD-reperfusion injury. (3) Furthermore, edaravone attenuates the damage of OGD-reperfusion on mitochondria and regulated Bcl-2/Bax protein imbalance expression after OGD-reperfusion.

CONCLUSIONNeuroprotective effects of edaravone on ischemic or other brain injuries may be partly mediated through inhibition of Bcl-2/Bax apoptotic pathways by recovering from the damage of mitochondria.

Animals ; Antipyrine ; analogs & derivatives ; pharmacology ; Apoptosis ; drug effects ; Flow Cytometry ; Ischemia ; prevention & control ; Microscopy, Electron ; Mitochondria ; drug effects ; Neuroprotective Agents ; pharmacology ; PC12 Cells ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Rats ; bcl-2-Associated X Protein ; analysis

OBJECTIVETo evaluate the effectiveness of anterior versus posterior surgical treatments of thoracolumbar fractures.

METHODSRandomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified from MEDLINE (1966 - 2006.7), EMBASE (1966 - 2006.7), PubMed (1996 - 2006.7), Cochrane Library (Issue 2, 2006).We hand-searched Chinese Journal of Orthopedics (from establishment to May 2006) and Orthopaedic Journal of China (from establishment to May 2006). RCTs and CCTs were included. Data were extracted by two reviewers with designed extraction form. RevMan 4.2.8 software was used for data analysis.

RESULTSTwo RCTs and four prospective clinical trials were included. The combined results showed that compare with posterior surgical management, anterior approach in the treatment of thoracolumbar fractures proved the less incidence of complications; better neurologic recovery and corrected kyphosis angle; more complete and reliable decompression of the canal. However, there was not difference between the two groups in the general status outcomes.

CONCLUSIONSTo compare with posterior fixation system, anterior surgical managements in the thoracolumbar spinal trauma might be the optimal choices because the lower rates of complications and loss of corrected kyphosis angle; better neurologic recovery, also. Besides, due to the lack of Evidence-based guidelines for the treatment of thoracolumbar spinal injuries, the results which indicated above need further study.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome

OBJECTIVETo explore the relationship between the levels of estrogen (E2) and progestogen (P), expression of estrogen receptor (ER) and progesterone receptor (PR) and cervical cancer.

METHODSA case-control study with hospital and community controls was employed. The levels of serum estrogen and progesterone were detected by enzyme linked immunosorbent assay (ELISA) for 141 cervical cancer cases, 137 uterine myoma patients as controls and 129 health women as controls. ER and PR were measured by immunohistochemistry sABC in cervix tissues from patients with cervical cancer and uterus myoma as well.

RESULTSThe levels of estrogen (47.49 ng/mL) and progesterone (2.34 pg/mL) in cases were significantly higher than those in both control groups. The association between estrogen and cervical cancer was significant both before and after menopause-adjusted, with over 89% of attributable risk percentage (ARP), and showed a dose-response relation. Using the lowest value of 2 pg/ml in follicular phase as cut off point for progesterone, there were no statistically significant difference between cases and controls, and neither in progesterone nor in premenopausal. The expressions of ER and PR in cases were lower than those in controls, even after being menopause-adjusted.

CONCLUSIONThe high level of endogenous estrogen and progestogen might increase the risk of cervical cancer. Compared with progestogen, estrogen showed a higher risk that was not influenced by menopause. In some sense, ER and PR may exert certain protective effect on progressing of cervical carcinogenesis.

Adult ; Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Estrogens ; blood ; Female ; Humans ; Immunohistochemistry ; Leiomyoma ; blood ; metabolism ; Middle Aged ; Postmenopause ; blood ; metabolism ; Progesterone ; blood ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis ; Risk Factors ; Uterine Cervical Neoplasms ; blood ; metabolism ; Uterine Neoplasms ; blood ; metabolism