Objective To evaluate the clinical results of an anatomical reconstruction technique for the lateral ligaments with semitendinosus autografts in treatment of chronic lateral ankle instability.Methods From October 2008 to October 2009, 16 patients with lateral instability of the ankle underwent surgery using the proposed methods. They were 8 men and 8 women, with a mean age of 28.2 years (range,19 to 47 years) . Nine patients received only the anterior talofibular ligament reconstruction. Seven patients received both the anterior talofibular ligament and the calcaneofibular ligament reconstruction. Standard stress radiographs under anesthesia were taken to determine which ligament would be reconstructed. The semitendinosus autografts were secured to the fibular insertion site with suture anchors and to the talar or calcaneus insertion site with interference screws. The American Orthopaedic Foot and Ankle Society (AOFAS) scores and standard stress radiographs were used to assess the patients preoperation and at the last follow-up.Results We had a mean follow-up of 12. 1 months (range, 6 to 18 months). In the 16 patients, the average preoperative AOFAS score was 70. 50 ± 3.98, and the final average AOFAS score increased to 93.06 ± 4. 78 ( t = - 24. 010, P = 0. 000). Their average anterior drawer sign improved from 8. 75 ± 3.38 mm to 3.51 ±1.63 mm ( t = 7. 028, P = 0. 000). In the 7 patients who had received both lateral ligaments reconstruction,their average talar tilt improved from 16. 18° ± 7.30° to 5.57° ± 2. 99° ( t = 5. 661, P = 0. 001 ). No significant complications were found in all but one patient who had a 10° limitation of dorsal flexion of the ankle.Conclusions Our short-term results reveal that anatomical reconstruction of the ligaments with chronic lateral ankle instability using the above-mentioned methods may be effective and have the advantages of precise anatomical reconstruction, firm fixation of the grafts, mini-invasive procedure for the fibular skeletal structure and peroneal tendons, and saving the length of grafts.

Congresses as Topic ; Humans ; Otorhinolaryngologic Surgical Procedures

Acupuncture ; Acupuncture Points ; Animals ; Brain ; physiopathology ; Electroacupuncture ; Humans ; Magnetic Resonance Imaging ; Pain ; physiopathology ; Pain Management

AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients,to observe the patients` visual quality,to evaluate the patients` distance visual acuity,near visual acuity,Pseudo-accommodative power,residual astigmatism,the rotational stability of AcrySof IQ Toric Restor intraocular lens (IOLs),contrast the rate of off-distance glass,the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.METHODS:Carried out in 46 patients (48 eyes) with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016.All the cases were randomly divided into 2 groups: experimental group: 23 cases (24 eyes),AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification;control group: 23 cases (24 eyes),AcrySof IQ was implanted.Uncorrected distance visual acuity (UCDVA) and best corrected distance visual acuity (BCDVA),uncorrected near visual acuity (UCNVA) and best-corrected near visual acuity(BCNVA),Pseudo-accommodative power,residual astigmatism,preoperative and postoperative corneal astigmatism,the rate of off-distance glass,the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05).At 1wk,1,3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group (P<0.05).UCNVA were also statistically better than the control group (P<0.05).The mean residual astigmatisms 1wk,1,3 and 6mo postoperatively were statistically differences between the control group and experimental group (P<0.05).At 6mo postoperatively,patients satisfaction of experimental group were significantly better than control group (P<0.05).Spectacles independence for near vision achieved 83% and 17% in experimental group and control group,experimental group were statistically better than control group(P<0.05).Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group,experimental group were statistically better than control group(P<0.05).CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity,which can significantly reduce preexisting corneal astigmatism in cataract surgery,improve spectacles independence for distance vision and spectacles independence for near vision,have a high patient satisfaction.

Objective To investigate the effect of ulinastatin on postoperative cardiac troponin I ( cTnI) in patients underwent carotid endarterectomy ( CEA) under general anesthesia. Methods Forty patients with severe symptomatic carotid artery stenosis underwent unilateral CEA under general anesthesia from January 2011 to March 2012 were divided into either a ulinastatin group or a control group according to a random number table ( n=20 in each group) . Patients in the ulinastatin group received 500 000 U of ulinastatin via veins before induction of anesthesia. The patients in the control group were given the same amount of isotonic saline. The serum concentrations of cardiac troponin I ( cTnI ) were detected before surgery and at day 1,2,and 3 after procedure. Myocardial injury was defined as the cTnI peak concentration>0. 04μg/L . Results The levels of serum cTnI before procedure and at day 1,2,and 3 after procedure in the ulinastatin group were median (M) 0. 00 (0. 00-0. 03) μg/L,0. 07 (0. 00-1. 45) μg/L,0. 01 (0. 00-1. 21)μg/L,and 0. 05 (0. 00-0. 89)μg/L,respectively;those in the control group were 0. 00 (0. 00-0. 01)μg/L,0. 00 (0. 00-1. 42)μg/L,0. 00 (0. 00-1. 39)μg/L,and 0. 00 (0. 00-1. 24)μg/L, respectively. At day 1 after procedure,6 patients ( 30%) in the control group and 11 ( 55%) in the ulinastatin group occurred myocardial injury. There was no significant difference between the two groups (P<0. 05). In all the patients with the increased cTnI levels,the peak cTnI occurred at the first day after procedure,however,they did not reach the level ( >1. 5μg/L) of indicating patients occurring myocardial infarction. Conclusion Ulinastatin may not decrease the postoperative serum cTnI levels in CEA patients under general anesthesia. For whether to the CEA patients have myocardial protective effect,more samples are needed to be confirmed.

Objective To investigate the relationship between 5 ,10-methylenetetrahydrofolate reductase (MTHFR) gene C677T locus polymorphism and unexplained adverse pregnancy.Methods Three hundreds and twenty pregnant women with unknown ad-verse pregnancy ≥ 2 times in the infertility department ,and obstetrics and gynecology department of our hospital from June 2014 to May 2016 were selected as the case group and 388 healthy non-abortion parous women were taken as the control group.The MTH-FR gene C677T locus polymorphism in the two groups was analyzed by using gene chip method.The differences in genotype and al-lele frequency distribution were compared between the two groups ,and the relationship between unexplained adverse pregnancy and MTHFR C677T locus polymorphism was analyzed.Results The frequency distribution of MTHFR genotype C677T C/C had sta-tistically significant difference between the case group and control group (P<0.05 ,OR=0.284).The frequency distribution of gen-otype C/T had no statistical difference between the case group and control group (P=0.400 ,OR=1.140).The frequency distribu-tion of genotype T/T had statistical difference between the case group and control group (P<0.05 ,OR=7.672).The frequency distribution of allele C and T had statistical difference between the case group and control group ( P< 0.05 ,OR= 0.304 ). Conclusion The high expression of MTHFR C677T genotype T/T may be a risk factor of unknown adverse pregnancy in child-bearing age women.

Objective To compare traditional arthroscopic reconstruction of anterior cruciate ligament (ACL) and the arthroscopic ACL reconstruction assisted by fluoroscopy-based navigation system in accuracy and reproducibility of the tunnel placement. Methods Fluoroscopy-based navigation system was used in 40 cases of arthroscopic ACL reconstruction from December 2005 to March 2006. Another 40 cases of traditional arthroscopic ACL reconstruction performed between June 2005 and March 2006 were used as control. The positions of the femoral and tibial tunnels were measured on their radiograms and compared statistically. Results The femoral tunnel position measurements averaged 62. 3%?5. 6% (52% - 73% ) in navigation-assisted ACL reconstruction, and 56. 6%?7. 3% (46% - 77% ) in the traditional arthroscopic operation. The tibial tunnel position measurements averaged 45.4%?3. 8% (37%-53% ) in the navigation-assisted ACL reconstruction, and 41. 1%?6. 0% (25% - 54% ) in the traditional arthroscopic operation. The differences were statistically significant ( P

AIM To establish an HPLC method for the simuhaneous content determination of five flavonoids in Duchesnea indica (Andr.) Focke at five picking time (April,May,June,July and August).METHODS The analysis of D.indica methanol extract was performed on a 25 ℃ thermostatic Agilent ZORBAX SB-C18 column (250 mm×4.6 mm,5 μm),the mobile phase comprising of acetointrile-0.1％ methanoic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 350 nm.RESULTS Rutin,hyperoside,isoquercitrin,celereoin and kaempferol showed good linear relationships within their own ranges (R2 ≥0.998 6),whose average recoveries were 97.1％-101.5％ with the RSDs of 1.37％-2.37％.The contents of five constituents in samples at different picking time exhibited obvious differences,among which lutin and hyperoside contents were the highest in June,isoquercitrin content was the highest in July,and celereoin and kaempferol contents were the highest in August.CONCLUSION The suitable picking time of D.indica is June and July.

Objective To determine the prognostic factors after radical resection (RR) for hepatocellular carcinoma (HCC).Methods Altogether 144 patients who had undergone RR for HCC from 1988 through 1995 were included for a univariate and a Cox multivariate analysis.Nineteen factors contributing to overall survival rate (SR) and disease-free SR were analysed.Results The 5-year SR and disease-free SR (N=144) were 47.3% and 23.9%,separately.Multivariate analysis revealed that classification of RR was the signficant factor to overall SR,and presence of vessel invasion was the signficant factor to disease-free SR.The 5-year SR and disease-free SR in the patholngically RR and clinically RR groups were 60.2%,29.0% and 14.0%,0%,respectively.The 5-year disease-free SR in the group without (or with) vessel invasion was 27.8% (or 0%).Conclusions The classification of RR is the determinative prngnostie factor.Pathologically RR is the first option for patients with in- dications.It is essential to improve adjuvant therapy to decrease postoperative recurrence and metastasis rates.

The DNA microarray study showed that in STZ-induced diabetic rats the elevatedexpression of 42 genes in artery were depressed markedly after atorvastatin treat ment .This suggeststhat atorvastatin may have the protective effects on the diabetic vascular lesion.