Humanism ; Humans ; Orthopedics

Arthroplasty, Replacement ; methods ; Diskectomy ; methods ; Humans ; Spinal Diseases ; surgery ; Spine ; surgery

Adolescent ; Humans ; Scoliosis ; classification ; surgery ; Spinal Fusion ; methods

Humans ; Orthopedics ; trends

OBJECTIVETo investigate the perioperative and early-term efficacy of bilateral total knee arthroplasty (BTKA) in one-stage procedure.

METHODSTotally 93 patients operated with BTKA in one-stage procedure from 2003 June to 2005 June were followed up and the curative effect was determined with Hospital for Special Surgery knee-rating system (HSS). The complications were then analyzed.

RESULTSThe mean postoperative HSS score was 89. 6 (55 approximately 96 scores) and the excellence/good rate reached 95. 7% (excellent in 74 cases, good in 15 cases, moderate in 2 cases, and poor in 2 cases). Except for the muscle power, the pain, joint function, range of joint movement (ROM) , deformity, and stability were significantly improved after operation (P < 0. 05). The average ROM of knee was improved to 99. 8 (75-135 ) degrees after operation from 88.9 (25-110) degrees before operation (P < 0. 01). Complications included deep vein thrombosis (n = 2) , incision fat liquidation (n = 2) , deep infection ( n = 1) , urinary infection ( n = 1) , and peroneal nerve palsy (n = 1). No death was documented.

CONCLUSIONBilateral total knee arthroplasty in one-stage procedure under secure conditions can be performed with good outcomes in selected patients without a definite increase in perioperative risk.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo explore the possible mechanism of the erector spinal muscles in idiopathic scoliosis by comparing the expression and localization of neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) of the thoracic erector spinal muscles on convex side and concave side.

METHODSThe patient group comprised 8 females and 2 males who were scheduled for spinal surgery. The apex of scoliotic curve in these patients arose between T6 and T11. The mean age was 14.3 (range 12-17) years, and the mean Cobb angle was 57.7 degrees (range 45 degrees-85 degrees). Muscle biopsies were taken bilaterally during surgery from the superficial multifidus muscle at the apex of the curve between the 6th and 11th thoracic vertebral levels. Part of the tissue was fixed in formalin and stained with hematoxylin and eosin; the remaining tissue was snap frozen and processed for immunohistochemistry and Western blot. Immunocytochemistry for nNOS and iNOS were performed using the EnVision two-step method. Western blot was done with antibodys to nNOS and iNOS. Immunoreactive bands were visualized by enhanced chemiluminescence according to the manufacturer's specifications (Amersham Corp).

RESULTSnNOS protein in the erector spinal muscles was localized at the sarcolemma. Western blot demonstrated that nNOS protein expression in the concave side of erector spinal muscles is more than that in the convex side. A significant decrease in nNOS protein and activity was found on the convex side of erector spinal muscles from idiopathic scoliosis patients; There was a little immunoreactivity to iNOS in erector spinal muscles. There was little difference in iNOS protein expression between both sides of the curve. Western blot detected the same results.

CONCLUSIONThere is a greater expression of nNOS and iNOS on the concave side than on the convex side, suggesting nNOS and iNOS may play a role in the pathogenesis of idiopathic scoliosis.

Adolescent ; Child ; Female ; Humans ; Immunohistochemistry ; Male ; Muscle, Skeletal ; cytology ; enzymology ; Nitric Oxide Synthase ; analysis ; metabolism ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type II ; Scoliosis ; enzymology

The traditional treatment of scoliosis is mainly based on open surgeries that use the anterior approach, the posterior approach, or both. These surgical procedures often lead to complications including massive blood loss, infections, and pain of incision.The minimally invasive spine surgery (MISS) was introduced in the 1990s and has shown many advantages including less blood loss, less pain, and lower infection incidences.Today MISS is mainly used in the treatment of adolescent idiopathic scoliosis and adult scoliosis. However, due to some inevitable complications, it still can not be routinely applied.This review will briefly summarize the advances in the application of MISS in surgical treatment of adolescent idiopathic scoliosis and adult scoliosis.
Adolescent ; Adult ; Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods ; Postoperative Complications ; epidemiology ; Scoliosis ; surgery ; Spine ; surgery

Objective To explore the effect of different proportions of mixed blood exchange transfusion on blood circulation in neonates with hemolytic disease.Methods Thirty-one newborn infants with hemolytic disease were treated by peripheral arteriovenous synchronization of exchange transfusion with different proportions mixed blood.AB type plasma was mixed with O type red blood cell(RBC) washing.The proportion for the treatment group was 1:1(the O type RBCs 2 U:the AB type plasma 200 mL),by exchange transfusion of haplotypes,in accordance with 80?mL/kg;the proportion for control group was 2:1(the O type RBC 4 U:the AB type plasma 200 mL),by exchange transfusion of double in accordance with 150-180 mL/kg.The indicators were detected,such as the exchange rate of neonatal serum bilirubin,RBC,hemoglobin(Hb),hematocrit(HCT),and the exchange transfusion quantity and days of hospitalization before and after the exchange transfusion were analyzed.Results The exchange rate of serum bilirubin of treatment group and control group was (44.92?3.99)% and (45.69?5.06)%,respectively,there was no significant difference between 2 groups(P=0.639),there was no significant difference of hospitalization days[(8.13?1.13) d vs(8.19?0.91) d]between 2 groups(P=0.884).After exchange transfusion in treatment group,the average level of the RBC,Hb and HCT were increased(P

Background The rapid diagnosis can win more treating opportunities for patients with fungal keratitis.Even though the fungal culture is the gold standard for the diagnosis of fungal keratitis,it is difficult in early diagnosis due to the long duration of cultivation and false-negative rate.Objective This trial was to explore the clinical value in the rapid diagnosis of fungal keratitis by the combination of corneal scraping with laser scanning confocal microscopy.Methods Corneal scraping and laser scanning confocal microscopy were separately performed in 167 eyes of 167 patients with fungal keratitis.All the eyes were examined by the slit lamp,followed by laser scanning confocal microscope,and then the 10％ KOH corneal smear was examined under the optical microscope.Results The positive rate of diagnosis was 75％ (125/167) by corneal scraping,and that by laser scanning confocal microscopy was 91％ (152/167).The positive rate of examining outcome was significantly higher in laser scanning confocal microscopy than that of corneal scraping (x2 =14.88,P =0.00).The positive results were 114 cases and negative results were 4 cases by two methods,with the concordance rate 70.7％ (118/167).The hyphae or spore were seen in 32 cases by laser scanning confocal microscopy in 42 negative cases by corneal scraping,and in 15 negative cases by confocal laser scanning microscopy,11 positive outcomes were offered by corneal scraping.Conclusions The combined application of corneal scraping with confocal laser scanning microscopy can improve and speed up the diagnosis positive rate of fungal keratitis.

This study is to investigate if madecassoside can protect against myocardial reperfusion injury in rabbit heart in vivo. The ischemia reperfusion model was established. Left ventricular function and ECG were monitored at the ischemia and reperfusion period. The infarct areas were expressed as percentage. The levels of LDH, CK, MDA and SOD were measured and C-reactive protein (CRP) in serum was measured by ELISA kit. Cardiomyocyte apoptosis were measured by TUNEL staining. A monoclonal rabbit anti-goat Bcl-2 proteins as primary antibody was used for Bcl-2 immunohistochemical staining. Treatment with madecassoside (3.2, 1.6 and 0.8 mg x kg(-1)) i.v. during ischemia reperfusion injury attenuated myocardial damage, that is, characteristic of decreasing infarct size, decreasing LDH and CK release. Activities of SOD were diminished and MDA level increased obviously in control group whereas pretreatment with madecassoside significantly blunted the decrease of SOD activity, markedly reduced the levels of MDA, CRP and cardiomyocyte apoptosis, and upregulated the expression of Bcl-2. Madecassoside has the protective effect against myocardial ischemia reperfusion injury, and effects of anti-lipid peroxidation, enhancement of SOD activity, anti-inflammation and anti-apoptosis.
Animals ; Apoptosis ; drug effects ; C-Reactive Protein ; metabolism ; Cardiotonic Agents ; isolation & purification ; pharmacology ; Centella ; chemistry ; Creatine Kinase ; blood ; Electrocardiography ; L-Lactate Dehydrogenase ; blood ; Lipid Peroxidation ; drug effects ; Male ; Malondialdehyde ; blood ; Myocardial Reperfusion Injury ; metabolism ; pathology ; Myocardium ; metabolism ; pathology ; Myocytes, Cardiac ; pathology ; Plants, Medicinal ; chemistry ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rabbits ; Random Allocation ; Superoxide Dismutase ; blood ; Triterpenes ; isolation & purification ; pharmacology