OBJECTIVETo investigate clinical outcomes of tendon allograft reconstruction with arthroscopy minimally invasive technique at stage I for the treatment of knee dislocation with multiple ligaments injury.

METHODSForty-eight patients with knee dislocation were reconstructed anterior and posterior ligament under arthroscopy at stage I from January 2008 to January 2012, and repaired ligaments injury of knee joint by minimally invasive technique. There were 38 males and 10 females aged from 20 to 59 years old with an average of 35.6 years old; 22 cases on the left side and 26 cases on the right side; the time from injury to operation ranged from 2 d to 2 weeks. Two cases combined with anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and posterolateral complex injuries, 36 cases combined with ACL, PCL, and MCL injuries, 10 cases combined with ACL, PCL and PLC injuries; 4 cases combined with peroneal nerve injury. Lysholm scoring were used to compared the cases before operation and final following-up to evaluate knee function.

RESULTSAll patients were followed up from 12 to 30 months with an average of (18.2 ± 6.3) months. Activity and stability of joint were obviously improved. Lysholm score were improved from 40.3 ± 4.1 before operation to 87.0 ± 6.4 at final following-up.

CONCLUSIONReconstruction with arthroscopy minimally invasive technique at stage I for the treatment of knee dislocation with multiple ligaments injury could recover stability of joint better,reserve joint function. Preoperative training and postoperative individualized rehabilitation treatment is the key point of recover knee joint function.

Adult ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Female ; Humans ; Knee Dislocation ; rehabilitation ; surgery ; Male ; Middle Aged ; Multiple Trauma ; surgery ; Posterior Cruciate Ligament ; injuries ; Reconstructive Surgical Procedures ; methods

Objective To explore the relationship of the ratio of plasma adrenomedullin(AM)and endothelin-1(ET-1)with serum concentration of neuron-specific enolase(NSE)in full-term neonates with hypoxic-ischemic encephalopathy(HIE).Methods Plasma concentrations of AM,ET-1 and serum NSE from 32 full-term neonates with HIE were detected by radioimmunoassay(RIA)on the 1,3 and 7 d after parturition,30 neonates in the corresponding periods in our hospital were employed as controls.The infants with HIE were divided into mild,moderate or severe group in terms of diagnostic standard of HIE.Results 1.Plasma concentrations of AM and ET-1 in newborns with mild,moderate or severe HIE were significantly higher than that of control group at 1 d after life with a decline from 3-7 d(Pa

Objective To investigate the clinical outcomes in the treatment of complex acetabular fractures through a single supra-ilioinguinal approach after the application of preoperative 3D printing and rapid prototyping simulating the operative procedure.Methods From January 2013 to January 2016,24 cases of complex pelvic and acetabular fractures in our hospital were retrospectively analyzed.Among them 18 cases were male and 6 were female.The average age was 39.2+±13.8 years (range,24-68 years).According to Letoumel-Judet's classification,there were 6 cases of transverse,4 cases of T shaped,4 cases of combined anterior column and posterior hemi-transverse (ACPHT) and 10 cases of 2-column fractures.The time from injured to operation averaged 9 days (range,4-18 days).Before operation,pelvic AP view,three-dimensional CT as well as CTA of iliac blood vessels was taken routinely in all cases.The CT and CTA scan data were then imported into Mimics software for 3D reconstruction.Surgical simulation and optimal placement of internal fixations were performed on computer.After that,the individual simulated model of the pelvis was printed by the use of 3D printing and rapid prototyping technique.The order of reduction,selection and optimal position of the implants were determined.The plates were bent before operation and the length and direction of the screws were recorded.A uniform supra-ilioinguinal approach was used in all cases.Results The length of incision averaged 9 cm (range,8-13 cm).The operative time average 130 min (range,90-220 min).The blood loss averaged 600 ml (range,300-1 500 ml).Once a satisfactory reduction was obtained,single placement of the plates was achieved.In accordance with the preoperative plan,the plates were perfectly fitted to the bone surface.The 24 patients were followed for an average time of 18.3 months (range,15-30 months).The fractures healed in all cases.The average healing time was 4.2 months (range,3-6 months).According to Matta criteria,there were 16 cases of excellent,6 cases of good,2 cases of poor and the excellent rate was 91.7％ (22/24).The average modified Merle d'Aubigne score was 16.5 (range,13-18).The functional outcome was excellent in 13 cases,good in 6 cases and poor in 5 cases.The excellent rate of hip functions was 79.2％ (19/24).There were 2 cases of femoral lateral cutaneous nerve injury (recovered one month later) and another 1 case of fat liquefaction of the incision happened three days postoperatively (the wound healed completely after several dressing changes).No inguinal hernia or abdominal wall hemias was found.No other postoperative complications was found.Conclusion The application of 3D printing and rapid prototyping technique allows preoperatively simulating reduction in vitro,determining the optimal position of the implants,bending the plates and measuring the length of the screws in advance,which could largely reduce the operative time,intraoperative blood loss and occurrence of postoperative complications.Adopting supra-ilioinguinal approach for the treatment of complex acetabular fractures with a small incision and less trauma,a full exposure could be obtained,so the reduction and fixation of the anterior,posterior and middle column (also named pubo-ischiatic column) could be completed in a direct visualization,resulting in a satisfactory clinical outcomes.

Objective To investigate the current situation of the prevention and contml of iodine deficiency disorders(IDD)in Hubei Province,SO as to provide a policy.making basis for controlling work of IDD. Methods Using the method of proportional population sampling(PPS),30 eounties were seiected in Hubei Province.In each selected county,1 primary school was chosen.In every primary school,40 pupil8 aged 8～10 years were selected to examine thyroid size,intelligent quotient(IQ),and salt iodine contents at their home.In the selected pupils,2 boys and 2 girls were chosen to determine their urinary iodine contents in each age grouD.Twenty pupils in the above school and 5 housewives ileal"to this school were tested in health education questionnaire. Results The median of salt iodine was 30.1 mg/kg,and the rate of comsuming qualified iodized salt was 96.2% (1154/1200).The rates ofchild goiter were 6.5%(78/1200)by palpation and 4.1%(49/1200)by B ultrasound.The median of urinary iodine Was 358.4μg/L and mean of the IQ was 105.3±14.4.The rate of qualified scores of both students and housewives Was 25.5%(153/600)、90.7%(136/150).Conclusions The current Bituation of iedine nutrition is good.The goal of eliminating IDD has been achieved in Hubei Province.

OBJECTIVETo explore the effect of a self-made guiding needle of steel wire in guiding the wire through the tibial tunnel for the treatment of avulsion fractures of tibial posterior cruciate ligament with open reduction and wire fixation.

METHODSFrom February 2011 to June 2014, a total of 22 patients with avulsion fractures of tibial posterior cruciate ligament underwent surgical treatments were analyzed, including 14 males and 8 females with an average age of 35.6 years old (ranged, 17 to 63 years old). According to Meyers classification, 9 patients were classified as type II, 13 patients were classified as type III. All the patients underwent open reduction and wire fixation with medial knee "L" shape approach. A wire guiding needle was used to guide the wire through the tibial tunnel during operation.

RESULTSWith the assistance of wire guidance needles, wires passed through the tibial tunnel rapidly during the operation in all the 22 patients. All the patients were followed up, X-ray imagings 6 months after operation showed the fractures healed well. The average follow-up time in all patients was 6 months (ranged, 6 to 12 months). The averaged Lysholm knee score in 22 knee was 92.7 +/- 3.4. All patients' posterior drawer test were negative.

CONCLUSIONSelf-made wire guiding needle can simplify the operation procedures in which the wires pass through the tibial tunnel, shorten the operation time, reduce the surgical trauma and complications, and be worthy of clinical application.

Adolescent ; Adult ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

Objective To confirm the distribution of high arsenic drinking water and the situation of endemic arsenism in Hubei Province, to provide reference basis for prevention and control of endemic arsenic disease. Methods Using typical investigation and sample investigation in 2006 and 2007, the arsenic content of water was detected sampled from 19 counties(cities or communities). And those water samples which were close to or exceeded the stipulated standard were rechecked by the national standard method. Furthermore, the situation of endemic arsenism was investigated in the cities having high arsenic contents of water. Results In 2006,10 028 water samples of 446 villages in 6 counties (cities or communities) were tested, the wells of high arsenic (> 0.05 mg/L) were found in 5 counties (cities or communities) and the proportion of the well that exceeded stipulated standard was 5.29%(530/10 028); In 2007,19 086 water samples of 1282 villages in 17 counties(cities or communities) were tested, the wells of high arsenic were found in 11 counties(cities or communities), and the proportion of the well that exceeded stipulated standard was 1.74%(333/19 086). In these two years, 29 114 water samples were tested, in which 863 water samples were exceeding the stipulated standard. The 2.96% of total wells exceeded stipulated standard and mainly distributed in 179 villages of 12 counties(cities or communities). And the highest arsenic content of water sample was 2.012 mg/L. In the endemic arsenism area, 2 critical, 1 moderate and 1 mild arsenism patients had been found. Conclusions The water of high arsenic content are scattered in Hubei Province and the situation of endemic arsenism disease is mild. Improving water aiming at decreasing arsenic and establishing patient files should be carried out immediately.

OBJECTIVETo investigate the current state of oral administration of Chinese patent medicine in treatment of chronic kidney disease (CKD) in the Westem medicine hospitals.

METHODSOutpatients of Department of Nephropathy, Peking University Third Hospital with diagnosed CKD confirmed by CKD diagnosis standard were surveyed by questionnaire in May 2009. The following patients' information was collected using the Questionnaire of the Current State of Oral Administration of Chinese Patent Medicine at CKD Clinics. (1) The present symptoms, tongue figure, pulse figure were syndrome typed referring to The Diagnosis, Syndrome Typing, and Efficacy Assessment of Chronic Renal Failure 2006 by Chinese Society of Renal Diseases, Chinese Society of Traditional Chinese Medicine. (2) Names of Chinese patent medicines and Western medicines patients use presently, the dose and dosage, names of hospitals responsible for prescriptions. (3) Patients' basic diseases including diabetes, hypertension, hyperuricemia, and so on at present. Irrational applications of Chinese patent medicines were classified according to the drug instruction and Guiding Principle of Clinical Application of Chinese Patent Medicines (issued by State Administration of Traditional Chinese Medicine). The irrationality was analyzed. Correlated factors such as age, sex, deficiency in origin syndrome, sthenia in superficiality syndrome, the nature and grade of hospitals responsible for prescriptions, total numbers of Chinese patent medicines, and primary diseases, etc. were analyzed using Logistic regression model. These factors might result in irrational application of Chinese patent medicines.

RESULTS102 questionnaires were handed out, with 78 effective ones. Of them, 41 patients (41/78, accounting for 52.6%) were taking Chinese patent medicines. Of the 41 patients, irrational application happened to 24 patients (24/41, accounting for 58.5%), absolute discrepancy of medicines and syndromes to 5 (5/41, accounting for 12.2%), repeated medication to 7 (7/41, accounting for 17.1%), and interaction to 2 (2/41, accounting for 4.9%). Logistic regression model was analyzed. Variables were screened by Enter method. The number of Chinese patent medicines had statistic significance (P<0.05).

CONCLUSIONSThe occurrence rate of irrational application of Chinese patent medicines in CKD outpatients in Westem medicine hospitals was higher. They were mainly manifested as absolute discrepancy of medicines and syndromes and repeated medication. Increased numbers of Chinese patent medicines in recipes would increase the occurrence rate of irrational application of Chinese patent medicines.

Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Outpatients ; Phytotherapy ; utilization ; Renal Insufficiency, Chronic ; drug therapy ; Surveys and Questionnaires

Objective To evaluate the efficacy of percutaneous endoscopic BEIS technique in the treatment of recurrent lumbar disc herniation and to analyze its possible prognostic factors.Methods A total of 39 patients who are diagnosed as lumbar disc herniation and treated with percutaneous endoscopic BEIS technique were selected from March 2013 to March 2015.The clinical efficacy was evaluated according to VAS,ODI,JOA and modified MacNab criteria in the follow-up,and the possible prognostic factors were analyzed.Results The average follow-up time was 14 months(12 ～ 18 months).According to the MacNab standard,the excellent and good rate was 82.1％.The average score of back and leg pain VSA was reduced from(7.33 ± 1.01)before operation to(2.69 ± 1.50)after operation,t =16.111,the difference was statistically significant (P ＜ 0.05);ODI and JOA were used to evaluate lumbar function,the score of ODI was reduced from (59.08 ± 7.16) to (13.54 ± 3.36),t =35.946,and that of JOA was increased from(14.92 ±3.37) to(26.05 ± 1.76),t =-18.526,the difference was statistically significant (P ＜ 0.05).Patients with symptoms lasting no more than 3 months and with no lateral recess stenosis were able to obtain good therapeutic effect.Conclusion This study indicates that percutaneous endoscopic BEIS technique is effective in the treatment of recurrent lumbar disc herniation,and duration of symptoms and lateral recess stenosis are important prognostic factors.

Colectomy ; Colorectal Neoplasms/surgery* ; Humans ; Laparoscopy ; Treatment Outcome

OBJECTIVETo explore the internal fixation selection and the operative method of Pilon fracture.

METHODSFrom Aug. 2004 to Aug. 2007,there were 40 patients with Pilon fractures involving 30 males and 10 females. Thirty cases were closed fracture and 10 were open fracture. Seven patients were treated by emergency operation, 3 patients were debrided and suture at first. Twenty-three patients were treated with open reduction and internal fixation (ORIF),the other seventeen patients were treated with LC-DCP,reconstruct plate for fixation or screw, Kirschner wire combine screw for fixation.

RESULTSAll patients were followed up for 6 to 32 months (means 19 months). The time of union of fracture was about 3 to 5 months. The outcome was evaluated according to Baired-Jackson criteria, the results were excellent in 27 cases,good in 7, fair in 5, poor in 1. Seven cases were found the operative incision and wound surface difficult to heal,among them 5 cases came from the emergency operation patients, 1 case was closed fracture patient. They were be healed by change of dressing or dermatoplasty or skin flap.

CONCLUSIONIt is the key factor of treatment for Pilon fractures to correct evaluate before operation and select correct operation time. It is also important to selected suitable internal fixation and good reduction.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; physiopathology ; surgery