Objective To evaluate the outcomes of meniscal injures treated by Ho∶YAG laser using arthroscopy.MethodsA total of 31 patients with meniscal injury were treated with holmium∶YAG laser by arthroscopy from January 2006 to March 2008 in our hospital.Among the cases,11 had flap tear,8 had horizontal tear,6 showed bucket-handle tear,and 6 were found with longitudinal tear.The pre-and post-operative Lysholm score,and compilations in the patients were recorded.Results The operation was completed successfully in all the cases with a mean operation time of 44 min(rang,22-55 min).No injuries to the vessels and nerves occurred in the surgery.The patients got out of bed in 1 to 4 days after the surgery(mean,2.1 days).All the surgical wounds achieved primary healing.Follow-up was carried out in the patients for 9 to 28 months(mean,14.5 months).The patients showed significantly lower Lysholm score at 6 months during the follow-up than that determined before the operation(92?6 vs 57?13,t=13.61,P=0.00).Among the cases,21 showed excellent outcomes,7 were good,and 3 were improved.The rate of excellent and good results was 90.3%(28/31).Conclusion Ho∶YAG laser is a safe,simple,and effective tool in cutting menisci under a arthroscope.

In the past two decades,with the development of electron optics,computer and imaging,hip arthroscopy surgery has become the best effective method in the diagnosis and treatment of the hip discord,as a method integrates less invasive and invisible characteristics.The indication of hip arthroscopy gradually expands and has become the gold standard in the diagnosis and therapy of hip discord.Recent research shows hip arthroscopy can provide early diagnosis and treatment hip unexplained pain,such as femoroacetabular impingement(FAI),labral tears,chondral lesions,furthmore hip arthroscopy shows good prospects in the treatment avascular necrosis of femoral head,synovial abnormalities,post hip arthroplasty discomfort.

Adult ; Crown Lengthening ; Dental Prosthesis ; Dental Prosthesis Design ; Esthetics, Dental ; Female ; Gingiva ; Humans ; Incisor ; Smiling

Objective To explore the relationship among the sense of coherence,empowerment and self-efficacy in peritoneal dialysis patients.Methods General information,the Sense of Coherence Scale,the Peritoneal Dialysis Empowerent Scale-Short Form and the Self-Efficacy for Managing Chronic Disease Scale were used to investigate a total of 160 peritoneal dialysis patients in a third-class hospital in Tianjin from March to June,2015.Results The mean score of the sense of coherence,empowerment,self-efficacy were (62.01±11.94) points,(4.09±0.68) points and (6.08±2.19) points.Both the sense of coherence and empowerment could positively influence the self-efficacy of peritoneal dialysis patients directly (r=0.429-0.571,P ＜ 0.01),and the sense of coherence could also indirectly influence the self-efficacy through the mediation of empowerment (β decreased from 0.429 to 0.172,P ＜ 0.01),the mediation effect accounted for 60.1％ of the total effect.Conclusions Medical staff should take different actions to improve the sense of coherence and empowerment to improve the self-efficacy of peritoneal dialysis patients.

Objective To evaluate the effective treatment for and prevention of complications. Methods The diagnosis and treatment of 32 patients with acute arterial ischemia of the lower extremity were analyzed (retrospectively). 4 cases were treated with thrombolytic therapy, 28 cases underwent emergency operation, of which 3 cases underwent amputation after embolectomy, and 25 cases were treated by arteriotomy of femoral artery and embolectomy with Fogarty catheter(7 cases underwent concomitant arterioplasty).Results One (patient) in the nonoperative group died; but there was no mortality in the operated group. Limb amputation was done in 3 cases, and limbs were saved in 28 cases. Conclusions For acute arterial ischemia of the lower (extremity), emergency arteriotomy of femoral artery plus embolectomy is the treatment of choice. This (therapeutic) approach can lower mortality and limb amputation rate.

Objective To investigate the therapeutic value of endoscopic implantation of metal stents for obstruction caused by left-sided malignant colorectal tumor.Methods Data of 29 patients with left-sided malignant colonic obstruction who underwent stenting from May 2007 to May 2011 were retrospectively analyzed.Results Self-expanding metal stents were successfully implanted in 27 patients.Symptoms of abdominal distention and vomiting subsided in these patients.The procedure failed in 2 patients (2/29,6.9％ ),because the guidewire failed to pass the colonic stricture due to edema and the length of the diseased colon.Technical success was achieved in 27 of total 29 patients (27/29,92.6％ ).Out of the 27 patients,stage Ⅰ primary left-sided colonic resection and anastomosis were successfully performed in 24 patients.Colonic perforation was found intraoperatively in 1 patient ( 1/27,3.7％ ) who subsequently recovered after operation.There was no death during the perioperative period with the average hospital stay of 11.7 days.A mean colonic stent patency for 5 months was observed in 3 patients who underwent palliative stenting only.Conclusion Endoscopic implantation of metal stents is effective for left-sided malignant colorectal obstruction.As a bridge to surgery,it facilitates sufficient bowel preparation for elective radical operation.

Objective:To evaluate the relationship between breast reconstruction and postoperative complications by meta-analysis.Methods:Through a defined search strategy, related literature was collected in databases from PubMed, MEDLINE, EMBASE, Cochrane, CNKI, Wanfang Database and VIP Database, from January 1990 to November 2017. Data were extracted and each merged data was analyzed using RevMan 5.3 software. The postoperative complications between transverse rectus abdominis musculocutaneous-flap (TRAM) and deep inferior epigastric perforatorflap (DIEP), TRAM and latissimus dorsiflap (LDF), LDF and LDF+ prosthesis, LDF+ prosthesis and simple prosthesis implantation were compared.Results:Twenty-nine papers met inclusion criteria of our study. The Meta-analysis results showed that the risk of local flap necrosis, seroma, infection, fat liquefaction, abdominal wall hernia and abdominal bulging in TRAM group were higher than those in DIEP group, and the differences were significant. There was no significant difference in total flap necrosis, wound dehiscence, venous congestion between the two groups; the risk of total flap necrosis, wound dehiscence and infection in TRAM group were higher than those in LDF group, and the differences were significant. The risk of seroma in TRAM group was lower than that in LDF group, and the differences were significant. There was no significant difference in fat liquefaction between the two groups; there was no significant difference in the postoperative complications between LDF group and LDF+ prosthesis group; the risk of seroma in LDF+ prosthetic group was higher than that in prosthetic group, and the differences was significant. The risk of prosthetic capsular contracture and prosthesis displacement in LDF+ prosthetic group were lower than those in prosthetic group, and the differences were significant. There was no significant difference in prosthesis exposure and infection between the two groups.Conclusions:DIEP has most of the advantages of TRAM and fewer complications. It plays an important role in breast reconstruction in the future. We should make a choice of breast reconstruction methods according to the patient＇s conditions as far as possible in clinical practice.

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

AIM: To investigate the protective effects of ulinastatin on the rats with paraquat-induced acute lung injury and its mechanisms .METHODS:The Wistar rats ( n=108 ) were randomly divided into control group , pa-raquat group and ulinastatin group .The rats in paraquat group and ulinastatin group were given paraquat by gavage , while the rats in control group were given sterile saline by gavage .The rats in ulinastatin group were also given ulinastatin treat-ment.The serum levels of MDA, SOD, IL-6, IL-10 and TNF-αwere measured after 1 d, 3 d, 7 d, 14 d, 21 d and 28 d. The expression levels of p 38 MAPK, MMP-2 and TIMP-1 in the lung were also measured .RESULTS:The levels of SOD in 1 d, 3 d and 7 d in paraquat group and ulinastatin group were significantly lower than those in control group ( P<0.01).The level of SOD in ulinastatin group was significantly higher than that in paraquat group (P<0.05).The levels of MDA, IL-6, IL-10 and TNF-αin 1 d, 3 d and 7 d in paraquat group and ulinastatin group increased compared with con-trol group (P<0.01), and those in ulinastatin group were significantly lower than those in paraquat group (P<0.05). The levels of p38 MAPK and TIMP-1 in 1 d, 3 d, 7 d, 14 d, 21 d and 28 d in paraquat group and ulinastatin group were higher than those in control group (P<0.01), and those in ulinastatin group was significantly lower than those in paraquat group ( P<0.05) .The level of MMP-2 in 1 d, 3 d, 7 d, 14 d and 21 d in paraquat group and ulinastatin group increased compared with control group (P<0.01), and that in ulinastatin group was significantly lower than that in paraquat group (P<0.05).CONCLUSION:Ulinastatin protects the lung tissues of rats from paraquat-induced acute lung injury by in-hibiting p38 MAPK signaling pathway and ameliorating inflammatory and oxidative responses .

Objective To investigate the optimum doses of combined chemotherapy with cyclophosphamide (CTX) and cisplatin (DDP).Methods 120 cases of ovarian cancer and malignant lymphoma were divided randomly into 6 groups.Drugs were administered to each group:CTX 500 mg/m2 + DDP 40 mg/m2,CTX 500 mg/m2 + DDP 50 mg/m2,CTX 500 mg/m2 + DDP 60 mg/m2,CTX 600 mg/m2 + DDP 40 mg/m2,CTX 600 mg/m2 + DDP 50 mg/m2,CTX 600 mg/m2 + DDP 60 mg/m2.Drugs were administered intravenously once a week for 2 consecutive weeks.Changes in the efficacy and adverse reaction were compared among the groups.Results There was no significant efficacy difference among the groups (P ＞ 0.05).Leukocyte inhibition rate (72.6 ％ and 79.3 ％,respectively) and damage to lymphocyte were maximal in the high-dose chemotherapy groups (CTX 500 mg/m2 + DDP 60 mg/m2,CTX 600 mg/m2 + DDP 60 mg/m2),and the levels of creatinine,blood urea nitrogen,alanine aminotransferase (ALT) in serum and aspartate aminotransferase (AST) were reduced significantly,whereas the hemogram was within normal range in the lowdose chemotherapy group (CTX500 mg/m2 + DDP 40 mg/m2),and the frequencies of damage to renal function and hepatic function were low.Conclusion The optimum dose of combined chemotherapy with cyclophosphamide and cisplatin was CTX 500 mg/m2 and DDP 40 mg/m2.