OBJECTIVETo evaluate the clinical results of Triple-Endobutton plates for the treatment of Rockwood type III to V acromioclavicular joint dislocation.

METHODSFrom March 2008 to June 2010,28 patients with Rockwood type II to V acromioclavicular joint dislocations were treated with Triple-Endobutton plates. There were 18 males and 10 females,ranging in age from 20 to 60 years old (averaged 38 years old). Twenty patients had dislocations in the left and 8 patients had dislocations in the right. All the patients had close injury. The Constant criterion was used to evaluate shoulder joint function.

RESULTSAll the patients were followed up,and the duration ranged from 18 to 24 months,with an average of 20 months. All the patients got good shoulder joint function,and no re-dislocation and pain occurred. The X-ray showed all acromioclavicular joints got good reduction. According to Constant criterion,preoperative score was 25.4 +/- 2.0, postoperative scores were 65.9 +/- 3.0, 87.2 +/- 3.2 and 95.7+/- 1.6 at 1 month,3 months and 6 months separately.

CONCLUSIONTreatment of Rockwood type III to V acromioclavicular joint dislocation with Triple-Endobutton plates has satisfactory clinical outcome, simple operation, few complications, without secondary operation and early functional exercise postoperatively.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective:To observe the acoustic characteristics of glottal stops produced by patients with cleft palate.Methods:Twenty boys with cleft palate who were judged to be glottal-stop-producers and 20 normal peers were included. In their own way, all the children were asked to produce following sounds: /iu/ /pai/ /t′u/, /s/ /k′/ /p′u/ /t′u/, /tA/ /ku/ and /i/ /k′u/ /ti/ /suan/. Then the speech spectroanalysis and the comparison were performed by one investigator.Results:The acoustic characteristics of glottal stops changed a lot when they substitute or accompany with different oral stops, which included the emergence of spikes, changes of voice onset time, the formant transitions and spetroanalysis of spikes. Conclusion:The acoustic changes of glottal stops are complicated. Every single aspects of acoustic analysis should be considered in the identification of the acoustic characteristics.

Cleft Palate ; surgery ; Humans ; Incidence ; Oral Fistula ; epidemiology ; etiology ; Palate ; surgery ; Postoperative Complications ; epidemiology ; Reconstructive Surgical Procedures ; adverse effects ; Statistics as Topic

Objective:Total 621 cases of medical disputes occurred during 2000 to 2013 were analyzed retro-spectively, to investigate the dispute factors and analysis of improvement, to promote doctor-patient relationship. Methods:621cases of medical disputes from 2000 to 2013, on a case by case attributes are classified, analyzed two year interval comparison, find the dispute factors in evolution.Results:Through the analysis of 621 cases of disputes over property, complications of the disease cause dispute case first, economic reasons, the second medical defect.Conclusions:Analysis of the two year interval comparison shows:how to strengthen the hospital scientific management, innovative service mode, the medical system implemented is the important link of reducing medical disputes.

To train medical students' clinical thinking ability is an important aspect of clinical probation practice and also the common goal of dermartology probation training. This article analyzes the problems around the cultivation of clinical thinking ability during probation practice in our department,and proposes the corresponded measures to improve it.

This paper introduces the background, implication and construction of the county health services community (County medical alliance) model in Anhui Province under the background of new medical reform,and briefly introduces the relationship between medical insurance, enhancing the ability to upgrade and standardize services and medical treatment integration of the typical experience.It also analyses the challenges faced in the construction of medical syndicate, such as the mechanism of regional environmental restriction, compensation and assessment mechanisms which have not been established yet, and the sustainable development of information technology that has lagged behind, and put forward the policy suggestion to improve the construction of medical community, with a view to providing reference for the next work.

Objective To explore the surgical method, clinical result, biomechanical property, and surgical indication of treatment of thoracolumbar burst fractures with titanium mesh fusion device. Methods 22 patients with the thoracolumbar burst fracture and paralysis were treated by anterior decompression and spinal stability reconstruction with titanium mesh fusion device and a titanium plate. In this group, the fracture was at the 12th thoracic vertebra in 7 cases, the 1st lumbar in 14, and the 2nd lumbar in 1. According to Frankel’s classification, 4 cases were of Grade A, 6 of Grade B, and 12 of Grade C. 20 patients experienced the kyphosis deformity. The kyphosis angles varied from 12 to 29 degrees with a mean of 19.5 degrees. Results The period of postoperative follow up varied from 0.6 to 2 years with an average of 1.2 years. The neural function was improved for more than 1 grade. 15 cases could control urination after the surgery. The kyphosis angles were reduced to 3 to 8 degrees with a mean of 5 degrees. The complications caused by the implants were not found. Conclusions To treat the thoracolumbar burst fractures with paralysis, the compressive elements from anterior side of the spinal cord should be completely removed. Since the titanium mesh fusion device plus a plate can reconstruct the spinal stability that satisfies spinal biomechanical property, it presents important application value.

OBJECTIVETo investigate the correlation between articulation, velopharyngeal function, and surgical age by comparing the changes in articulation after velopharyngeal closure is performed. This study is also conducted to investigate the influencing factors of omission change between pre- and post-operation.

METHODSA total of 48 patients, including 18 males and 30 females, mean age (13.3 ± 5.8) years, with non-syndromic cleft lips and palates were selected from January 2011 to December 2011. Their speech data and articulation between pre- and post-operation were retrospectively analyzed using non-parametric tests. Correlation study was performed to analyze the influencing factors of the changes in articulation. P < 0.05 was considered statistically significant.

RESULTSThe difference in articulation after velopharyngeal closure occurred was significant (Z = -3.796, P = 0.000). A negative correlation between the ratio of post-operative normal articulation and surgical age (R = -0.487, P = 0.000) was observed. The change in omission was positively correlated with surgical age (R = 0.589, P = 0.000) and gender (R = 0.404, P = 0.047). By comparison, the change in omission was negatively correlated with follow-up time (R = -0.235, P = 0.040).

CONCLUSIONArticulation and intelligibility are significantly improved after velopharyngeal closure is performed. These parameters are negatively correlated with surgical age to some extent. In addition, the change in omission is positively correlated with surgical age and gender, whereas the change in omission is negatively correlated with follow-up time.

Adolescent ; Articulation Disorders ; Child ; Cleft Lip ; Cleft Palate ; Female ; Humans ; Male ; Retrospective Studies ; Velopharyngeal Insufficiency ; Young Adult

OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

Objective To systematically review the evidence for the effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism. Methods We searched databases including Pubmed, Elsevier, Web of Science, and WANFANG Database etc. for randomized controlled trials comparing vitamin D or analogues with placebo. We extracted data on insulin resistance and blood glucose, including homeostasis model assessment of insulin resistance( HOMA-IR), fasting blood glucose, HbA1C (% ). A1l data were analyzed using Review Manager 5. 0. Results Nine studies involving 867 participants were included. The results of meta-analysis showed that: ( 1 ) For people who are obese and with abnormal glucose metabolism, meta-analysis showed a small improvement in HOMA-IR(SMD -0. 34,95% CI -0. 61 to -0. 06, P<0. 05) and a small effect on fasting glucose (SMD -0. 41 mmol/ L, 95% CI -0. 68 to -0. 15, P<0. 05),while such effects were not seen in people who are obese but with normal blood glucose. (2) No serious adverse events were associated with the administration of vitamin D. Conclusion vitamin D supplementation may be benefit for improving insulin resistance and fasting blood glucose in people who are obese and with abnormal glucose metabolism, but has no effect on obese people with normal blood glucose.