OBJECTIVETo evaluate the clinical outcomes and complications of Triple-Endobutton plates in treating Tossy type III acromioclavicular joint dislocation.

METHODSFrom January 2011 to January 2013,45 patients with Tossy type III acromioclavicular joint dislocation were treated with Triple-Endobutton plates. There were 35 males and 10 females with an average age of 30.5 (ranged from 19 to 60) years old. At the final follow-up, VAS, DASH, Constant-Murley criterion were used to evaluate shoulder function.

RESULTSAll patients were followed up from 15 to 36 months. No neurovascular injury, wound infection and stress fractures were found,but 3 patients had a re-dislocation. At the final follow-up,the mean VAS score was decreased from (5.7±1.6) preoperatively to postoperative (0.2±0.1); DASH score was significantly decreased from (19.6±4.3) preoperatively to (0.3±0.1) postoperatively; Constant-Murley score was improved from (34.4±4.3) before operation to (94.8± 3.5) after operation.

CONCLUSIONClinical outcomes of treating Tossy type III acromioclavicular joint dislocation with Triple-Endobutton plates is satisfactory. However, re-dislocation is still the most common complication. Careful perioperative management is an important factor in preventing re-dislocation.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Treatment Outcome ; Young Adult

To establish a fast sensitive, reproducible LC-MS/MS method to study pharmacokinetic properties of THC, and compare relative bioavailability of THC and its solid dispersion in mice. 200 mice were divided randomly into two groups, and administered orally with THC and THC-solid dispersion after fasting (calculate on THC:400 mg x kg(-1)), used HPLC-MS/MS method to determine the THC concentration of each period at the following times: baseline ( predose ), 15, 30, 45 min, 1, 1.5, 2, 3, 4, 6, 24 h after dosing. Calculating the pharmacokinetic parameters according to the C-t curv, and then use the Phoenix WinNonlin software for data analysis. The calibration curves were linear over the range 9.06-972 microg x L(-1) for THC (R2 = 0.999). The limit of detection (LOD) was 0.7 microg x L(-1), respectively. The average extraction recoveries for THC was above 75%, The methodology recoveries were between 79% and 108%. The intra-day and inter-day RSD were less than 13%, the stability test showed that the plasma samples was stable under different conditions (RSD < 15%). The precision, accuracy, recovery and applicability were found to be adequate for pharmacokinetic studies. Pharmacokinetic parameters of THC and THC-solid dispersion orally to mice shows as fllows: T(max), were 60 and 15 min, AUC(0-t) were 44 500.43 and 57 497.81 mg x L(-1) x min, AUC(0-infinity) were 51 226.00 and 68 031.48 mg x L(-1) x min, MRT(0-infinity) were 596.915 6, 661.747 7 min, CL(z)/F were 0.007 809 and 0.005 88 L x min(-1) x kg(-1). Compared with THC, the MRT and t1/2 of the THC-solid dispersion were all slightly extended, the t(max) was significantly reduced, AUC(0-24 h), AUC(0-infinity) and C(max) were all significantly higher, the relative bioavailability of THC-solid dispersion is 1.34 times of THC. The results of the experiment shows that the precision, accuracy, recovery and applicability were found to be adequate for the pharmacokinetic studies. After oral administration to mice, the relative bioavailability of THC-solid dispersion show significant improvement compared to THC.
Administration, Oral ; Animals ; Biological Availability ; Dronabinol ; administration & dosage ; chemistry ; pharmacokinetics ; Female ; Male ; Mice

Objective To investigate the nutrition status of the focus groups of iodine deficiency in the 5 coastal counties(districts)in Guangxi in 2008 to propose corresponding prevention and control measures.Methods In the 5 coastal counties(districts)in Guangxi,including Haicheng,Tieshangang,Yinhai districts and Hepu county in Beihai city,Qinnan district in Qinzhou city,the rates of iodized salt coverage,qualified iodized salt and consumption of qualified iodized salt had always been below the average level of Guangxi.In the study,6 towns were randomly picked in Hepu district,and 3 towns were randomly picked in each of the other 4 coastal counties(districts).Two administrative viRages were randomly picked in each town.Forty children ages 8 to 10 and 10 women of child-beating age from 18 to 42 which included 5 pregnant and lactating women,were picked from each administrative village.Arsenic-cerium catalyzed spectrophotometry(WS/T 107-2006)Was used to determine the urinary iodine.Results In total,1437 urine samples of the children Were picked.The median of the children's urinary iodine Was 191.0μg/L,with 1.4%(20/1437)of the children's urinary iodine<20 μg/L,and 5.4%(77/1437)<50 μg/L, and 20.3%(292/1437) < 100 μg/L. The medians of the children's urinary iodine were 134.5 - 220.0 μg/L.In Haicheng and Hepu, the medians of the children's urinary iodine were higher than 200 μg/L(220.0,209.5 μg/L, respectively). The medians of the children's urinary iodine in the other 3 counties(districts) were within the suitable range between 100 and 200 μg/L(134.5,162.4,199.3 μg/L, respectively). The medians of the 8- and 9-year-old ehildren's urinary iodine (192.3,206.7 μg/L, respectively) were higher than that of the 10-year-old children's(157.2 μg/L, χ2 = 19.644,41.997, all P < 0.017). Totally, 365 urine samples of the women were picked.The medians of the women's urinary iodine in the 5 counties were 88.2 - 195.6 μg/L, with 195.6 μg/L in Haicheng and 156.5 μg/L in Hepu, and 88.2 μg/L in Tieshangang, which was the lowest and below 100 μg/L. The median of the childbearing-age women's urinary iodine was the highest(152.6 μg/L). The median of the lactating women's urinary iodine was the second (131.9 μg/L). The median of the pregnant women's urinary iodine was the lowest (89.4 μg/L) and below 100 μg/L. Only 6.7%(2/30) of the pregnant women's urinary iodine were within the suitable range between 150 and 250 μg,/L. Conclusions In the 5 coastal counties(districts) in Guangxi, 8 to 10-year-old children had good nutrition levels while childbearing-age and lactating women were within the suitable range. As a whole, the pregnant women had insufficient iodine nutrition. We propose that the iodine nutritional status of pregnant women is monitored routinely, with further prevention, control measures, health publicity and education necessary to improve iodized salt coverage.

OBJECTIVETo analyze the data of angle variation on traction based on a finite element model of complete cervical spine with straight physiological curvature, and try to give experimental reference and suggestion in treating cervical spondylosis.

METHODSA 43-year-old female patient with straight cervical spine was chosen and the CT scan data were collected. By using specially designed modeling system, a high quality finite element model of complete cervical spine with straight physiological curvature is generated,which included ligament and muscle according to anatomy. After the model was confirmed, traction was loaded with angle 0 degree, anterior 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, to observe the data of distance change on between adjacent intervertebral foramen, processus articularis, uncovertedral joint, intervertebral discs, and stress of anulus fibrosus and nucleus pulposus.

RESULTSWhen the angle was 0 degrees-15 degrees, the distance between intervertebral foramen, Luschka joint and processus articularis posterioris was enlarged, the tensile stress was adequate and compressive stress was small. It met the clinical requests.

CONCLUSION0 degree-15 degrees anterior position is suggested for the treatment of cervical spondylosis.

Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; anatomy & histology ; surgery ; Female ; Finite Element Analysis ; Humans ; Spondylosis ; surgery ; Traction ; methods

OBJECTIVETo explore methods and clinical outcomes of microsurgical technique in treating patients with severed palm.

METHODSFrom January 2009 to December 2012,45 patients with severed palm were treated by replantation through microsurgical technique, included 37 males and 8 females, aged from 13 to 45 years old with an average of 25. Postoperative survival rate and evaluation standard of upper limb replantation function posposed by Chinese Medical Association were applied for evaluate clinical outcomes after operation.

RESULTSForty-five patients with severed plam were treated by replantation. Thirty-nine patients (121 fingers) were survived,and survival rate was 87%. All patients were followed up 3 to 15.5 months with an average of 11.5 months. According to evaluation standard of upper limb replantation function posposed by Chinese Medical Association, the total score was 80.27 +/- 1.93, and 27 cases got excellent results, 8 good and 4 poor.

CONCLUSIONThe success of replantation of severed palm depends on grasping operation indication strictly, knowing complexity and local anatomic relationship, debridement completely during operation, making full use of remaining organization, arteriovenostomy through microsurgical technique as early as possible, constructing circulation and repairing injuried nerve rationally.

Adolescent ; Adult ; Female ; Hand Injuries ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Replantation ; Young Adult

Objective：This study was designed to investigate microvessel density (MVD) and expression of vascular endothelial growth factor (VEGF)， basic fibroblast growth factor (bFGF) in pancreatic cancer, and the relevance of these three indexes to the biological behavior of the cancer． Methods：Intratumor MVD and the expression of VEGF and bFGF were examined by immunohistochemical staining in 47 pancreatic cancer tissues (polyclonal antibody for FⅧ and VEGF, monoclonal antibody for bFGF), and the relationship between either MVD or the expression of these two angiogenic factors and the clinicopathological features, including survival were analyzed． Results：MVD in cancer tissues was higher (10.32± 3.32) than that in normal tissues (6.72± 1.73) (P<0.01). In 47 cases, the positive rate of expression of VEGF, bFGF protein in pancreatic cancer was significantly higher than that in normal tissues(P< 0.05), 57.44％ of 47 pancreatic cancer were positive for VEGF protein in cancer cells,and 63.82％ showed strong bFGF staining in cancer and infilbrating cells． The overexpression of VEGF and bFGF protein correlated significantly with high MVD (P< 0.05). Advanced pathological grade of the disease was significantly more frequent in the patients with high MVD, positive staining of VEGF and bFGF, (P< 0.01)． The higher MVD and the overexpression of bFGF correlated with poor survival (P< 0.05)． Conclusions： Intratumor MVD is strongly related to the progress, invasiveness and metastasis of pancreatic cancer, and may serve as a meaningful prognostic factor． The overexpression of VEGF and bFGF may play an important role in the process of tumor-associated neovascularization and suggest that VEGF or bFGF system may be promising target for antiangiongenic strategy of pancreatic cancer．

Adult ; Bone Plates ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective To evaluating the effectiveness of comprehensive measures to control the plague in epidemic areas in Longlin county Guangxi from 2001 to 2010.Methods Original epidemic places was deratised,indicative animals were investigated,and epidemic clues were searched.Cage trapping method was used to capture rat and rat body fleas were collected in the plague epidemic areas.The flea-carrying rates and flea index of rodents were calculated based on the number of fleas collected from caged rodents.The animals were then subjected to etiological and serological tests to determine the plague infection rate.Results A total of 1008 rats were captured and 571 fleas were collected from 2001 to 2010,of which Rattus Flavipestus accounted tor 81.65％(823/1008) and Xenopsylla Cheopis for 64.10％(366/571).The annual average rodents infected with flea and the index of flea were 23.02％ (177/769) and 0.74,respectively.The annual average density of rodents decreased from 3.99％ (859/21 508,before deratised) to 0.96％ (149/15 600,after deratised).The deratization rate was 75.94％.Conclusion The risk of a plague epidemic in Longlin county is reduced after continued comprehensive measures be taken to deal with the disease.

Objective Application of the second metatarpophalangeal joint by traction prolong trans- plant repair the defects in the metacarpophalangeal joint,reconstruct the function of it.Methods By means of the apparatus to prolong finger in advance,then transplant the second metatarpophalangeal joint to recon- struct metacarpophalangeal joint for seven cases of obsolete defects in the metacarpophalangeal joint.Results The average of finger prolong was 2.6 cm,consultation from 1 to 4 years.average 2.5 years,thai the trans- plant joints have all survived and osteal concrescence.Through the criterion Chinese Medical Association,good rate was 85.7%. Conclusion It' s a good method to repair obsolete defects in the metacarpophalangeal joint by transplant traction prolong of the second metatarpophalangeal joint.

Objective To investigate the effect of different concentrations of human adipose stromal vascular fraction cells (SVFs) on the survival rate of fat transplantation.Methods 0.3 ml fat tissue,derived and refined from clinical liposuction patients.was mixed with different concentrations of SVFs as 5 × 105/ml in Group A,or 1 × 106/ml in Group B,or 2 × 106/ml in Group C,or completely medium in control group D.Then the mixture was injected randomly under the back skin of 6 nude mice.The transplanted fat tissue in four groups was harvested at 3 months after implantation.Wet weight of fat grafts was measured for macroscopic aspects.After HE staining,blood vessel density,viable adipocytes and fibrous proliferation were counted respectively for histological evaluation.Results The wet weight of fat grafts in group B(81.670 ± 7.528) mg was significantly higher than that in group A、C、D [ (60.000 ±6.325 ) mmg、(68.330 ± 7.528 ) mg、(48.330 ± 7.528 ) mg,respectively,P ＜ 0.05 ) ],but the difference between group A and group C was not statistically significant(P ＞ 0.05).The grafts in group A 、B and C had significantly higher blood vessel density than those in the control group D,whereas blood vessel density was the highest in group B( P ＜ 0.05 )and there was no significant difference between group A and C (P ＞0.05).Compared with group A,C and D,histological analysis revealed that the fat grafts in group B was consisted predominantly of adipose tissue with less fat necrosis and fibrosis (P < 0.05 ).However,fibrosis counts were significant lower in group A,B and C than those in group D( P <0.05),and there was no significant difference between group A and C(P ＞0.05).Conclusions The human isolated SVFs has the advantages to improve the survival rate of fat transplantation,and the magnitude of 1 × 106/ml is more practical and safe,indicating a wide clinical application in the future.