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

Acupuncture Points ; Acupuncture Therapy ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male ; Scalp

The leading bioregional pesticide,Bacillus thuringiensis,is accepted by the public and widely used biopesticide in the world.B. thuringiensis chitinase may contribute to the biocontrol of phytopathogenic fungi and enhance insecticidal activity.It helps to take full advan- tage of Bt and upgrade the efficiency.This paper reviews the progresses of B.thuringiensis chitinase.

AIM: To discuss the effects of preoperative vitreous cavity injection of ranibizumab on 25G minimally invasive vitreoretinal surgery (VRS) in patients with proliferative diabetic retinopathy(PDR).METHODS: From February 2013 to December 2015,74 patients with PDR received VRS (82 eyes) were retrospectively analyzed.Patients were divided into VRS + IVR group and VRS group according to preoperative VRS treatment.VRS+IVR group: preoperative injection of ranibizumab (10mg / mL) at 3-5d before operation;VRS group: VRS only.We recorded VRS operation time,filling situation,iatrogenic retinal hole and so on.RESULTS: The operation time and coagulation times of VRS+IVR group were significantly lower than VRS group.The two groups in operation time and coagulation times were statistically significant (all P<0.05).In the VRS+IVR group,the number of cases of iatrogenic retinal hole and the use of silicone oil were lower than those of VRS group,the difference between the two groups was statistically significant (P<0.05).While the use number of C3F8 and perfusion fluid were not statistically significant (P>0.05).In VRS-IVR group within 3mo after operation,4 eyes appeared to vitreous body hematocele,VRS group was 13 eyes,the difference was statistically significant (x2=4.966,P<0.05).CONCLUSION: PDR patients with 25G minimally invasive VRS with preoperative therapy can reduce postoperative ocular bleeding,rate of retinal injury and silicone oil filling,shorten the operation time,the incidence rate and improve the success rate of surgery and reduce eye bleeding,postoperative complications such as adhesion.

Air Pollutants ; toxicity ; Air Pollution, Indoor ; adverse effects ; Animals ; DNA Damage ; drug effects ; Female ; Interior Design and Furnishings ; Male ; Mice ; Mutagenicity Tests

Objective To understand the status and drug resistant patterns of strains of extended spectrum ?-lactamase(ESBLs) in children with lower respiratory tract infection,and to give clinical suggestions for rational treatment.Methods Escherichia coli and klebsiella pneumoniae were isolated from the 2 969 nasopharyngeal secretions which collected from lower respiratory tract of children in our hospital from Jan.2006 to Dec. 2007.Dual-sheets and sheets-diffusing method (K-B method) were used to determine the ESBLs and antibiotic susceptibility was tested by K-B method which included 18 kinds of antibiotics,the results were marked by resistant,intermedial and sensitive.Chi-square test was used to analyze the data.Results Total 135 strains were detected,73 strains were escherichia coli,of which 54 strains(74.0%)produced ESBLs,62 strains were klebsiella pneumoniae,of which 33 strains(53.2%)produced ESBLs.The 2 bacterias were found more in children with 1-6 months old than those in other age groups,the ratio of which were 50 strains and 41 strains,respectively (Pa0.05).The resistant rate of ESBLs-producing strains to penicillins,cephalosporins,quinolones,aminoglycosides and sulfamido was higher than that of non ESBLs-producing strains respectively.And the resistant rates to beta-lactam antibiotics of ESBLs strains were located on a high level.Whether producing ESBLs or not,the 2 bacterias were still sensitive to amikacin,cefoxitin,cefoperazone/sulbactam and imipenem.Conclusions The prevalences of ESBLs-producing escherichia and klebsiella pneumonia were high.There was a multi-drug resistance to the varied antibiotics.It is very important to make sputum culture and use sensitive antibiotics in treatment according to drug sensitivity test to control the occurrence and conveying of the ESBLs.

Objective To study the effectiveness and safety of combined laparoscopy and gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EM).Methods From January to December 2010,198 patients with EM undergoing treatment in Department of Obstetrics and Gynecology,Beijing Anzhen Hospital were randomly divided into three groups,which include 52 cases treated by only laparoscopy in laparoscopy group; 76 cases treated by laparoscopy combined with domestic Leuprolide acetate with dose of 3.75 mg every 28 days in Leuprolide acetate group; 70 cases treated by laparoscopy combined with imported Goserelin acetate with dose of 3.6 mg every 28 days in Goserelin acetate group.The efficacy,pregnancy rate and adverse reactions were compared among the three groups.Results Thirteen cases lost following up,including 3 cases in laparoscopy group,6 cases in Leuprolide acetate group and 4 cases in Goserelin acetate group.(1) Effective rates:effective rates were 47 ％ (23/49)in laparoscopy group,77％ (54/70)in Leuprolide acetate group and 74％ (49/66)in Goserelin acetate group.Compared with laparoscopy group,the effective rate of Leuprolide acetate group and Goserelin acetate group was significantly elevated (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(2) Recurrence rate:recurrence rate were 33％ (16/49) in laparoscopy group,13％ (9/70)in Leuprolide acetate group and 12％ (8/66)in Goserelin acetate group.Compared with laparoscopy group,the recurrence rate of Leuprolide acetate group and Goserelin acetate group was significantly declined (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(3) Pregnancy rate:the number of patients require fertility were 28 cases in laparoscopy group,39 cases in Leuprolide acetate group and 35 cases in Goserelin acetate group.After 2 years follow up,pregnancy rate of 62％ (24/39) in Leuprolide acetate group and 60％ (21/35)in Goserelin acetate group were high than 39％ (11/28)in laparoscopy group significantly,which did not reached significant difference (P ＞ 0.05).(4) Adverse drug reaction:rates of a adverse reactions were 21％ (15/70) in Leuprolide acetate group and 20％ (13/66) in Goserelin acetate group,including irregular vaginal bleeding associated with low estrogen level.There was no significant difference in adverse reactions (P ＞ 0.05).Conclusions Compared with laparoscopy alone,laparoscopy combined with GnRH-a is more effective in treatment of,which exhibit lower recurrence rate,higher pregnancy rate and fewer adverse reactions.Domestic Leuprolide acetate have similar safety and efficacy compared with imported GnRH-a.

BACKGROUND:Ultrasound therapy can relieve pain and improve the movement function in patients with knee osteoarthritis, but there lacks of consistency in the literatures of ultrasound therapy.
OBJECTIVE:To further identify the effectiveness of ultrasound therapy in the treatment of knee osteoarthritis.
METHODS:Twenty-four rabbits were randomly divided into three groups:normal group, model group and ultrasound group. The rabbit in the normal group received no intervention;rabbits in the model group received anterior cruciate ligament transaction to establish the knee osteoarthritis model without any treatment;the rabbit in the ultrasound group received ultrasound therapy after modeling for 10 minutes once time, once per day, 0.3 W/cm2 , 1 MHz and treated for 10 times. Hematoxylin-eosin staining was conducted for histological observation of rabbit articular cartilage;western blot and reverse transcription PCR assessment were used to assess the expressions of caspases-3 and caspases-8 in rabbit articular cartilage, while Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to assess the ratio of chondrocytes apoptosis of rabbit knee articular cartilage.
RESULTS AND CONCLUSION:The normal rabbit cartilage tissues and chondrocytes were neatly arranged in column;the middle cartilage layer of the model was thin;the chondrocytes were arranged disorderly and became less. After ultrasound therapy, the chondrocytes were rearranged neatly, and the number was increased. Compared with the normal group, the Mankin scores in the model group and ultrasound group were higher;the apoptotic rate of chondrocytes was higher in the model group and ultrasound group than in the normal group, and was also higher in the model group than in the ultrasound group. Compared with the normal group, the expressions of caspases-3 and caspases-8 were higher in the model group and the ultrasound group, while decreased after ultrasound therapy. The results indicate that ultrasound can improve the structure of cartilage tissues, decrease the expressions of caspases-3 and caspases-8 and reduce the apoptosis rate of chondrocytes. It is effective for the treatment of knee osteoarthritis with ultrasound therapy.

Professor WEI Pin-kang believes that, as a complication of gastric cancer, malignant ascites and gastric cancer have the same pathogenesis: water and dampness retention is the external performance and phlegm resistance is the inner essence. Hence therapy of resolving phlegm and promoting diuresis is suggested for the fundamental treatment of gastric ascites. Using the method of the combination of internal and external treatment, this therapy includes resolving phlegm and draining water medicine both to dispel pathogen and to improve symptoms. Xiaotan LishuiDecoction based on this therapy is composed of Arisacma Cum Bile, processed Pinelliae Rhizome, Cremastrae Pseudobulbus Pleiones Pseudobulbus, old pericarp of bottle gourd, Polyporus, Natriee Sulfas, Phytolaccae Radix and Poria.

Objective To explore the effect of early goal-directed therapy (EGDT) according to pulse indicated continuous cardiac output (PiCCO) on septic shock patients.Methods Eighty-two septic shock patients in Subei People's Hospital of Jiangsu Province from January 2009 to December 2012 were enrolled and randomly divided into two groups using a random number table,standard surviving sepsis bundle group (n=40) and modified surviving sepsis bundles group (n =42).The patients received the standard EGDT bundles in standard surviving sepsis bundle group.PiCCO catheter was placed in modified surviving sepsis bundles group.Fluid resuscitation was guided by intrathoracic blood volume index (ITBVI) with the aim of 850-1 000 mL/m2.Dobutamine was used to improve the heart function according to left ventricular contractile index (dPmax) and stroke volume index (SVI).The mean arterial blood pressure (MAP) was maintained 65 mmHg (1 mmHg=0.133 kPa) or above with norepinephrine.Extra-vascular lung water was monitored for the titration of liquid and diuretics.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,sequential organ failure assessment (SOFA) score,the number of patients needed vasopressor,serum procalcitonin (PCT),lactic acid and lactate extraction ratio,the amount of fluid resuscitation,duration of mechanical ventilation,duration of intensive care unit (ICU) stay,hospital mortality were recorded in both groups.Results After treatment,the APACHE Ⅱ score,SOFA score and the number of patients needed vasopressor were gradually reduced in both groups,and those in modified surviving sepsis bundle group were significantly lower than those of standard sepsis bundle group at 72 hours (APACHE Ⅱ score:13.1 ± 6.5 vs.20.9 ± 7.5,SOFA score:8.8 ± 4.3 vs.14.6 ± 4.9,the number of patients needed vasopressor:8 vs.17,all P＜0.05).Arterial blood lactate clearance rate was gradually increased after treatment in both groups.Lactate clearance rate in modified surviving sepsis bundle group was significantly higher than that of standard surviving sepsis bundle group [6 hours:(18.2 ± 8.3)％ vs.(10.8 ± 7.5)％,t=-6.036,P=0.001 ; 12 hours:(22.6 ± 7.3)％ vs.(12.4 ± 8.1)％,t=-4.536,P=0.001 ; 24 hours:(27.8 ± 5.6)％ vs.(16.4 ± 9.5)％,t=-5.882,P=0.000].The amount of fluid resuscitation within 6 hours in modified surviving sepsis bundle group increased significantly compared with standard surviving sepsis bundle group (mL:3 608 ± 715 vs.2 809 ± 795,t=-3.865,P=0.033).The amount of fluid resuscitation within 24,48 and 72 hours in modified surviving sepsis bundle group was significantly less than that of standard modified surviving sepsis bundle group with the nadir at 72 hours (mL:918 ± 351 vs.1 805 ± 420,t=5.907,P=0.037).Duration of mechanical ventilation (hours:98.4 ± 20.3 vs.143.3 ± 29.6,t=9.766,P=0.001) and ICU stay (days:7.1 ± 3.1 vs.9.5 ± 2.5,t=2.993,P=0.004) were significantly reduced in modified surviving sepsis bundle group compared with standard surviving sepsis bundle group.The hospital mortality in modified surviving sepsis bundle group was slightly lower than that in standard surviving sepsis bundle group [16.7％(7/42)比 17.5％(7/40),x2=0.010,P=0.920].Conclusions Modified surviving sepsis bundle treatment according PiCCO can reduce the severity of disease in patients with septic shock,can make more accurately guide fluid resuscitation,and can reduce lung water and duration of mechanical ventilation and ICU stay.It has great clinical significance.