OBJECTIVETo explore the relationship of the classification of talus fracture and surgery methods with avascular necrosis.

METHODSFrom March 2009 to November 2013, 78 patients with talus fracture were treated, of them, 43 cases were followed up from 2 to 5 years. There were 27 males and 16 females, aged from 17 to 65 years old with the mean of 38.6 years. Thirty-nine cases had talar neck injury and 4 cases had talar body injury. Different treatments were performed according to different injury conditions. The time from injury to treatment was from 6 to 48 hours. The effect of classification of talus fracture and surgery methods on avascular necrosis was analyzed.

RESULTSIn 43 cases,19 cases occurred avascular necrosis, including talar neck fracture of type I in 2 cases, type II in 5 cases, type III in 5 cases, type IV in 5 cases and talar body fracture in 2 cases (combined with talar neck fracture). And 29 patients were treated with operation, there was no statistically significant differences in avascular necrosis with different operations.

CONCLUSIONCompared with talar body fracture, talar neck fracture is more easily to develop into avascular necrosis. In the 4 types of talar neck fracture, the possibilities of type III and IV were the most ones.

Adolescent ; Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; surgery ; Humans ; Male ; Middle Aged ; Osteonecrosis ; surgery ; Talus ; blood supply ; injuries

OBJECTIVETo summarize experiences of operative treatment for Essex-Lopresti injury, and analyze the effect of the compare repair of interosseous membrane of forearm(IOM)on the forearm function.

METHODSTwenty-four patients of Essex-Lopresti injury were treated from January 2005 to December 2013, 16 patients(group A) with radius and/or ulna fractures were treated with open reduction and internal fixation of radius or ulna and repair of forearm bone membrane at the same time, and then treated with open reduction and internal fixation of head of radius, as well as lower ulnar joint fixation or repair of wrist triangle fiber complex. Another 8 patients without radius and or ulna fractures(group B) were treated with open reduction and internal fixation of head of radius, as well as lower ulnar joint fixation or repair of wrist triangle fiber complex. The wrist joint function was evaluated using Cooney wrist functional rating index, and the elbow joint function was evaluated using Mayo elbow-performance score 2 weeks and 2 years after operation.

RESULTSAccording to Cooney wrist functional rating index, 4 patients in group A got a fair result and 12 poor, 2 patients in group B got a fair result and 6 poor 2 weeks after operation; 8 patients in group A got a good result, 6 fair and 2 poor, 5 patients in group B got a good result, 2 fair and 1 poor 2 years after operation. According to Mayo elbow-performance score, 2 patients in group A got a good result, fair and 6 poor, 1 patient in group B got a good result, 5 fair and 2 poor 2 weeks after operation; 8 patients in group A got a good result, 6 fair and 2 poor, 4 patients in group B got a good result, 3 fair and 1 poor. There were no statistically differences between two groups 2 weeks and 2 years after operation.

CONCLUSIONSIt is important to restore the length of radius and/or ulna and maintain the dynamic stabilization of elbow and wrist for treat Essex-Lopresti injury. The repair of IOM has no effect on the forearm function.

Decompression, Surgical ; Gout ; Humans ; Lumbar Vertebrae ; Spinal Stenosis

OBJECTIVETo compare the clinical outcomes between HLA allele matched (HLA-M) and 1 approximately 2 alleles disparity mismatched (HLA-mis) unrelated allogeneic bone marrow transplantation (URD-BMT).

METHODSThirty-nine patients received HLA-M and 21 received HLA-mis URD-BMT for the treatment of acute leukemia, chronic myeloid leukemia in chronic phase (CP) and myelodysplastic syndromes (MDS) in our hospital between November 1998 and December 2002. Conditioning regimen was Bu 16 mg/kg plus CTX 120 mg/kg, and mycophenolate mofetil (MMF), CsA and MTX were given to prevent aGVHD.

RESULTSThirty-eight of the HLA-M group and 18 of the HLA-mis group were engrafted successfully. The median follow-up duration was 11 (2.5 - 52.0) months for HLA-M group and 9 (2 - 46) months for HLA-mis group. The 3-year probabilities of disease-free survival (DFS) for HLA-M and HLA-mis group were (79.2 +/- 7.1)% and (45.8 +/- 15.5)%, respectively (P < 0.05). Grade II - IV aGVHD occurred in 10 (26.3%) patients in HLA-M group and 6 (33.3%) in HLA-mis group, respectively (P > 0.05).

CONCLUSIONURD-BMT is an effective modality for the treatment of leukemia and MDS. The outcome after URD-BMT can be optimized by matching the HLA-A, B and DR alleles between the donor and recipient.

Adolescent ; Adult ; Alleles ; Bone Marrow Transplantation ; Child ; Disease-Free Survival ; Female ; Histocompatibility Testing ; Humans ; Leukemia ; mortality ; therapy ; Male ; Middle Aged ; Myelodysplastic Syndromes ; mortality ; therapy ; Transplantation, Homologous

An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient’s low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.