Objective To investigate the methods, feasibility, outcome and indications of atlantoaxial pedicle screw system in the treatment of upper cervical injury. Methods Thirteen patients with upper cervical injury were treated by atlantoaxial pedicle screw system. There were four patients with old odontoid fractures, two with new odontoid fractures (Aderson ⅡC), three with rapture of the transverse ligament of C1 and four with C1 fracture. Results A total of 26 pedicle screws and 26 pedicle screws were implanted. The mean operation time and perioperative blood loss were 2.6 hours and 470 ml, respectively. No injury to the vertebral artery and spinal cord was observed. All patients were followed up for 4-25 months (mean 13 months). The clinical symptoms were improved to some extent according to Japanese Orthopedic Association scoring system, with improvement rate of 72%-91% (mean 81%). The screws were verified to be fixed in a proper position, and no hardware broken or loosening was observed except for one C1 screw penetrating the medial superior cortex of lateral mass for 3 mm without affecting occipito-aflantal motions. All patients had a solid bony fusion 3-6 months later. Conclusion The atlantoaxial pedicle screw system is feasible in the treatment of upper cervical injury with the advantages of better outcomes and wider indications.

This study was designed to observe the clinical value of low-density lipoprotein immune complexes (LDL-ICs) in patients with type 2 diabetes mellitus (T2DM). Fifty-four patients with type 2 diabetes + macroangiopathy (DM-MA group), 48 patients with type 2 diabetes (DM group), 45 patients with macroangiopathy ( MA group), and 30 normal controls ( NC group) were enrolled. LDL-ICs levels in the DM-MA group were significantly higher than those in the other three groups. The levels of LDL-ICs in the MA group were higher than those in the NC and DM groups. There was a significant difference in LDL-ICs between the DM and NC groups. LDL-ICs levels were positively related with body mass index (BMI), glycesylated hemoglobin Alc(HbAlc), blood pressure, total cholesterol, and triglyceride. There was no significant relationship between low-density lipsprotcin cholesterol and LDL-ICs. A significantly negative correlation was recorded between high-density lipoprotein cholesterol and LDL-ICs. Our study suggests that LDL-ICs, blood pressure, and HbAlc may be risk factors of macroangiopathy in type 2 diabetic patients.

OBJECTIVETo explore the clinical effect of plantar medial perforator artery based reverse island medial dorsal pedal neurocutaneous vascular flaps.

METHODS12 cases with soft tissue defects of forefeet were treated by plantar medial perforator artery based reverse island medial dorsal pedal neurocutaneous vascular flaps. The flap size ranged from 3.0 cm x 3.5 cm to 5.5 cm x 8.5 cm.

RESULTAll flaps survived completely. The patients were followed up for 6 - 24 months. The texture and flexibility of the flaps were normal with no ulcer. The sensation improved with the two-point discrimination of 7 - 10 mm. The cosmetic and functional results were satisfactory. The wounds at donor site healed primarily.

CONCLUSIONSThe flaps have expanded size for large defects with good flexibility, thickness and texture. It is easily performed with less morbidity to main artery.

Adult ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Tibial Arteries ; surgery ; Young Adult

Biomarkers ; blood ; Diagnostic Techniques, Digestive System ; Elasticity ; Hepatitis C, Chronic ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; etiology

OBJECTIVETo study the value of ultrasound elastography in evaluation of ethanol-induced lesions of liver.

METHODSAlcohol with a dose of 2 ml was injected into a fresh porcine liver under ultrasound guidance to create stiff necrosis. Then freehand elastography of the lesion from the identical scan plane was obtained with SONOLINE Antares system using VF10-5 probe at about every 30 seconds till 6 minutes later. The original high quality radiofrequency data were acquired through an ultrasound research interface which was provided by the ultrasound system. Then, corresponding elastograms were produced offline using cross-correlation technique and compared with gross pathology findings.

RESULTSGray-scale sonogram showed a hyperechoic area with acoustic shadow below appeared immediately after alcohol injection. The hyperechoic area tended to be diffuse and its boundary to be illegible with time. On the contrary, the ethanol-induced lesion in elastogram appeared as a low strain hard region surrounded by high strain soft hepatic tissues, with clear but irregular boundaries. Sequential elastograms with the sketched lesion boundaries showed that the lesion area increased in the first 3 minutes after ethanol injection, and then reached a plateau which corresponding to gross specimen.

CONCLUSIONUltrasound elastography is capable of detecting and evaluating the diffusion of ethanol-induced hepatic lesion, and more sensitive and accurate than routine sonography.

Animals ; Elasticity ; Elasticity Imaging Techniques ; instrumentation ; methods ; Ethanol ; pharmacology ; Liver ; diagnostic imaging ; drug effects ; pathology ; Swine ; Ultrasonics

OBJECTIVETo study the value of ultrasound elastography in the evaluation of ethanol-induced lesions of liver.

METHODSAlcohol with a dose of 2 ml was injected into a fresh porcine liver under ultrasound guidance to create stiff necrosis. Then freehand elastography of the lesion from the identical scan plane was obtained with Siemens SONOLINE Antares system using VF10-5 probe at about every 30 seconds till 6 minutes later. The original high-quality radio-frequency data were acquired through an ultrasound research interface provided by the ultrasound system. Corresponding elastograms were then produced offline using cross-corre-lation technique and compared with gross specimen.

RESULTSA hyperechoic area with acoustic shadow below appeared immediately after alcohol injection. The hyperechoic area diffused and its boundary was illegible following injection. On the contrary, the ethanol-induced lesion in elastography appeared as a low strain hard region surrounded by high-strain soft hepatic tissues with clear but irregular boundaries. Sequential elastograms with the lesion boundaries sketched showed that the lesion area grew in the first 3 minutes after ethanol injection and then reached a plateau, which corresponded to the gross specimen.

CONCLUSIONUltrasound elastography can be used to detect and evaluate the diffusion of ethanol-induced hepatic lesion.

Animals ; Disease Models, Animal ; Elasticity Imaging Techniques ; methods ; Ethanol ; adverse effects ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Diseases ; diagnosis ; diagnostic imaging ; pathology ; Swine

OBJECTIVETo assess the treatment outcome of ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug(LIFT-plug) for transsphincteric perianal fistulas.

METHODSClinical data of 36 patients with transsphincteric perianal fiftula who were managed by the LIFT-plug technique between November 2010 and February 2012 were analyzed retrospectively.

RESULTSClinical healing of the fistula, defined as the absence of drainage with no evidence of residual fistula tract, occurred in 34(94.4%) patients. The operative time ranged from 12 to 35 minutes(mean, 17 minutes). The median postoperative length of stay was 5 days. The median healing time was 18 days. No complications requiring intervention occurred. The postoperative follow up was at least 3 months and two patients had recurrence(5.6%).

CONCLUSIONSLIFT-plug procedure for the management of transsphincteric perianal fistulas is simple with high healing rate, minimal invasiveness, quick healing, and without disturbance to anal function. LIFT-plug is an ideal procedure for intrasphinteric fistula.

Aged ; Fecal Incontinence ; Humans ; Ligation ; Operative Time ; Rectal Fistula ; surgery ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Wound Healing

The clinical evaluation methods of facial paralysis can be divided into functional evaluation scales,neuro-electrophysiologi-cal tests and computer evaluation systems.The commonly used function evaluation scales include House-Brackmann Grading Scale(HB-GS),Burres-Fisch Facial Nerve Scoring System,Nottingham System,Sunnybrook facial grading System(SFGS),Degree of Facial Nerve Paralysis Hierarchical Scale,Facial Disability Index(FDI)and Facial Clinimetric Evaluation(FaCE)Scale,etc.Neuro-electrophysiological tests mainly consist of facial electromyography (EMG), electroneurography (ENoG), blink reflex (BR), and neural excitatory test (NET), etc.The computer evaluation system based on the sensor is mainly divided into the computer evaluation system based on infrared thermal image technology and the computer evaluation system based on biomedicine image recognition.This article briefly summarized the existing methods of facial paralysis evaluation in terms of sensitivity,stability,accuracy,ease of operation and economics.

Objectives To explore the relationship between polymorphism in estrogen receptor alpha (ERα)gene Xba I and child dental fluorosis.Methods Qiulou township of Kaifeng and Sunying township of Tongxu counties of Henan province were chosen as the investigation spots in 2006.An area of water drinking endemic fluorosis(high fluoride area)and a non-endemic area(control area)were chosen in every spot,where dental fluorosis of children aged 8 to 12 years old were examined and diagnosed by using the Dean method.The children in the high fluoride areas were divided into dental fluorosis group and control group of the endemic areas according to dental fluorosis status,and the children in the control areas as control gruop of non-endemic areas.The Xba I polymorphism in the ERα gene was genotyped using the PCR-RFLP procedure.The fluoride levels in the urine samples from the three groups were detected by fluoride ion selective electrode and over standard rate of the urine was counted.Results The prevalence rate of dental fluorosis in high fluoride areas was 51.7%(74/143)and the community fluorosis index was 1.310.No dental fluorosis case was checked out in the control and the community fluorosis index was 0.021.The over standard rate of urine fluoride in dental fluorosis group[84.6%(121/143)]was significantly higher than that of control in non-endemic area[9.6%(9/94);χ2=125.95,P<0.01].The frequency distribution of ERα Xba I genotype was XX 6.8%(5/74),xx 36.5%(27/74),xx 56.8%(42/74)in dental fluorosis group;XX 15.9%(11/69),Xx 37.7%(26/69),xx 46.4%(32/69)in the eontrol of the endemic areas;XX 14.9%(14/94),Xx 43.6%(41/94),xx 41.5%(39/94)in children from the control in non-endemic area,respectively.No significant difference was found among the three groups(χ2= 3.450, P > 0.05). Allele frequency of ERα Xba I genotypes was X 22.7%(30/132), x 77.3%(102/132) in dental fluorosis group and X 35.5%(39/110),x 64.5% (71/110) in the control in endemic area when urine fluorosis of children was exceeding standard and significant difference was found in this two groups(χ2 = 4.768, P < 0.05; OR = 0.535,95% CI:0.305 - 0.941). Conclusion Children who carried X allele frequency of ERα Xba I genotypes have a lower risk of dental fluorosis when children with high-loaded fluoride status.

Objective To observe the clinical efficacy of Tiao Shen Jie Jing needling (regulating the mind and release spasm) in treating post-stroke upper-limb spastic palsy. Method Ninety patients with post-stroke upper-limb spastic palsy were randomized into an observation group and a control group, 45 cases each. The observation group was intervened by Tiao Shen Jie Jing needling, while the control group was given ordinary acupuncture. The Modified Ashworth Scale (MAS), short-form Fugl-Meyer Assessment (SFMA) and Barthel Index (BI) were evaluated and recorded prior to the treatment, after 2-week and 4-week treatment and 3 months later after the intervention; the serumγ-aminobutyric acid (GABA) was detected before and after the treatment. Result The total effective rate was 83.3% in the observation group versus 61.0% in the control group, and the efficacy of the observation group was superior to that of the control group (P<0.05). The scores of each scale showed improvements after the treatment in both groups (P<0.05), and the improvements in the observation group were more significant (P < 0.05). The follow-up showed continuing improvements in the scales in the observation group, which were superior to those in the control group (P<0.05); after the treatment, the content of GABA in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Tiao Shen Jie Jing needling can effectively ameliorate the upper-limb spasm,as well as the motor function of the upper extremities, improve the activities of daily living and maintain a long-term efficacy, better than ordinary acupuncture. The action mechanism is related to the regulation of GABA content in serum.