Objective To evaluate the clinical efficacy of AF (atlas fixator) internal fixation in treatment of thoracolumbar fracture and dislocation. Methods 42 cases of thoracolumbar fracture were treated by posterior AF internal fixation. Prior to surgery, anteroposterior and lateral radiographs, and CT scan through bone windows were done for all the patients. During surgery, all the pedicle screws were inserted by Mergerls method and proper insertion was confirmed by radiographs. Results The follow ups of 39 patients averaged 21 months (ranging from 6 to 29 months). After surgery, the correction of anterior vertebral body height averaged 40.2%, and of Cobbs angle 23.2?. 12 cases of incomplete spinal cord injury had significant improvement and 2 ones of complete spinal cord injury had no improvement. Conclusion The AF screw is especially helpful in reconstruction of stability of thoracolumbar region after posterior decompression and reduction, because it results in simplicity, safety, less fixation segments, and little invasion or bleeding.

BACKGROUND:Micro-fracture surgery method is simple, easy to operate, which is an effective way to treat articular cartilage defects, but there are stil some problems such as regenerated fibrocartilage and regenerated cartilage degradation. Scholars have focused on the use of various methods to improve the micro-fracture effect on repairing cartilage defects.
OBJECTIVE:To explore the effects of micro-fracture enhanced by autologous bone marrow mesenchymal stem cells extracellular matrix (aBMSC-dECM) scaffold for treating cartilage defects in minipig models.
METHODS:Bone marrow was extracted from the minipigs and bone marrow mesenchymal stem cells were obtained. aBMSC-dECM membranes were col ected. Cross-linking and freeze-drying technology were used to make the three-dimensional porous aBMSC-dECM scaffold. Ful thickness cartilage defects, 2 mm in depth and 6 mm in diameter, were created on the femoral condyles and trochlea grooves of the two knees of the minipigs. The right knees were treated with micro-fracture as control and the left were treated with micro-fracture enhanced by aBMSC-dECM scaffold. Six months later, histological examination and Wakitani score were used to evaluate the cartilage regeneration, and glycosaminoglycans and DNA contents in the regenerative tissue were determined.
RESULTS AND CONCLUSION:After 6 months, the tissue treated by micro-fracture enhanced by aBMSC-dECM scaffold got better surface and integrated with the surrounding cartilage. Safranin O and fast green staining and Masson staining showed that the regenerated cartilage of the left knee, with abundant matrix and dense bone trabeculae, was better than that of the right. Wakitani score of the left knee was higher than that of the right. Glycosaminoglycans content of the left knee was much more than that of the right, while the DNA content was lower in the left knee than the right knee. Better results were observed in the left knee undergoing micro-fracture enhanced by aBMSC-dECM scaffold, and improvements in the femoral condyles and trochlea grooves showed no differences.

Objective To investgate the value of various parameters obtained from monoexponential, biexponential, and stretched exponential diffusion?weighted imaging models in the differential diagnosis of breast lesions. Methods A retrospective study performed in 54 patients with pathologically confirmed malignant tumors(n=30), benign lesions(n=34) and normal fibroglandular tissues (n=30). All patients underwent T1WI, T2WI, dynamic enhancement and diffusion weighted MRI with multi?b values at a 3.0 T magnetic resonance imaging unit. All parameters were measured at a workstation. ADC was calculated by using monoexponential analysis(b=0, 800 s/mm2). Slow apparent diffusion coefficient (ADC?slow), fast apparent diffusion coefficient (ADC?fast), and perfusion fraction (f) were calculated using the biexponential model. Distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained from diffusion?weighted images using the stretched exponential model. All parameters were statistically compared among normal fibroglandular tissues, benign lesions and malignant tumors using Kruskal?Wallis rank sum test. Mann?Whitney U test were used for further comparisons between specific group pairs. ADC values were compared with ADC?slow and DDC for different groups by paired Wilcoxon test. Correlations between ADC?value, ADC?slow and DDC were assessed by using Spearman rank correlation coefficient. Receiver operating characteristic curve was used to analyze and compare the ability of these parameters in differentiation of benign and malignant breast lesions. Results The ADC, ADC?slow, f, DDC and α values were significantly different among the normal fibroglandular tissues, benign tumors and malignant tumors (P<0.05). Further differential comparisons of the four parameters between each pair showed that the ADC, ADC?slow, f, DDC and α values were significantly lower in malignant tumors than both in normal fibroglandular tissues and benign tumors(P<0.016 7). The ADC values of normal fibroglandular tissues, benign tumors and malignant tumors were significantly higher than ADC?slow and DDC (P<0.05). The f and DDC had higher area under the receiver operating characteristic curve (0.688 and 0.657 respectively). The optimal cutoff values for ADC, ADC?slow, f, DDC and α were 1.235 × 10-3mm2/s, 0.428 × 10-3mm2/s, 57.8%, 1.175 × 10-3mm2/s and 0.721, respectively. Theαvalue showed higher specificity (65.5%) and the f value had higher sensitivity (82.9%). Conclusion The parameters derived from biexponential and stretched exponential DWI could be helpful for differentiation between benign and malignant breast tumors.

0.05],significantly higher than stage Ⅲ,Ⅳ[60%(6/10),50%(5/10);P

OBJECTIVETo study the efficacy of Xiaoyao Powder (XYP) combined with interferon alpha (IFN-alpha) in treating HBeAg positive chronic hepatitis B (CHB) patients and the effect on their quality of life (QOL).

METHODSTotally 193 patients with HBeAg-positive CHB confirmed by liver biopsy were randomly assigned to 2 groups, Group A (94 cases) and Group B (99 cases). IFN-alpha1b was subcutaneously injected to patients in Group A at the dose of 50 microg, thrice per week. Those in Group B additionally took XYP. The therapeutic course for all was 24 weeks. Clinical efficacy was observed by assessing ALT restoration rate, HBeAg negative rate, HBeAg conversion rate, HBV DNA negative rate, complete response rate, partial response rate, and symptoms integral. The evaluation of QOL was performed by using chronic liver disease questionnaire (CLDQ) score. Adverse reaction occurrence rate was observed in the two groups.

RESULTSBetter effects were obtained in Group A on ALT restoration rate, HBeAg negative rate, HBV DNA negative rate, complete response rate, partial response rate, TCM symptoms integral, the total effective rate of TCM sysmptoms, CLDQ score, and adverse reaction rates, showing statistical difference when compared with Group B (P < 0.05, P < 0.01).

CONCLUSIONXYP could elevate the efficacy of TCM symptoms of HBeAg-positive CHB patients and anti-viral effect, improve their QOL, and reduce adverse reaction of IFN-alpha.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Quality of Life ; Treatment Outcome

Objective To investigate the effect of prosthetic replacement for senior patients with unstable intertrochanteric fractures of the femur.Methods Fifty-three senior patients with comminuted intertrochanteric fracture of the femur were subjected to total hip arthroplasty (n =23) and bipolar artificial femoral head replacement (n =30).Uncemented long-stem prostheses were used in 50 patients and cemented long-stem prostheses in 3.Time interval between admission and surgery was 3-13 days (mean 6 days).Results The total hip arthroplasty had the operation time for mean 90 minutes (range,80-110 minutes) and blood loss for mean 350 ml (range,260-410 ml).While the hemiarthroplasty had operation time for mean 65 minutes (range,50-90 minutes) and blood loss for mean 230 ml (range,180-290 ml).Fifty-one patients were available to mean 49.6-month follow-up (range,13-65 months).Four patients presented with frequent hip pain at a tolerable level after hemiarthroplasty and the symptom was relieved after oral non-steroidal anti-inflammatory drug therapy.One patient with postoperative infection was cured by timely debridement.Seven patients were died of heart and brain disorders in 5 years,with no relation to surgical complications.The period for fracture healing was mean 10 months,with excellence rate of 96％ for hip function but with no acetabulum abrasion,implant loosening or submersion.Conclusion Early prosthetic replacement is an effective treatment for unstable intertrochanteric femoral fractures in the elderly.

BACKGROUND:Numerous studies have shown that air wave pressure therapy plays an important role in prevention of deep venous thrombosis of lower limb after a major operation on the hip.
OBJECTIVE:To explore the efficacy of air wave pressure therapy on deep vein thrombosis of the lower extremity in patients with total knee arthroplasty.
METHODS:A total of 80 patients with total knee arthroplasty were randomly divided into experimental group and control group. Patients in the control group were treated only with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise;patients in the experimental group were treated with air wave pressure therapy at 2 days postoperatively, and were also treated with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise. Swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were recorded in both groups.
RESULTS AND CONCLUSION:At 2 weeks after treatment, swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were significantly reduced in the experimental group, and its effects were significantly better than those in the control group (P<0.05). Early use of air wave pressure therapy after total knee arthroplasty can al eviate limb swel ing effectively and have obvious advantages in improving coagulation index and blood coagulation condition and in preventing deep vein thrombosis of the lower extremity after total knee arthroplasty.

BACKGROUND:Studies have shown that arthroscopic al-inside technology for meniscus repair has achieved good outcomes, and arthroscopic suture combined with sodium hyaluronate has an important role in the cartilage repair. OBJECTIVE:To observe the therapeutic effect of arthroscopic al-inside suture repair combined with sodium hyaluronate injection in the repair of discoid meniscus tears. METHODS:Twenty-two patients with discoid meniscus injury were subjected to arthroscopic al-inside suture repair combined with sodium hyaluronate injection. Al cases were confirmed to have attached edge relaxation or longitudinal crack in operation. After repair, effective rehabilitation training was done. RESULTS AND CONCLUSION:The operations for the 22 cases were al successful and there was no complication. Al patients were fol owed up for over 18 months. According to Ikenchi’s method (Lysholm knee score criterion), 11 cases were rated excel ent, 8 were rated good, and 3 were rated fair, with an excel ent/good rate of 86.36%. It is demonstrated that the al-inside suture repair under the guide of arthroscopy in discoid meniscus cases can remain the most appropriate anatomical structure of the meniscus that can play an effective function, and has the advantage of minimal invasion. Arthroscopic al-inside suture repair combined with intra-articular injection of sodium hyaluronate and standard rehabilitation training result in a lower complication rate and effectively promotes the meniscus repair.

Objective To evaluate the effects of dietary intervention with low glycemic index (LGI) and low glycemic load (LGL) on dietary knowledge and dietary modification of patients with type 2 diabetes mellitus (T2DM).Methods This study was a cluster randomized controlled study.From June to September 2010,105 T2DM patients were randomly sampled from 3 residential areas (n =35 in each) in Jin Pen Ling community,Changsha,Hunan province and divided into three groups with a random number table:whole-day dietary intervention group (group A,n =35),breakfast dietary intervention group (group B,n =35),and control group (group C,n =35).Interventions included 3-month health education and dietary intervention.Dietary knowledge,dietary oils,glycemic index (GI),and glycemic load (GL) of the three groups were compared before and after intervention.Results Before intervention,all the three groups showed a low level of knowledge about GI (57.7 ％),and high levels of average GI value of each meal (69.71 ± 8.55),GL value per day (132.45 ± 16.25),and daily cooking oil intake [(39.95 ± 20.64)g].The average knowledge level about GI increased after intervention in both group A (96.3％ vs.57.1％,P ＜0.05) and group B (94.5％ vs.60.5％,P＜0.05),but not in group C (54.8％ vs.55.3％,P＞0.05).The reduction of daily cooking oilintake in group A was larger than those in group B and group C [(7.81 ± 3.91) g vs.(-5.12 ± 1.37) g,(7.81 ± 3.91) g vs.(-3.45 ± 5.95) g,both P ＜ 0.05];so was the average GI value of each meal [group A,(5.95±2.27);groupB (-0.85±1.87);groupC,(-2.87±1.93);allP＜0.05].The changes of GL values in group A (11.31 ±4.31) was better than in group B (1.23 ±27.82) and group C (-0.43 ± 18.40)(both P ＜0.05).Conclusions The average GI value,GL value,and daily cooking oil intake of T2DM patients were all at a high level before intervention,while the level of knowledge about GI was at a low level.Health education providing GI knowledge may effectively improve the knowledge about GI in T2DM patients,while LGI and LGL dietary intervention may promote diet modification.Whole-day dietary intervention may be more effective than breakfast intervention.

Object To evaluate the efficacy and toxicity of L-asparaginase based regimen for extranodal nasal type NK/T cell lymphoma (ENKTL).Methods 36 patients were treated with L-asparaginase based regimen from February 2008 to November 2011. 20 stage Ⅰ /Ⅱ patients were administered with VLD regimen based chemo-radiotherapy. 4 of 16 stage Ⅲ/Ⅳ patients received modified SMILE regimen chemotherapy, followed by involved field radiation therapy (IFRT), while others received modified SMILE regimen chemotherapy alone.Results Among 36 patients,35 were eligible for treatment response evaluation.The overall response rate (RR) was 68.6％ (24/35) with complete response (CR) rate of 54.3％ (19/35).After the median follow-up of 13.5 (range 3-31) months,for all patients,the 1-year overall survival (OS) rate was 82 ％,and the rate of progression-free survival (PFS) at 1 year was 65 ％.The patients who attained response with treatment showed better 1-year OS (93 ％) and PFS (80 ％) as compared with patients without response (35 ％; 33 ％),and the differences were statistically significant (x2=13.909,P =0.000; x2=8.216,P =0.004).The major adverse event was myelosuppression. No chemotherapy-related mortality occurred. Conclusion L-asparaginase based regimen is obviously effective and well tolerant for ENKTL. The large prospective clinical trials of L-asparaginase based regimen in the first-line treatment for ENKTL are worth for further investigation.