The real sanghuang is a new species belonging to the Inonotus, which is commonly used for cancer treatment and human immune system improvement. This review summarized the progress on the studies of Phellinus Quel in recent years, including its taxonomy status, bioactive components, pharmacodynamics, separation and purification technologies. In addition, some related problems and perspectives were also discussed.
Animals ; Basidiomycota ; chemistry ; classification ; Humans ; Medicine, Chinese Traditional ; methods

BACKGROUNDIn recent years, the number of patients undergoing primary total knee arthroplasty in China has rapidly increased. However, the incidence of primary total knee arthroplasty is unknown. The purpose of this study was to investigate the sex, age and, annual incidence of primary total knee arthroplasty based on 3118 Chinese patients who underwent the procedure during the period of 2000 - 2011.

METHODSTotal knee arthroplasties were performed on 511 males and 2607 females in our hospital during the period of 2000 - 2011. The sex, age, and annual incidence of primary total knee arthroplasty were evaluated.

RESULTSThe annual incidence of primary total knee arthroplasty increased from 35 knees in 2000 to 681 knees in 2011. The average annual percentage increase in incidence was 33.2%. Females accounted for 83.2% of the patients who underwent primary total knee arthroplasty. In both males and females, the highest incidence was observed in the group aged 65 - 74 years.

CONCLUSIONSThis study demonstrated a rapid increase in the incidence of primary total knee arthroplasty in our Chinese study population. The sex and age incidence of primary total knee arthroplasty in our study population differed from those reported in Western populations.

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; statistics & numerical data ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Sex Distribution ; Young Adult

OBJECTIVECompletion pneumonectomy (CP) is widely known to be associated with a high morbidity and mortality. However, in certain instances, CP offers the only chance for a cure. Now to explore the indications, prevention and management of complications as well as late outcomes of CP.

METHODSDuring a period of 21 years from January 1985 to August 2006, 24 patients received CP, representing 2.3% of 1026 patients who had undergone pneumonectomy in the same period. There were 17 right and 7 left CPs done in 20 male and 4 female patients with an average age of 58 years (range from 42 to 67 years). Lung malignancy accounted for 22 of these cases in which the indication included local recurrence in 18, second primary tumors in 2 and primary malignancies that developed after right upper lobectomies for pulmonary tuberculoma and pulmonary cyst respectively in 2 cases. Benign disease was progression or recurrence of bronchiectasis in 2 cases. Before CP, 17 patients had had a lobectomy, 5 a bilobectomy, 1 sleeve lobectomy and 1 wedge resection. There were 16 of 20 lung cancer patients receiving postoperative chemotherapy and 3 with positive residues having radiotherapy. The mean interval between the two procedures was 65 months for the whole group (5.5-360) and 32 months for lung cancer patients (5.5-120). They all underwent CP, included sleeve CP in 1 patient.

RESULTSFor all patients, the previous thoracotomy incision was reopened and maneuvers such as rib resection, intrapericardial blood vessel ligation, division of the bronchus first, local application of glues and hemostatic agents, and bronchial reinforcement were routinely used. Intrapericardial route was used in 10 patients (41.7%). Two patients had right pulmonary artery injured. The operation lasted 4-7 hours, with blood loss of 300 to 3000 ml. Overall respectability, morbidity and hospital mortality were 95.8%, 29.2% and 4.2%. No intraoperative deaths occurred. There was 1 early postoperative death after 40 days from adult respiratory distress syndrome. There was no occurrence of bronchopleural fistula, and the 25% associated morbidity rate was a result of bleeding necessitating reexploration in 1 case, chronic empyema in 1 case, arrhythmia in 1 case, anemia in 1 case and fever of unknown reason in 2 cases. Actuarial 1-, 3-, 5-year survival rates from the time of completion pneumonectomy for patients with lung cancer were 77.3%, 50.0% and 29.4%. And 1-, 3-, 5-year survival rates for patients with recurrent lung cancer were 72.2%, 47.1% and 29.4%.

CONCLUSIONSCP can be performed with an acceptable operative mortality and morbidity rate in selected patients. For patients with local recurrence, first and second primary bronchogenic carcinoma as well as benign pulmonary disease, treatment should be surgical when a less invasive procedure is not available and the patients are in good health. In addition, patients undergoing CP have a reasonable prospect for long-term survival.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lung Diseases ; surgery ; Male ; Middle Aged ; Pneumonectomy ; adverse effects ; methods ; Postoperative Complications ; etiology ; mortality ; therapy ; Prognosis ; Retrospective Studies ; Survival Analysis ; Survival Rate ; Treatment Outcome

BACKGROUND: Recently, adjustable-loop devices (ALDs) have been widely used, and their reliability has always been the focus of attention. This study compared loop length changes under pull stress caused by flexion and extension of the cadaver knee between ALDs and fixed-loop devices (FLDs) in terms of femoral fixation after anterior cruciate ligament (ACL) reconstruction. METHODS: ACL reconstruction in cadaveric knee joints was performed under arthroscopy with femoral suspension devices and tibial fixation by tying sutures on staples. The knee joint was repeatedly flexed and extended 30 times after fixation. According to the femoral fixation device used (Endobutton or Ultrabutton), the knee joints were divided into two groups: the ALD group (12 specimens) and the FLD group (ten specimens). The length of the loop before and after fixation was measured, and the loop length of the ALD group was re-measured 1 day after reconstruction. RESULTS: There was no significant difference in the length of the loop between the two groups (t = 0.579, P = 0.569). One day later, the loop length of the ALDs retracted by 0.29 ± 0.33 (0-1.1) mm, and there was no retraction in three specimens. CONCLUSION There was no significant difference in the loop length under flexion and extension stress after ACL reconstruction between ALDs and FLDs.

BACKGROUNDSeveral reports have shown the progression of articular cartilage degeneration after anterior cruciate ligament (ACL) reconstruction. No report has been published about the cartilage comparing changes after single-bundle (SB) and double-bundle (DB) ACL reconstructions. The purpose of this study was to evaluate the articular cartilage changes after SB and DB ACL reconstructions by second-look arthroscopy.

METHODSNinety-nine patients who received arthroscopic ACL reconstruction were retrospectively reviewed at an average of 14 months after reconstruction, 58 patients underwent SB ACL reconstruction and 41 patients underwent DB ACL reconstruction. Hamstring tendon autografts were used in all patients. Second-look arthroscopy was done in conjunction with the tibial staple fixation removal at least one year after the initial ACL reconstruction. Arthroscopic evaluation and grading of the articular cartilage degeneration for all patients were performed at the initial ACL reconstruction, and at the second-look arthroscopy.

RESULTSThe average cartilage degeneration at the patellofemoral joint (PFJ) was found significantly worsened after both SB and DB ACL reconstructions. This worsening were not seen at medial tibiofemoral joint (TFJ) and lateral TFJ. Grade II cartilage damage was the most common. At second-look arthroscopy, the average patellar cartilage degeneration was 1.14 ± 0.14 (at first look 0.52 ± 0.11) for the SB group, and 1.22 ± 0.15 (at first look 0.56 ± 0.12) for the DB group. The average trochlear cartilage degeneration was 1.05 ± 0.16 (at fist look 0.10 ± 0.06) and 0.66 ± 0.17 (at fist look 0.17 ± 0.09), respectively. The average patellar cartilage degeneration showed no significant difference in both groups. However, the average trochlea cartilage degeneration in DB group was significantly less than in SB group.

CONCLUSIONSPatellofemoral cartilage degeneration continued to aggravate after ACL reconstruction. DB ACL reconstruction could significantly decrease the trochlea cartilage degeneration compared with SB ACL reconstruction.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Reconstruction ; methods ; Arthroscopy ; methods ; Cartilage, Articular ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Second-Look Surgery ; methods ; Treatment Outcome ; Young Adult

BACKGROUNDDifferent kinds of minimally invasive surgery (MIS) procedures have now been used in total knee arthroplasty (TKA). Compared with traditional TKA procedure with a long skin incision, clinical studies showed MIS procedures had some advantages. Quadriceps sparing (QS) procedures are the most minimally invasive MIS procedure until now. This study was aimed to find the insertion types for Chinese patients' vastus medialis and if the QS procedure had some advantages in patients' early recovery.

METHODSBetween February 2006 and May 2007, 120 consecutive patients underwent unilateral primary TKA under general anesthesia, among whom 14 patients were lost to follow-up, the remaining 106 cases were enrolled in this study. Among the 106 cases there were 85 right knees, 21 left knees (15 men and 91 women, with a mean age of 65.1+/-7.4 years); osteoarthritis in 97 patients (91.5%) and rheumatoid arthritis in 9 patients (8.5%). MIS TKA was performed in 49 cases (MIS TKA group), while MIS-QS TKA in 57 cases (MIS-QS TKA group). During the operation, the type I, II and III insertions of the vastus medialis for all patients were recorded. Each knee was rated post-operatively according to the Hospital of Special Surgery (HSS) scoring system. Clinical follow-up was undertaken at 1 week, 2, 6, 12 and 24 weeks. Operating time and complications were recorded.

RESULTSThere was no statistically significant difference between the two groups for gender distribution, age, left or right knee incidence, pre-operative diagnosis, incidence of varus or valgus deformity. Of the 106 cases there was 1 (0.9%) case with a type I insertion of the vastus medialis, 4 (3.8%) cases with type II insertions, 101 (95.3%) cases with type III insertions. The HSS scoring was significantly different between the MIS-QS TKA group and MIS TKA group within the first two weeks post operation. From 2 weeks later to 24 weeks, no significant difference was found. The average operating time was (53.3+/-12.4) minutes in the MIS TKA group and (64.1+/-15.1) minutes in the MIS-QS TKA group (P<0.001). In the MIS-QS TKA group, 1 patient had delayed healing of the partial skin incision (1.8%). No other complications were found in either group.

CONCLUSIONSAlthough most of the Chinese patients had type III insertions of the vastus medialis, the MIS-QS TKA procedure showed less injury to the quadriceps than the standard MIS TKA and this could contribute to the earlier recovery of the patients. But a shorter skin incision and more tension on the skin may also lead to more skin complications.

Aged ; Aged, 80 and over ; Anesthesia Recovery Period ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Quadriceps Muscle ; surgery ; Time Factors

BACKGROUNDAllograft meniscal transplantation is an increasingly popular treatment option for the symptomatic young patients with meniscus deficiency. However, many questions still surround it. In this research, we studied the anatomical location and histological structure of human meniscal horn bony insertions and to observe the anatomical morphology and histomorphology of peri-meniscal attachments based on meniscal allograft transplantation.

METHODSTwenty-two fresh-frozen adult cadaver knees were dissected. The locations of meniscal anterior and posterior horn bony insertions to tibia were measured. The anatomical morphology of peri-meniscal attachments was observed and the histological structure of meniscal horn bony insertions and peri-meniscal attachment were studied by HE staining.

RESULTSThe anterior horn bony insertion of medial meniscus was (9.19 +/- 1.83) mm inferior to the corresponding anterior border of tibial plateau, and (7.81 +/- 2.25) mm lateral to the axial line of the medial intercondylar eminence. The posterior horn bony insertion of medial meniscus was in the posterior intercondylar fossa of tibia, located between the anterior fibers of the posterior cruciate ligament (PCL) tibial insertion and anterior border of the tibial posterior intercondylar fossa, and was (5.05 +/- 1.18) mm lateral to the axial line of the medial intercondylar eminence. The distance between anterior and posterior horn bony insertions of the lateral meniscus was (13.68 +/- 2.19) mm. Anterior horn bony insertion of the lateral meniscus was (3.99 +/- 1.27) mm medial to the axial line of the lateral intercondylar eminence, and the posterior horn bony insertion of the lateral meniscus was (5.80 +/- 1.36) mm medial to the axial line of the lateral intercondylar eminence. Except for the meniscal horn bony insertions, which is the typical enthesis, we call the attachment of the other parts of menisci as 'peri-meniscal attachment'. The morphological and histological study showed that the main peri-meniscal attachment was the meniscotibial ligament, through which the meniscus attached to the tibia with enthesis structure, and there was only loose connective tissue between menisci and capsule.

CONCLUSIONSIn meniscal allograft transplantation, the traditional meniscal size-matching method which take medial and lateral intercondylar eminences as references is not as accurate as expected. Attention should be taken to locate both anterior and posterior horn tunnels of medial meniscal allograft inferior to the tibia plateau, and to locate anterior and posterior horn tunnels of lateral meniscus close enough (mean 13.68 mm). The best way to reconstruct the peri-meniscal attachment is to suture the allograft to the preserved outer remnant of the original meniscus.

Adult ; Anterior Cruciate Ligament ; anatomy & histology ; cytology ; Cadaver ; Female ; Humans ; Male ; Menisci, Tibial ; anatomy & histology ; cytology ; transplantation ; Transplantation, Homologous

Objective To evaluate the clinical efficacy of endoscopic transnasal palatal nerve block for persistent allergic rhinitis.Methods 123 patients with heavy persistent allergic rhinitis who aged over 17 years old in Longhua central hospital affiliated to Guangdong medical university from October 2013 to February 2015 were divided into observation group and control group.The patients in the observation group(72 cases) were blocked with endoscopic sphenopalatine,the control group (51 cases) treated with medicine.The rhinoconjunctivitis quality of life questionnaire (RQLQ) and VAS were assessed before and after treatment for 6 months,1 year and 2 year survival.Results 106 patients were followed up for 2 years.In observation group,the average score of RQLQ and VAS before treatment were (2.39 ± 0.43),(7.45 ±1.24) respectively;6 months after treatment,the average scores of RQLQ and VAS were (0.82 ± 0.38),(2.47 ± 1.42) respectively;1 years (0.93 ± 0.41) and (2.53 ± 1.54);2 years (1.05 ± 0.47) and (2.67 ± 1.69);the differences were statistically significant (P ＜ 0.05).The control group showed no obvious difference in RQLQ and VAS before and after treatment.Conclusion Endoscopic sphenopalatine nerve block can effectively improve the quality of life of patients with persistent rhinitis allergic,which is safe and effective in the treatment of severe persistent allergic rhinitis.

OBJECTIVETo summary the experience in the diagnosis and management of septic arthritis after anterior cruciate ligament (ACL) reconstruction.

METHODSThe knee joint infections after arthroscopic anterior cruciate ligament reconstruction were retrospectively studied. From January 1997 to July 2007, 16 of 3638 patients undergoing anterior cruciate ligament reconstructions experienced postoperative septic arthritis. The incidence, cause, presentation, laboratory results, treatment, and outcome of all infected patients were analyzed. The experiences of diagnosis and management of septic arthritis after anterior cruciate ligament reconstruction were summarized.

RESULTSThe incidence of septic arthritis after ACL reconstruction was 0.44%. The most common symptoms of the infected patients were fever, swelling, severe pain, tenderness, restricted motion. Eleven (68.8%) patients were positive for bacteria cultures, and Staphylococcus epidermidis was the most common bacteria. Nine of the 16 patients were performed arthroscopic debridement, and the other 7 patients were conservatively treated. All patients regained full range of motion and normal stability at the 19.7 months follow-up.

CONCLUSIONSSeptic arthritis, which could bring the dysfunction of the joint, is subsequent with cartilage injury and the failure of the ACL grafts. Early diagnosis and treatment of arthroscopic debridement in time are essential to the ultimate clinical outcome.

Adolescent ; Adult ; Aged ; Anterior Cruciate Ligament ; surgery ; Arthritis, Infectious ; diagnosis ; etiology ; therapy ; Arthroscopy ; Bone-Patellar Tendon-Bone Grafting ; Child ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Prognosis ; Retrospective Studies

OBJECTIVE: To estimate the prevalence rate of bone and joint injury in China and to describe the three-dimension distribution of the disease (area, time and people). METHODS: Based on a cross-sectional design, a retrospective study was conducted by using Chinese basic medical insurance database from January 1, 2013 to December 31, 2017 to analyze the epidemiological characteristics of bone and joint injury. The prevalence rate of bone and joint injury in each city was calculated, and then using meta-analyses to estimate the pooled prevalence of each area and the whole country. The pooled prevalence rates were compared among the different groups of populations, in terms of geographical area, time and population characteristics (age and gender). RESULTS: A total of 28 419 264 subjects were included in this study, including 705 793 patients with bone and joint injury. From 2013 to 2017, in Chinese basic medical insurance database, the overall prevalence rate of bone and joint injury was 141.5(95%CI: 90.4－203.7) per 10 000 population, and the prevalence rates of non-specific or polyarticular disease, knee disease, and shoulder disease were 101.6 (95%CI: 63.5－148.4)per 10 000 population, 22.5(95%CI:15.1－31.4)per 10 000 population and 10.9 (95%CI: 6.4－16.4)per 10 000 population. The prevalence rates varied across the areas, the highest rate was observed in North China, with the prevalence of 310.6 (95%CI: 12.6－989.7) per 10 000 population, and the lowest rate was observed in Southwest China, with the prevalence of 59.0 (95%CI: 37.5－85.2) per 10 000 population. The prevalence rate of bone and joint injury increased over the study period, from 111.1 (95%CI: 56.0－182.5)per 10 000 population in 2013 to 175.5 (95%CI: 116.8－245.5)per 10 000 population in 2017. The prevalence of bone and joint injury in the female population was 149.1 (95%CI: 94.2－215.9) per 10 000 population, which was higher than that of men [133.6(95%CI: 86.2－190.9) per 10 000 population]. The higher prevalence of knee disease, unspecified or polyarticular disease, and bone and joint injury were observed in people aged 60 years and older, while the prevalence of shoulder disease peaked in 40－59 years old people [20.6 (95%CI: 12.5－30.5) per 10 000 population]. CONCLUSION This study reported a relative low prevalence of bone and joint injury in China from 2013 to 2017. The prevalence increased over the study period, and the highest prevalence rate was observed in North China. The prevalence rate showed differences among different groups of populations, and higher rates were observed in females and people aged 60 years and older.
Adult ; China ; Databases, Factual ; Female ; Humans ; Insurance, Health ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Urban Population