[Objective]To investigate the advantages, risks and kye points of minimally invasive total knee arthroplasty with subvastus approach. [Method] From April 2005 to December 2006, 204 primary total knee arthroplasties were performed, among them 146 cases with convention incision (CI), 58 cases with minimally invasive subvastus approach(MIS). All knees were implanted with the same prosthesis (NEXGEN-LPS, Zimmer).The anesthesia time,operation time, hospitalization time were recorded.The first walking time, walking distance, active knee range of motion, preoperative and postoperative HSS Score and the complications were compared. [Result] Totally 204 cases were followed up and the mean follow-up time was 22 months (range, 13-36 months). The difference of anesthesia time, length of incision, operation time, hospitalization time, walking time had significance between the CI and MIS groups ( u test, P0.05). The difference of active range of motion in 24 hours, 1 week, 2 weeks postoperation had significance between the two groups ( u test, P0.05).The difference of HSS score in 24 hours, 1 week, 2 weeks after operation had significance between the two groups ( u test, P0.05). [Conclusion] The minimally invasive total knee arthroplasty with subvastus approach reduces the quadriceps injury, offers early active knee motion and quickly recovery of knee function. However there is no significant difference in long-term walking distance, range of motion and HSS score.

[Objective]To investigate the mechanism and pathologic changes of anterior cruciate ligament impingement syndrome as well as its arthroscopic diagnosis and treatment.[Method]From January 2005 to June 2007,28 patients with a history of anterior cruciate ligament impingement were diagnozed and treated arthroscopically.The patients' clinical findings were mainly anterior patellar pain and limited knee joint.The reasons of anterior cruciate ligament impingement syndrome were indentified by routine arthroscopic examination:straitness of intercondylar notch or osteophytes formation in 19 cases,old avulsion fracture in the tibial intercondylar in 4 cases,anterior cruciate ligament cyst in 3 cases,incorrect tibial tunnel placement on reconstructed anterior cruciated ligament in 2 cases.Different surgical procedures were carried out according to the results of the examination:joint debridement and intercondyle's plasty;intercondyle's plasty and osteophytes resection;joint debridement and ACL cysts resection;ACL tibial eminence insertion reconstruction were performed.[Result]Twenty-eight cases were followed for an average of 15 monthes(6-34 monthes).The rate of good to excellent was 82.1%,recurrence was observed in 1 case.[Conclusion]The gradual constriction of the knee is mainly caused by the anterior cruciate ligament impingement syndrome.Arthroscopy is very valuable in diagnosis and treatment of anterior cruciate ligment impingement syndrome.It can also acquire whole assessment of the joint injuries and makes out reasonable treatment program to normal knee joint function.

Objective To explore the curative effect of traditional Chinese herbal packet combined with ST 36 injection therapy on gastrointestinal dysfunction in severe patients. Methods Sixty severe patients with gastrointestinal dysfunction were randomly divided into the control group and treatment group with random digital number, 30 cases in each group. The control group received conventional care and besides conventional care , the treatment group was treated with traditional Chinese herbal packet combined with ST 36 injection. The two groups were compared 7 days after treatment in terms of scores by (acute physiology and chronic health evaluationⅡ, APACHEⅡ) and improvement of gastrointestinal dysfunction. Result After treatment, the APACHE II score and improvement of gastrointestinal dysfunction of the treatment group were significantly higher and better than those of the control group (P<0.05). Conclusion The traditional Chinese herbal packet combined with ST 36 injection can promote the recovery of gastrointestinal dysfunctional in severe patients.

Objective To investigate the efficacy and safety of adjusting the doses of diuretics of different time in the treat-ment of advanced schistosomiasis ascites. Methods A total of 80 advanced schistosomiasis patients with ascites were randomly divided into an observation group and a control group(40 cases each). The patients in the observation group received spironolac-tone and furosemide,and the first doses were 100 mg/d and 40 mg/d,respectively. If the efficacy was poor,according to the first doses of the standard increments once every four days,the doses gradually increased to the maximum doses of spironolactone 400 mg/d and furosemide 160 mg/d,respectively. The patients in the control group received spironolactone and furosemide,and the first doses were the same as those of the observation group. If the efficacy was poor,according to the first doses of the standard in-crements once every seven days,the doses gradually increased to the maximum doses as those of the observation group. Other con-ventional treatments were the same in both groups. Results In both groups,the reductions of the total amount of the weight were (5.62±1.28)kg and(5.42±1.37)kg respectively;the time of efficacy beginning was(3.84±2.36)days and(4.65±2.86)days re-spectively;the average daily amounts of weight loss were(0.41 ± 0.16)kg and(0.35 ± 0.11)kg respectively;the efficient rates were 95%and 92.5%respectively;and there were no significant differences between the two group(all P>0.05). However,the time of reduction from moderate ascites to mild ascites was(10.70±3.01)days(6-20 days)in the observation group and the time was(14.75±5.62)days(7-30 days)in the control group(u=3.876,P<0.01). Conclusion The therapy of diuretic doses ad-justed by a four-day cycle is more useful for advanced schistosomiasis patients with ascites.

Objective:A combined therapy of Aidi and Kanglaite injection was employed to enhance the living quality of patients with tumors.Method: 50ml Aidi was added into 5% glucose 500ml,together with100 to 200 ml Kanglaite was injected per day,a medical treatment course lasts for 15 to 20 days,and the duration includes 1 to 3 courses.Result: 25% of all patients treated show a complete cure of tumor pain,43.8% of all patients show relief to some extent,with a total efficiency of 68.8%,and 72.8% of all treatment group show an increase in living quality.Conclusion: The combined therapy together with humanistic nursing care results in a significant effect in treating patients with terminal tumors.

Objective To investigate the imaging appearances of non-ossifying fibromas in healing stage and its clinical value.Methods The imaging features of non-ossifying fibroma in healing stage in 10 cases followed-up clinically(2 cases of them were verified by pathology after operation) were analyzed. All of the cases were examined by radiography,4 cases were examined by CT, 1 case underwent MRI. Results All of the cases were located in long bone of lower extremity. 8 cases were in tibia,2 cases were in femur. 5 cases were shown as homogeneous sclerosis,lucent areas were presented in sclerotic foci in 5 cases. 5 cases were unchangeable after followed-up 1 to 4 years .Conclusion The non-ossifying fibroma is being sclerotic stabilized foci after puberty , no operation is necessary for the healed form non-ossifying fibroma.

OBJECTIVE: To discuss the potential problems caused by the exfoliation of the tunic albuginea after the low-temperature plasma operation. METHOD: To observe the occurrence of the tunic albuginea, exfolliating time, wound healing and its complications by following the patients received the low-temperature plasma operation from November in 2012 through June in 2013 (including 116 cases of tonsillectomy, 98 cases of adenoidectomy, 255 cases of the ablation of the inferior turbinate,8 cases of the ablation of the cyst of epiglottis, and 4 cases of the ablation of the tumor of larynx) together with reviewing the relevant literatures. RESULT: The tunic albuginea exfolliated about two weeks after tonsillectomy, bleeding was found in 3 cases, one of which was related with inappropriate eating; the exfoliation about two or three weeks after adenoidectomy, without the occurrence of the narrow nostril and pharyngeal cavity adhesion; about four weeks after the ablation of the cyst of epiglottis, bleeding was found in 1 case; about three or four weeks after the ablation of the inferior turbinate, massive bleeding was found in one case after two months; and the ablation of the tumor of larynx, one with severe atypical hyperplasia and carcinoma in situ, the theunic albuginea did not completely exfoliate four moths after the surgery and new creatures could be found, the wound looked smooth and healed well nine moths after the surgery. The full exfoliation occur four months after the surgery for one with the neurilemmoma in the left laryngeal ventricle and the new creatures could also be found. It exfoliated eighth days after the surgry for one patient with left subglottic epitheliaoid heman-gio endothelioma and it did not recur even six months after the surgery. Another one with the cyst of the left plica aryepiglottica failed to be followed. The first three patients did not suffer from such complications as bleeding, endogenous in trachea, etc. CONCLUSION Low-temperature plasma surgery has obvious advantages, but the potential problems caused by the surgery need to be taken in accounted, especially the exfoliating time of the tunia albuginea is different after the ablation of the tumor of larynx, which is inconsistent with what the literatures reported, it could partially due to the action time of low-temperature plasma surgery with surrounding tissues.
Adolescent ; Adult ; Catheter Ablation ; methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Young Adult

Objective To analyze the clinical results of mini-incision Schwab grade 4 osteotomy combined with percutaneous pedicle screw fixation for old thoracolumbar compression fractures combined with kyphosis deformity.Methods A retrospective case series study was made on 14 patients with old thoracolumbar compression fractures combined with thoracolumbar kyphosis undergone mini-incision Schwab grade 4 osteotomy plus percutaneous pedicle screw fixation from January 2014 to May 2015.There were 5 males and 9 females,with mean age of 64.5 years (range,58-70 years).The period between injury and surgery ranged between 6 and 14 months (mean,8.6 months).At the time of surgery,the fracture was already healed in 10 patients,while non-healing was found in other 4 patients.Preoperative visual analogue score (VAS) of back pain was (8.5 ± 1.1)points (range,6.5-10 points).Three patients were associated with neurological dysfunction [American Spinal Injury Association (ASIA) grade D].Apex of kyphosis located at T12 in 6 patients and at L1 in 8 patients.Preoperative kyphosis Cobb angle was (42.5 ± 6.0)° (range,39.5°-47.2°).Operation time,blood loss,perioperative complications,postoperative kyphosis Cobb angle,bone fusion,state of implants,neurological function and VAS were determined.Results Operation time was (280 ± 50) min,and blood loss was (110 ±70)ml.No segmental vessels injury,neurological deficit or dural disruption occurred during the surgery and after surgery.Compared to the preoperative detection,kyphosis Cobb angle was improved to (9.3 ±1.7) ° (range,6.2°-12.1 °) after operation (P ＜ 0.05),with the correction rate of 78.1％.Postoperative CT showed 7 screws (6.3％,7/112) were grade 1 screws.The follow-up was lasted for mean 25.2 months (range,14-28.9 months).At the latest follow-up,the kyphosis Cobb angle was (9.6 ±4.1)°(range,6.0°-13.1°),revealing no correction loss.Interbody bone fusion was good,with no instrumentation-related complications observed.Three patients with neurological dysfunction (ASIA grade D) were recovered to ASIA grade E.Compared to the preoperative detection,back pain was improved with the VAS of (2.6 ± 1.0) points at the latest follow-up (P ＜ 0.05).Conclusion Mini-incision Schwab grade 4 osteotomy combined with percutaneous pedicle screw fixation of old thoracolumbar compression fractures with kyphosis deformity can attain satisfactory and reliable efficacy and bone fusion,with low incidence of complications.

Objective To study the clinical characteristics of early esophageal varices bleeding after endoscopic varices liga-tion EVL in advanced schistosomiasis patients. Methods The data of 206 advanced schistosomiasis patients who received VEL were collected and studied retrospectively. Results There were 17 cases of early esophageal varices bleeding after EVL in-cluding 1 died case the early hemorrhage rate was 8.25% and the mortality rate was 0.5%. The early bleeding occurred from the 4th to 12th day and 76%occurred from the 7th to 9th day postoperatively. The direct cause of hemorrhagic was ligation ring falling off and the inducements were the improper diet 10 cases 58.8% and increased abdominal pressure 6 cases 35% . All the cases of early esophageal varices bleeding occurred in the patients whose liver function being Child-Pugh C. Conclu-sions The incidence and mortality of EVL early postoperative hemorrhage are both low and mostly occur from the 7th to 9th day postoperatively. We should pay attention to the diet and nursing and the patients with Child-Pugh C liver function are the high risk group.

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