OBJECTIVETo explore clinical effect of treatment of fractures of the talar neck with hollow compression screw via inner malleolus tomy approach.

METHODSTwelve patients with fractures of the talar neck included 7 males and 5 females with a mean age of 38 years (reaging from 20 to 56 years). According to the Hawkins classification, 8 cases were type II and 4 cases were type II. Twelve patients were treated with hollow compression screw via inner malleolustomy approach.

RESULTSAll the patients were followed up for 1 year to 6 years and 8 months (average 4 years and 5 months), all the fractures were bony union. The mean Hawkins score was excellent in 5 cases, good in 5 cases, fair in 1 case and poor in 1 case.

CONCLUSIONIt is a good method to treat the fractures of the talar neck with hollow compression screw via inner malleolus tomy approach.

Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Neck Injuries ; surgery ; therapy ; Pressure ; Treatment Outcome ; Young Adult

OBJECTIVETo study the application and effect of retrograde titanium elastic nails fixation for the treatment of displaced clavicle fracture in children under closed reduction.

METHODSFrom January 2014 to November 2016, 26 children with displaced fractures of the clavicle were treated by closed reduction and retrograde inserted titanium elastic nails including 14 boys and 12 girls with an average age of 9.2 years old ranging from 7 to 14 years. Time from injury to operation was 2 to 7 days with an average of 2.8 days. Visual analogue score (VAS) was used to evaluate the main complaint pain in all patients before and 2 days after operation. The Neer score of shoulder function between affected side and healthy side at 2 months after operation were compared.

RESULTSAll the 26 children were followed up for 6 to 12 months. All cases healed well without infection, broken nails or titanium elastic nails exit complications. All children achieved anatomical reduction, good bony union, and good recovery of shoulder joint activity. The average time of removing nail was 14 to 32(16.25±2.62)weeks. The pain VAS score was significantly relieved 2 days after operation (<0.05). At 2 months after operation, the Neer score of shoulder joint was 98.46±1.07 in affected side and 98.58±1.10 in healthy side respectively, there was no significant difference between the two groups (>0.05).

CONCLUSIONSTitanium elastic intramedullary nail fixation for the treatment of displaced clavicular fracture in children has the advantages of minimal invasion, no effect on skin beauty, rapid healing of fracture, good recovery of postoperative function, simple nailing and less complications.

OBJECTIVETo explore the influence of Chinese medicine constitution type on the susceptibility of hypertensive patients to intracerebral haemorrhage.

METHODSPrimary hypertensive patients were studied and divided into the hypertension and the hypertensive intracerebral haemorrhage groups, depending on whether or not the patients had intracerebral haemorrhage. The demographic characteristics, physiological characteristics, living habits, biochemical tests, other chronic diseases, Chinese medicine constitution type, etc. were collected and compared between the two groups. The neurological deficit in the hypertensive intracerebral haemorrhage group was also compared among the different constitution types.

RESULTSA total of 304 patients participated in this investigation, including 213 cases in the hypertension group and 91 cases in the hypertensive intracerebral haemorrhage group. The percentages of dampness-heat and qi-depression types in the intracerebral haemorrhage group were greater than those with the same types in the hypertension group (20.9% vs 6.1%, 22.0% vs 8.0%; P<0.05). The percentages of each constitution type were different between genders in both groups. In addition, there were more male cases (14/20) with qi-depression type and more female cases (7/8) with phlegm-dampness type in the hypertensive intracerebral haemorrhage group than those with the same types (3/17 and 9/34, respectively) in the hypertension group (P<0.05). The cases with phlegm-dampness and qi-depression types had greater levels of blood lipids in the intracerebral haemorrhage group than those with the same types in the hypertension group (P<0.05). Furthermore, the cases with the qi-deficiency type presented with a more severe neurological deficit than those with the other types (P<0.05).

CONCLUSIONSChinese medicine constitution type might have an impact on the susceptibility of hypertensive patients to have an intracerebral haemorrhage. The heat-dampness and qi-depression types might lead to greater susceptibility than the other types. In addition, the patient's gender and blood lipids might also influence the susceptibility along with the constitution type.

Aged ; Body Constitution ; Cerebral Hemorrhage ; etiology ; Disease Susceptibility ; pathology ; Female ; Humans ; Hypertension ; complications ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nervous System ; pathology

Adolescent ; Adult ; Child ; Debridement ; methods ; Electricity ; Female ; Foreign Bodies ; diagnostic imaging ; surgery ; Humans ; Magnetics ; Male ; Metals ; isolation & purification ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the technique and clinical results of minimally invasive percutancous plate osteosynthesis (MIPPO) for the treatment of fractures of the distal tibia.

METHODSA retrospective study was conducted to analyze 65 patients with the distal tibia fractures who had been treated with MIPPO. The average age of the patients was 35 years old (ranging from 13 to 75). There were 42 males and 23 females. According to AO fracture classification for the distal tibial fractures, there were 5 cases of type-A1 fracture, 22 type-A2, 32 type-A3 and 6 type-C1.

RESULTSAll the patients were followed up and ranged from 6 to 18 months (averaged 11 months). All the fractures showed union. The time required for the bony union ranged from 3 to 6 months (averaged 4.5 months). The patients were evaluated with respect to functional recovery according to Mazur Grating System for the Ankle. Forty patients obtained excellent results, 19 good and 6 fair. The total satisfactory rate was 90.7%.

CONCLUSIONThe technology of minimally invasive percutancous plate osteosynthesis (MIPPO)is a safe and effective procedure for the distal tibial fractures with the benefits of limited invasion,less complications and high rate of bone union.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery

Objective To compare the difference of T-stage between Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma,and to investigate the optimization of T-stage and provide suggestions for further revision.Methods The MRI data of 183 patients with histology-proven newly diagnosed nasopharyngeal carcinoma in our hospital were enrolled from September 2009 to May 2017.All the anatomic sites mentioned in the two staging systems were marked,and all patients were staged according to the 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma.Comparisons of T-stage were made between the two staging systems.Results Involvement of oropharynx,nasopharynx,prevertebral muscles,cervical vertebra,hypopharynx and orbit were 100％ accompanied with other same or more advanced T-stage classifications.The invasion rates of the cervical vertebra,orbit and hypopharynx were very low (all ＜ 5.00％).The incidence of involvement of pterygoid structure was 15.30％,most of which incorporated with erosion of skull base,only 1 case was invaded alone.All cases of involvement of paranasal sinuses were incorporated with erosion of skull base.Compared with the 2008 staging system,the consti-tuent ratio of T1 + T2 in the 2017 staging system increased from 36.61％ to 61.75％,and that of T3 + T4decreased from 63.39％ to 38.25％,the constituent ratio of T-stage between the 2017 staging system and the 2008 staging system was significantly different (x2 =26.94,P ＜ 0.001).There was moderate consistency of T-stage between these two staging systems (Kappa =0.514,P ＜ 0.001).Conclusion The T-stage of 2017 staging system still has a larger simplification and optimization space.Therefore,according to the principle of concise,the T-stage parameters including oropharynx,nasopharynx,prevertebral muscles,paranasal sinuses,cervical vertebra,orbit and hypopharynx are recommend to delete,and it does not have an impact on the composition of T-stage.We suggest that the pterygoid structure shall combine with the skull base to be one anatomical structure.

OBJECTIVE: To systematically review the therapeutic effect of acupuncture-moxibustion therapies on post-stroke constipation based on the network Meta-analysis. METHODS: The randomized controlled trials of acupuncture and moxibustion for post-stroke constipation were retrieved from the databases, starting from the time of establishment through to June, 2019, i.e. the PubMed, EMbase, Cochrane Library, Web of Science, SinoMed, CNKI, Wanfang and VIP. The literature was selected according to inclusion and exclusion criteria, the quality of literature was evaluated by bias risk assessment tool of Cochrane Review Manual 5.3 and the data was statistically analyzed by softwares of Stata 13.1 and R Language. RESULTS: A total of 28 trails were included, involving 9 intervention methods. The therapeutic effect was arranged from high to the low according to the surface under cumulative ranking area (SUCRA), i.e. acupuncture combined with medication (0.86), warm needling (0.83), electroacupuncture combined with medication (0.68), electroacupuncture (0.68), moxibustion (0.50), auricular point sticking (0.44), acupuncture (0.31), Chinese herbal medicine (0.12) and western medication (0.04). CONCLUSION Acupuncture- moxibustion therapies have superiority on treating post-stroke constipation, acupuncture combined with medication has the most optimum therapeutic effect and the therapeutic effect of acupuncture-moxibustion combined with medication is superior to the single treatment of medication.

INTRODUCTIONThis study aims to assess whether cryosurgery is a feasible local therapy for bone metastatic prostate cancer (bmPCa).

METHODSA total of 23 patients with bmPCa who received cryosurgery and adjuvant androgen deprivation therapy (ADT) were included in the cryosurgery group (Group 1). Another 23 matched patients who received only ADT served as the control (Group 2). Prostate-specific antigen (PSA) nadir level, time to PSA nadir, time to castration-resistant prostate cancer (CRPC), progression-free survival and therapy response of bone metastases were compared between the groups.

RESULTSThe median follow-up time in Group 1 and Group 2 patients was 37 (range 19-53) months and 42 (range 24-56) months, respectively. Patients in Group 1 had fewer local complications, lower PSA nadir level (0.23 ng/mL vs. 4.01 ng/mL; p = 0.024), shorter median time to PSA nadir (3 months vs. 7 months; p < 0.001), longer median time to CRPC (36 months vs. 27 months; p = 0.002) and longer progression-free survival (35 months vs. 26 months; p = 0.003) compared to those in Group 2. Therapy responses of bone metastases were similar in the two treatment groups (p = 0.689).

CONCLUSIONCryosurgery is a feasible local therapy for bmPCa patients with prostate volume less than 50 mL and without bulk tumours outside the prostate capsula. Cryosurgery may decrease PSA nadir level, local complications and time to PSA nadir, delay time to CRPC and improve progression-free survival.

OBJECTIVETo study the values of immunohistochemistry staining and cytological diagnosis by using cell block sections prepared with the effusion fluid cytology specimens.

METHODSNinety-nine effusion cytology specimens with the diagnoses of reactive mesothelial hyperplasia, atypical cells and metastatic carcinoma were enrolled into the study. The cytospin preparations/smears, cell block sections and immunohistochemical study were performed and correlated with the clinical findings and follow-up data.

RESULTSAmongst the 99 cases studied, the percentage with positive diagnosis using cytospin preparations/smears was 68.7% (68/99). The percentages with negative and equivocal diagnoses were 16.2% (16/99) and 15.1% (15/99), respectively. As for cell block sections, the percentages were 71.7% (71/99), 16.2% (16/99) and 12.1% (12/99), respectively. On the other hands, the percentages became 76.8% (76/99), 20.2% (20/99) and 3.0% (3/99), respectively, when coupled with immunohistochemical findings. The overall percentages of positive, negative and equivocal diagnoses were 77.8% (77/99), 17.2% (17/99) and 5.0% (5/99), respectively, upon clinicopathologic correlation. The difference between cytospin preparations/smears and cell block sections was not statistically significant (P > 0.05). When coupled with immunohistochemical findings or clinicopathologic correlation, the difference in rates of equivocal diagnosis however carried statistical significance (P < 0.05). The false-negative rate of immunohistochemical study applied on cell block sections was 1.0% (1/99).

CONCLUSIONSImmunohistochemistry, when applied on cell block sections, is useful in delineation of the primary origins of the tumor cells in effusion fluid cytology specimens. Combination of morphologic examination, immunohistochemical findings and clinicopathologic correlation can further improve the rate of positive diagnosis.

Adult ; Aged ; Aged, 80 and over ; Ascites ; metabolism ; pathology ; Ascitic Fluid ; metabolism ; pathology ; CA-125 Antigen ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Cytodiagnosis ; Female ; Gastrointestinal Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; pathology ; Male ; Membrane Proteins ; metabolism ; Middle Aged ; Ovarian Neoplasms ; metabolism ; pathology ; Pericardial Effusion ; metabolism ; pathology ; Pleural Effusion ; metabolism ; pathology ; Pleural Effusion, Malignant ; metabolism ; pathology ; Young Adult

OBJECTIVETo investigate the protective effects of hypothermia combined with dexamethasone on the testis of rats after testicular torsion reduction and on the expression of eNOS and apoptosis of spermatogenic cells.

METHODSWe made unilateral testicular torsion models in 80 adolescent male Sprague-Dawley rats by 720 degrees torsion of the left testis, and then randomly divided them into four groups of equal number to be treated with normal temperature + physiological saline (group A), hypothermia + physiological saline (group B), hypothermia + dexamethasone (group C), and normal temperature + dexamethasone (group D). After 48 hours, we collected the testes, observed pathological changes of the testicular tissue by HE staining under the light microscope, determined the expression of eNOS by immunohistochemistry, and detected the apoptosis of spermatogenic cells by TUNEL.

RESULTSHE staining showed different degrees of testicular tissue injury in all the four groups of rats, most obvious in group A, while protective effect was observed in the other three groups. Immunohistochemistry revealed significantly more positive cells and higher positive staining intensity in the torsion (left) testis in group A than in B (P < 0.05), C (P < 0.01) and D (P < 0.01). The nuclei were deep brown or brown. Lots of apoptotic spermatogenic cells were seen in the torsion testis of group A, with a significantly higher apoptosis index (31.12 +/- 4.68) than in B (16.58 +/- 6.22) (P < 0.05), C (8.60 +/- 1.15) (P < 0.01) and D (13.52 +/- 3.06) (P < 0.01).

CONCLUSIONIschemia-reperfusion injury after testicular torsion reduction can increase the apoptosis of spermatogenic cells and decrease testicular reproductivity. Hypothermia combined with dexamethasone can protect the testis from injury as well as the reproductive function of the testis after testicular torsion reduction.

Animals ; Apoptosis ; Dexamethasone ; pharmacology ; Germ Cells ; cytology ; metabolism ; Hypothermia, Induced ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spermatic Cord Torsion ; metabolism ; pathology ; Spermatogenesis ; Testis ; metabolism ; pathology