Objective To study the preliminary effect of sartorius iliac flap in repair of acetabulum defect for developmental dysplasia of the hip (DDH) in elder children.Methods We retrospectively studied 17 elder children with acetabulum defect in DDH at the age＞6 years old who received acetabular repair with sartorius bone flap in this hospital from 2014 to 2016.All patients with acetabulum defect in DDH were treated with open reduction in general anesthesia.Three-dimensional osteotomy under the femur rotor was conducted to correct the femoral anteversion and neck-shaft angle.According to the height of femoral head dislocation lines,femur tuberosity was shorten and fixied with steel plates,joint capsule was reconstructed,The iliac sartorius musculocutaneous flap was took to the upper edge of the acetabular to repair the acetabular defect.The lower extremities were treated with plaster for 6 to 8 weeks after surgery.The hip joint function was trained and the function was evaluated with Mckay's criteria.The hip joint morphological evaluation was performed with reference to Severin's X-ray standard.Results Seventeen patients were followed up for 6 to 29 months.Postoperative reduction of the femoral head was good,the head mortar inclusive was satisfactory;there were no wound infection and femoral head necrosis.According to Mckay's criteria,2 patients got excellent,13 good,and 2 fair,with the fineness ratio at 88.2％;According to Severin's critera:11 patients excellent.Conclusion The overturned sartorius iliac flap can repair acetabulum defect,promote bone healing,and effectively improve acetabulum to cover head of femur.

Objective To evaluate the clinical effect of long incision and reticular incision in the treatment of osteofascial compartment syndrome(OCS)in children.Methods The study involved 56 children with OCS who met failure of the conservative treatment.The injury sites included mainly the forearm and the leg.All the children underwent decompression by a small reticular incision procedure from January 2000 to May 2009.The fractures were treated with one stage reduction and fixation or second stage open reduction.Meanwhile,the study involved another 21 children(including 13 earthquake victims)who were treated with long incision for open decompression in the other hospitals before admission.All the wounds were healed by direct suture or dermatoplasty after 1-5 weeks of infection control.Bacterial culture was performed in all the wounds.The fractures were treated with secondary open reduction and fixation.Bacteria culture was done in all wounds.Results The reticular incisional wounds of 56 patients were healed free from dermatoplasty,with no infection or sensory dysfunction.Among 21 patients treated with long incision,the bacteria culture was positive in 16 patients(including 13 earthquake victims)and verve injury found in five patients(including two with radial nerve injury and three with peroneal nerve injury).Four patients with partial or complete cut-off of the verves were improved after repair by secondary operation.Direct suture of incisions was done in nine patients and skin graft performed in 12,with average healing time for three weeks.The patients were followed up for mean 5.6 years,which showed no claw hands,with overall satisfactory rate for about 98% and 95% respectively in two groups according to the probation standard of amputated finger function evaluation from the Hand Surgery Plant of Chinese Medical Association.Conclusions Both long incision and reticular incision procedures can be used early in the treatment of pediatric OCS,while the reticular incision procedure is more convenient and simple,with less complications.

Hedgehog signaling pathway is a conserved and important signaling pathway involved in proliferation and differentiation of many types of cells. Latest studies have found that Hedgehog signaling pathway may induce MSCs osteoblast differentiation by increasing the expression of the Runx2 and Osx and inhibit MSCs differentiate to adipocyte. Hedgehog signaling pathway may also promote osteoblast proliferation by regulating cyclin. This review summarizes the mechanism that Hedgehog signaling pathway regulates osteoblast differentiation and proliferation,and concludes that Hedgehog signaling pathway can regulate bone metabolism. It might provide new ideas for the treatment of osteoporosis.
Cell Differentiation ; Core Binding Factor Alpha 1 Subunit ; genetics ; physiology ; Hedgehog Proteins ; physiology ; Humans ; Mesenchymal Stromal Cells ; cytology ; Osteoblasts ; cytology ; Osteoporosis ; drug therapy ; etiology ; Signal Transduction ; physiology ; Sp7 Transcription Factor ; Transcription Factors ; genetics ; physiology

Objective To compare the clinical effect of tensile band wire fixation and plate fixation for treating children with olecroanon fracture.Methods Sixty-three children with olecroanon fracture at Children's Hospital of Chongqing Medical University from January 2006 to January 2014 were selected.In those cases of fracture by means of open reduction,41 cases were treated with tensile band wire,and 22 cases were treated with internal fixation with anatomical plate.Operation time,bleeding during operation,recovery time postoperatively,postoperative complications and joint function recovery were analyzed by using independent sample t-test and chi-square test.Results In the group of tensile band wire,there was no case of Kirschner wire loosening and displacement fracture.In group of steel plate,there were 2 cases of myositis ossificans.In the 2 groups,there was no case of bone nonunion.The average operation time:plate fixation group was (65.3 ± 8.4) min and tension band wire group was (58.4 ± 12.6) min,and there was a significant difference between the both groups (t =7.419,P ＜ 0.05);blood loss:plate fixation group was (5.3 ±0.8) mL and tension band wire group was (4.7-± 1.2) mL,and there was a significant difference between the both groups (t =2.595,P ＜ 0.05);fracture healing time:plate fixation group was (74.1 ± 8.4) d and tension band wire group was (61.7 ±9.3) d,and there was a significant difference between the both groups (t =10.636,P ＜0.05).With Broberg-Morrey to evaluate two groups'quality rate of function recovery,there was no significant difference in statistics with 85.3％ (35/41 cases) in tensile band wire group and 81.8％ (17/22 cases) in steel plate group(x2 =0.651,P ＞ 0.05).Conclusions Olecranon fracture in children using tension band wire fixation may be a better way,more suitable for promotion and implementation at basic hospital.

Objective To compare the effect of titanium elastic nailing (TEN) and plating in treatment of both radius and ulna fractures in children older than 10 years.Methods This retrospective analysis comprised 38 children (50 sides) of both radius and ulna fractures treated with TEN (30sides) or plate (20 sides) between 2009 and 2014.Parameters compared between the two fixation methods were operation time,ratio of open/close reduction,time to internal fixation removal,incidence of postoperative complications,and bone union time.Anderson score was used to evaluate the treatment results.Results Operation time [(94.3 ± 39.5) min vs (120.5 ± 45.4) min],time to internal fixation removal [(210.8 ± 84.1) d vs (264.4 ± 88.9) d],and ratio of open/close reduction (20/10 vs 20/0)varied significantly between TEN and plating groups (P ＜ 0.05 or 0.01).Whereas,no statistically significant differences were noted in regard to complication rate,bone union time,and effect evaluation.Conclusion For fracture of the radius and ulna in children older than 10 years,TEN should be used for closed type without obvious displacement,but plate fixation is associated with lower incidence of fracture malunion and better outcome in treatment of open type with obvious displacement.

ObjectiveTo survey 0—6 years old disabled children in Guiyang.Methods4 999 children aged 0—6 years old chosen randomly from 9 145 children of 12 blocks were investigated with the disability sampling survey criteria of 1987.ResultsThe rate of disabled children in Guiyang was 1.58%, and was not significantly different compared with that of whole country (1.36%) and other three areas including Siping City (P>0.05),but significantly higher than that of other six districts including Heping district of Tianjin municipality (P<0.05). All kinds of disability found by this survey were separately intellectual disability (0.92%),comprehensive disability (0.28%),limb disability (0.24%),vision disability (0.10%),psychiatric disability (0.03%),and hearing disability (0.02%). Rates of intellectual and vision disabilities were significantly higher than that of whole country ( P>0.05).ConclusionSome diseases are directly relative to occurrence of disability. The poor income of the children family,lower education of his parents and not gotten preschool education were risk factors of disability. The institution based rehabilitation and community based rehabilitation are main rehabilitation forms to disabled children.

Objective To evaluate liver biopsy for the diagnosis in liver transplant patients with suspected acute rejection. Methods From Oct. 2004 to Apr. 2005, liver biopsies were performed 53 times in 39 transplant cases. Results Based on Banff schema for grading liver allograft rejection, laboratory abnormalities and result of treatment, acute rejection was diagnosed on 16 episodes, preservation injury in 12, bile duct strictures in 9, drug-induced injury in 11, chronic rejection in 3 and acute hepatic failure in 2. Conclusions Hepatocyte ballooning with necrosis features preservation injury. Drug-induced injury commonly has a combination of hepatocyte denaturalization with mild portal inflammation. Histologic features of early bile duct strictures in liver biopsy show prominent bile ductular proliferation and the canalicular cholestasis with mild hepatocyte damage which help to exclude acute rejection.

OBJECTIVETo analyze the current situation and trend of Mycobacteria other than tuberculosis (MOTT) in the old city area of Guangzhou and to provide information for diagnosis, treatment and policy on tuberculosis (TB) control in the city.

METHODSRelevant data regarding Mycobacteria culture, species identification and drug-resistance from out-patients under suspicion of having pulmonary tuberculosis seen at our TB and Pulmonary Tumor Control Institute, was analyzed retrospectively during 1994-2003.

RESULTSA total number of 12,634 strains of Mycobacteria were isolated and 794 strains were identified as MOTT which accounted for 6.28% of the isolated strains during the ten years. The annual isolation rates of MOTT were between 3.51% and 10.06%. When compared with 1994, the rates of isolation on MOTT had increased 73.15% in 2003, i.e. from 5.81% in 1994 to 10.06% in 2003. 512 strains were not susceptible at least to rifampin and isoniazid out of 613 MOTT strains tested for drug susceptibility to isoniazid, rifampin, streptomycin sulfate and ethambutol. The average rate of multi-drugs resistance of these strains was 83.5%, and the annual rates were between 71.4% and 93.9%. Based on the results of species identification on 136 strains of MOTT in 2003, most of them belonged to pathogenic/opportunistic species of Mycobacteria. All together, 30 strains of M. abscessus, 26 of M. intracellulare, 17 of M. smegmatis, 14 of M. scrofulaceum, 11 of M. avium, 5 of M. kansasii and M. chelonae and M. fortuitum respectively, 4 of M. nonchromogenicum, 2 of M. triviale and 1 of M. aurum were identified. People at 45 years of age or older, with 55-65 the most, were more susceptible to MOTT than other age groups. Sex ratio was 3.36 to 1.

CONCLUSIONBased on information from the Third National Tuberculosis Epidemiology Survey in 1990 and the Fourth one in 2000, the current situation and trend of MOTT were nearly the same in the old city area of Guangzhou during 1994-2003. However, the rising tendency of rate of isolation, mainly consisted of opportunistic pathogens and the surprisingly high rate of multi-drugs resistance to MOTT all call for special attention. Studies regarding the epidemiology of MOTT should be posed and implemented in the National TB Control Program.

Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous ; epidemiology ; Mycobacterium avium-intracellulare Infection ; epidemiology

Abstract: Objective　To analyze the emergency response and long-term intervention effects after the detection of infectious snails epidemic by loop-mediated isothermal amplification (LAMP) assays in Hannan District, Wuhan City, and to explore the application of LAMP in early surveillance and early-warning of schistosomiasis transmission. Methods Snails picked up by the risk monitoring system in Hannan District were examined by anatomical microscopy and LAMP technology to identify the schistosomiasis infection. Emergency response and intensive intervention were initiated in the environment where positive snails appeared, and the long-term effects were evaluated. Results In May 2018, the infectious snails were detected by LAMP technology in Hannan District, and the positive snails were located in Zhujiacha, Dongzhuang Village, Obstacles and weeds were removed and buried by machine in Zhujiacha. 12 700 m2 of snails were killed by drugs, and the mortality rate of snails was more than 80%; no new seropositive persons were found in the emergency examination within 500 m of the positive snail sites. 506 people were examined in Dong Zhuang Village at the end of the year, and 30 positive IHA cases were detected with a blood positive rate of 5.93%, no positive fecal test was found, and all positive blood test patients took preventive medication. The monitoring results of sentinel rats and wild feces were all negative. Health education was carried out, 7 warning signs were deployed and refreshed, and 500 publicity brochures were distributed. After nearly three years of intensified intervention and monitoring in the villages where the positive environment is located, and the density of snails on the stubborn snail has dropped from 0.094/frame to 0.027/frame, and the positive rate of blood test in Dongzhuang Village has steadily dropped from 5.93% to 3.74%. Conclusions The infected snails missed by microscopy were detected by LAMP in Hannan District, which created conditions for the rapid emergency treatment of environment and elimination of positive snail and improved the sensitivity of the surveillance and early warning system in transmission-interrupted areas.

OBJECTIVE: Meta-analysis was used to compare the clinical efficacy of high tibial osteotomy(HTO) and unicondylar arthroplasty (UKA) in the treatment of medial compartment osteoarthritis (MIOA) and provide a better surgical choice for patients with MIOA. METHODS: The Cochrane Library (Issue 6, 2017), PubMed, Ovid, ELSIVE, CNKI and Wanfang databases were searched by a computer. Literatures on HTO and UKA for MIOA from January 1, 1970 to June 30, 2017, including complications, knee joint score, knee mobility, revision rate and excellent and good rate, were searched and screened out according to the inclusion criteria, and strict quality evaluation was carried out. RevMan 5.0 software provided by Cochrane collaboration network was used to conduct the meta-analysis of the included research results and to test the heterogeneity of the data. RESULTS: Total 13 articles met the inclusion criteria, and the total sample size was 1 043. Among them, 462 were HTO treatment group and 581 were UKA treatment group. By comparison between HTO treatment group and UKA treatment group, there were significant differences in the contralateral deterioration rate[WMD=3.21, 95%CI(1.13, 9.10)], pre-operative knee range of motion[WMD=6.55, 95%CI(1.44, 11.66)], Lysholm knee score[WMD=-3.15, 95%CI(-4.77, -1.53)], complications[WMD=2.78, 95%CI(1.52, 5.11], revision rate[WMD=1.81, 95%CI(1.17, 2.80)], the rate of excellent and good[WMD=0.49, 95%CI(0.30, 0.80)], and femorotibial angle changes[WMD=-2.37, 95%CI, (-3.63, -1.11)](<0.05). There were no significant differences between the HTO treatment group and the UKA treatment group in patellofemoral deterioration rate[WMD=1.59, 95%CI(0.65, 3.84)] and the free walking speed[WMD=-0.02, 95%CI(-0.09, 0.04)](>0.05). CONCLUSIONS Based on the limited data, high tibial osteotomy is a better choice for the treatment of medial compartment osteoarthritis in the comparison of short and medium-term clinical outcomes, and long-term clinical outcomes may need further study.
Arthroplasty, Replacement, Knee ; Humans ; Knee Joint ; Osteoarthritis, Knee ; Osteotomy ; Tibia ; surgery ; Treatment Outcome