Objective To investigate the causes of non-union and delayed union of fractures and to report the surgical techniques and outcomes of the treatments. Methods 107 cases of non-union, 54 cases of delayed union and 2 cases of congenital non-union of tibia were treated between July 1990 and December 2004 in our hospital. The treatments were evaluated retrospectively to analyze the causes of the disorder and the treatment outcomes at the follow-up. 18 cases of delayed union were treated conservatively while the other 145 cases in this series underwent surgery. Results Except in the 2 cases of congenital non-union of tibia, iatrogenic factors were found to be responsible for nonunion or delayed union in all the other 161 cases. 153 cases were followed up for an average of 17 (6 to 28) months only to reveal bone union in all the cases with a mean healing time of 10 (6 to 14) months. All the limbs regained good function. Conclusion Since development of non-union and delayed union of fractures chiefly result from iatrogenic technical defects, satisfactory results can be achieved as long as appropriate treatments are performed according to different etiological factors.

OBJECTIVE:To establish a method for identification and determination of illegal adding of chemical substance glibenclamide in traditional Chinese medicine(TCM)for health care,and to provide the reference for the governmental de?partment of drug surveillance and drug inspection.METHODS:TLC and HPLC were employed to isolate and analyze the ex?tract from Qiaoqi capsule suspected of illegal addition of glibenclamide.Glibenclamide was identified by HPLC-DAD spec?trography and ESI-MS technology,and the content determination was made by HPLC.RESULTS:Both capsule sample A and B were detected to contain glibenclamide,the concentrations of which were1.51mg per capsule and0.55mg per capsule respectively.CONCLUSION:The established method is specific,sensitive,and convenient,and can be used efficiently for con?trol and surveillance of illegal adding of chemical substance glibenclamide in TCM for health care.

Objective To observe the predictive value of Alberta stroke program early CT score (ASPECTS) and hemorrhage after thrombolysis score (HAT score) for the hemorrhagic transformation (HT) of acute cerebral infarction (ACI) patients after thrombolysis with Alteplase.Methods One hundred and twenty-one patients with ACI admitted to the Department of Neurology of Tianjin Jinghai District Hospital from January 2015to March 2017 were enrolled, they were all treated by using Alteplase 0.6 mg/kg for thrombolysis, maximum dose being 90 mg, and 1/10 of the total dose was intravenously injected in 1 minute, and then the residual part dissolved in 100 mL normal saline was intravenously dripped continuously for 1 hour. The ASPECTS and HAT score were carried out before the start of thrombolysis, and then the HT incidence situations in patients with different ASPECTSs and HAT scores were compared, and logistic regression analysis was used to analyze the risk factors of HT after thrombolysis in patients with ACI; then the receiver operating characteristic (ROC) curve was drawn, and the clinical value of HAT score and ASPECTS in diagnosing HT occurrence was analyzed.Results In cases with ACI, it was discovered that the higher the ASPECTS, the lower the incidence of HT, indicating that the incidences of HT in patients with ASPECTSs 0-4, 5-7, 8-10 were 57.1% (4/7), 26.7% (8/30), 14.3% (12/84) respectively; Similarly, in such cases, the higher the HAT scores, the higher the incidence of HT, showing that the incidences of HT of patients with HAT scores 0, 1, 2, ≥ 3 were 7.1% (4/56), 21.0% (8/38), 33.3% (7/21), 83.3% (5/6) respectively. The single factor analysis showed that the risk factors influencing the HT incidence included the systolic blood pressure on admission, anti-platelet medicine taken in the past history, the sign of high density of middle cerebral artery shown in head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT store and ASPECTS [odds ratio (OR) values were 0.972, 0.279, 0.992, 0.311, 2.628, 2.625, respectively, 95% confidence intervals (95%CI) were 0.9352-1.012, 0.093-0.836, 0.983-1.000, 0.105-0.916, 1.362-5.071, 1.522-4.525,P values were 0.034, 0.023, 0.042, 0.034, 0.003, 0.045 respectively]; the multifactorial logistic regression analysis showed that the independent risk factors influencing HT incidence were as follows: the systolic blood pressure on admission, anti-platelet medicines taken in the past history, the sign of high density of the middle cerebral artery shown in the head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT score and ASPECTS (OR values were 1.766, 1.012, 1.574, 1.030, 2.155, 2.431, 95%CI were 1.233-2.103, 1.009-1.204, 1.186-2.091, 1.009-1.053, 1.237-4.907, 1.213-5.815,P values were 0.023, 0.004, 0.002, 0.005, 0.007, 0.047); HAT score and ASPECTS could predict the risk of HT incidence after venous thrombolytic therapy, sensitivity, specificity, area under ROC curve (AUC), 95%CI in ASPECTS were higher than thoes of HAT score (94.4% vs. 94.0%, 61.4 vs. 41.0%, 0.77 vs. 0.70, 0.710-0.830 vs. 0.650-0.800).Conclusions It is shown in this study that the higher the ASPECTS, the lower the incidence of HT, and the higher the HAT score, the higher the incidence of HT; both HAT score and ASPECTS can predict the risk of HT incidence after venous thrombolytic therapy, and the predictive value of ASPECTS system is higher than that of HAT score.

T1 glottic carcinoma is part of early laryngeal carcinoma which involves the vocal cords, including anterior commissure or posterior commissure. We analyzed the treatment options of T1 glottic carcinoma by reviewing the related literatures about T1 glottic carcinoma treated by conservative surgery (open surgery and laser microsurgery), radiotherapy, robot surgery, photodynamic treatment.
Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; therapy ; Laser Therapy ; Microsurgery ; Vocal Cords

n -3 polyunsaturated fatty acids (n -3 PUFAs),essential fatty acids for human body,have varied biological activities.They are absolutely or relatively deficient in modern human diets.Supplementation of n -3 PUFAs in early life is important for the optimal growth and development in fetus,infants and children,and well as for prevention of chronic non -communicable diseases in later life,such as attention deficient hyperactivity disorder,allergic diseases, asthma,hyperlipidemia and non -alcoholic fatty liver disease.The human body can synthesize eicosapentaenoic acid (EPA)and docosahexaenoic acid (DHA)with linolenic acid,but the ability is limited.Therefore,intake of pre -formed EPA and DHA is needed for body requirement.For pregnant women and infants,supplementation of DHA and EPA with a ratio above 51 is suggested.In clinic,n -3 PUFAs have been applied for treatment of chronic non -com-municable diseases and proved to be beneficial in relief of symptoms.

Objective　To evaluate the efficacy and safty of pegging hydroxyapatite orbital implants.Methods　Fourty-five patients who received drilling and pegging of hydroxyapatite orbital implants were studied retrospectively, and all patients used the peg and sleeve system followed-up 2 to 24 months.Results　The rate of success of the first operations is 82.2%. Complications associated with pegging included peg hole drilled on an angle, drilling off-center, drilled hole shallow, granuloma and infection, total complications occured in 22.2% in the review, most that are of a minor nature can be cured.Conclusions　The hydroxyapatite orbital implants can be directly coupled to the prosthesis through a peg system, allowing a wide range of prosthesis movement and giving a more lifelike quality to the prosthesis. When and how to drill and exactly hole on implant is the key for pegging.

With the development of clinical education,Urology Department in Xiangya Hospital has identified teaching object and scheme,and improved the condition and modality of teaching and the level and development of clinical teaching.

ObjectiveTo observe the therapeutic effect of standing bed on orthostatic hypotension with cervical spinal cord injury. Methods36 patients with cervical spinal cord injury were divided randomly into the standing bed group and routine treatment group. The blood pressure of all patients were measured every day during rehabilitation treatment. The function of spinal cord was assessed before and after treatment.ResultsThe function of sensory and motor in the two groups were all improved, but there was no statistical difference between the two groups in the grades of spinal cord function. There were 27 patients who had orthostatic hypotension in the study. All the patients with complete spinal cord injury suffered the orthostatic hypotension. There was no improvement in blood pressure of complete spinal cord injury after treatment. In incomplete spinal cord injury patients, there was a significant improvement and the difference of blood presure between lying and standing was decreased in standing bed group after treatment (P<0.05). Compared with routine treatment group, the blood pressure in standing bed group was improved (P<0.05). Conclusions Cervical spinal cord injury could have orthostatic hypotension. Complete spinal cord injury would suffer orthostatic hypotension in different degree. The standing bed treatment could improve the orthostatic hypotension in incomplete spinal cord injury.

Objective To investigate the feasibility and effects of minimally invasive video-assisted parathyroidectomy(MIVAP)for parathyroid adenoma or cyst.Methods A 2 cm skin transverse incision was made above the suprasternal notch.Without gas insufflation,a cavity was built with retractors.Under endoscopic assistance,parathyroidectomy was performed by using a harmonic scalpel(3 cases of nonfunctioning parathyroid cyst and 7 cases of parathyroid adenoma accompanying hyperparathyroidism).Results The operation was successfully accomplished in all the 10 cases,without conversions to open surgery.The operative time was 20～70 min(mean,40 min).No hoarseness,choking cough,or hemorrhage occurred.A transient hypocalcemia developed in 3 cases.All the patients were followed for 2～18 months(mean,9 months),with satisfactory curative and cosmetic results.Conclusions Minimally invasive video-assisted parathyroidectomy appears to be a safe and effective treatment with good cosmetic results and postoperative outcomes.

Endoscopic drainage was practised in 23 patients with acute or chronic pancreatitis. Among them 13 cases with acute pancreatits (AP) including 5 serious ones were treated with endoscopic sphincterotomy (EST) and naso biliary drainage (ENBD).Following successful drainage ( n =11) all the patients were cured with an average of 10 4 days (5-18 days). Among 11 patients with chronic pancreatitis, there were 7 cases treated by endoscopic pancreatic sphinterotomy (EPS), 2 cases by extraction of pancreatic duct stones with balloon, 5 cases by dilatation of pancreatic duct with bougienage, 6 cases by endoscopic naso pancreatic drainage(ENPD), and 7 cases by pancreatic duct drainage(PDE). After the operation, abdominal pain was eliminated in 5/7 cases. Pancreatic duct stones were extracted out in 2 patients and pancreatic cyst disappeared in 4 patients. It is concluded that endoscopic drainage is safe and useful in management of acute or chronic pancreatitis.