Forty type 2 diabetic patients with diabetic peripheral neuropathy (DPN) were assigned to two groups and treated respectively with?-lipoic acid or mecobalamin for 2 weeks.The results suggested that?-lipoic acid could accelerate the nerve conduction velocity and decrease the plasma level of endothelin and C reactive protein as well as microalbuminceria with a effect similar to mecobalamin therapy on DPN.

OBJECTIVETo investigate clinical results of percutaneous reduction and hollow screw internal fixation for the treatment of calcaneal fractures, and to compare therapeutic effects between close reduction hollow screw internal fixation and open reduction plate internal fixation.

METHODSFrom August 2007 to May 2010, 53 patients with calcaneal fractures were retrospectively analyzed. All the patients were divided into two groups, 25 patients in group A (PR group) treated with percutaneous reduction and hollow screw internal fixation, including 17 males and 8 females, with an average age of (39.4 +/- 9.9) years. While 28 patients in group B (OR group) treated with open reduction and plate internal fixation, including 18 males and 10 females, with an average age of (38.6 +/- 10.2) years. According to Sanders classification, there were 18 patients with type II fractures, 29 patients with type III and 6 type IV. In both groups, operative time, blood loss, postoperative complications and radiology were recorded. Functional recovery was evaluated by Maryland score.

RESULTSAll the patients were followed up, and the duration ranged from nine months to thirty-five months (averaged 20.4 months). There were no significant differences in sex, age, fracture type, fracture classification, initial Böhler angle, or late complications between the two groups. But significant difference can be seen between operative time, blood loss, and skin complications (in group A no nonunion and skin complications occurred, but subtalar posttraumatic arthritis occurred in 1 case; in group B, 3 patients had complications of skin necrosis, 1 patient suffered from a delayed union due to large defect filled with artificial bone, and 1 patient got subtalar posttraumatic arthritis). No difference were found in the latest X-ray film. According to Maryland score, in group A, 8 got an excellent result and 12 good. In group B, 10 got an excellent and 14 good. There were no significant differences between the two groups in Margland score.

CONCLUSIONThe results of this study suggest that in comparison with open reduction, percutaneous reduction and hollow screw internal fixation minimizes complications and achieves good results. Further study of this technique is needed.

Adolescent ; Adult ; Aged ; Bone Screws ; Calcaneus ; surgery ; Case-Control Studies ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the effects of ulinastatin (Uti) and low-molecular-weight heparin (Lmwh) on coagulation function and deep vein thrombosis (DVT) in patients undergoing hip joint replacement.

METHODSFrom March to December 2010 150 ASAI-II patients with average age of 72.5 (65 - 85) years undergoing hip joint replacement were randomly divided into 3 groups (n = 50 each): normal saline (NS) control group (Group C), Uti group (Group U) and Lmwh group (Group L). Group U received intravenous infusion of ulinastatin (10 000 U/kg) at preoperative, perioperative and after operation 1, 2 and 3 d, respectively. Group C received the same volume of NS instead of Uti. Group L were injected Lmwh subcutaneously (3200 U/d) at preoperative, after operation 1, 2 and 3 d. Blood samples were taken before operation (T(0)), at the end of surgery (T(1)), 1 d (T(2)), 2 d (T(3)) and 3 d (T(4)) after operation for determination the values of R, K, α angle, MA and CI, using thromboelastography, and the DVT were also examined through color Doppler ultrasonography at 3 d after operation.

RESULTSCompared with T(0), R, K were shorter, α angle, MA and CI were larger in group C, the values at T(2) were up to the peak then declined at T(4). Compared with group C, the value of R, K were larger, the value of α angle, MA and CI were shorter in group U and group L. The DVT checked by ultrasonography were found in 20 cases in group C, 1 case in group U, and zero case in group L. The differences were no statistically significant between group U and group L.

CONCLUSIONIntravenous infusion of Uti during the period of operation can correct the hypercoagulability of blood and decrease the incidence of DVT after operation.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Blood Coagulation ; Double-Blind Method ; Female ; Glycoproteins ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Postoperative Complications ; prevention & control ; Venous Thrombosis ; etiology ; prevention & control

OBJECTIVETo evaluate the preventive effects of ulinastatin (Uti) on postoperative complications in elderly patients undergoing hip joint replacement.

METHODSFrom Angust 2009 to June 2010, 160 elderly patients undergoing selective hip joint replacement with ASA I to II were assessed according to American Society of Anesthesiologists classification, including 81 males and 79 females ranging in age from 65 to 83 years (mean 73.9 years). All the patients were divided into 2 groups according to random number table (80 patients in each group): control group (group C) and ulinastatin group (group U). The patients in Group U received intravenous injection of ulinastatin with a dose of 10,000 U/kg before skin incision,and then with dose of 5000 U/kg respectively at 1, 2 and 3 days after operatio. The patients in Group C received the same volume of normal saline instead of ulinastatin. Blood samples were taken preoperatively,at the end of surgery and 1, 2, 3 days after operation for determination of ALT, AST, Scr, BUN and Plasma D-dimer. Deep vein thrombosis and postoperative cognitive dysfunction (POCD) were also examined through color Doppler ultrasonography and neuroeognirive assessment on the postoperative 3 days respectively.

RESULTSCompared with the preoperative values, the contents of ALT, AST, Scr, BUN and plasma D-dimer in each group all increased. Compared with group C,the values of ALT, AST, Scr, BUN and plasma D-dimer decreased markedly (P < 0.05). The incidence rate of DVT and POCD was 0 and 3.75% in group U, which were lower than those of patients in the group C (40%, 27.5%) respectively.

CONCLUSIONIntravenous infusion of ulinastatin during operation can protect important organ function, correct blood hypercoagulability, lower the occurrence of DVT and POCD, and prevent the postoperative complications in some degree.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Blood Urea Nitrogen ; Case-Control Studies ; Cognition Disorders ; prevention & control ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Glycoproteins ; therapeutic use ; Humans ; Male ; Postoperative Complications ; prevention & control ; Trypsin Inhibitors ; therapeutic use ; Venous Thrombosis ; prevention & control

OBJECTIVETo evaluate the surgical techniques and clinical effect of Ni-Ti patellar concentrator combined with Herbert screw and wirerope in treating comminuted patellar inferior pole fractures.

METHODSFrom March 2008 to June 2010,34 patients with comminuted patellar inferior pole fracture were treated with Ni-Ti patellar concentrator combined with Herbert screw and wirerope. Of them, there were 19 males and 15 females with an average age of 38.6 years old(ranged from 22 to 75). Early functional exercise was guided postoperatively and the patients were regularly followed up and their outcomes were assessed.

RESULTSAll patients were followed up with an average of 13.5 months (ranged,7 to 20). All fractures healed. According to Böstman Clinical Rating System, the average score was 28.43 +/- 2.34,and excellent results in 21 cases,good in 13 cases and no poor case.

CONCLUSIONNi Ti patellar concentrator combined with Herbert screw and wirerope for the treatment of comminuted patellar inferior pole fracture is an effective method and of great value to clinical application.

Adult ; Aged ; Bone Screws ; Bone Wires ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Nickel ; Patella ; injuries ; surgery ; Titanium ; Young Adult

OBJECTIVETo evaluate the indications, surgical techniques and clinical effects of the fixation of posterior malleolus in complicated external rotation ankle fractures and illuminate the importance of anatomical reduction and rigid internal fixation of posterior malleolar fracture.

METHODSFrom July 2007 to June 2009, 32 patients were treated with open reduction and internal fixation,involving 21 males and 11 females with an average age of 36 years old (ranged from 19 to 68 years old). According to Lauge-Hansen classification: 13 cases of pronation-external rotation type (IV), 7 and 12 cases of supination-external rotation type (III and IV). Postoperative functional exercise and regular follow-up were done and outcomes were assessed.

RESULTSAll the patients were followed up,and the duration ranged from 7 to 20 months,with an average of 14.5 months. According to Ankle Hindfoot Clinical Rating System of the American Orthopaedic Foot & Ankle Society (AOFAS), 23 patients got an excellent result, 7 good, 2 fair, 0 poor.

CONCLUSIONAnatomical reduction and rigid internal fixation of posterior malleolar fracture as well as early functional exercise have significance in restoring ankle joint function and reducing the incidence of traumatic arthritis.

Adult ; Aged ; Ankle Injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Rotation

OBJECTIVETo explore operative method in the treatment of syndesmosis injury of ankle fractures.

METHODSTwenty-four patients with ankle fractures and syndesmosis diastasis were treated with shape memory fracture staples, including 10 males and 14 females ranging in age from 19 to 71 years, with an average of 43 years. All patients were diagnosised with history, body examination and image data and were operated according to classification of Lauge-Hansen.

RESULTSAll patients were followed up from 6 to 28 months with an average of 16 months, and all fractures healed, with a mean time 9.2 (8 to 14) weeks. Only one case had radiological and clinical manifestations of traumatic arthritis, but no breakage of shape memory fracture staple in all cases. Sixteen patients got excellent results, good in 5, fair in 2, poor in 1.

CONCLUSIONShape memory staple fixation for the treatment of syndesmosis diastasis in ankle fractures not only can perseve the physical motion of ankles, but also be remove earlier before weight bearing.

Adult ; Aged ; Ankle Fractures ; Ankle Injuries ; complications ; diagnostic imaging ; surgery ; Ankle Joint ; diagnostic imaging ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

OBJECTIVETo discuss the mechanism, clinical characteristics, diagnosis and treatment of thoracolumbar Chance fractures.

METHODSAmong all the 21 patients, 13 patients were male and 8 patients were female, ranging in age from 23 to 57 years, with an average of 32 years. The injury was at the level of T11 in 3 patients, at the level of T12 in 9 patients, at the level of L1 in 8 patients and at the level of L2 in 1 patient. According to Denis classification, 10 patients were type A, 2 type B, 5 type C, and 4 type D. All the patients were treated with pedicle screw internal fixation and posterior lateral fusion at the level of injury.

RESULTSTwenty-one patients had been followed up for an average of 18 months (13 to 28 months). According to ASIA neurologic grading system, 4 cases in grade C or D recovered to grade E postoperatively and one case in grade B was not improved. Postoperative X-ray showed good reduction and fixation in all cases and no looseness or breakage in the fixation system. The results of postoperative back pain and function assessment were mostly satisfactory.

CONCLUSIONThoracolumbar Chance fractures are due to flexion-distraction injuries and regarded as unstable, which are uncommon and usually not present with a neurologic deficit. Reduction and stabilization with posterior pedicle screw internal fixation is suggested in patients with thoracolumbar Chance fractures.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries

OBJECTIVETo determine whether homeostatic conditions (pH, glycine or ion concentration) affect the protective effects of edaravone on ischemic injury in rat cortical neurons.

METHODSIn cultured rat cortical neurons, the compositions in the experimental solutions were changed to mimic the disturbance of homeostasis after cerebral ischemia. In vitro ischemic injury was induced by oxygen-glucose deprivation (OGD) for 3 h and reperfusion for 12 h, and the neuron injury was evaluated by 3-(4, 5-dimethylthiazol-2yl)-2, 5-diphenyl tetrazolium bromide (MTT) reduction assay and lactate dehydrogenase (LDH) release. Effect of edaravone on OGD injury was observed in different experimental solutions.

RESULTIn weak alkalified solution (pH 7.8) or the solution containing glycine (10 micromol/L), OGD injury became more serious; but in weak acidic (pH 6.5) or higher Mg(2+) (1.8 mmol/L) solutions, OGD injury was attenuated. Edaravone (1 micromol/L) reversed the injury in the solutions with pH 6.1,7.4 and 7.8 or the solution containing glycine, but did not show protective effect in the solution with pH 6.5 and the higher Mg(2+) or lower Ca(2+) solution.

CONCLUSIONThe changes of homeostatic conditions affect the severity of ischemic injury of neurons and the protective effect of edaravone.

Animals ; Animals, Newborn ; Antipyrine ; analogs & derivatives ; pharmacology ; Cell Hypoxia ; Cells, Cultured ; Cerebral Cortex ; cytology ; Glycine ; pharmacology ; Homeostasis ; Hydrogen-Ion Concentration ; Magnesium ; pharmacology ; Neurons ; pathology ; Neuroprotective Agents ; pharmacology ; Rats ; Reperfusion Injury ; prevention & control

Objective To evaluate the effects of PCR melting curve analysis assay on a rapid screening program regarding the resistance of Mycobacterium tuberculosis (MTB) clinical isolates to streptomycin and ethambutol.Methods A total of 331 clinical isolates of MTB had been collected since 2007-2009 in Shenzhen.Mutations at codon 306,378-380,406 and 497 of embB gene,codon 43,88 of rpsL gene,and 513-517,905-908 region of rrs gene were detected by PCR melting curve analysis.Results were compared with that of conventional drug susceptibility test.Results Compared to drug susceptibility test,sensitivity,specificity and accuracy for streptomycin resistance were 78.6％,90.1％ and 86.7％,respectively while 83.0％,93.3％ and 91.8％,respectively for ethambutol resistance detected by PCR melting curve analysis.PCR melting curve method was in good agreement with drug susceptibility test.Conclusion PCR melting curve analysis on genetic regions associated with resistance to streptomycin and ethambutol seemed to be a rapid,specific and closed-tube method so it could be used for detection oftreptomycin and ethambutol resistance in MTB.