BACKGROUND:Kienb?ck disease lacks of suitable animal models, which are similar to the pathological process of avascular necrosis of human lunate bone.
OBJECTIVE:To establish a new animal model of Kienb?ck disease using medical TH adhesive embolism and to explore the rationality of model establishment.
METHODS:A total of 30 healthy adult New Zealand rabbits, male or female, were selected. Using self-control method, the rabbits were randomly assigned to experimental sides and control sides. By dril ing in the center of the lunate bone, 0.2 mL of medical TH glue was injected three times. An equal volume of physiological saline was injected into the center of the lunate bone on the control side. X-ray examination, general observation, Micro-CT measurement of bone, and tissue pathology detection were conducted at 4, 8 and 12 weeks.
RESULTS AND CONCLUSION:Gross specimen, X-ray and histological results showed that ischemic necrosis of the lunate bone on the experimental side was visible at 8 weeks after model induction. The ischemic necrosis of the lunate bone became more typical at 12 weeks. Among the Micro-CT microscopic parameters of trabecular bone, trabecular bone density parameters bone volume fraction and the number of trabecular bone were significantly lower on the experimental side than those on the control side (P<0.05). Spatial parameters of trabecular bone significantly increased. Trabecular separation and structure model index on the experimental side were significantly greater than those on the control side. Results suggested that ischemic necrosis of the lunate bone appeared on the experimental side at 8 weeks after injection of medical TH glue. Rabbit models of ischemic necrosis of the lunate bone can be established at 12 weeks. Thus, alterations, which were similar to ischemic necrosis of human lunate bone, appeared, such as blood transportation damage in the lunate bone, trabecular bone fracture, and empty lacuna, when surrounding tissues were not obviously injured.

BACKGROUND:Single-row and double-row suture method are commonly used in the rotator cuff repair. Previous studies have shown that, double-row suture is not better than single-row suture in clinics.
OBJECTIVE:To compare clinical outcomes of single-row suture and double-row suture for rotator cuff repair, and evaluate the difference of therapeutic efficacy between two methods.
METHODS:A computer-based search was performed in the Medline (from January 2003 to February 2014), EMBASE (from January 2003 to February 2014) and Cochrane library (February 2014). According to the inclusion and exclusion criteria, al the randomized control ed studies addressing the outcome of single-row repair and double-row repair techniques were included in this meta-analysis. The methodological quality of each study was judged and a meta-analysis was conducted using Revman5.0. The preoperative and postoperative differences between the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, the re-rupture rate and the muscle strength were compared. The forest chart was used to compare the data between two groups, and the funnel plot was finished to detect the publication bias.
RESULTS AND CONCLUSION:A total of 10 randomized control ed trials (Levels I, II) were included. Meta-analysis showed that, there was no statistical y significant difference in the Constant, ASES and UCLA scores in the double-row group and the single-row group before and after treatment. In the postoperative fol ow-up, double-row group had a lower re-rupture rate and a higher abductor muscle strength than single-row group. When the rotator cuff tear was less than 3 cm, double-row group had no significant difference with the single-row suture group. While in the over 3-cm tear group, double-row group showed better results than the single-row suture group on the Constant scpre, ASES score and UCLA score. Double-row suture has a low re-rupture rate than single-row suture in rotator cuff injury, and could achieve better abduction muscle strength. There is no significant difference in the functional score between double-row suture and single-row suture in the rotator cuff tear of less than 3 cm, while in the over 3-cm tear, double-row suture could achieve better functional score.

Yang deficiency syndrome.There were 126 cases with one diseased artery branch(31.1%),135 cases with two diseased artery branches(33.3%),144 cases with three diseased artery branches(35.6%).The blood stasis syndrome and phlegm-turbid syndrome were mainly in those cases with three diseased artery branches,and Qi stagnation syndrome was common in those with one diseased artery branch(P

Objective To investigate the characteristics of infection and risk factors after pediatric living donor liver transplantation (PLDLT).Method Form April 2005 to April 2014 the clinical data of 45 cases of PLDLT in General Hospital of Chinese People's Armed Police Forces were retrospectively investigated,and the difference between the patients after PLDLT with infection and those without infection was analyzed.Result Eighty-four infections occurred in 27 (60.0％) of 45 patients,including 25 cases of bacterial infections,14 cases of viral infections,and 3 cases of candida albicans infections.Most infections occurring within 3 months after PLDLT have been found to be caused by bacteria,viruses and fungi.The trough level of tacrolimus (Tac) was in target therapeutic window in 16/20 infected patients and more than 10 ng/mL in 4/20 infected patients within 3 months after PLDLT,and there were 12/16 infected patients with the trough level of Tac of more than 10 ng/mL 3 months post-PLDLT,with the difference being significant (P＜0.05).Multivariate analysis revealed that post-transplant infection was significantly related with the factors as weight＜10 kg,age ＜12 months,biliary intestinal anastomosis,pediatric end-stage liver disease (PELD) score,ChildPugh score,total bilirubin,blood loss per kg body weight and graft to recipient weight ratio (GRWR).Logistic regression analysis suggested that PELD score was independent risk factor of infection after PLDLT.Conclusion The infection after PLDLT has their special characteristics.The proper irnmunosuppressive protocol and control of above risk factors are helpful to decrease the incidence of infection after PLDLT.

Objective To analyse our clinical experience in pediatric living donor liver transplantation (PLDLT).Methods The clinical data of 45 patients who underwent PLDLT in our hospital from April 2005 to April 2014 were retrospectively studied and their preoperative,intraoperative and postoperative data were analyzed.Results All donors recovered well.The graft to recipient weight ratio (GRWR) ranged from 1.0％ ～ 6.4％ (2.5％ ± 1.2％).Size reduction of graft were performed in 2 patients.An interposition venous conduit from the confluence of the native right and left portal vein (PV) to the graft PV was carried out in 1 patient,venous grafts for revascularization of the tributaries of the middle hepatic vein from segment Ⅴ and Ⅷ were used in 3 patients,and a venous patch for revascularization of the left hepatic vein was used in 2 patients.Hepatic artery re-reconstruction was performed in 3 patients after hypoperfusion was detected on intraoperative Doppler ultrasound.The postoperative complications included acute rejection (n =2),vascular complications (n =7),biliary complications (n =11),and infectious complications (n =27).The 1-,2-and 5-year survival rates were all 84.4％.Seven of 45 recipients died within one year post transplantation,with 3 patients who died of vascular complications,and 4 patients who died of infection.The differences in age [(50.8 ± 49.8) months vs (12.6 ± 14.9) months],body weight [(16.2 ± 10.5) kg vs (7.3 ± 1.7) kg],serum total bilirubin [(177.0 ± 126.5) μmol/L vs (301.9 ± 110.6)μmol/L],Pediatric end-stage liver disease (PELD) score (16.1 ± 12.1 vs 26.2 ± 11.3) and GRWR (2.2％ ± 0.8％ vs 4.2％ ± 1.6％) between the survival and the dead groups were significant (P ＜ 0.05).Conclusions PLDLT is an effective method to treat children with end-stage liver disease.Using a multidisciplinary approach in the preoperative management,excellent surgical techniques,and proper postoperative management are extremely helpful to improve postoperative survival rate.

Objective To explore the clinical value of therapeutic alliances of oviduct recanalization and video-laparoscope in the treatment of infertilitas feminis caused by multiple salpingemphraxis. Methods Sixty-seven patients with salpingemphraxis in 127 oviducts complicated with adhesions in fimbriated extremities were enrolled into our study. All the patients underwent separation of adherences in fimbriated extremities and neostomy using a video-laparoscope 2 to 3 days after selective oviduct recanalization. The therapeutic effects were retrospectively reviewed focusing on recanalization rate of proximal three segments, complete recanalization rate, and pregnancy rate and relevant complications during the follow-up period were analyzed. And patients with infertilitas feminis in the follow-up period underwent repeated salpingography to determine whether oviduct was repeatedly obstructed. Results The therapeutic alliance of oviduct recanalization and video-laparoscope were performed successfully in this cohort. Owing to the treatment of oviduct recanalization, recanalization rate of proximal three segments was 97.6% oviducts (124/127). Due to the alliance of oviduct recanalization and video-laparoscope, complete rate of oviduct were 98.4% (122/124). One year after operation, the pregnancy rate, ectopic pregnancy rate, and non pregnancy rate were 58.2% (39/67), 4.5% (3/67), and 37.3% (25/67), respectively. The patients with non pregnancy were composed by repeated oviduct obstruction in 25.4% (17/67) and non obstruction in 11.9% (8/67). Conclusion Therapeutic alliances of oviduct recanalization and video-laparoscope could be an effective method for the treatment of infertilitas feminis caused by multiple salpingemphraxis, and be helpful for the enhancement of pregnancy rate.

Objective To establish a closed-chest pulmonary embolism-reperfusion animal model by Swan-Ganz catheter and to explore the mechanisms of pulmonary embolism(PE)-reperfusion injury(RI). Methods Experiments were made on 14 mongrel dogs,ranging in weight from 15 to 18 kg,anesthetized with 3% pentobarbital sodium.The dogs were intubated with I.D.7 endotracheal tubes.Under sterile conditions,a 7 F Swan-Ganz catheter via the external jugular vein was positioned in the unilateral pulmonary diaphragmatic lobe(DL)artery.Occlusion/reperfusion of the DL artery was controlled with 1.2 ml diluted contrast agent filled into/drawn from the balloon.After the 24 h PE,the balloon was deflated to result in 4 h reperfusion of the DL.Measurements of blood gases and tumor necrosis factor-?(TNF-?)were made at normal condition,at 24 h PE and at 4 h reperfusion.Thin-section CT scans were performed at normal condition,24 h PE,30 min,1,2,3 and 4 h reperfusion,respectively.At the end of each experiment, tissue specimens of bilateral diaphragmatic lobes were obtained for both wet/dry(W/D)weight ratio and for pathological study.Results Reperfusion pulmonary edema(RPE)was an acute,mixed,noncardiogenic edema that was observed in all 14 dogs who had been successfully established as PE/RI animal models.RPE demonstrated heterogeneous ground-glass opacifications that predominated in the areas distal to the recanalized vessels.It manifested pathologically as an edematous lung infiltrated by inflammatory cells.The mean ofPaO_2 and TNF-? of 4 h reperfusion was(81?4)mm Hg(l mm Hg=0.133 kPa)and(16.0? 2.5)pg/ml,which were significantly different(P

Objective To investigate the clinical features,diagnostic modalities and treatment of duodenal Brunner′gland adenoma(BGA).Methods Fifteen patients with duodenal BGA were evaluated base on clinical presentations,the results of serologic test,barium meal examination,gastroscopy and endoscopic ultrasonography(EUS)as well as treatment.The post-operative histological results were compared with pre-operation EUS findings.Results Eight out of 15 patients with duodenal BGA had presentations,including duodenal ulcer(4 patients),upper gastrointestinal hemorrhage (4 patients). The serologic tests of all patients were within the normal limits.Six patients underwent barium meal examination and 13 patients received gastroscopy.Seven patients underwent surgical treatment and 8 patients received endoscopic resection.The post-operative histological results were compatible with the pre-operative EUS findings.Conclusions Duodenal BGA is a benign tumor.EUS was helpful in making the diagnosis and determination of treatment methods(surgical operation or endoscopic resection).

OBJECTIVETo investigate the curative effect and mechanism of transcutaneous laser disc decompression for the treatment of cervical vertigo.

METHODSFrom October 2000 to October 2004, 42 patients with cervical vertigo were treated with percutaneous laser disc decompression by applying a Nd: YAG laser (wavelength is 1064 nm). The postoperative follow-up period was more than 2 months, the change of patients' vertigo were observed.

RESULTSAll the patients were followed up. The mean follow-up period was 7.5 months (from 2 to 36 months). After 2 months of postoperative, 28 patients' vertigo disappeared (67%), 6 patients' vertigo improved (14%), 8 patients' vertigo did not improve. The effective rate was 81%, there was no complication (infection and nerve injury).

CONCLUSIONSCervical intervertebral disc protrusion and cervical spine instability irrigate the neck sympathetic nerve, result in the spasm of vertebral artery, which is the main cause of cervical vertigo. Percutaneous laser disc decompression can decrease intradiscal pressure, increase local temperature, remove the spasm of the vertebral artery. The therapeutic effect for the treatment of cervical vertigo was remarkable.

Adult ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Diskectomy, Percutaneous ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; surgery ; Intervertebral Disc Displacement ; complications ; surgery ; Laser Coagulation ; methods ; Male ; Middle Aged ; Treatment Outcome ; Vertigo ; etiology ; surgery