OBJECTIVETo investigate the long-term clinical effects of modified double Endobutton technique for the treatment of acromioclavicular joint dislocations of Tossy type III.

METHODSA retrospective study was done in 42 patients with acromioclavicular joint dislocations of Tossy type III treated with modified double Endobutton technique from December 2008 to December 2010. There were 24 males and 18 females, ranging in age from 21 to 56 years old (averaged, 32.5 years old). All the patients were treated with open reduction, coracoclavicular ligament reconstruction using double Endobutton technique, and repair of acromioclavicular ligament. The Karlsson system was used to evaluate therapeutic effects. The distance from coracoid to clavicle was measured to evaluate reduction loss.

RESULTSAll the patients were followed up, and the duration ranged from 2.0 to 3.2 years (averaged,2.4 years). According to Karlsson system, 32 patients got an A degree and 10 patients got a B degree at three months post-operatively; 26 patients got an A degree and 16 patients got a B degree at the latest follow-up; 6 patients got an A degree at 3 months after operation lowered to B degree at the latest follow-up. The coracoid-clavicle distance increased from (26.91 +/- 0.91) mm at 3 months after operation to (27.41 +/- 1.10) mm at the latest follow-up. Te patients treated with over-reduction during operation or with heavy physical labour work after operation had obvious widened coracoid-clavicle distance. Bone absorption was found around the plate in most cases, mainly in the clavicular side.

CONCLUSIONTreatment for acromioclavicular joint dislocations of Tossy type III with modified double Endobutton technique has satisfactory early clinical results. But with time passing, loss of reduction and bone absorption around the plate could be observed, and clinical outcomes of some cases downgrade during the long-term follow-up.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Female ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Animals ; Free Radicals ; metabolism ; Hepatocytes ; metabolism ; Male ; Obesity ; metabolism ; Polyphenols ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Tea ; chemistry

Objective To investigate the diagnosis and treatment of sequential diffuse large B-cell lymphoma (DLBCL) after peripheral T-cell lymphoma (PTCL).Methods A case with sequential DLBCL after PTCL was reported,and the characteristics and responses of this case were analyzed.The previous literature was reviewed in order to explain the mechanism and prognosis of such type of disease.Results This patient was diagnosed as PTCL not otherwise specified (PTCL-NOS) definitely,but after a period of treatment,DLBCL was developed as a second tumor.The characteristics and onset interval were just similar to those described in the literature,in which the mechanisms were mentioned as common effects of tumor cell,microenviroment and therapies.This patient got effects through the initial treatment,but considering the poor outcome by former researchers,the prognosis needed to be closely followed up.Conclusion Sequential development of EBV-unrelated DLBCL after PTCL-NOS is very rare,and the mechanism,therapy and prognosis need further investigation.

Objective To investigate the expression of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) after cerebral infarction and treatment with curcumin combined with electroacupuncture.Methods Middle cerebral artery occlusion was successfully introduced to simulate cerebral infarction in 60 healthy,male Wistar rats.They were then randomly divided into a control group,an electroacupuncture group,a curcumin group and a curcumin combined with electroacupuncture group (the observation group),each of 15.After the modeling,the four groups were given the planned interventions for 2 weeks,with the control group receiving no intervention.All of the rats were sacrificed after neurobehavioral scoring and immunological staining of brain tissue from the infarction area was used to detect the expression of BDNF and NGF.Results The average Bederson score in the observation group was significantly lower than those of the other groups.Cells expressing BDNF and NGF were significantly more numerous in the observation group than in the other three groups.Conclusion Curcumin combined with electroacupuncture can significantly improve the expression of BDNF and NGF in the infarcted area,and this may play a neuroprotective role.

OBJECTIVETo explore the treatment of chronic calcaneal osteomyelitis with bone defect after debridement and evaluate its clinical outcomes.

METHODSFrom June 2009 to June 2011, 52 patients with chronic calcaneal osteomyelitis were treated with stage-one compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone,including 12 females and 40 males with an average age of 43 years old ranging from 18 to 67. According to Cierny-Mader classification, there were 34 cases with stage III and 18 with stage IV. There were 32 cases on right side and 20 on left,with a course of 6 months to 3 years. The area of soft tissue wound ranged from 3.0 cm x l.5 cm to 23.0 cm x l2.0 cm. The clinical effects were evaluated according to infection controlling, calcium sulfate absorption,bone defect repair and heel functional recovery.

RESULTSAll patients were followed up for 2 to 3.8 years (averaged 2.8 years). Primary healing was achieved in 52 patients. Two cases of recurrence were found post-operatively, 1 case in 3 months and another in 5 months,which were cured after a second operation. Bone repair healing was gained in 1.5 to 3.5 months (averaged 2.5 months). Complete radiological absorption of calcium sulfate was found in 1.2 to 3 months(averaged 2.2 months). Local exudation after removal of drainage tube had been persisting in 10 patients for 2 to 3 months, which was consistent with the time when cacium sulfate were totally absorbed. Flap had partial necrosis in 4 cases,and the wounds were closed after appropriate treatment finally. The mean Maryland score was 88.15±7.70. There were excellent results in 32 cases, good in 14, fair in 6.

CONCLUSIONA satisfactory short-term clinical results can be gained by one-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone in chronic calcaneal osteomyelitis, but the long-term results need further follow-up. And much more study is also demanded to reduce the exudation of calcium sulfate.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bone Transplantation ; Calcaneus ; injuries ; surgery ; Calcium Sulfate ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteomyelitis ; drug therapy ; physiopathology ; surgery ; Surgical Flaps ; Wound Healing ; Young Adult

Objective To determine clinical characteristics and the effects of drug-eluting stents on the occurrence of major adverse cardiac events during percuteneous coronary artery interventional(PCI)and long- term outcomes in patients with chronic renal insufficiency(CRI).Methods Nine hundreds and seventy three patients with angiographically-documented coronary artery disease(lumen inner diameter narrowing＞50%), included 516 patients complicated with experienced renal impairment(CRI group)and 457 with normal renal function(control group).Baseline clinical data and coronary angiographic features were recorded.Results Comparing with control group,patients in CRI group were older with higher incidence of hypertension or diabetes and simultaneously complicated by reduced left ventricular ejection fraction,and more complex coronary lesions(type C).During follow-up(mean 17 months),the mortality was significantly higher in CRI than in control group(6.2% vs 3.3%,P＜0.05),but the former with CRI was significantly lower by using drug-eluting stents in comparing with bare-metal stents(4.1% vs 8.5%,P＜0.05).Conclusion Patients with CRI often complicated with severe coronary artery disease,the mortality after PCI would be significantly reduced by using drug-eluting stents.

10.3969/j.issn.2095-4344.2013.26.013

Aged ; Aged, 80 and over ; Blood Platelets ; chemistry ; Humans ; Receptor, PAR-1 ; blood ; Receptors, Thrombin ; blood ; Renal Dialysis ; Uremia ; blood ; therapy

In this study, the regulatory effects of chlorogenic acid (CGA) on the expression of programmed cell death ligand 1 (PD-L1) in esophageal squamous cell carcinoma (ESCC), as well as the role of interferon γ (IFN-γ), has been discussed using both in vitro and in vivo animal models. ESCC murine model was established according to the standard operating procedures (SOP) of Animal Experiment Center of Institute of Materia Medica, Chinese Academy of Medical Sciences. The expression of PD-L1 in esophageal tissues of murine models was analyzed using the microarray assay. Then, the results were verified by qRT-PCR, Western blot and immunohistochemistry (IHC) staining, the molecular mechanism was explored in KYSE180 and KYSE510 ESCC cells in vitro. The results showed that CGA could suppress the expression of PD-L1 in tumor tissues in murine models significantly, rather than the expression in KYSE180 and KYSE510 ESCC cells in vitro. However, after the pretreatment of IFN-γ, the expression of PD-L1 was significantly increased, then it was down-regulated by CGA in both dose- and time-dependent manner. Meanwhile, the expression of interferon regulatory factor 1 (IRF1), an upstream regulatory factor of PD-L1, was suppressed by CGA in both KYSE180 and KYSE510 pretreated with IFN-γ, which was consistent with the expression of PD-L1. These results indicate that CGA down-regulates the expression of PD-L1 in ESCC via IFN-γ-IRF1 signaling pathway, providing the molecular theoretical basis for exploration of new treatment of ESCC.

Objective To compare the response and adverse reactions of NP time-chemotherapy with that of routine NP for advanced breast cancer.Methods 52 patients with advanced breast cancer were ran- domly assigned to groupA which received NP time-chemotherapy,or group B which received routine NP.Re- suits The overall response rate is 69.2 % in Group A compare to 30.8 % in group B,there was significant difference(P