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 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.

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.

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

Objective To investigate the relationship between CYP2J2*7 mutation(G-76T) and coronary heart disease (CHD) in Chinese Hanpopulation and to study the effects of CYP2J2 geneover-expressionon the proliferation and migrationof aortic smooth muscle cells of ApoE-/- mice. Methods CYP2J2*7 genotype was detectedin 500 patients with CHD and 478 controlsubjects by the Polymerase Chain Reaction-Restriction Frag-ment Length Polymorphism (PCR-RFLP). Culturedaortic smooth muscle cells of ApoE-/- mice were divided into control group, sham transfectiongroup and CYP2J2 over-expression group. Cell proliferation and migration were investigated after CYP2J2 over-expressionby MTS and Transwell assay. Results The frequency of CYP2J2*7 in CHD group was significantly higher than that incontrol group (10.00% vs. 6.49%, P = 0.046). Same is the case in female cases(P = 0.026). Compared with these of aortic smooth muscle cells incontrol group and sham trans-fectiongroup, the cell proliferation in 24, 48, 72 h, and the cell migration in 48 h after CYP2J2 over-expression in CYP2J2 group were significantly suppressed. Conclusions CYP2J2*7 mutation might increase the risk of CHD in Chinese Han population. CYP2J2 over-expression can suppress the proliferation and migration of aortic smooth muscle cells and CYP2J2 might have the effect of anti-atherosclerosis.

Objective To evaluate the prognostic effect of different ratios of fresh frozen plasma (FFP) to packed red blood cells (PRBC) in massively transfused trauma patients.Methods A retrospective cohort study was conducted for 210 trauma patients who received more than 10 units of PRBC during the initial 24 hours from January 2007 to June 2015.The patients were divided into four groups:Group A(PRBC:FFP ≤1,n=41),GroupB (1 ＜PRBC:FFP≤1.5,n=63),GroupC(1.5＜PRBC:FFP≤2,n=30) and Group D (PRBC:FFP ＞2,n =76).At 24 hours after admission,blood transfusion amount,blood transfusion ratios,post-transfusion adverse reactions (allergy,non-hemolytic febrile transfusion reaction,hemolysis,congestive heart failure,pulmonary edema,etc) and coagulation changes [hemoglobin (Hb),platelet count (PC),prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio (INR),etc] were compared among groups.Prognostic markers including sequential organ failure assessment(SOFA),hospital stay,ICU stay,30-day mortality and causes of death were also evaluated.Results Use of PRBC was decreased significantly in Group A than in other groups (P ＜ 0.01),and there were no differences in blood transfusion adverse reactions among all groups (P ＞ 0.05).The coagulation indices (PT,APTT and INR) in Groups A and B were significantly decreased compared to Group D after transfusion (P ＜ 0.05).There were no differences in length of hospital stay and ICU stay among all groups (P ＞ 0.05).Group D was associated with higher SOFA and higher 30-day mortality than other groups(P ＜0.01),but no differences were found in Group A,B and C (P ＞0.05).Meanwhile,ratio of patients died of massive hemorrhage in Group D was also higher than other groups (P ＜0.01).Kaplan-Meier survival analysis showed the survival interval was the shortest in Group D,while the longest in Group B and C.Conclusions Modest transfusion ratios (1.5 ＜ PRBC:FFP ≤2)within 24 hours can substantially improve outcomes in trauma patients.Aggressive ratios may improve coagulation indices and reduce use of PRBC,with no more benefit to the outcomes.