OBJECTIVETo study clinical results of reduction and fixation under arthroscopy for the treatment of osteochondrotical lesion in the knee.

METHODSFrom December 2012 to December 2013, 4 patients with the knee joint osteochondritis lesion and free bone fragments were treated with arthroscopy to detect the stripped cartilage, and then the cartilages were reduced with small incision and fixed by cartilage nail. There were 3 males and 1 female, with age of 15, 15, 20 and 27 years old. The durations of the disease were 1 d, 5 d, 1 month and 1 year. All the patients had swelling and effusion in the knee joint, and the floating patellar test was positive. CT examination showed bone defects and loose bodies. The Lysholm, VAS, and Tegner scale were used to evaluate the knee joint functions before and after operation.

RESULTSAll the patients underwent successful surgery. Postoperative CT showed good location of the cartilage without loss of reduced bone and cartilage. All the patients were followed up, and the duration ranged from 10 to 13 months, with a mean of 12 months. In one patient, arthroscopy examination was conducted for a second time to examine the connection of the fracture part to the surrounding cartilage, and it showed that the internal fixator was not absorbed. The Lysholm, VAS and Tegner scale of all patients were better than those before operation.

CONCLUSIONTreatment of osteochondritis lesion with the fixation of absorbable cartilage nails may reconstruct the integrity of articular surface and recover the stability of joints, and it is an effective treatment method.

Adolescent ; Adult ; Arthroscopy ; methods ; Female ; Humans ; Knee Joint ; surgery ; Male ; Osteochondritis Dissecans ; etiology ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Visual Analog Scale

CD4 Antigens ; immunology ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; T-Lymphocyte Subsets ; immunology ; physiology ; T-Lymphocytes, Regulatory ; physiology

OBJECTIVE To investigate the clinical manifestation,diagnosis and treatment of Castleman disease(CD)in the neck. METHODS The data of 2 patients with pathological proved CD in the neck,who were seen in our hospital,were reviewed retrospectively in order to analyze their clinical manifestations,clinical and histological types, imaging characteristics and treatment. RESULTS The age of onset were 24 and 29 years respectively. Both of them only presented as a solitary,painless neck mass and met the criteria of localized CD, and also had histological evidence of the hyaline vascular variant. Complete surgical resection was the first treatment.Both of them were alive without evidence of recurrence for one year and half a year respectively. CONCLUSION CD in the neck often presents as localized lesion,which often presents as a progressive, painless, slowly growing lymph node enlargement that is generally asymptomatic. The locations most commonly are the cervical lymph nodes. CD in the neck is almost always the hyaline-vascular variant and complete surgical excision of the tumor is the best treatment.

This study was to evaluate the feasibility of hepatectomy for primary liver cancer (PLC) without hepatic blood flow occlusion. Methods 194 PLC patients admitted between 1988～1998 underwent hepatectomy without hepatic blood flow occlusion including nonanatomical hepatectomy (100 cases),hepatolobectomy (41 cases), combined adjacent organ resection (30 cases), hepatic segmentectomy (22 cases) and left hemihepatectomy (3 cases). Results Operative time was 2 4 hr, intraoperative blood transfusion averaged at 649 ml. Operative complication rate was 18 0%, and there was no mortality. Conclusion Hepatectomy without hepatic blood flow occlusion for PLC patients can be performed safely, so it is a useful technique for hepatectomy.

Objective To study the operative techniques and clinical effect of arthroscopic reconstruction for posterior cruciate ligament (PCL) with ligament advanced reinforcement system (LARS)Y-shape double bundles artificial ligament.Methods From June 2006 to August 2010,14 patients (10 males and 4 females,at age range of 19-58 years,mean 38 years) with PCL ruptures were treated with LARS under arthroscopic observation.The injury causes included sports contusion in nine patients,traffic accidents in three and falling from height in two.Five patients were with left knee injury and three with right knee injury.The course of injury was 10-30 days (average 15.7 days).MRI indicated complete PCL ruptures in 14 patients and complete anterior cruciate ligament (ACL) ruptures in two.The combined injuries included medial meniscus injury in five patients,lateral meniscus injury in three and posterior acetabular wall fracture in one.The preoperative Lysholn score was (40 ± 7.9 ) points ( range,20-55 points).According to the international knee documentation committee (IKDC) grading,three patients were rated as grade C and 11 as grade D preoperatively.The operation was performed under arthroscopic observation.The ending point and tunnel of PCL of the femur and tibia were drilled with the help of a locator.ResultsAll the patients obtained primary healing,with no complications such as infection,spontaneous rupture or laxity of graft postoperatively.The regular follow-up for all cases ranged from6-60 months ( average 20.5 months).The postoperative Lysholn score was ( 88 ± 3.6 ) points ( 84-93 points),with statistical difference in comparison with the preoperative score (P ＜ 0.05 ) The IKDCgrading was A in 10 patients and B in four 12 months postoperatively. ConclusionsArthroscopic reconstruction with LARS artificial ligaments can effectively recover the stability of the knees,avoid the complications brought by autologous tendon and prevent the allograft rejection complications induced by allogenic tendon graft.The treatment is characterized by simple procedures,minor wound and fast recovery.

Objective To investigate the effects of vitamin E (VE) on renal ischemia/reperfusion (I/R) injury of rats.Methods A total of 18 male Wistar rats were randomly divided into sham-operated group,I/R group,VE + I/R group,and each group of 6 rats.All the animals were killed at the end of 24 h of reperfusion.Nephridial tissue were examined by light microscopy,and the level of blood urea nitrogen(BUN) and serum creatinine (SCr) were measured.The protein expressions of tumor necrosis factor α (TNF-α) were detected by Western blotting.Results Compared with sham-operated group,tubulointerstitial pathological injury in I/R group was significantly aggravated,which was shown by HE and PAS stain.Compared with I/R group,the degree of morphological changes as well as renal dysfunction in VE + I/R group were obviously lessened.Meanwhile,the levels of BUN,SCr in I/R group,VE + I/R group were (10.13 ± 2.14) mmol/L and (7.67 ± 1.63) mmol/L,(80.33 ±7.15) μmol/L and (63.67 ±5.40) μ mol/L,significantly higher than those in shamed-operated group ((3.85 ± 0.21) mmol/L,(48.67 ± 3.61) μmol/L;P ＜ 0.05).And the level of BUN and SCr in VE + I/R group were significant lower than those in I/R group(P ＜0.05).Western Blotting showed that the protein expressions of TNF-α in VE + I/R group were obviously lower compared with those in group of I/R without VE treatment (P ＜ 0.05).Conclusion Vitamin E can attenuate over-expressions of TNF-α in kidney following I/R,thus protect against structural damages and renal dysfunction in I/R rat models.

Objective To study the effects of polysaccharide from Ecklonia kurome on pulmonary interstitial fibrosis induced by bleomycin in rats.Methods The pulmonary interstitial fibrosis model was established by endotracheal injection of bleomycin in rats.25,50,100mg?mL-1 doses of the polysaccharide from Ecklonia kurome were ig administered to the rats respectively,and the contants of hydroxyproline in rat lung were determined by kits at 0,3,7,14,28 d after the model was made.Results At 7,28d after the model was made,the treatment groups of middle and high doses compared with the model group showed signi-ficantly decrease of hydroxyproline level(P

Objective To investigate the regulation of melatonin (MT) on Toll-like receptor 4 (TLR4) signaling in diabetic db/db mice kidneys.Methods The 48 10-week-old male db/db mice were randomly divided into db/db group,db/db+MT 50 μg/kg group,db/db+MT 100 μg/kg group and db/db+MT 200 μg/kg group,each consisting of 12 mice.These mice received i.p.injections of MT These mice received i.p.injections of MT [dissoved in phosphate buffer solution (PBS)/ dimethylsulfoxide (DMSO) solution,given every day].Alternatively,12 db/m mice served as the control group.db/m and db/db group were injected i.p.with the same volume of PBS/DMSO solution.The animals were sacrificed after 12 weeks of dosage administration.Blood glucose (BG),body weight (BW),kidney weight (KW) and 24 h urinary albumin excretion rate (UAER) were determined;Kidney pathological lesions were evaluated by renal pathological staining.Immunohistochemistry of renal TLR4,NF-κB p65,and ED-1 was performed to determine the immunoreactivity.Western blotting was used to detect the expression of renal TLR4,myeloid differentiation factor 88 (MyD88),TIR-domaincontaining adaptor inducing interferon-β (TRIF),interferon regulatory factor 3 (IRF-3) and NF-κB p65,while the mRNA expressions of renal tumor necrosis factor-α (TNF-α) and monocyte chemotactic protein-1 (MCP-1) were evaluated by real-time PCR.Results Compared with control group,the levels of BG,BW,KW and UAER were much higher in db/db mice group (P ＜ 0.01),while KW in db/db+MT (100,200 μg/kg) groups and UAER level in db/db+MT (50,100,200 μg/kg) groups were distinctly decreased compared with those in db/db group (P ＜ 0.01).In week 12 db/db mice,the glomerular mesangial expansion index and tubulointerstitial injury index were increased compared with those in db/m mice (P ＜ 0.01).The above kidney histopathologic lesions were distinctly ameliorated by 50,100,200 μg/kg MT (P ＜ 0.05).Immunohistochemistry intensity of renal TLR4,NF-κB p65 and ED-1 displayed obvious differences between db/m mice and db/db mice (P ＜ 0.01),and that were remarkably decreased in db/db+MT (50,100,200 μg/kg) mice compared with db/db mice (P ＜ 0.05).Western blotting showed that the protein expression of renal TLR4,MyD88,TRIF,IRF-3 and NF-κB p65 were stronger in db/db group compared with those in db/m group (P ＜ 0.05) and weaker in db/db+ MT (50,100,200 μg/kg) groups compared with those in db/db group (P ＜ 0.05).Futhermore,the mRNA expressions of renal MCP-1 and TNF-α were higher in db/db group compared with those in db/m group (P ＜ 0.01) and lower in db/db+MT (50,100,200 μg/kg) groups compared with those in db/db group (P ＜ 0.01).Conclusion Melatonin may partly down-regulate TLR4 signaling pathway to inhibit Inflammatory reaction and alleviate kidney injury in diabetic db/db mice.

Objective To learn the species distrilbution and drug-resistance of Gram-negative bacilli among bloodstream infections (BSI) in Yunnan province of China during 2012 to 2014.Methods Bloodstream infected Gram-negative bacilli were collected from 28 general hospitals in Yunan province of China.Data from all hospitals were applied with the same method of bacteria culture,isolation,identification and antibiotic sensitivity tests.WHONET 5.6 was used to perform the statistical analysis.Results A total of 9042 clinical strains of non-repetitive gram-negative bacilli were collected.Enterobacteriaceae and Non-fermenter bacteria accounted for 82.4％ and 17.6％ respectively.Enterobacteriaceae were mainly composed of Escherichia coli and Klebsiella pneumoniae.Non-fermenter bacteria were mainly composed of Acinetobacter baumannii and Pseudomonas aerouginosa.Escherichia coli accounted for the majority 49.29％,other species were Klebsiella pneumoniae 13.17％,Acinetobacter baumannii 4.04％ and Pseudomonas aeroginosa 3.85％.The susceptible rate of Enterobacteriaceae strains to the first generation cephalosporin was lower than 60％.The susceptible rate of E coli and Klebsiella pneumoniae to impenem was close to 100％,to Amikacin was more than 85％,to piperacillin-tazobactam was more than 70％,to Cefepime was more than 70％.But the susceptible rate of Klebsiella pneumoniae to impnem and amikacin decreased year by year from 2012 to 2014.The susceptible rate of Enterobacter cloacae to Amikacin was 86.4％ ～ 93.6％,Ciprofloxacin 70.5 ～ 76％,Cefepime 72.1 ～ 82.8％.It was less than other Enterobacteriaceae.The susceptible rate of Non-fermenter bacteria to normal antibiotics was much lower than Enterobacteriaceae.The susceptible rates of Pseudomonas aeroginosa to Impnem was 58.9％,Tobramycin 85％,Ciprofloxacin 71.7％,Amikacin 82.9％,Piperacillintazobactam 75.3％,Piperacillin59.6％,Atreonam 46.5％,Ceftazidime 69.1％ and Cefepime 68.9％ respectively.Furthermore,Acinetobacter baumannii's durg-resistance was more severe.The susceptible rate of Acinetobacter baumannii was lower than 30％,to the third and fourth generation cephalosporin,the susceptible rate of Ampicillin/Sulbactam,Cefoperazone/Sulbactam,Carbapenems,Piperacillin/Tazuobatan,Quinolones and Carbapenems was less than 40％.Conclusion Gram-negative bacilli have low susceptibilities among BSI.E.coli is the most common pathegon among BSI.The resistant rate of Non-fermenter bacteria to normal antibiotics is severe in hospitals.

Objective To explore the value of carbon nanoparticles in patients with papillary thyroid carcinoma (PTC) undergoing total thyroidectomy combined with ipsilateral central lymph node dissection.Methods 43 patients with unilateral PTC were retrospectively analyzed.All patients underwent total thyroidectomy combined with central lymph node dissection.Patients were divided into carbon nanoparticles group and the control group according to whether carbon nanoparticles were used in the operation.The operation time,postoperative hospitalization time,the serum calcium level and its rate of change,the parathyroid hormone and its rate of change on the 1 st day after surgery,the number of central lymph node and the transfer rate,and the postoperative complications were compared between the 2 groups.Results There was no statistical difference between the 2 groups in operation time(P ＞ 0.05),while the postoperative hospitalization time of the carbon nanoparticles group was shorter than that of the control group(P ＜ 0.05).The serum calcium and the parathyroid hormone on the 1 st day after surgery in the carbon nanoparticles group was (2.31 ± 0.13) mmol/L and (33.45 ± 14.37) pg/ml respectively,higher than those of the control group (P ＜ 0.05).The low blood calcium rate (3/20 (15％)),the temporary hypoparathyroidism rate (2/20 (10％)) and the decline degree of parathyroid hormone (47.3 ± 14.31)％ in the carbon nanoparticles group were lower than those of the control group(P ＜0.05).The number of central lymph node dissected (9.45 ± 2.33) pieces/case in the carbon nanoparticles group was more than that of the control group (P ＜ 0.05).The number of lymph node in the right recurrent laryngeal nerve (3.12 ± 0.65) pieces/case was more than that of the control group(P ＜ 0.05).The lymph node metastasis rate had no significant difference between the 2 groups(P ＞ 0.05).The incidence of postoperative complications in the carbon nanoparticles group was lower than that of the control group (P ＜ 0.05).Conclusion The application of carbon nanoparticles in total thyroidectomy combined with central lymph node dissection can contribute to the recognition and protection of parathyroid glands and its blood supply,improve the rate of central lymph node dissection,and reduce the incidence of postoperative complications.