OBJECTIVETo discuss arthroscopic technique of single Kirschner wire and suture avoiding epiphyseal line fixation for tibial intercondylar eminence fracture and its clinical results.

METHODSFrom May 2008 to December 2012, 21 patients (13 males, 8 females, ranging in age from 6 to 14 years old) with tibial intercondylar eminence fracture were treated arthroscopically with single Kirschner wire and suture avoiding epiphyseal line fixation technique. According to Meyers and McKeever classification, 7 patients were type II, 10 patients were type III, and 4 patients were type IV. Active rehabilitation began at one week after operation. The patients were followed up for 10 to 30 months. X-ray films were taken to evaluate fracture healing at 1, 3, 6 months after operation; range of motion, the anterior drawer test, the lachman test and the Lysholm knee score were used to evaluate clinical effects.

RESULTSAll fractures were healed without displacement at 6 weeks after operation. Anterior drawer test and the lachman test were both negative in all patients at 3 months after operation. Lysholm knee score was 95.5 ±2.5 at 6 months after operation, and postoperative X-ray film did not find epiphyseal line broadening or narrowing.

CONCLUSIONArthroscopic treatment for tibial eminence intercondylar fracture with single Kirschner wire and 8-shaped suture avoiding epiphyseal line fixation technique has many advantages, such as firm fixation,early mobilization, less invasive, less injury of physis and satisfactory effect.

Adolescent ; Arthroscopy ; Bone Wires ; Child ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Sutures ; Tibial Fractures ; surgery

Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC).Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy.According to the characteristics of infection and pharmacokinetics,clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose.Results After consultation and evaluation by clinical pharmacist,the patient was diagnosed as ARC.According to pharmacokinetics characteristics reported by literature,vancomycin was adjusted to 1 g (once per 8 h).Based on detection result of pathogenic bacteria,meropenem was replaced by cefoperazone/sulbactam,and the dose was increased to 3 g (once per 6 h).And then,vancomycin concentration was detected again,and it reached ＞ 10 μg· mL-1;pathogenic bacteria culture result was negative.This patient obtained good therapeutic effect.Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient,and improve ARC patient's therapeutic effect.

Objective To investigate the value of contrast-enhanced ultrasound(CEUS) to diagnose thyroid nodules with different calcifications,and analyze its correlation with age and gender.Methods The image characteristics of high frequency ultrasound and pathological results of 522 patients with calcified thyroid nodules were analyzed retrospectively.CEUS enhancement patterns of different age and gender were observed and compared.Results There were no malignant nodules in patients under the age of 10.In the group of male and female,malignant nodules patients constituted the highest proportion between 40-49years old and a minimal proportion between 10-19 years old.The CEUS for weak enhancement with micro calcifications were mostly malignant nodules;the high or equal enhancement with macrocalcifications were mostly benign nodules.But a part of micro calcifications in young women patients (20 to 29 years old) with high or equal enhancement were mostly malignant nodules.Conclusions The CEUS for weak enhancement with microcalcifications are mostly malignant nodules,but a part of microcalcifications in young women patients (20 to 29 years old) with high or equal enhancement are mostly malignant nodules.

Objective Establishing a fingerprint method to identify the characteristic chemicals in the roots of Gentiana macrophylla and evaluate their quality.Methods RP-HPLC was developed for fingerprint analysis and determination of four ingredients in G macrophylla roots from different sources.LC-ESI-TOF-MS was employed to identify the chromatographic peaks of the fingerprint.Results Five common peaks were identified by comparing their retention time with reference secoiridoid glucosides.Eight major peaks in chromatographic fingerprint were analyzed by on-line LC-ESI-TOF-MS.Four secoiridoid glucosides were identified based on their MS data.Conclusion The method is specific and could be served for the quality identification and comprehensive evaluation of G macrophylla.

This paper summarized nursing experience of 23 patients with malignant tumor treated by 3D printing individualized template and 125I seed implantation.Nursing points included:preoperative assessment and preparation,reviewing the process of template conduction,assisting the physician to simulate the position of patients,making treatment plans,preparing templates before operation;resetting and maintaining position of patients,performing template alignment,seed implantation,monitoring vital signs and complications during operation;observation of complications,providing radiation protection and discharge guidance after operation.All 23 patients completed 125I seed implantation and no serious complication was observed.All patients recovered well and were discharged after treatment.

BACKGROUNDWith features of high tissue contrast, MRI can be used for the qualitative and quantitative evaluation of atherosclerosis plaques. In this study we investigated the development of atherosclerosis plaque with high resolution 3T MRI in a rabbit model and compared the findings with the histopathological results.

METHODTwenty male New Zealand white rabbits were randomly allocated into an experimental group (n = 16) and a control group (n = 4). Atherosclerotic lesions were induced in the abdominal aorta by balloon injury and cholesterol feeding. Multiple sequences MRI examination (ToF, T1WI, T2WI, and CE T1WI) were performed at the 2nd, 3rd, and 4th months after aortic denudation. Vessel wall thickness, total vessel area, lumen area, and vessel wall area were recorded. Plaque components were analyzed using histological results as a standard reference.

RESULTSSeventeen rabbits (14 in the experimental group and 3 in the control group) received all three MR examinations. Gradually, from 2 months to 4 months, vessel wall thickness and area in the experimental group increased significantly compared with the control group (P < 0.01). In the lumen area progressive stenosis was not found, even a slight dilation had developed in the experimental group. Lipid, fibrotic and calcified plaques can be differentiated by MR image. According to histological results, MRI had good performance in detection of lipid plaque.

CONCLUSIONMRI can be used to monitor progression of atherosclerosis and differentiate plaque components.

Animals ; Aorta, Abdominal ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Plaque, Atherosclerotic ; pathology ; Rabbits ; Random Allocation

OBJECTIVETo study the influence of SGHWJN particles on inflammation and the mediators of inflammation in esophageal tissues of rat with reflux esophagitis.

METHODFifty SD rats were randomly divided into 5 groups, namely, a control group, a sham-operated group, a model group, a SGHWJN particles group and a PPI group. Reflux esophagitis was induced by adopting partial pyloric ligation plus cardiomyotomy. One week later, the rats were orally administered twice daily for 28 days. Pathological changes of esophagus mucous membrane were evaluated by using HE staining and Harry S. Cooper's method in every groups. MDA and SOD contents in esophageal tissues were measured by colorimetric method. Expression of TNF-alpha in esophageal tissues were examined by real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-FQ-PCR) with SYBR Green.

RESULTModel group, esophageal inflammation scores, expression of TNF-alpha in esophageal tissues and MDA contents compared with the normal group and sham operation group were significantly higher (P < 0.05). SOD contents in the esophageal tissues of the model group was significantly lower than that of control group and sham-operated group (P < 0.05). SGHWJN particles group and PPI group of esophageal tissue inflammation scores, expression of TNF-a in esophageal tissues and MDA levels than those in model group decreased significantly (P < 0.05). SOD content was significantly higher than that of model group (P < 0.05), SGHWJN particles group and PPI group showed no statistically significant difference between the above-mentioned indicators. The above-mentioned indicators showed no statistically significant difference between the normal group and sham-operated group. MDA content and expression of TNF-alpha in esophageal tissue was positively correlated with inflammatory scores of model group (r = 0.813). Model group esophageal tissue SOD content and inflammation scores were negatively correlated (r = -0.847). Esophageal tissue SOD levels were negatively correlated with MDA levels (r = -0.863).

CONCLUSIONSGHWJN particles can effectively inhibit inflammation in rat with reflux esophagitis through regulating TNF-alpha, SOD and MDA.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Esophagitis, Peptic ; drug therapy ; genetics ; immunology ; Esophagus ; drug effects ; immunology ; Female ; Gene Expression ; drug effects ; Humans ; Inflammation Mediators ; immunology ; Male ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; genetics ; immunology

OBJECTIVETo evaluate the arthroscopic diagnosis and treatment of the chronic ankle pain after injury.

METHODSFrom April 1999 to June 2008, 39 patients with posttraumatic chronic ankle pain were treated. The mean duration between the initial injury and treatment was 18 months (2 months to 11 years). There were 15 males and 24 females with a mean age of 32 years (15 to 58 years). All the patients were treated with arthroscopic debridement. The preoperative and postoperative ankle functions were evaluated by the AOFAS (the American Orthopaedic Foot and Ankle Society) Clinical Rating System for the ankle-hindfoot.

RESULTSTwenty-six patients had osteochondral lesions. Impingement syndrome in ankle was observed in 21 patients. The impingement tissue included synovial hypertrophy in 3 patients, ligament injury in 10 patients (7 patients had anterior talofibular ligament injury and 3 patients had anteroinferior tibiofibular ligament injury), meniscoid tissue in 6 patients, pathological labrum in 3 patients. All the patients were followed up with an average of (14.2+/-8.4) months (ranged from 5 to 36 months). The AOFAS scores increased significantly from pre-operative (59.7+/-16.9) to post-operative (68.8+/-21.2), and it was obvious in relieving pain, which was pre-operative (22.8+/-10.0) and post-operative (29.5+/-12.1).

CONCLUSIONArthroscopy can be used to diagnose the cause of chronic ankle pain after injury. Furthermore, arthroscopic debridement was useful to relieve the pain and improve the joint function, and it is appropriate for patients who had no fractures and dislocations.

Adolescent ; Adult ; Ankle Injuries ; complications ; surgery ; Ankle Joint ; pathology ; surgery ; Arthroscopy ; methods ; Debridement ; methods ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective:To compare the clinical prognosis of modified and traditional knotless suture bridge technique in treatment of rotator cuff tear under shoulder arthroscopy.Methods:A retrospective case-control study was conducted to analyze 60 patients with rotator cuff tear admitted to Affiliated Hospital of Qingdao University from June 2018 to June 2019，including 19 males and 41 females，aged 32-74 years［（59.3±10.1）years］. There were 26 patients on the left side and 34 patients on the right side，with the body mass index（BMI）of 19.5-32.4 kg/m 2［（25.5±2.6）kg/m 2］，rotator cuff tear of 2.0-3.7 cm［（2.7±0.4）cm］and pain duration of 2-88 days［（26.2±17.1）days］. A total of 31 patients were repaired with a modified knotless suture bridge（modified group）and 29 patients with a traditional knotless suture bridge（traditional group）. Comparison was made between the two groups in aspects of range of motion of shoulder flexion，abduction and external rotation，visual analog scale（VAS），University of California Los Angeles（UCLA）should function score，Constant shoulder function score，retear and complications at postoperative 3 and 12 months. Results:All patients were followed up for 9-15 months［（12.0±1.8）months］. Three months after operation，the two groups showed no significant differences in shoulder range of motion of abduction，flexion，external rotation，UCLA shoulder function score or Constant shoulder function score（ P>0.05）；while VAS was（2.7±1.2）points in modified group，significantly lower than（3.4±1.2）points in traditional group（ P<0.05）. Twelve months after operation，the shoulder range of motion of abduction and flexion in modified group was（146.9±21.4）° and（150.4±16.2）°，significantly higher than that in traditional group［（130.7±27.4）°，（140.6±18.4）°］（ P<0.05）；There was no significant difference in external rotation activity between the two groups（ P>0.05）；VAS，UCLA shoulder function score and Constant shoulder function score［（1.2±0.5）points，（29.5±2.3）points，（80.4±5.4）points，respectively］in modified group were significantly higher than those in traditional group［（1.5±0.5）points，（27.2±2.7）points，（76.3±6.6）points，respectively］（ P<0.05）. Three months after operation，there was no significant difference in the classification of Sugaya between the two groups（ P>0.05）. Twelve months after operation，the classification of Sugaya was significantly different between the two groups（ P<0.05），with no retear in modified group but 3 patients with retear in traditional group. No postoperative complications occurred，such as non-healing，infection or persistent swelling. Conclusion:For patients with rotator cuff tear，the modified knotless suture bridge technique under shoulder arthroscopy has better range of motion and function，more obvious pain relief and a lower rate of retear than the traditional technique.

Among digestive malignancies, compared with gastrointestinal tumors, biliary and pancreatic tumors are difficult to diagnose in the early stage and have fewer opportunities for radical surgical resection, with a shorter survival time and poorer quality of life, and the clinical diagnosis and treatment of such tumors remain a difficult issue that needs to be solved urgently in clinical practice. Based on the different locations and features of biliary and pancreatic tumors, the SELECT concept selects the optimal combination of minimally invasive endoscopies (laparoscopy, choledochoscopy, duodenoscopy, Spyglass, and endoscopic ultrasound) and applies traditional Chinese medicine treatment in the perioperative period, so as to achieve early diagnosis and treatment, prolong the survival time with tumor, improve quality of life, and strive to realize the goal of cure.