Objective To investigate the easement degree of pain after the treatment of low back pain patients in 6 months after the operation.Methods To treat lumbar degenerative osteoarthritis (21cases),lumbar disc herniation(31 cases),Lumbar spinal stenosis assompanied with lumbar disc herniation(1 cases) with percutaneous radiofrequency-ablation,compare the JOA,VAS,Oswestry score of the patients before and at the just after operation,2 weeks,6weeks,3 months,6 months after operation.Results The JOA score of patients after operation rise obviously than that of patients before operation,and VAS and Oswestry score reduce obviously,they all have statiscal significance(P ＜ 0.05).Conclusion The pain of patients who suffered from discogenic low back pain,lumbar disc herniation is relieved by percutaneous radiofrequency-ablation,the quality of patients'life is heightened,all of above indicate that the treatment is an effective method for discogenic low back pain,lumber disc herniation.

Objective To compare the short-term follow-up cu ra tive effect of primary total hip replacement (THR) in treating fresh and old fem oral neck fractures. Methods Double follow-ups with an in terval of 13 months were performed in patients with femoral neck fractures under going THR in our department from January 1997 to October 1999. Results After a follow-up for 37-62 months (mean 44 months), we obtained f ull data of 47 patients [41-77 years old, (61.8?5.22) years old] with preoperative Harris score of 28.40?10.14 and postoperative score of 85.20?7. 91. The Harris score of patients with fresh femoral neck fractures (FFNF) incr eased from 21.60?8.73 preoperatively to 82.50?9.81 postoperatively〔at age of (63.50?5.53) years〕 and that of patients with old femoral neck fracture (O FNF) from 37.70?13.50 to 90.63?5.79, [at age of (58.90?7.81) years]. Of 47 patients, only one case had dislocation once within six weeks postoperative ly during function exercise and recovered after manual reduction. Another one wi th excellent function evaluation was given again internal fixation three years a fter THR because of femoral shaft fracture and obtained satisfactory recovery. N o complications were found in other patients. The mean Harris score in patients with OFNF was significantly higher than those with FFNF ( P

Objective To observe the effectiveness and safety of oral anticoagulants and antithrombotic therapy in elderly patients with atrial fibrillation. Methods Patients were divided into anticoagulant group (warfarin) and antithrombotie group (aspirin or clopidogrel) based on the initial treatment. The prothrombin time (PT), activated clotting time (ACT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fihrinogen (FIB), thrombin time (TT), coagulation factor Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ, and Ⅹ,fibrin degradation product (FDP) and D-dimer were tested at baseline and after therapy in both groups. Results The average treatment period was 44.2±37.5 months in antithrombotic group and 39.0±61.5 months in anticoagulant group. There were six cases of isehemic stroke, one acute artery embolism in right lower limb and three gastrointestinal bleeding in antithrombotic group, while two gastrointestinal bleeding and two fatal hemorrhagic stroke in anticoagulant group. The results of PT, ACT, INR, APTT, FIB, TT, coagulation factor Ⅱ,Ⅴ ,Ⅶ, Ⅷ,Ⅸ,Ⅹ,FDP and D-dimer had no significant differences compared with the baseline in antithrombotic group. However, there were significant increase in PT and INR [(8.4±7.5)s and (0. 93±0. 83)s, both P<0. 05)], and significant decrease in ACT, coagulation factor Ⅱ,Ⅶ, Ⅸ and Ⅹ (all P<0. 05) in anticoagulant group. Conclusions Anticoagulant therapy may he effective in prevention of ischemic stroke in elderly patients with atrial fibrillation. However, it may slightly increase the hemorrhage incidence. The overall adverse events were not significantly reduced.

Glioma is one of the most refractory tumors affecting the central nervous system. As a new technique, cryoablation has been considered for the treatment of glioma. Considering previous studies, we summarized the mechanism of cryoablation to treat glioma based on pathology and molecular biology perspectives. We also analyzed the indications, effects, and problems of cryoablation in clinical practice. Furthermore, we proposed that this technique may be used in future trends and applications. The mechanism of eradicating tumor cells by cryoablation involves the following:(1) using an ultralow temperature to induce necrosis and apoptosis;(2) changing the local microcirculation of tumors;and (3) adjusting anti-tumor immunity. As an alternative surgical treatment, cryoablation could improve the therapeutic effects by real-time medical imaging. Cryoablation combined with chemotherapy, radiotherapy, immunotherapy, and other methods could provide a more effective treatment for gliomas. Therefore, cryotherapy could be a possible treatment for glioma and become a sustained research field.

Objective Based on the Traditional Chinese Medicine Inheritance Support System (TCMISS) (V2.0), to analyze the point-selection rules in acupuncture-moxibustion prescriptions for gastroptosis indexed by China National Knowledge Infrastructure (CNKI), Wanfang and Vip databases, and to obtain novel prescriptions, for providing clinical references. Method Acupuncture-moxibustion prescriptions for gastroptosis indexed by CNKI, Wanfang and Vip databases were collected and filtered, and then input into the TCMISS. The prescriptions were analyzed by using data mining method. Result The frequency and core combination of the commonly-used acupoints were determined out of the 76 eligible prescriptions for gastroptosis, and 3 novel prescriptions were obtained. Conclusion The TCMISS is an important tool in mining and analyzing the point-selection rules in acupuncture-moxibustion treatment, and the new acupoint prescriptions generated by this system provide references to the treatment of gastroptosis.

BACKGROUND: Autologous bone graft was always applied to repair bony cavity defect produced by benign bone tumor.OBJECTIVE: Taking autogenous bone graft for repairing bony cavity defect caused by bone tumor or tumor-like pathological change as control standard, to observe transplantation of deproteined bovine cancellous bone combined with autogenous red marrow in occluding the residual cavity and the density of newly formed bone.DESIGN: A randomized grouping design, controlled observation SETTING: Department of Orthopaedics, the 175 Hospital of Chinese PLA PARTICIPANTS:We recruited 175 cases of bony cavity defect who received treatment in the Department of Orthopaedics, the 175 Hospital of Chinese PLA from July 1993 to July 1998. They were randomly assigned into two groups: experimental group and control group. There were 63 cases treated in the experimental group. The average disease-suffering time was (6.2±2.1) months and bone defect was (136±30) mm3. There were 62 cases treated in the control group. The average disease-suffering time was (6.1±2.3)months, and bone defect was (133±37) mm3.METHODS: Deproteined bovine cancellous bone combined with autogenous red marrow was transplanted in the experimental group and autologous bone graft was applied in the control group. We curetted tumor completely, cauterized the wound with alcohol of 0.95 volume fraction, then curetted the area of cauterization to make it bled. Bone graft was applied.The quantity of implanted bone should be abundant, and disposed compactly. The X-ray films of the first week after operation were used as a standard for density of new bone growth. X-ray films were taken at the 3rd,6th and 8th months postoperatively, and the X-ray films of the eighth months after operation were used as a standard.MAIN OUTCOME MEASURES: To compare the bone union in two groups with a standard of residual cavity occluding and density of bone growth.RESULTS: All patients were followed up for an average of 20 months.One case was lost six months after operation. And two cases were lost eighteen months after operation respectively in the experimental group and control group. After 8 months of operation, residual cavities of bone defect of 44 cases in experimental group and 46 cases in control group were disappeared. Palingenetic bone fused with left bone organization. Its density was the same as or higher than normal bone organization. Residual cavities of 12 cases in experimental group and 10 cases in control group were disappeared basically. The density of palingenetic bone was approximate to normal bone organization. To compare with autologous bone graft, deproteined bovine cancellous bone and an autogenous red marrow had an identical effect for repairing bony cavity defect.CONCLUSION: Bony cavity defect produced by benign bone tumor is often repaired by bone transplantation. To explore the substitutable grafting materials of autogenous bone in this study, a composite material composed of deproteined bovine cancellous bone and an autogenous red marrow (DBCAM) is applied to repair the bony cavity defect.

OBJECTIVETo investigate the therapeutic effect of facial artery perforator flap for the soft tissue defects at nose, lip and cheek.

METHODSThe facial artery perforator adjacent to the defect was identified by Doppler ultrasonography. The perforator flap was designed according to the defect location, size and shape. The subcutaneous tissue around the perforator was kept as much as possible to protect the venous drainage.

RESULTSFrom Oct. 2012 to Oct.2013, 26 cases were treated with facial artery perforator flaps, with 9 cases of nasal defects, 10 cases of lip defects and 7 cases of buccal defects. The defects size ranged from 1.5 cm x 2.0 cm to 3.0 cm x 3.0 cm and the flaps size ranged from 2.0 cm x 2.5 cm to 3.5 cm x 3. 5 cm. Superficial necrosis(3mm in width) happened at the end of one flap. All the other 25 flaps survived completely. 16 cases were followed up for 3 months to 2 years with no relapse and satisfactory cosmetic and functional results were achieved.

CONCLUSIONSBoth cosmetic and functional effect can be achieved with facial artery perforator flap for defects at nose, lip and cheek.

Arteries ; Cheek ; surgery ; Graft Survival ; Humans ; Lip ; surgery ; Nose ; surgery ; Perforator Flap ; blood supply ; transplantation ; Rhinoplasty ; methods

OBJECTIVETo design a kind of internal fixation device to treat the syndesmosis injury.

METHODSThe elastic syndesmosis hook plate is made of medical stainless steel alloy, which is consisted of locking or common screw fixing hole of the tibial side for the head, tridentate fork like arc anatomical fibula side plate for the tail and serpentine elastic connecting body. By reduction of the joint of the lower tibia and fibula, the steel plate tail is fixed at the side of the fibula and the head is fixed at the side of the tibia for fixing the symphysis.

RESULTSThe design of elastic syndesmosis hook plate is reasonable, and the operation is convenient. There is no need to penetrate the substantia ossea and the plate has elastic micro-movement feature, the problem of internal fixation breakage and loosening is avoid in huge degree, so it is safe and reliable.

CONCLUSIONThe elastic syndesmosis hook plate is a new type medical apparatus of internal fixation of the symphysis, which is worthy of clinical popularization and application.

Ankle Injuries ; Bone Plates ; Bone Screws ; Fibula ; Fracture Fixation, Internal ; instrumentation ; Humans ; Stainless Steel ; Tibia

Objective To investigate the influence of simvastatin treatment on Toll-like receptor 4 (TLR4) in monocytes of peripheral blood in patients with sepsis and severe sepsis and its significance. Methods A prospective randomized controlled trial was conducted. 106 patients with sepsis and 92 patients with severe sepsis admitted to Department of Critical Care Medicine of Henan Provincial People's Hospital from August 2013 to June 2015 were enrolled. These two groups of patients were randomized into conventional treatment group and simvastatin group. All patients received treatment according to the 2012 International Sepsis Treatment Guidelines, including anti-infection drugs, nutritional support, and palliative treatment, and the patients with severe sepsis were given early goal-directed therapy (EGDT). The patients in simvastatin group received simvastatin 40 mg daily orally for at least 15 days. The peripheral blood was collected and the monocytes were isolated at 1, 5, 10, 15 days after intensive care unit (ICU) admission. TLR4 expression on the surface of TLR4/CD14+ double positive monocytes was determined by flow cytometry, and adverse reaction was observed during treatment. Results TLR4 expression on the surface of monocytes showed a tendency of decreasing with prolongation of simvastatin treatment in the simvastatin group in patients with sepsis (n = 59) or severe sepsis (n = 54). However, in patients with sepsis, TLR4 level was significantly decreased from 10 days in simvastatin group as compared with that of conventional therapy group (n = 47), and it was decreased up to 15 days [mean fluorescence intensity (MFI): 21 (19, 28) vs. 27 (25, 33) at 10 days, Z = 2.198, P = 0.021; 16 (15, 21) vs. 26 (23, 34) at 15 days, Z = 4.611, P = 0.002]. In patients with severe sepsis, there was no significant difference in TLR4 level at different time points between simvastatin group and conventional treatment group (n = 38) [MFI: 55 (52, 63) vs. 56 (48, 65) at 1 day, Z = 0.313, P = 0.692; 47 (42, 56) vs. 49 (41, 58) at 5 days, Z = 0.827, P = 0.533; 40 (35, 42) vs. 42 (37, 45) at 10 days, Z = 1.012, P = 0.301; 33 (30, 38) vs. 38 (35, 41) at 15 days, Z = 0.539, P = 0.571]. No adverse reaction related with simvastatin was found during treatment in patients with sepsis or severe sepsis. Conclusions Statins could significantly down-regulate the TLR4 expression on peripheral blood monocytes in septic patients, while it showed no significant influence on TLR4 expression in patients with severe sepsis. A different effect of statins on TLR4 expression and the downstream inflammation process in sepsis and severe sepsis patients might partially explain the discrepancy in previous reports about the therapeutic effect of statins therapy in sepsis and severe sepsis patients.

Objective To explore the value of Doppler tissue imaging(DTI) in assessing the left ventricular diastolic function of patients with essential hypertension.Methods Twenty healthy person(group A),35 essential hypertension(EH) patients with normal left ventrecular mass index(LVMI,group B) and 30 EH patients with left ventricular hypertrophy(LVH,group C) were included.The mitral annular velocity in early diastole(Ea) and late diastole(Aa) were detected by DTI,meanwhile the mitral inflow velocity E and A were detected.Results The E,E/A,Ea,Ea/Aa of group B and group C were lower than those of group A(P0.05).The Ea,Ea/Aa of group C were lower than those of group B(P