1.Clinical Observation on Electroacupuncture Treatment of Shoulder-Hand Syndrome in Apoplectic Hemiplegia
Journal of Acupuncture and Tuina Science 2006;4(6):347-349
To investigate the therapeutic effect of electroacupuncture on shoulder-hand syndrome in apoplectic hemiplegia. Methods:One hundred and sixty patients were randomly divided into two groups. 80 cases in the control group was treated by conventional acupuncture by filiform needles and 80 cases in the treatment group were treated by electroacupuncture. The therapeutic effects were evaluated after two courses of treatment.Results:After two courses of treatment,the therapeutic effect for edema on back of the hand and hand pain in digital flexion and the total effective rate were better in the treatment group than in the control group (P<0.05). Conclusion:Electroacupuncture is of significant importance for relieving pain on back of hand,preventing the muscular atrophy of hand and promoting recovery from apoplexy.
2.Treatment of flexion deformity of the hallux after fibular fracture
Chinese Journal of Orthopaedics 1996;0(09):-
Objective To discuss the etiology,clinical findings,anatomical characters,diagnosis and treatment of the painful flexion deformity of the hallux after open reduction and internal fixation of the fibular fractures.Methods From October 1996 to March 2004,we treated 33 cases with flexion deformity of the hallux after fibular fracture,including 19 males,14 females,with a mean age of 33.2 years old(ranged from 22 to 49 years).24 cases were ankle fractures,according to Lauge-Hansen clssification,pronation-external rotation for 18 cases;supination-exteral rotation for 4 cases;pronation-eversion for 2 cases.9 cases were distal third tibial and fibular fractures.19 cases were simple hallux flexion deformity,8 cases were combined with the second and third toes deformity,6 cases were combined with not only the second and third toes but also the fourth and fifth toes deformity.The deformities were corrected by flexor hallucis longus tendolysis or lengthening alone or flexor digitorum longus lengthening in combination.Results 19 cases were simple hallux flexion deformity,the deformities were corrected simply by flexor hallucis longus tendolysis(7 cases)and lengthening(12 cases).14 cases were combined with the lesser toes deformity,the flexor hallucis longus tendon were lengthened alone in 6 cases,and both the flexor hallucis longus and the flexor digitorum longus were lengthened in 8 cases.During an average duration of follow-up of 6 months(2 to 10 months),there were no postoperative complications.All patients had full correction of all deformed toes and reported relief from pain,ease of shoe-fitting and subjective improvement of gait.There was no recurrence of the deformity.Conclusion Adhesions of the flexor hallucis longus tendon to the fibular fracture site should be considered when a flexion deformity of the hallux occurs after open reduction and internal fixation of the fibular fractures.Variations in the interconnections between flexor hallucis longus and flexor digitorum longus in the region of the knot of Henry also have special clinical significance.
3.Reconstruction of the lateral ankle ligaments with autograft of semitendinosus & bio-interference screws in chronic lateral instability of the ankle
Lilai ZHAO ; Xiangyang XU ; Jinhao LIU
Chinese Journal of Orthopaedics 2011;31(9):959-963
ObjectiveTo observer the effect of autograft of semitendinosus and interference screws for reconstruction of lateral ankle ligaments. MethodsA total of 12 cases of injured lateral ankle ligaments were selected, including 7 males and 5 females with an average age was 29.4 years, with a course of disease from 3 to 6 months. All lateral ligaments were reconstructed by autograft of semitendinosus & bio-interference screws. A 4.5 mm diameter tunnel was drilled on the lateral ankle, where the tendon of semitendinosus was permeated through, both ends of semitendinosus tendons were fixed with bio-interference screws on talus of at the end of anterior talofibular ligament and calcaneus of at the end of calcaneofibular ligament, maintaining ankle neutral and moderate valgus position. Following operation, the ankle was fixed in neutral position and slightly valgus position with plaster cast. The wound healing, the outcomes of American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and stress radiographic evaluation were assessed at the follow-up. ResultsAll 12 patients showed no infection and the wound healed well at the primary stage. At 3, 6, 12, 24 months after operation, all patients were followed-up. According to AOFAS and FAOS of preoperation and final follow-up postoperation, function of ankle in all patients was significantly improved (P<0.01), the scores of Chrisman-Snook group were more lower than this approach. No patients complained of instability of the ankle, and stress radiograph confirmed this improvement. ConclusionReconstruction of lateral ligaments of the ankle with autograft of semilendinosus & biointerference screws is a practical and reliable treatment, which restores stability and function of the ankle.
4.Alleviative effects of lidocaine postconditioning on pulmonary ischemia-reperfusion injury of rats
Mao XU ; Feng GAO ; Xiangyang GUO
Basic & Clinical Medicine 2010;30(1):24-27
Objective To investigate the alleviative effects of lidocaine postconditioning on pulmonary injury following ischemia reperfusion. Methods Seventy-two adult SD rats were randomized to 4 groups; sham group, ischemia-reperfusion (I-R) group, ischemic postconditioning(IPC) group and lidocaine postconditioning group. The pulmonary ischemia-reperfusion model was established by occlusion of the left hilum of lung for 45 min and the reperfusion was taken by removing the clamp for 2 h. At the moment of reperfusion, lidocaine 4 mg/kg was injected as a priming dose following a continuous rate of 4 mg/(kg · h). PaO_2, TNF-α, W/D of left lung, the level of MDA of left lung tissue were measured. At the end of reperfusion left lung was removed for microscopy. Results After reperfusion PaO_2 of lidocaine group was much higher than that of I-R group (P<0.05). Lidocaine postconditioning induced a significant decrease in the level of MDA of lung tissue[(7. 03±1.17) μmol/L] compared with ischemia reperfusion group [(8.77±1.42) μmol/L] (P<0.05). Lidocaine postconditioning resulted in a lower level of TNF-α [(1. 69±0.34) μg/L] than that of I-R group [(2. 52±0. 54) μg/L] (P < 0. 05). Microscopic examination showed that lidocaine postconditioning could decrease the level of edema of left lung and accumulation of neutro-phils. Conclusion Lidocaine postconditioning exerts a protective effect on pulmonary ischemia-reperfusion injury administered in the beginning of reperfusion. The effect may be explained by to the antioxidant effect and the suppression of expression of TNF-α.
5.Treatment of degenerative Achilles'tendon rupture using V-Y tendinous flap and transfer of flexor hallucis longus tendon
Yuhui SHEN ; Jinhao LIU ; Xiangyang XU
Chinese Journal of Orthopaedic Trauma 2008;10(3):238-241
Objective To introduce the technique.indication and outcome of treatment of degenerative Achilles'rupture with transfer of flexor hallucis longus tendon and V-Y tendinous flap. Methods From October 2003 to May 2006,21 cases of degenerative Achilles'tendon rupture were treated in our department using transfer of flexor hallucis longus tendon and V-Y tendinous flap.Rivets were used in 17 cases and surface screws in 4.They were followed up for 12 to 18 months(average,14). Results According to the Arner-Lindholm criteria for curative results,19 of the 21 cases were excellent and 2 good.Follow-ups revealed no Achilles'tendon re-rupture,infection,skin necrosis,stiff ankle,or injury to nerves and vessels.Walking gaits nearly recovered to normal.The repair strength allowed early functional exercise of the Achilles'tendon. Conclusion Transfer of flexor hallucis longus tendon combined with V-Y tendinous flap can cure the degenerative Achilles'tendon ruptures and defects of Achilles'tendon within 3 cm.
6.Comparison of Shikani optical stylet and Macintosh laryngoscope for double-lumen endotracheal tube intubation
Ting XU ; Min LI ; Xiangyang GUO
Journal of Peking University(Health Sciences) 2015;(5):853-857
Objective:To compare the efficacy and safety of Shikani ( S) optical stylet and Macintosh (M) laryngoscope for double-lumen endotracheal tube intubation .Methods:In the study, 60 patients undergoing elective thoracic surgery were randomly allocated to group S ( n=30 ) and group M ( n=30 ) . After general anesthesia induction , the patients in group S and group M were intubated double-lumen en-dotracheal tube ( DLT) by Shikani optical stylet ( SOS) and macintosh laryngoscope respectively .Intuba-tion time, intubation attempts , cuff broken and oral mucosal or dental injury were recorded;Blood pres-sure and heart rate at baseline ( T0 ) , at the time of intubaiton onset ( T1 ) , 1 minute after intubaiton (T2), 3 minutes after intubation (T3) and 5 minutes after intubation (T3) were also recorded;Hoarse-ness and throat sore of the patients 24 hours after surgery were evaluated .Results:The intubaiton time with the SOS was faster than with the Macintosh [(37.4 ±9.7) s vs.(43.9 ±13.7) s, P=0.039] and the first attempt success rate (87%vs.80%, P=0.488) did not differ between the groups; No tube cuff broke in both the groups;Group S had fewer patients who suffered oral mucosal or dental injury than group M (8 vs.2, P=0.038);The blood pressure and heart rate at T0,T1,T2,T3 and T4 did not differ between the groups;Throat sore(7 vs.10, P=0.390) and hoarseness (5 vs.7, P=0.519) incidence did not differ between the groups .Conclusion:By comparison of the Macintosh laryngoscope , the SOS provides faster DLT intubation and causes less oral Mucosal or dental injury .
7.Treatment of Sanders' type Ⅲ intra-articular fracture of the calcaneus using a small dorsolateral incision
Bozhou LI ; Mu HU ; Xiangyang XU
Chinese Journal of Orthopaedic Trauma 2014;16(12):1043-1048
Objective To investigate the operative treatment of Sanders' type Ⅲ displaced intra-articular fractures of the calcaneus using a small dorsolateral incision.Methods From October 2006 to April 2012,90 patients with displaced intra-articular calcaneal fracture of sanders' type Ⅲ were treated by open reduction and internal fixation through a small dorsolateral incision at our department.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.They were 69 men and 21 women,aged from 17 to 61 years (average,39 years).On the right side were 49 cases and on the left side 41 cases.According to Sander's classification,26 fractures were of type Ⅲ AB,36 of type Ⅲ AC and 28 type Ⅲ BC.The displacements of articular facet were all larger than 1 mm.The foot functions were evaluated before and after operation by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system.Results For each patient,4 to 6 calcaneal cannulated screws of 4.0 mm and 2 full threaded screws of 6.5 mm were used.No incision infection,skin necrosis or injury to the posterior tibial nerve or vessels occurred after surgery.Seventy-six patients were followed up for 10 to 56 months (average,20.5 months).Clinical union was achieved after 8 to 12 weeks (average,9.5 weeks).The lateral and axial X-ray films of the calcaneus at the last follow-up showed fine reduction and fixation of the fracture fragments and significant improvements in the length,width,height,and B(o)hler and Gissane angles of the calcaneus compared with the preoperation (P < O.05).The ankle and hindfoot scored 70 to 100 AOFAS points at the last follow-up.Forty-five cases were excellent,24 good,5 fair and 2 poor (excellent to good rate of 90.8%).Follow-up observed no infection,nonunion or osteomyelitis.Conclusion Open reduction and internal fixation through a small dorsolateral incision is a good option for Sanders' type Ⅲ calcaneus fractures with a displacement of more than 1 mm,because it leads to minimal soft tissue damage,excellent exposure and convenience for later removal of internal fixators and subtalar arthrodesis.
8.Severe lower limb injury
Xiangyang XU ; Lei WANG ; Yu CHEN
Chinese Journal of Orthopaedics 2000;0(02):-
Objective To discuss the issue of the limb salvage versus the amputation of serious lower limb injury. Methods The history, the age, the clinical presentation, the treatment time and method of the 72 severe open fractures of the lower limb were studied. Following the patients admission, they were examined completely in emergency room and were sent to radiological department for taking X ray films. According to Gustilo and Andserson classification, there were 48 limbs of type ⅢB and 24 limbs of type ⅢC.16 limbs had multiple trauma as well as severe lower extremity injury. Among them, there were 7 (9.7%) limbs with head or spine injury, 5(6.9%) limbs had abdominal trauma, 4(5.6%)limbs had thoracic trauma. Results 16 limbs in 72 limbs were amputated, in which 7 limbs were type ⅢB and 9 limbs were ⅢC. 4 limbs in 8 limbs of more than 50 years old were amputated. The ratio of amputation was 50.0 %. 12 limbs in 64 limbs younger than 50 years old were amputated. The ratio of amputation was 18.8%.Their comparison has statistically significance(?2=4.018, P
9.Study on Removal of Nitrogen Oxides in Tobacco Smoke Main Stream
Shaomin LIU ; Ping XU ; Xiangyang YAN
Journal of Environment and Health 1993;0(03):-
ve To explore the effective methods for removing the nitrogen oxides in tobacco smoke main stream. Methods Porphyrin and ferriporphyrin were added into cigarette filter with doses of 2.0, 4.0 and 8.0 ?g per cigarette. The effectiveness of removal of nitrogen oxides in tobacco smoke main stream by porphyrin and ferripor-phyrin were determined by muriatic acid naphthaline-ethylene diamine spectrophotometry. Results The contents of nitrogen oxides in tobacco smoke main stream decreased with the increases of the contents of porphyrin and ferripor-phyrin added into the cigarette filters (porphyrin: r= -0.9943, P
10.Old Lisfranc fracture- dislocations
Xiangyang XU ; Jinhao LIU ; Yuan ZHU
Chinese Journal of Orthopaedic Trauma 2004;0(12):-
Objective To analyze and discuss the causes of late dysfunction following the mismanagement of acute Lisfranc fracture- dislocations in light of the latest advancement in this field. Methods From March 2000 to February 2005, we treated 34 cases of old Lisfranc fracture- dislocation. 24 cases were treated with open reduction and internal fixation, and 10 with arthrodesis. Results According to the AOFAS for midfoot, 2 cases scored 50 to 60, 4 cases scored 60 to 70, 5 cases scored 70 to 80, 18 cases scored 80 to 90 and 5 cases scored 90 to 100. Conclusions Since the incidence of Lisfranc fracture- dislocation tends to increase, clinic orthopedists must take great care to examine the midfoot strain lest a case should be overlooked. The late complications are related to poor reduction, inadequate fixation, or inadequate postoperative immobilization. For most patients, open reduction and internal fixation within 6 weeks after injure is preferred. The cannulated screws are simple and stable for fixation of lateral and medial columns, and screw removal should be done 3 to 4 months after surgery to prevent recurrent diastasis and screw breakage.