The management of periprosthetic fracture following total knee arthroplasty (TKA) remains a challenging problem. Periprosthetic fractures are increased with increasing TKA times,aging,and increased activity after TKA. Periprosthetic fractures after TKA involves the femur,tibia,or patella,in particular at the supracondylar region of the femur. In addition,periprosthetic fractures can also occur in operation. According to fracture morphology,various cause factors,and the timing of fracture,a number of treatment options are available to treat this complex problem. Appropriate fracture classification would assist clinical physicians to evaluate fracture site,type,bone loss and prosthesis fixation. Because of the complexity,periprosthetic fractures often require tailored treatment to attain a more individualized treatment strategy to promote fracture healing,reconstruct bone mass and maintain joint function. Recently,with improving internal fixation materials and surgical techniques,the methods of surgical treatment of periprosthetic fracture have made great progress.

[Objective]To investigate the treatment and results of reconstruction with composite type metal raiser block of proximal tibia AORI type Ⅱ bone defect in total knee arthroplasty(TKA).[Method]Nine patients(12 knees)of reconstruction with composite type metal raiser block of proximal tibia AORI type Ⅱ bone defect in TKA were followed from August 2004 to May 2008.There were 3 males with 3 knees and 6 females with 9 knees.The average age was 69 years ranging from 48 to 76 years.[Result]The average follow-up time was 26 months,ranging from 6 to 42 months.All genu varum and genu valgum were corrected.Pain disappeared and the motion of the knee was satisfactory.The HSS knee score improved from preoprative 14.5(range 10-25)to postoprative 85.5(range 74-95).The movement range improved from preoprative 74.6?(range 15?-100?)to postoprative 110.3?(range 80?-155?).[Conclusion]The appliance of composite type metal raiser block for proximal tibia AORI type Ⅱ bone defect in total knee arthroplasty is helpful for the constancy of prothesis and the achievement rate of opration.

We reported a case of children's OSAHS caused by the huge fibrolipoma in pharynx nasalis. The patient was a 10-years-old child who went to the hospital with the chief complaint of "Snoring and mouth breathing during sleep for 10 years". Imaging tests found one huge tumor in pharynx nasalis before the operation. The tumor was resected totally. The postoperative pathological diagnosis was fibrolipoma. No recurrence was noted during the follow-up visit one year postoperatively. The clinical features, diagnosis, treatment, pathology and prognosis were reviewed herein.
Child ; Humans ; Lipoma ; complications ; surgery ; Neoplasm Recurrence, Local ; Pharynx ; pathology ; Prognosis ; Sleep Apnea, Obstructive ; etiology ; Snoring

BACKGROUND: Cytridinie triphosphate(CTP) is predominantly used for cerebrovascualr accident and its sequelae, brain concussion, cerebral arteriosclerosis, senile dementia. What about its effect on diabetic peripheral neuropathies?OBJECTIVE: To observe the efficacy of cytridine triphosphate in improving nerve function and nerve conduction velocity in diabetic peripheral neuropathy.DESIGN: A prospective and randomized and controlled trial based on the patients.SETTING: Endocrine department of a military medical university.SUBJECTS: Totally 50 patients with diabetic peripheral neuropathy, hospitalized in Endocrine Department of Xijing Hospital of Fourth Military Medical University, were enrolled in this study from September 1999 to February 2000. All the patients were according to the including criteria, including 28 male and 22 female patients. They were randomly divided into treatment and control group averagely. Informed consent was obtained from all patients.METHODS: The 25 patients in treatment group received daily intravenous injection of 60 mg CTP. The other 25 in the control group received 100 mg vitamin B1 and 500 μg vitamin B12 and 20 mg scopolamine(654-2) and 100 mL saline as well every day. The treatment lasted for 14 days. The nerve conduction velocity was orthodromicly measured by surface electrode.MAIN OUTCOME MEASURES: Nerve conduction velocity in both groups.RESULTS: After treatment, the nerve conduction velocities of median nerve,ulnar nerve, fibular nerve, tibial nerve in the treatment group were higher than those in the control group (P < 0.05- 0. 01 ) . The neurological symptom and sign score in the treatment group(1. 4 ± 0.5, 3.0 ± 0.5) was less than that in the control group(2.6±0.3, 4.0±0.3) (t=3.255,2.005, P <0.05).CONCLUSION: CTP is effective in improving nerve conduction velocity in diabetic peripheral neuropathy.

BACKGROUND:Open reduction and plate internal fixation has become a major repair and treatment method for clavicle fracture, however, this method often causes postoperative local skin numbness and hypoesthesia. Currently, there was stil controversial about the effect of internal fixation on the free protection of supraclavicular nerve. OBJECTIVE:To investigate the clinical significance of supraclavicular nerve dissection and protection on open reduction and plate internal fixation of clavicle fracture. METHODS:Total y 57 patients with the middle third of the clavicle fracture were randomly divided into control group (n=34) and nerve protection group (n=23). Patients in these two groups al underwent plate internal fixation treatment. Patients in the nerve protection group underwent precious identifications and dissections of supraclavicular nerve when approaches were being done, careful y protections in the process of internal fixation. The incidence of local numbness, numbness severity, size, degree of influence on life, the improvement of the degree of numbness and pain were compared during the telephone fol ow-up after 1 year of surgery. RESULTS AND CONCLUSION:Total y 17 patients were fol owed up in each group. At the time of most serious symptom, 100%of al patients appeared local numbness in the control group, while 16 (94%) patients affected numbness in the nerve protection group. Until the latest fol ow-up, the number of patients with mild numbness symptoms decreased to 7 (41%) in control group and 3 (18%) in the nerve protection group, but there was no significant difference between the two groups (P>0.05). The severity of numbness and the degree of influence on daily life al improved over time. These results suggest that local skin numbness is a higher incidence of complications after the internal fixation for clavicle fracture. The protection of the supraclavicular nerve may help the improvement of the long-term numbness symptoms, but not as good as expected.

BACKGROUND:The correlation of zinc with Stro-1+cells and bone morphogenetic protein 7 surrounding the prosthesis may affect the bone fusion and survival rate in hip prosthesis. ＜br> OBJECTIVE:To analyze the correlation of zinc content with Stro-1+cells and bone morphogenetic protein 7 in proximal femur. ＜br> METHODS:Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement. Bone marrow mesenchymal stem cells were cultured in vitro. At 14 days after culture, Stro-1+cells in bone marrow mesenchymal stem cells were detected using flow cytometry. Bone morphogenetic protein 7 expression in cellsupernatant was detected using enzyme-linked immunosorbent assay. Zinc content in supernatant was measured using radio-immunity assay. ＜br> RESULTS AND CONCLUSION:No significant difference in the zinc content was detected in different age groups and different gender groups. Zinc content was positively associated with Stro-1+cells and bone morphogenetic protein 7 expression. The further study of the trace element zinc in proximal femur can predict and intervene the longevity of hip prosthesis.

BACKGROUND:The prosthesis fusion rate after total hip replacement is closely related to the reconstruction process of bone,which is affected by the factors around the implant of patient.Trace elements are strongly associated with the ossification.Thus,the content of trace elements in proximal femur may affect the bone fusion and survival rate of the prosthesis.OBJECTIVE:To analyze the correlation of trace elements and bone fusion surrounding the prosthesis in proximal femur.METHODS: Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement.Trace element (calcium,magnesium,zinc,parathyroid hormone,activated vitamin D3) contents were detected aftervitro cel culture.Bone mineral density was tested surrounding the prosthesis at 1 week,3 and 6 months after replacement by dual energy X-ray absorption method with a bone density meter.The difference in trace elements was compared in patients at different ages and different genders.The correlation between above five kinds of trace elements and bone mineral density was analyzed.RESULTS AND CONCLUSION:No significant difference in trace element contents was detected in different age groups and different gender groups (P＞ 0.05).Zinc content was positively correlated with parathyroid hormone and magnesium contents (P＜ 0.05).Zinc was positively associated with bone mineral density in the region 7 (P＜ 0.05).The further studies concerning the trace elements in proximal femur can be used to predict and intervene in the longevity of hip prosthesis.

Objective:To explore the relationship between lifestyle,self-esteem and life satisfaction among Chinese adolescents.Methods:10 899 adolescents in middle schools and colleges from 9 provinces in China were investigated by using Chinese Adolescent Lifestyle Scale(CALS),Rosenberg Self-Esteem Scale(SES).Results:The distribution of adolescents in the four groups divided by lifestyle and life satisfaction scores were different regarding the area and grade of these students(?2=248.93,P

[Objective] To observe the clinical effect of TCM diet therapy on type-2 diabetes.[Method] Select the said patients 76 cases,randomly divide them into treatment group and control group with 38 cases in each group,which were administered with routine western medicine,while the treatment one was added with TCM diet medication.[Result] Compare the fasting glucose before medication,showing marked difference(P

Objective To compare the difference of serum adiponectin levels between polycystic ovary syndrome (PCOS) patients and age, boby mass index (BMI) and insulin-resistance index matched controls, and explore its influence factors.Methods Case-control study, involving 97 women with PCOS and 116 age, BMI, fasting plasma glucose and insulin levels, homeostasis model assessment-insulin resistance index (HOMA-IR) matched controls.Hormone profiles, and serum adiponectin levels were measured and compared.Hormone profiles and serum adiponectin levels were compared among the four PCOS phenotypes.Multiple regression analysis was used to evaluate the factors affecting serum adiponectin levels.Results (1) Serum adiponectin level was significantly lower in PCOS group [(21 ± 16) mg/L] than controls [(25± 13) mg/L, P=0.038], and the same result in stratified analysis on weight height ratio (WHR, ≥0.8 and ＜0.8).(2) There was statistical differences in testosterone among different four PCOS phenotypes (P=0.001), there were no statistical differences in FSH, LH, WHR and serum adiponectin levels among four PCOS phenotypes (P＞0.05).(3) WHR and PCOS status were independent determinants of serum adiponectin levels (P＜0.05).Conclusions Low serum adiponectin levels in the women with PCOS is correlated with PCOS per se, independent of insulin resistance and obese.This fact supports the further study of the effect of adiponection in the pathophysiology of PCOS and its log-term impact.