Objective To introduce the arthroscopic treatment of acute tibial insertion avulsion fracture of posterior cruciate ligament through double posteromedial portal and "Y" shaped bony tunnel, and to evaluate the clinical results. Methods 33 cases of acute tibial insertion avulsion fracture of posterior cruciate ligament were treated arthroscopically through routine portal and double posteromedial portal. The high posteromedial portal was 4 cm proximal to the joint line, and the low posteromedial portal was just at the level of the joint line. The posterior cruciate ligament and avulsion bone fragment were held together with two USP 6 Aesculap polyester threads, which were first wrapped around the posterior cruciate ligament from anterior to posterior, and then tied behind the posterior cruciate ligament and over the bone fragment. The "Y" shaped bone tunnel was made with the common opening at the anteromedial aspect of the tibia and the tunnel arms opened backward at the inferomedial and inferolateral side of the tibial bed respectively. The threads were pulled out through the "Y" shaped bony tunnel and fixed on titanic button. With twisting of the button the threads were tightened and the fixation was insured. The patients were followed up for six months. Fracture reduction and union, knee stability, range of motion, as well as the total knee function were evaluated. Results All fractures were united without displacement. Six months postoperatively, except for one case with Ⅰ degree of positive posterior drawer test, no knee instability was detected; knee extension restored to normal in all cases and average range of flexion were 139??4.1?. 10? to 15? flexion limitation was found in 3 cases. The mean Lysholm knee score was 91.4?3.6. Conclusion Arthroscopic treatment of acute tibial insertion avulsion fracture of posterior cruciate ligament is minimally invasive. The procedure through double posteromedial portal is appropriate, the use of "Y" shaped bony tunnel and button twisting are useful to assure the fixation.

Objective To introduce the way of arthroscopic patellar retinaculum adjustment and Fulkerson osteotomy, and to study its clinical results. Methods 35 cases of recurrent patella dislocation were treated by modified Fulkerson tibial tubercle anteromedial transfer, and arthroscopic patellar retinaculum adjustment including the medial retinaculum plication and lateral retinaculum releasing. The tibial tubercle was transferred 1.5 cm anteriorly and medially, and fixed with three Kirschner wires. The patients were followed for 25 months in average. The rate of reccurence, the subjective symptoms and the function of the injured leg were evaluated according to the IKDC and Lysholm rating scale. X-ray examination was taken to evaluate the patella-femur congruence. Results There were no recurrence at the last follow-up. Anterior knee pain, though in slight degree, still existed in 8 cases. The IKDC subjective knee scores were 37.4?4.9 and 92.1?5.3(P

Objective To compare the clinical results of two bundle anterior cruciate ligament(ACL) reconstruction respectively with four and eight strands of hamstring tendons. Methods 76 patients with chronic ACL rupture were randomized separated in two groups for two bundle ACL reconstruction. In the first group the semitendinous tendon was used to make two two-stranded grafts. In the second group the semitendinous tendon was used to make one four-stranded graft, and the gracilis tendon was used to make the other four-stranded graft. 33 patients in the four-strands group and 35 patients in the eight-strands group were followed up for more than one year. IKDC and Lysholm scales were used to evaluate the clinical results. Results In the four-stranded graft group, the side to side difference was

This paper reports the perioperative care of a patient undergoing the bilateral posterior ventral globus pallidus deep brain stimulation treatment for neuroacanthocytosis. The nursing points mainly included psychological care of the patient before surgery,preoperative preparation,postoperative care and special nursing before and after deep brain stimulation opening. The patient's dance-like involuntary movements and compulsive behavior reduced significantly after the treatment with no complications.

Objective To replicate the rats model of human metabolic syndrome (MS),determine the standard of the model,evaluate the success rate of model,provide the experimental basis for the study of the pathogenesis and therapeutic study of MS.Methods Eighty specific pathogen free male Wistar rats aged 7 weeks were randomly divided into the normal group (n =10) and the experimental group (n =70),which were respectively fed with normal diet and high fat,high sugar,high salt diet for 16 weeks.The rats' body weight,abdominal circumference,body length,blood pressure and fasting plasma glucose (FPG) were measured every 4 weeks.The experimental group rats were injected with streptozocin(STZ) 35mg/kg intraperitoneally once at the fifteenth week,the blood lipids (TC,TG,LDL-C and HDL-C) and FINS were measured,and HOMA-IR was calculated a week late.Results With the feeding time gradually extended,the rats' body weight,abdominal circumference,blood pressure,FPG,TG,TC,FINS,HOMA-IR and LDL-C levels were all significantly higher in the experimental group than in the normal group (P ＜ 0.05),while HDL-C was lower than that of the normal group (P ＜0.05).There was no significant difference in body length between the two groups(P ＞0.05).The success rate of MS rats models were 74.3％.Conclusion High fat,high sugar,high salt diet combined with a small dose of STZ intraperitoneal injection can successfully replicate the rat model of MS.This kind of rat models conforms to the pathological characteristic of MS,which can be easily operated and with high success rate.Therefore,it could be applied as an ideal MS animal model for the study of MS and drugs therapeutic effect.

Objective To explore the clinical effects of atomization inhalation pulmicort respules in treatment with pediatric acute infectious laryngitis. Methods 104 cases with pediatric acute infectious laryngitis admitted in Xiaoshan Hospital of Zhejiang Province from January 2011 to July 2013 were radomly divided into experimental group(n=52)and control group(n=52). Patients in experimental group were given atomization inhalation pulmicort respules,and patients in control group were received dexamethasone by intravenous injection. The symptom improvement,disappearing times of symptoms and therapeutic effect in two groups were observed and compared. Results Compared with control group,the improvement scores were higher,and disappearing time of symptoms were shorter in experiment group(P<0.05). The therapeutic effect in experimental group was up to 100%, while control group was 90.74%,and the difference between them was statistically significant(P<0.05). Conclusion Compared with dexamethasone, atomization inhalation pulmicort respules has advantages in treatment with pediatric acute infectious laryngitis,with better efficacy,shorter treatment time and fewer side effects.

Postgraduate students make an important contribution to scientific research work,and they are also important for discipline development,scientific research subject verification and talents cultivation.Besides,the problems existing in postgraduate training are analysed,which further expounded the role postgraduate training in the overall research potential of the institute.

Objective To explore the treatment effect and comfort of colostomy surgery with fecal water der-matitis around stoma after application of multilayer soft silicone dressings.Methods Approved by the Hospital Ethics Committee and the patients'informed consent,120 patients were divided into the hydrocolloid dressings group ( the control group) and multi-layer soft silicone dressing group (the treatment group),60 cases in each group.Before treatment,after treatment 24h and 36h,DET score,GCO score and the treatment effect were evaluated.Results After treated for 24h,the DET,GCO scores and treatment effects ( in the control group,cured in 3 cases,effective 45 cases, in the treatment group 5 patients were cured,effective in 46 cases) had no significant differences between the two groups (t=-2.624,P>0.05,t=-0.429,P>0.05,χ2 =0.519,P>0.05).After treated for 36h,the DET,GCO scores and treatment effects ( in the control group:cured in 29 cases,effective in 25 cases,in the treatment group:51 patients were cured,effective in 9 cases) had significant differences between the two groups ( t=-5.022,P<0.01,t=12.784,P<0.01,χ2 =6.316,P<0.05).Conclusion Colostomy fecal water dermatitis around stoma after application of multilayer soft silicone dressings can significantly improve the patients'comfort.

OBJECTIVE:To observe clinical efficacy and safety of Modified xiaohuang paste in the treatment of paralytic ileus after thoraeolumbar fractures.METHODS:One hundred and thirty-eight patients with paralytic ileus after thoracolumbar fractures were divided into control group (group A,43 cases),Xiaohuang paste group (group B,47 cases) and Modified xiaohuang paste group (group C,48 cases).Group A was given routine treatment as fasting,gastrointestinal decompression,fluid replacement,nutritional support;group B was additionally given Xiaohuang paste on the basis of group A;group C was additionally given Modified xiaohuang paste on the basis of group A.Group B and C were given relevant paste every 12 h until intestinal peristalsis was recovered and gas exhausted from anus,at the most for 5 days.The improvement time of clinical symptom improvement,VAS score and CRP level were compared among 3 groups as well as the occurrence of ADR.RESULTS:After treatment,the time of gastrointestinal decompression,bowel sound recovery and passage of gas by anus in group B and C were significantly shorter than group A,and group C was significantly shorter than group B,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in VAS score and CRP level among 3 groups (P＞0.05).After treatment,VAS score of abdominal pain and distension,CRP level of 3 groups were decreased significantly compared to before treatment;those of group C were significantly lower than group A and B,and CRP level of group B was significantly lower than that of group A,with statistical significance (P＜0.05).There was no statistical significance in VAS score between group A and B (P＞0.05).No significant ADR was found in 3 groups.CONCLUSIONS:For paralytic ileus after thoracolumbar fracture,Modified xiaohuang paste can significantly shorten treatment duration,relieve abdominal distension and pain,inflammation with good safety.