OBJECTIVETo retrospectively analyze therapy comparison between hinged external fixator combining with internal fixation, soft tissue repair and plaster fixation after routine surgery for terrible triad of the elbow.

METHODSFrom January 2003 to June 2011,26 patients with terrible triad of the elbow (posterior dislocation associated with fracture of both the radial head and the ulnar coronoid process) were treated respectively by unilateral hinged external fixator and plaster fixation. Fourteen patients were treated with external fixator combining with internal fixation, soft tissue repair and reconstruction, including 8 males and 6 females,ranging in age from 20 to 62 years with an average of (33.60 +/- 8.53) years. The mean time of fixation was 7.5 weeks (ranged, 6 to 8 weeks), and forearm rotation exercise was performed after the first day of operation, elbow flexion and extension activities after 4 to 6 days. Twelve patients were treated with plaster external fixation combining with open reduction and internal fixation,including 8 males and 4 females,ranging in age from 21 to 63 years with an average of (34.80 +/- 7.41) years. The mean time of plaster fixation was 30.4 days, and functional exercise was carried out after 4 to 6 weeks of plaster removal. JOA assessment score were used to evaluate the elbow joint function.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 36 months,with an average of 18.6 months. The mean time of fracture healing was (8.6 +/- 3.1) weeks in plaster group and (9.0 +/- 2.7) weeks in fixator group, with no statistical difference between the two groups (t =1.47, P > 0.05). The function and are of motion in plaster group and fixator group showed significant difference. While the pain, articular instability and deformity showed no statistical difference. The total assessment score between two groups indicated markedly difference (t = -2.66, P < 0.01).

CONCLUSIONHinged external fixator can enhance lateral stability of elbows,benefit the reduction of fracture dislocation, guarantee early and safe functional exercise, prevent elbow stiffness, and reduce heterotopic ossification. In treating terrible triad of the elbow, the hinged external fixator is superior to other therapies with respect of improving the function of elbow joint.

Adult ; Case-Control Studies ; Elbow Joint ; diagnostic imaging ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the synergistic effects of electroacupuncture on the treatment of knee osteoarthritis after arthroscopic debridement.

METHODSFrom May 2008 to July 2010, 78 patients with knee osteoarthritis were randomly divided into two groups. There were 42 patients in the experimental group, including 16 males and 26 females, ranging in age from 41 to 63 years, with an average of (53.62 +/- 6.53) years; the disease course ranged from 8 to 24 months, with an average of (10.35 +/- 6.42) months. The patients were treated with arthroscopic debridement combined with electroacupuncture after operation. There were 36 patients in the control group, including 14 males and 22 females, ranging in age from 40 to 62 years, with an average of (54.34 +/- 7.67) years; the disease course ranged from 6 to 25 months, with an average of (11.94 +/- 5.13) months. Those patients were treated only with arthroscopic debridment. All the patients performed isometric quadriceps femoris contraction exercise and knee flexion and extension activities after operation. The visual analog scale(VAS) score and Lysholm knee score were used to evaluate the therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 30 months, with an average of 15.6 months. At the final follow-up, VAS score was significantly decreased, and the Lysholm score, except for the item demanding for support, significantly increased, compared with those before surgery respectively in both groups. There was significant difference in VAS score between two groups after treatment. As to Lysholm score, there were significant differences in limp, pain, swelling, stair activity and squat, but there were no significant differences in items of interlocking and instability between two groups after treatment.

CONCLUSIONElectroacupuncture can effectively improve the clinical symptoms and knee joint's motor function of knee joints in patients with knee osteoarthritis, as well as the synergistic effects on the treatment of knee osteoarthritis after arthroscopic debridement, leading to a much better long-term therapeutic effect with respect of improving the function of knee joint. This therapy, combined with traditional Chinese medicine and Western Medicine,is worth of clinical application in the treatment of knee osteoarthritis.

Adult ; Aged ; Arthroscopy ; Case-Control Studies ; Combined Modality Therapy ; Debridement ; Electroacupuncture ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; therapy ; Treatment Outcome

Congenital hydronephrosis is the main cause of childhood chronic renal disease and renal failure,which is also one of the most common anomalies in pediatric urology division.Although the operation is performed to treat obstruction,the renal function of patients get worse and worse,postoperatively.Up to date,there are lots of controversies in evaluation of hydronephrosis and treatment at prenatal and postnatal.According to recent articles,the recent examinations,evaluation system,follow-up and treatment strategies of hydronephrosis are introduced.

Objective To investigate the clinical characteristics,treatment options and prognosis of duplex kidneys in children.Methods Data were retrospectively collected from all patients who were hospitalized at Shengjing Hospital Affiliated to China Medical University from January 2008 to May 201 5.The surgery to retain moie-ty nephron was performed in 30 cases:1 2 cases underwent non common sheath ureter reimplantation,4 cases of the patients had common sheath ureter reimplantation,1 2 patients underwent transurethral resection of the cyst,1 case of them had pyeloureterostomy,and the other patients underwent lower -pole pyeloplasty.Removal of renal moiety was performed in 52 cases:43 patients underwent upper -pole heminephrectomy,8 patients underwent upper pole hemi-nephrectomy and lower -pole ureter reimplantation,and 1 case of the patients had upper -pole heminephrectomy and lower -pole ureteroplasty.Results A total of 54 cases were followed up,the follow -up rate reached 65.9%,the follow -up time lasting 2 months to 4 years,with an average time of 9.53 months.All clinical symptoms disappeared after remove moiety operation.There were small ureteral cysts but compared with the preoperative condition,the symp-toms reduced significantly in 4 cases.All clinical symptoms disappeared in patients whose nephron was retained after operation,and hydronephrosis was alleviated.De novo 2 degree of vesicoureteral reflux was found in 3 out of 1 2 pa-tients who underwent transurethral puncture of the cyst.Conclusions The clinical manifestations of duplex kidney have some characteristics which include recurrent urinary tract infection,normal intermittent voiding urine dripping, abdominal pain,urethral orifice mass,abdominal mass and aggravation of hydronephrosis.Duplex kidney is often asso-ciated with cardiac malformation and cryptorchidism.The preoperative testicular examination and echocardiography should be performed.The choice of operation depends on the clinical manifestation,auxiliary examination results and comprehensive analysis.The prognosis of duplex kidney is well,but patients need to be further followed up af-ter operation.

Recently studies have shown that ketamine given to patients under mechanical ventilation and background anesthetics without adversely altering cerebral hemodynamics. More studies have also shown ketamine has neuroprotective effects. The main mechanisms may involve changing the expression of apoptosis-regulating proteins, inhibiting the toxicibility of excitatory amino acid and decreasing Ca2+ influx by blockade of NMDA receptors activation. It can also inhibit proinflammatory cytokine production induced by tissue ischemia and affect the protein kinase phosphorylations related to cerebral ischemia, etc..

Objective To explore the preventive and therapeutic effects of diminazene (DIZE) on pulmonary arterial hypertension (PAH) in rats.Methods Left pulmonary lobectomy combined with injection of monocrotaline was used to establish a rat model of pulmonary arterial hypertension.One hundred adult male Wistar rats were randomly divided into blank control group (group A,n=20),DIZE control group (group B,n=20),PAH model group (group C,n=20),PAH model plus DIZE group (group D,n=20) and PAH model plus DIZE and C-16 group (group E,n=20).Angiotensin-converting enzyme 2 (ACE2),IL-6 and IL-8 levels were determined by fluorescence resonance energy transfer (FRET) and enzyme linked immunosorbent assay (ELISA),and the mean pulmonary arterial pressure (mPAP) and right ventricular hypertrophy index (RVHI) were measured.The wall thickness (WT) and intimal hyperplasia score were calculated,and the pulmonary vascular lesions were analyzed using elastic fiber staining.Results RVHI,ACE2 enzyme activity and WT in the group A were significantly different from those of the groups C,D and E (P<0.05).Those of the group D and E were significantly different (P<0.05).The five groups showed significant differences in the overall analysis of each index (P<0.05).Conclusions Diminazene can increase the ACE2 enzyme activity,and decrease the mPAP,RVHI and WT,while reducing the pulmonary arterial medial hypertrophy,and inhibit intimal hyperplasia of pulmonary arterioles.The results of this study provide an experimental basis for the use of diminazene in the treatment of human pulmonary hypertension.

Objective To explore the pathogenesis of autism by observation of changes of brain-derived neurotrophic factor(BDNF) positive neurons and the morphology of pyramidal cells in hippocampal CA1 region,and provide theoretical evidence for the therapeutic schedule.Methods Animal model of autism was obtained by Schneider method.Using the immunohistochemistry methods and image analysis,the number of BDNF positive neurons was examined in hippocampal CA1 region of the autism model rats and the normal rats,and the changes of pyramidal cell were observed in hippocampal CA1 region after HE staining.Results The numbers of BDNF positive neurons in the hippocampal CA1 region of the autism model rats were more than those of the normal rats (5.00 ±1.60 vs 3.00 ± 1.04,t =3.63,P =0.0015).The morphology of pyramidal cells showed that the pyramidal cells of the autism model rats in hippocampal CA1 region had apoptosis.Conclusion The occurrence of autism may be related to the changes of BDNF and the morphology of pyramidal cells in hippocampal CA1 region.

Objective To investigate the feasibility and procedures of semi-open establishment of pneumoperitoneum(SOEPP) for laparoscopic surgery in patients with a history of abdominal surgery. Methods 117,patients,with a history of abdominal surgery received SOEPP and were retrospectively reviewed from October 1994 to January 2002. Results Out of 117 patients,pneumoperitoneum was established successfully in 115 cases by SOEPP.The successful rate of SOEPP was 98 3%(115/117). Conclusions SOEPP is a safe and feasible method in most patients with abdominal operative history.

Objective To analyze the clinical features of sarcoidosis for improving the recognition of the articular manifestations of sarcoidosis.Methods The clinical data of 63 patients with sarcoidosis confirmed by biopsy were retrospectively analyzed.Results In 13 patients with sarcoidosis articular manifestations appeared (20 6%).Seven patients with sarcoidosis showed arthritis.Five patients of them showed oligoarthritis that was asymmetric and affected especially knees,ankles and ivrists.Two patients of them showed polyarthritis.Six patients with sarcoidosis showed arthralgia.Conclusion The articular manifestations of sarcoidosis may be divided into 3 types which are oligoarthritis,polyarthritis and arthralgia.The articular manifestations of sarcoidosis are of no specific characteristics.The diagnotic possibility of sarcoidosis should be considered for the joint involvements.

Objective To evaluate the surgical treatment of huge staghorn stones. Method The clinic dates of 184 cases treated with an incision of the infrarenal sinus supplemented by a postrenal low pole segmental incision were studied. Result 184 cases were all successful.Conclusion We conclude that this method, need no interruption of renal blood flow had advantages of simple procedure less bleeding, completely removing calculi, protecting renal function.