Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Dyspnea ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Young Adult

BACKGROUND: To predict the functional outcome basing on hospitalization data as earlier as possible has important significance for evaluating the prognosis and discharged recovery. In recent years, researches on the balance function of stroke patients has drew more and more attentions, but less related reports about the relationship between balance and discharge functional outcome are available.OBJECTIVE: To predict the discharg functional outcomes of stoke patients basing on hospitalization data, as well as the relationship between it and scores for Fugl-Meyer balance(FMB) and Berg balance scale(BBS).DESIGN: Multiple factors and multi-variable study based on patient' s clinical presentation.SETTING: Rehabilitative department in a college hospital.PARTICIPANTS: Between August 2002 and May 2003, 40 patients with stoke for the first time were hospitalized in Rehabilitative and Neurological Department of Tongji Hospital, who accorded with the enrolling standards.METHODS: The available hospitalization data and discharge functional outcomes were subjected to single factor and multiple factor analysis, and collected data includes the history of disease, physical examination, scores for FMB and BBS when hospitalization, scores for daily life ability(ADL)and functional independence measure(FIM) . Functional outcome was presented by the discharge FIM.MAIN OUTCOME MEASURES: Simple correlative analysis of BBS, FMB and FIM, regressive analysis of discharge FIM influencing factors.RESULTS: Simple liner correlative analysis indicted that scores for BBS and FMB was strongly correlated with the scores for FIM at hospitalization and discharge( P ＜ 0. 001 or P ＜ 0.05), regressive analysis revealed that scores for FIM, ADL and BBS at hospitalization could be used for predicting the discharge functional outcomes of stroke patients.CONCLUSION: Predictors for discharge functional outcomes includes scores for FIM, ADL and BBS when hospitalization, which are closely correlated with BBS.

OBJECTIVETo explore the effect of reduction and fixation with multi-Kirschner wires for treatment of Lisfranc fracture-dislocations.

METHODSThere were 49 patients (37 male and 12 female aged from 20 to 28 years old) involved in the study. According to the Myserson damage typing, type A in 12 cases, B1 in 3, B2 in 28, C1 in 4 and C2 in 2. Kirschner wires were applied to fix and reconstruct the three-column in three directions according to the structural characteristic of midfoot. Reconstruction of three-column needed not only to reduce and to fix every single column, but also to establish union of the columns.

RESULTSAccording to the evaluation of AOFAS for midfoot, 14 cases were excellent (90 to100), 22 cases good (80 to 89), 8 cases fair (70 to 79) and 5 cases poor (60 to 69), with an average score of 84.200+/-9.663.

CONCLUSIONThe diagnosis and treatment of Lisfranc fracture-dislocations should comply with the theory of three-column reconstruction of foot arch, which can achieve the static balance of biomechanics and provide a stable environment for healing of fracture and soft tissue. Reduction and fixation with multi-Kirschner wires is an effective treatment method for Lisfranc fracture-dislocations.

Adult ; Bone Wires ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Joints ; injuries ; Male ; Metatarsal Bones ; injuries ; Middle Aged ; Tarsal Bones ; injuries

Humans ; Liver Diseases ; Practice Guidelines as Topic ; Prognosis

Objective To investigate the morphological changes in the sciatic nerve and the dorsal root ganglions (DRGs) and also gene expression in DRGs after non-freezing cold injury, and to explore the molecular mechanism of peripheral nerve cold injury and regeneration. Methods Twenty-four male Wistar rats were used. The sciatic nerve on one side was cooled to 4℃ for 2 h, and the sciatic nerve on the opposite side was exposed, but without cooling. Sciatic nerves and L4, L5 and L6 DRGs from both sides were harvested at the 1st, 2nd and 3rd week after cooling. Any pathological changes were observed using light and electron microscopy. Laser capture microdissection (LCM) was used to investigate the DRG neurons' gene expression. The array result was verified with RT-PCR for eight genes. Results Large fiber degeneration was obvious by the 7th day after cooling. Myelinated fiber regeneration had begun by the 14th day, so this time was chosen to explore the neurons' gene expression. Ninety-six genes and expressed sequence tags (ESTs) were up-regulated greater than 2 fold. Their proteins' functions were classified as adaptive response to external stimulus, apoptosis regulation, cell adhesion, immune and inflammation response,nerve regeneration, pain associated molecules, microtubule cytoskeleton, ion-channels, neurotransmitters and receptors, and neuropeptides. Conclusions A complex molecular mechanism is involved in cold injury and regeneration of the sciatic nerve, and many genes are involved. Large scale microarray analysis is a potent means to screen out related genes, thus suggesting future repair strategies.

OBJECTIVETo radiographically analyze the osseous fixation zone for the iliac crest external fixation with Schanz screws and in order to guide their placement.

METHODSNine adults with 2.0-mm-slice continuous pelvic axial CT scans were selected as research subjects. Each CT scan data was imported into MIMICS 10.0. The osseous fixation zone the upper portion of the anterior column of the acetabulum which is located between the anterior superior iliac spine and the gluteal medius pillar and between the iliac crest and the acetabulum-for the iliac crest external fixation with Schanz screws was reconstructed into true sagittal and true coronal planes by using the software. Then the measurements were taken on the reconstructed planes with measuring tools. Finally, the measured data was analyzed.

RESULTSThe palpable iliac crest segment, which was of 49.6 mm width and located 16.5 mm posterior to the anterior superior iliac spine could be used to locate the start points of the Schanz screws. Under the above-mentioned iliac crest segment, the osseous zone was deep, got ample bony materials and could intraosseously contain Schanz screws with 5.0 mm diameter. The screws could be safely inserted to a minimal depth of 71.7 mm towards the acetabular dome and to a maximal depth of 143.5 mm posterior to the acetabulum.

CONCLUSIONThe study can guide the effective insertion of the iliac crest Schanz screws. By setting a suitable start point in the above-mentioned iliac crest region and angling correctly relative to the acetabulum,the Schanz screw can be inserted into the relative strong cancellous bone above or posterior to the acetabulum with a considerable depth, to getting more bone engagement.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Ilium ; diagnostic imaging ; injuries ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; Tomography, X-Ray Computed

OBJECTIVETo establish a HPLC-based method for simultaneous determination of 2 classes of compounds (flavonoids and chromones) and 6 their effective components,(including prin-O-glucosylcimifugin, cimifugin, 4'-O-beta-D-glucosyl- 5-O-methylvisamminol, quercetin, sec-o-glucosylhamaudol and formononetin), in Yupingfeng Decoction.

METHODSHPLC-based separation of the agents was performed on Agilent Extend-C(18) column (4.6 mm x 250 mm, 5 microm) at 25 degrees with the mobile phase of MeOH-1% acetic acid water solution (gradient elution), flow rate of 0.8 ml/min and detection wavelength of 254 nm.

RESULTS AND CONCLUSIONHPLC allowed simultaneous quantitative determination of the 6 components in Yupingfeng Decoction, and they showed good linear relationships when their sample amount ranged 90-1810 ng, 97-1940 ng, 190-1906 ng, 105-3144 ng, 88-2625 ng and 109-3279 ng, respectively, with correlation coefficients all beyond 0.9999 and average recovery rates of 98.2%, 99.1%, 97.3%, 97.8%, 98.8% and 99.2%, respectively. This simple and convenient method accommodated a broad linear range with high sensitivity and precise and reproducible results.

Chromatography, High Pressure Liquid ; methods ; Chromones ; analysis ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; analysis ; Isoflavones ; analysis ; Quercetin ; analysis ; Reproducibility of Results

OBJECTIVETo introduce a technique pertaining to S2 iliosacral screw insertion.

METHODSThe screw pathway was first measured on the preoperative pelvic CT scan or the standard sacral lateral radiograph to make sure the existence of the "safe zone" in the S2 segment for screw insertion. Under general anesthesia, patients were positioned supine or prone, depending on the injury pattern of pelvic ring or associated injuries requiring concomitant operation. The operation field was routinely sterilized using iodine and subsequent alcohol solution and draped. The tip of a guide wire was inserted through a stab wound to the posterior outer iliac table, manipulated in the "safe zone" being enclosed by the anterior aspect of the S2 nerve root tunnel, the anterior aspect of the sacral vertebrae, and the inferior aspect of the S1 foramen under the guidance of the standard sacral lateral fluoroscopy, and then the tip was hammered one to two millimeters into the iliac cortex. The guide wire progressed along the trajectory between the inferior aspect of the S1 foramen and the superior aspect of the S2 foramen on the pelvic outlet fluoroscopic view, and then along the posterior to the anterior aspect of the S2 sacral vertebrae and alae on the pelvic inlet fluoroscopic view with a predetermined length. At that moment, in order to ensure the safety, another standard sacral lateral view was imaged to detect the guide wire's tip which should locate posterior to the anterior aspect of the sacral vertebrae and anterior to the anterior aspect of the S2 nerve root tunnel. Subsequently, the depth was measured, the trajectory was drilled and tapped, and the screw was inserted. Following the removal of the guide wire, the wound was irrigated and sutured.

RESULTSUtilizing this insertion technique, there were 30 S2 iliosacral screws in total being placed to stabilize the injured and unstable posterior pelvic ring in 27 patients. Each S2 screw was accompanied by an ipsilateral S1 screw. The S2 screw location was completely intraosseous in all patients, which was verified by postoperative pelvic outlet and inlet radiographs and CT scans. The insertion accuracy was 100 percent in the present series.

CONCLUSIONThe S2 iliosacral screw insertion technique is safe and reproducible to guide the placement of the S2 screw, enhancing the stability for the compromised posterior pelvic ring.

Adult ; Bone Screws ; Female ; Fractures, Bone ; surgery ; Humans ; Ilium ; injuries ; surgery ; Male ; Sacrum ; injuries ; surgery

Objective To investigate the effects of Ganlu Xiaodu Pills and its residues on PSGL-1 and proinflammatory cytokines in Coxsackie virus A16 (CoxA16) mouse model; To discuss its antiviral mechanism of action. Methods Totally 150 ICR mice at age of 7 days were randomly divided into normal group, model group, all-side group, aromatic residual group, clearing residual group and removing residual group, with 25 mice in each group. Except for normal group, other groups were injected intraperitoneally with 20 μL of 107TCID50 CoxA16 standard stock solution to establish models. Except for normal group and model group, other groups were given relevant medicine for intervention. The expressions of PSGL-1, TNF-α, IL-1β and IL-4 and histopathological observation were detected after 10 days of medication. Results Except for the normal group, the existence of a large number of CoxA16 in other groups of mouse muscle tissues proved successful modeling. HE staining showed that Ganlu Xiaodu Pills and residual could reduce damage to the muscle by CoxA16 virus. Compared with the normal group, the expression of PSGL-1 protein in the model group increased (P<0.01); compared with the model group, all-side group, aromatic residue group, clearing residual group, removing residual group inhibited the expression of PSGL-1 protein, reduced the inflammatory factors of TNF-α, IL-1β, and IL-4 (P<0.01). Conclusion Ganlu Xiaodu Pills and its residues have anti-inflammatory effects, and the all-side group shows the best efficacy.