Objective To compare treatments of intra-articular calcaneal fractures with and without bone graft in foot and ankle surgery.Methods A comprehensive search was conducted on line for all English research articles published from January 1990 through December 2010 dealing with open reduction and internal fixation with and without bone graft for intra-articular calcaneal fractures.Two reviewers evaluated each study to determine whether it was eligible for inclusion and collected the data of interest.Meta-analytic pooling of group results across studies was performed for the 2 treatments.Results The systematic review identified 32 qualified primary studies with 1281 fractures.No significant differences were found in postoperative infection, osteoarthritis or subtalar fusion between the 2 treatments ( P ＞ 0.05) .The average full weight-bearing time in bone graft treatment was significantly lower (5.4 weeks) than in non-graft treatment (10.5 weeks) .The mean B(o)hler angle was significantly larger and long-term loss of collapse significantly lower in bone graft treatment than in non-graft treatment.The bone graft treatment had a lower American Orthopaedic Foot and Ankle Society (AOFAS) score (71.4 points vs.80.5 points) but a higher Creighton score (89.9 points vs.81.0 points) compared with non-graft treatment.Pooled mean results showed no significant differences in the weighted excellent-to-good rate between the 2 treatments (excellent 35%, good 40%, fair 21% and poor 4% for the bone graft treatment versus excellent 34%, good 42%, fair 14%, and poor 10% for the non-graft treatment).Conclusions Open reduction and internal fixation with bone graft for intra-articular calcaneal fractures may lead to better reduction of B(o)hler angle and early return to full weight-bearing without increased risk of postoperative infection.However, since more cases of joint depression and comminuted fracture have been included in the bone graft group in the present study, a prospective controlled comparative study with a large scale of samples is still needed.

[Objective]To explore displacement and plantar pressure distribution of the forefoot before and after the plantar fascia and other plantar ligaments were sectioned.[Method]Seven fresh adult cadaveric feet were tested with the main plantar ligaments exposed,including the plantar fascia,spring ligament,short plantar ligament and long plantar ligament.The displacements of the metatarsals were recorded and calculated with digital speckle correlation measurement(DSCM),also F-scan insoles were put under the plantar aspect of the feet when the speciments were loaded to 700N vertically.The special shifts and plantar pressure data of the metatarsals was collected and stored before and after the main plantar ligaments were sectioned.[Result]The transverse movements of the metatarsals did not change significantly,the same as their vertical displacements except the first metatarsal after the plantar fascia was sectioned,while the peak pressure shifted laterally.When the four major plantar ligaments were all injured,all of the above changed significantly.[Conclusion]The plantar fasciotomy will not consequentially lead to collapse of the forefoot structure.But the redistribution of the plantar pressure and the compensation of other ligaments may result in later complication.

Objective To investigate the properties of hind foot motion and it's changes in ankle or subtalar joint arthrodesis. Methods Eight fresh frozen adult leg-foot specimens were mounted in a coordinated system, a Steinmann pin was perforated across the calcaneus as a marker. The displacements of the marked points in the coordinated system were recorded when subtalar or ankle joint was fixed respectively. Through matrix translation and Euler equation, the angle of the calcaneus rotation were calculated, representing the motion of the subtalar and ankle joints in different condition, Statistical analysis were also taken between different conditions. Results Three dimensional (3-D) motion was observed in hind foot motion. The range of motion with ankle joint fixation was: inversion 15.99??2.81?, eversion 8.62??1.90?, dorsiflexion 3.70??1.00?, plantar flexion 5.87??1.39?, adduction 7.64??2.04?, and abduction 3.99??1.78?. When subtalar joint was fixed, they were: 7.13??1.07?, 5.52??0.85?, 17.09??2.87?, 30.75??5.04?, 10.77??1.56?, and 6.54??1.88? respectively. While they were 22.62??3.21?, 40.88??5.77?, 18.87??3.89?, 9.12??2.05?, 17.48??2.26? and 11.47??2.29?, when no joint was fixed. Arthrodeses of ankle or subtalar joint would affect the hindfoot motion significantly (P

[Objective]To discuss the operative treatment for adult flatfoot deformity with severe pain.[Method]From August 2002 to October 2004,operative treatment for 12 cases of unilateral adult flatfoot deformity with severe pain underwent operative treatment,which included 7 males and 5 females with an average age of 35 years(range,20 to 56 years),left side was involved in 8 cases,and right side was affected in 4 cases.According to etiological factor,stageⅡ~Ⅲ posterior tibial tendon dysfunction were 6 feet,congenital flatfoot were 3 feet,neurological flatfoot were 2 feet and postoperative equinovarus was 1 feet.Every case received special operative treatment,for instance lateral column lengthening,medial displacement calcaneal osteotomy,arthrodesis,repair posterior tibial tendon,sping ligament reefing,FDL tendon transfer and so on.All patients were fixed with plaster cast at inversion position for 4~6 weeks,then changed to plaster splint fixing at neutral position for 4 weeks.Functions of ankle and foot were evaluated before and after operation.[Result]All patients were followed up for an average of 22 months(ranged,16 to 28 months).The total excellent and good rate was 83.3% according to Marryland foot score.The specific index of X-ray improved obviously(P

OBJECTIVE To evaluate the sterilization steps and effects of low temperature plasma on heat-resistant items. METHODS Low temperature plasma sterilization was adopted to operate according to standard procedures including pre-sterilizaing, packaging, sterilization, unloading and storageing. RESULTS Low temperature plasma had the features of reliable sterilization effect, easy to monitor, short time needed, and high utilization rate which could greatly increase the number of surgery and have a long term storage. CONCLUSIONS Low temperature plasma sterilization is a kind of fast, safe and effective way of sterilization by which the sterilization quality is guaranteed and the hospital infection rate is reduced greatly to meet the clinical demands to sterile items.

Objective To understand the characteristics of subtalar joint motion and to probe a new method in evaluating the subtalar joint. Methods Eight fresh frozen adult shank-foot specimens with calcaneus marked were placed in a Cartesian coordinate system. The motion of the subtalar joint was obtained through matrix translation and Euler equation. Comparatively, the same specimens were underwent CT scan and established three dimensional reconstruction through the radiographic method. Results Both the mechanical and the radiographic methods had no significant difference in reflecting the motion of subtalar joint in coronal and transversal plane. Conclusion To evaluate the motion of subtalar joint with mechanical method was more precise, economic and easier to perform. Although the radiographic method had considerable discrepancy among examiners, as a non-invasion examination, it needs further research.

To retrospectively analyze the clinical data of 42 patients at our department with bulbar myasthenia gravis.They underwent video-assisted thoracoscopic extended thymectomy (VATET) from May 2003 to August 2010.Another 42 patients treated with medications alone were selected as controls.Compared with the control group (4.32 ± 0.23),postoperative dysphagia scores improved significantly in patients undergoing VATET(9.21 ±0.41).And so did the dysphagia assessment classification (P ＜0.05).Thus VATET could effectively and definitely relieve dysphagia in patients with bulbar myasthenia gravis.

Objective To investigate the function of apoptosis in the renal injury by observing change of renal pathology and ultrastructure in the rat with obstructive jaundice(OJ) and if salvia miltiorrhiza(SM) can lighten the renal dysfunction of obstructive jaundice.Methods A total of 100 adult Sprague-Dawley rats were studied.Among them,the 80 models of obstructive jaundice were established by ligating bile duct(BDL),then divided into two groups: the OJ rats administered daily abdomen injections of SM(1.7g per rat) after operation of bile duct ligation(the SM group,n= 40);the OJ rats receiving only the same normal saline(the OJ group,n=40).The other rats with sham operation receiving only normal saline(the control group,n=20).Three groups of rats were sacrificed in groups at postoperation 1,2,3 and 4 week,respectively.Then serum BUN & Cr were tested and renal change of histopathology and ultrastructure were observed;Apoptosis of renal tissue were assayed by TUNEL method.Results With the time of BDL extending,the value of serum BUN & Cr increased;Apoptotic cells increased in renal tissue.After treatment with SM,the injury degree of renal function and histopathologic changes decreased.Conclusion Obstructive jaundice can lead to renal injury.Apoptosis had an important effect on renal function injury in the rat with obstructive jaundice.Salvia miltiorrhiza can ease the degree of renal function injury.

Objective To evaluate the value of region Ⅵ lymph nodes in surgical treatment of cN0 papillary thyroid carcinoma(PTC). Methods 98 cases of PTC with cN0 which received functional lymph nodes dissection were collected. We analyzed the results of pathologic examination by region Ⅵ lymph nodes distinguished from lateral neck lymph nodes(Ⅱ～Ⅴ) retrospectively. Results In 98 cases, the rate of region Ⅵ lymph nodes metastasis was 20.4 %(20 cases); the rate of region Ⅱ～Ⅴ lymph nodes metastasis was 13 cases(13.3 %). In cases with region Ⅵ lymph nodes metastasis, the rate of Ⅱ～Ⅴ lymph nodes metastasis was 45.0 %(9/20). Meanwhile in cases without region Ⅵ lymph nodes metastasis, the rate of Ⅱ～Ⅴ lymph nodes metastasis was 5.1 % (4/78, P

Objective To study the value of three dimensional contrast enhanced subtraction MRA(3D CES MRA)in the diagnosis of body and lower extremity blood vessel disease Methods Eighteen cases were studied by 3D ECS MRA and proved by operationResults 3D CES MRA images were of diagnostic quality without ghost for all 18 patients.3D CES MRA clearly showed normal vascular anatomy and various disorders.According to surgery,the sensitivity and specificity of 3D CES MRA in the diagnosis of body and lower extremity blood vessel diseases were both 100%.Conclusion 3D CES MRA is a new technique in diagnosing of body and lower extremity blood vessel diseases.It is proved to be a simple,noninvasive and commercial method in diagnosing blood vessel diseases.