OBJECTIVETo compare the difference of early postoperative hip abductor strength and function between improved Gibson anterolateral approach (group A) and conventional Gibson posterolateral approach (group B) in patients who had underwent total hip arthroplasty (THA).

METHODSAmong 149 patients performing total hip arthroplasty,130 patients were followed up and were randomly divided into two groups (19 unqualified cases were excluded). Group A included 65 cases who underwent anterolateral approach, and the other group included 65 cases who underwent posterolateral approach. In the group A, male:female = 26:39,with an average age of (72.5 ± 8.3) years old, BMI of (24.7 ± 3.7) kg/m², and hip abductor strength of (1.08 ± 0.49) N · m/kg. In the group B, male:female = 30:35, with an average age of (71.6 ± 7.1) years old, BMI of (25.5 ± 3.9) kg/m², and hip abductor strength of (1.05 ± 0.51) N · m/kg. In the age-related control group, male:female = 33:32, with an average age of (73.1 ± 7.5) years old, BMI of (24.2 ± 3.8) kg/m², and hip abductor strength of (1.17 ± 0.53) N · m/kg. The age, BMI, hip abductor strength, anatomy of surgical approach, hip abduction angles and Harris score in all patients were evaluated at the day before surgery and at 1, 2, 3, 6, and 12 months after surgery. All preoperative clinical data (age, BMI and abductor strength of the uninjured side limb ) of these cases had no significant differences.

RESULTSAt 1, 2, 3, 6, and 12 months after surgery, the hip abductor strength in group A were (0.53 ± 0.13), (0.66 ± 0.21), (0.85 ± 0.15), (0.95 ± 0.19), (1.03 ± 0.13) N · m/kg respectively, while in group B were (0.46 ± 0.14), (0.57 ± 0.18), (0.78 ± 0.12), (0.85 ± 0.18), (0.98 ± 0.14) N · m/ kg respectively.The differences between the two groups at the 6th months after operation were significant; the hip abduction angles in group A were (25.35 ± 4.31)°, (36.53 ± 5.13)°, (48.07 ± 1.62)°, (61.53 ± 1.77)°, (68.62 ± 3.16)°,while in group B were (23.47 ± 2.41)°, (33.42 ± 4.23)°, (46.64 ± 2.51)°, (60.96 ± 1.75)°, (67.47 ± 4.36)°. The differences between the two groups at the 3rd month after operation were significant. Harris score in the group A were 72.23 ± 2.57, 79.36 ± 3.91, 84.75 ± 3.17, 88.63 ± 2.16, 95.21 ± 1.37 repectively ; while in the group B were 71.58 ± 3.62, 78.96 ± 2.21, 83.97 ± 3.57, 87.92 ± 2.94, 94.83 ± 1.62 respectively. There were no significant differences between them.

CONCLUSIONOwing to less muscles interrupted, the THA with improved Gibson anterolateral approach offers a better improvement in earlier hip abductor strength and abduction angle compared with the conventional surgery.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Muscle Strength ; Muscle, Skeletal ; physiology ; Postoperative Period

With the in-depth study of oral hypoglycemic drugs , the safe-ty and effectiveness of glyburide in the treatment of gestational diabetes has been confirmed.Related studies showed that glyburide had a lower placental transmission.And the studies about placental transport mecha-nisms showed that it might be associated with a variety of transport pro-teins, including ATP ( adenosine 5 ’ -triphosphate ) -binding cassette ( ABC ) transporters and organic anion transporting polypeptides ( OATPs).

OBJECTIVETo explore the influences of intervention on the abilities of detecting pulmonary tuberculosis cases in general hospitals.

METHODSWe selected 6 general hospitals at 3 different levels (A, B, and C). The intervened group included hospitals A1, B1, and C1, and the non-intervened group included hospitals A2, B2, and C2. The results after intervention were compared.

RESULTSThe report rate of pulmonary tuberculosis, sputum positive rate of reported cases, and sputum check rate of reported cases were significantly higher in hospital A1 than grouping hospital A2 (P = 0.000, P = 0.045, and P = 0.017, respectively). The report rate and sputum examination rate of reported cases were significantly higher in hospital B1 than grouping hospital B2 (P = 0.000, P = 0.024, respectively). The report rate and sputum examination rate of reported cases were significantly lower in hospital C1 than grouping hospital C2 (P = 0.000, P = 0.001, respectively). In hospital A1, the report rate, sputum positive rate of reported cases, and sputum check rate of reported cases were not significantly different before and after intervention (P = 0.182, P = 0.116, and P = 0.583, respectively). In hospital B1, the report rate were significantly different before and after intervention (P = 0.004), while the sputum positive rate of reported cases and sputum check rate of reported cases were not significantly different (P = 0.909, P = 0.052, respectively). In hospital C1, the report rate was significantly higher after intervention (P = 0.025). In hospital C2, the sputum check rate significantly increased (P = 0.000).

CONCLUSIONSIntervention influences the hospitals abilities to detect pulmonary tuberculosis cases. However, more optimized and long-term intervention mechanism should be established to increase case detection rate of pulmonary tuberculosis.

Hospitals, General ; Humans ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; diagnosis

OBJECTIVETo investigate the clinical application of the reversed sural neurovascular fasciocutaneous flap.

METHODSFrom January 2007 to May 2009,10 patients (6 males and 4 females) with soft tissue defects on lower limbs were treated by reversed sural neurovascular fasciocutaneous flap. The end-to-side neuroanastomosis were used to reinnervate the flap and microsurgery was used for anastomosing small saphenous vein. The age ranged from 16 to 55 years (mean, 32 years). There were 6 patient with soft tissue defects on foot, 2 patients with exposed bone after operation, 2 patients with chronic ulcer on limb. The patients were evaluated with appearance, blood supply, texture and 2-PD of the flaps.

RESULTSAll the patients were followed for 6 to 24 months (mean, 15 months). The flaps in all 10 patients survived completely. The appearance, blood supply and texture of the flaps were excellent and 2-PD was 9 to 12 mm.

CONCLUSIONThis flap has sufficient blood supply and high survival rate. It also effectively retains the feeling of dorsolateral heeland improved quality of life.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; blood supply ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the clinical effect of the treatment for complex fractures of the tibial plateau through the application of the external fixator and the locking plate.

METHODSFrom Feb. 2006 to Oct. 2008,12 patients with tibial plateau fractures were treated with external fixator and locking plate included 8 males and 4 females with an average age of 38 years ranging from 23 to 59. According to Schatzker type, 7 cases were type V and 5 cases were type VI. Using an anteromedial incision and an anterolateral approach, the locking plate were fixed in the tibia lateral. The collapse and height lossing of tibial plateau was observed through X-ray film before and after operation. The function of knee joint was evaluated according to HSS scoring.

RESULTSThese patients were followed up for 4 to 18 months (means 9.79 months). Eleven cases had bone primary union,and 1 delayed union. No deep phlebothrombosis and osteofascial compartment syndrome occurened. The average healing time was 3.1 months. Between the preoperative and postoperative X-ray film there were no second stage depression fracture of the tibial plateau,postoperative reduction loss and bad alignment. The range of knee flexion was 90 degrees to 110 degrees. The HSS knee functional scoring was(75.50 +/- 10.01)scores after operation and (21.50 +/- 11.68) scores before operation.

CONCLUSIONThe treatment with the external fixator and the locking plate for complex fractures of the tibial plateau could provid continuous stability of fixation,prevent the fracture from second stage displacement and the knee force line change, protect the soft-tissue around the knee, reduce the postoperative complications. The knee joint function is satisfied.

Adult ; Bone Plates ; External Fixators ; Female ; Humans ; Knee Joint ; physiopathology ; Male ; Middle Aged ; Tibial Fractures ; physiopathology ; surgery

Objectives: To explore the relationship between body fat indexes and hypertension levels by quantitative CT (QCT) study. Methods: A total of 1488 participants from "prospective urban-rural epidemiology (PURE) study" were enrolled. The participants' age were from 42 to 82 years; based on blood pressure (BP) they were divided into 2 groups: Non-hypertension group, n=783 and Hypertension group, n=705. QCT fat measurement software was used to examine L2 level abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT); body mass index (BMI), waist circumferences (WC), hip circumferences (HC) and waist-to-height ratio (WHtR) were measured and calculated; liner Logistic regression analysis and 2-classified Logistic analysis were conducted to study the relationships between hypertension and anthropometric indices, abdominal VAT, SAT respectively. Results: Compared with Non-hypertension group, Hypertension group had increased BMI, WC, HC, WHtR, abdominal VAT and SAT, P<0.05. BMI, WC, HC, WHtR, abdominal VAT and SAT were related to both systolic BP (SBP) and diastolic BP (DBP), P<0.05. Multivariable Logistic regression analysis indicated that WHtR, abdominal VAT, SAT were the independent impact factors of SBP and WC, abdominal VAT were the independent impact factors of DBP; further investigation showed that abdominal VAT and WC were the independent impact factors of hypertension. Conclusions: Abdominal VAT was robustly related to hypertension in Chinese population, it might be helpful for risk stratification in hypertension patients.

The use of traditional finite element method (FEM) in occlusal stress analysis is limited due to the complexity of musculature simulation. The present purpose was to develop a displacement boundary condition (DBC)-FEM, which evaded the muscle factor, to predict the dynamic occlusal stress. The geometry of the DBC-FEM was developed based on the scanned plastic casts obtained from a volunteer. The electrognathographic and video recorded jaw positional messages were adopted to analyze the dynamic occlusal stress. The volunteer exhibited asymmetrical lateral movements, so that the occlusal stress was further analyzed by using the parameters obtained from the right-side eccentric movement, which was 6.9 mm long, in the stress task of the left-side eccentric movement, which was 4.1 mm long. Further, virtual occlusion modification was performed by using the carving tool software aiming to improve the occlusal morphology at the loading sites. T-Scan Occlusal System was used as a control of the in vivo detection for the location and strength of the occlusal contacts. Data obtained from the calculation using the present developed DBC-FEM indicated that the stress distribution on the dental surface changed dynamically with the occlusal contacts. Consistent with the T-Scan recordings, the right-side molars always showed contacts and higher levels of stress. Replacing the left-side eccentric movement trace by the right-side one enhanced the simulated stress on the right-side molars while modification of the right-side molars reduced the simulated stress. The present DBC-FEM offers a creative approach for pragmatic occlusion stress prediction.