OBJECTIVETo observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.

METHODSFrom January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.

RESULTSAll patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.

CONCLUSIONClavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Suture Anchors ; Treatment Outcome ; Young Adult

Objective To evaluate the significance of the treatment of intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop. Methods The authors respectively analyzed 24 cases of intra- or extra- hepatic recurrent stones and/or acute cholangitis treated through the subcutaneous jejunal loop from January 1989 to January 2003. Results Of the 24 cases, 10 cases (18 times) of acute cholangitis received drainage through the subcutaneous jejunal loop and their symptoms relieved (18/18); 14 cases (17 times) of recurrent intra- and extra- hepatic stones received selective drainage placement through the subcutaneous jejunal loop. The extra- or intra- hepatic stones were removed under choledochoscope through the subcutaneous jejunal loop, the stone clearance rate being 79.2% (19/24). Conclusions It is a convenient, minimally invasive, and effective method to treat intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop.

Adult ; Endocarditis ; complications ; Endocarditis, Bacterial ; complications ; Heart Defects, Congenital ; complications ; Humans ; Male ; Pulmonary Valve ; microbiology

The glucose-regulated protein78 (GRP78) is a member of the heat-shock protein 70 (HSP70) family and responsible for cellular homeostasis. GRP78 is highly expressed in various tumors. It plays an im-portant role in tumor proliferation, survival, metastasis, and drug resistance. Suppression of GRP78 in tumors could enhance cancer treatment. Inhibition of GRP78 in tumors may provide a noval approach toward cancer therapy.

Objective To study the long-term effect of different surgical procedures for juxtapapillary duodenal diverticula accompanying biliopancreatic diseases. Methods The study included 86 cases of juxtapapillary duodenal diverticula accompanying biliopancreatic diseases treated with different operations from April 1982 to October 2001.The 5-year incidence of postoperative cholangitis was retrospectively analyzed using the life table method. Results There were 45 cases of treatment of biliopancreatic diseases without management of the diverticula,9 cases of Roux-en-Y choledochojejunostomy,11 cases of subtotal gastrectomy with gastrojejunostomy(Billroth Ⅱ),and 13 cases of sphincteroplasty,with their incidences of cholangitis in 5 years being 52.0%,40.0%,75.0%,and 66.7%,respectively. Other procedures were carried out in 8 cases.There was no statistically significant difference in incidences of cholangitis in 5 years among these procedures(?~2=1.49,P=0.8287). Conclusions Management of juxtapapillary duodenal diverticula is not required in patients without the stenosis of the papilla.If postoperative cholangitis cannot be explained with biliary diseases,surgical procedures should be performed depending on the patient's individual condition and the surgeon's experience.The incidences of cholangitis in 5 years among these procedures are not significantly different.

Objective To explore rational and effective treatment strategies by comparing long-term effects of different treatment methods for hepatolithiasis. Methods One hundred and fifty-nine cases of hepatolithiasis treated in this hospital from January 1993 to December 2002 were analyzed retrospectively.Five treatment methods: conservative treatment,choledocholithotomy followed by choledochostomy,hepatolobectomy,hepaticojejunostomy,and hepaticoplasty with the conservation of the Oddi's sphincter,were compared in respect of postoperative complications and long-term outcomes.Results Out of the 159 cases,follow-up was completed in 146 cases(91.8%,146/159) for 2~12 years(median,7 years).Of 16 cases of conservative treatment,15 were followed.Cholangitis occurred in all the 15 cases,with 1 fatal case.Of 47 cases of extrahepatic surgical exploration,the incidence of residual stones was 100%.Follow-up in 43 cases found 32 cases of cholangitis(74.4%) with 7 fatal cases.Of 16 cases of hepatolobectomy,residual stones were noted in 3 cases(12.5%).Follow-up in 15 cases found 4 cases of cholangitis(26.7%) with 1 fatal case.Of 32 cases of hepaticojejunostomy,residual stones were found in 11 cases(34.4%).Follow-up in 29 cases found 14 cases of cholangitis(48.3%) with 3 fatal cases.Of 48 cases of sphincter-sparing operation,residual stones were found in 8 cases(16.7%).Follow-up in 44 cases found 7 cases of cholangitis(15.9%).The incidence of residual stones was significantly higher in cases of extrahepatic surgical exploration than in cases of other treatment(P=0.000).The recurrence rate of cholangitis was significantly higher in cases of conservative treatment and extrahepatic surgical exploration than in cases of other treatment(P

1.5 cm in diameter) are significant risk factors for the failure of stone clearance. Prophylactic cholecystectomy of an acalculous gallbladder is unnecessary.

Objective To assess the efficacy of subcutaneous tunnel and hepatocholangioplasty using the gallbladder (STHG) in the treatment of hepatolithiasis. Methods A retrospective analysis was done on 43 patients with hepatolithiasis who underwent STHG between June 2001 and May 2008. The strictured bile duct at the hilus was opened after removing the stones or cutting the damaged liver segments. The gallbladder was anastomosed to the widely opened bile duct in the hilus to form a widened pass way through the intrahepatic to the extrahepatic ducts. And the fundus of the gallbladder was mobilized and pulled to the abdominal wall to form a subcutaneous tunnel as a re-entry to the biliary tree. Results Totally 18 patients (41.9%) underwent resection of the liver,17 patients (39.5%) had residual stones. The rate of residual stone was 27.8% (5/18) in those treated by STHG combined with hepatectomy,and 48.0% (12/25) in those received STHG only. One patient developed biliary leakage and 1 patient had fungous infection after the operation. The 43 patients were followed up for a mean of 27.6 months (range,1-83). During the period,3 patients had recurrence of cholangitis and hepatolithiasis,1 showed cholangitis,and 1 had recurrent stones. The recurrent cases were cured by drainage or removing the stones through the subcutaneous tunnel. Conclusion STHG is safe,effective,minimally invasive and easy to manipulate for the treatment of hepatolithiasis.

OBJECTIVETo evaluate the efficacy and the relevant effect factors of acupuncture for type 2 diabetes mellitus (T2DM) in females.

METHODSOf 83 female patients of T2DM, 49 cases were deficiency of kidney yin syndrome and 34 cases were yin and yang deficiency syndrome. Acupuncture was adopted and the acupoints were selected according to the syndrome differentiation. In kidney yin deficiency syndrome, Taixi (KI 3), Shenmen (HT 7), Taichong (LR 3) and Sanyinjiao (SP 6), etc. were selected. In yin and yang deficiency syndrome, Shenshu (BL 23), Pishu (BL 20), Yishu (Extra) and Jingmen (GB 25), etc. were selected. In 3 courses of treatment, the changes in fasting plasma glucose (FPG), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistace index (Homa-IR), index of islet beta-cell function (Homa-beta), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared before and after treatment between the two groups. The relationship of the efficacy was analyzed in terms of the syndrome differentiation, age, duration of sickness, obesity and hereditary factors.

RESULTSAfter the treatment, the levels of FPG, FINS, Homa-IR, TC, TG and LDL-C were reduced obviously (all P < 0.01) and the levels of ISI, Homa-beta and HDL-C were increased apparently (all P < 0.01). The total clinical effective rate was 80.7% (67/83), in which, that of kidney yin deficiency syndrome was 83.7% (41/49) and that of yin and yang deficiency syndrome was 76.5% (26/34). The efficacy was not different significantly between the two syndromes. But, the younger the age was, the better the efficacy was.

CONCLUSIONAcupuncture positively regulates the glucose and lipid metabolism in the patients of T2DM. This therapy improves insulin resistance, enhances the body sensitivity to insulin and improves insulin beta-cell function. The efficacy is related to the patient's age.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

BACKGROUND:As a bone reconstruction material, nano-hydroxyapatite has good biocompatibility and osteoconduction, but the clinical use of nano-hydroxyapatite alone stil has many deficiencies. OBJECTIVE:To explore the in vivo osteogenic capability of nano-hydroxyapatite/ polyamide composites. METHODS: Twenty-four New Zealand white rabbits were subjected to humeral head replacement using nano-hydroxyapatite/polyamide composite material. X-ray observation and histological observation were done at 3, 6, 12, 24 weeks after replacement. RESULTS AND CONCLUSION: (1) X-ray observation: No thinned cortical bone and ectopic ossification occurred on the upper end of the composite material at different time, and the nano-hydroxyapatite/polyamide material had no signs of fragmentation. The cortical bone around the composite material was fuzzy, and the bone mineral density was increased with time. (2) Histological observation: At 3 weeks after replacement, a large number of cels could be visible, including mesenchymal stem cels and mononuclear macrophages. At 6 weeks after replacement, a large amount of fibrous tissues, fibroblasts and mononuclear macrophages stil existed in the boundary membrane, but chondrocytes and osteoblasts distributed less. At 12 weeks after replacement, a wide range of original trabecular bone began to form and were mostly flat that arranged regularly. At 24 weeks after replacement, the boundary membrane was ful of bone cels, but the cels on the surface of trabecular bone were relatively regular and primitive cels in the bone tissue began to transform into the lamelar bone. These findings indicate that the nano-hydroxyapatite/polyamide material has good osteogenic capability.