1.Measures of prevention and treatment in the operative complications of displaced acetabular fracture
Yufeng ZHANG ; Zhigang ZHONG ; Xueli QIU
Orthopedic Journal of China 2006;0(14):-
[Objective]To discuss the common complications and the methods of prevention and treatment in the operation of displaced acetabular fracture.[Method]Sixty-six cases with displaced aceuabular fracture were treated operatively from August 2005 to June 2009.Approach included anterior ilioinguinal approach,posterior Kocher-Langenbeck approach,or combined ilioinguinal and Kocher-Langenbeck approach.The functional results and complications were analyzed.[Result]All cases were followed up for an average of 29 months(12-46 months).According to the Matta evaluation,the anatomical reduction of acetabular fracture were in 34 cases,perfect in 25,and unsatisfactory in 7.According to the modified Merle d' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as being excellent in 23 cases,good in 29,fair in 8,poor in 6.Sciatic nerve injury after operation were noted in 2 hips,osteoarthritis in 14,heterotopic ossification in 10,and avascular necrosis of femoral head in 2.No infection and death were founded in this group.[Conclusion]The important factors to decrease the operative complications of acetabular fracture include correct fracture classification,suitable operative time,good operative approach,proficient technique of reduction and fixation and reasonable perioperative measures.
2.Diagnosis,treatment,and prognostic analysis of thirty-one cases with primary bronchopulmonary carcinoid
Wenjuan ZHONG ; Feng QIU ; Lili HU ; Yanjun YIN ; Zhanmin ZHANG
Chinese Journal of Clinical Oncology 2014;45(11):724-728
Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.
3.Less invasive stabilization system for comminuted tibial fractures
Yufeng ZHANG ; Zhigang ZHONG ; Yubin YANG ; Xueli QIU ; Laixi ZHOU
Chinese Journal of Trauma 2009;25(1):57-60
Objective To discuss the method and efficiency of less invasive stabilization system (LISS) in treatment of comminuted tibia[ fractures. Methods A total of 14 patients with comminuted tibial fractures were treated with LISS between January 2005 and July 2006. There were 10 males and four females, at age range of 19-61 years (mean 34 years). Of all, 11 patients were with proximal fractures of tibia and three with distal ones, including six with open fractures and eight with closed ones. The period from injury to operation was 2-13 days. An observation was done on postoperative soft tissue recovery and fracture healing. Results The average period of follow-up was 9.4 months (4-16 mouths). All frac-tures were healed up after average 7.8 months (4-12 months). All incisions were healed up at one stage, with no complications on nerves, blood vessels or soft tissues. The axes of tibia were good, with sound function of knee and ankle joints. Conclusion LISS is characterized by easy operation, minor trauma, high healing rate and low complications in treatment of comminuted tibial fractures.
4.Survey of health adult serum N terminal pro brain natriuretic peptide concentration correlation of body level in Heyuan area
Guoquan ZHONG ; Jianping XU ; Yeshuang ZHANG ; Dandan QIU
International Journal of Laboratory Medicine 2015;(12):1730-1732
Objective To investigate the healthy adults in Heyuan area of serum N terminal pro brain natriuretic peptide (N‐proBNP) concentration distribution and the preliminary investigation on the normal reference range .Methods From 2010 Novem‐ber to 2012 November in the physical examination ,laboratory examination center of our hospital indicators ,ECG ,B ultrasound ex‐amination showed no abnormalities of the healthy people 1 017 ,according to the different gender and age :A group less than 25 years ,group B was 25- <35 years ,35- <45 years ,group C ,group D 45- <55 years ,55- <65 years of E group ,F group for over 65 years a total of 6 age groups ,content determination of serum N‐proBNP by Roche chemical instrument light .Results age ,gen‐der can affect the distribution of N‐proBNP level ,and with the increase of age ,adjacent to the age groups (except F group) to com‐pare the serum levels of N‐proBNP ,the difference was statistically significant (P<0 .05);Compared with the F group in each age group was significantly increased(P<0 .05) ,there was statistical significance compared with the group ;the serum N‐proBNP level of different sex ,the difference was statistically significant (P<0 .05) .Conclusion age ,gender and other physiological factors can affect the distribution of N‐proBNP levels ,should establish the corresponding reference interval according to the different age ,gen‐der ,provide the corresponding parameters for the diagnosis and treatment of related diseases .
5.Treatment of traumatic upper cervical instability with single posterior atlantoaxial pedicle screw system
Yufeng ZHANG ; Zhigang ZHONG ; Huiyang SHEN ; Xueli QIU ; Bendan LIN
Chinese Journal of Trauma 2015;31(5):418-422
Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.
6.Comparison of the effect of anterior and posterior cruciate ligaments reconstruction between autologous ;tendon and tendon allograft
Jin HUANG ; Kejie WENG ; Yufeng ZHANG ; Xueli QIU ; Zhigang ZHONG
Chinese Journal of Primary Medicine and Pharmacy 2016;23(19):2936-2940
Objective To investigate the potential differences in efficacy of anterior and posterior cruciate ligaments(ACL &PCL)reconstruction by using arthroscopy between autologous tendon and tendon allograft.Methods A total of 144 patients with ACL or PCL fracture were assigned into two groups,namely anterior tibial muscle tendons allograft(n =82)and tendons autograft(n =63).The graft was fixed by using the Endobutton and Intrafix systems. The general information,drawer test,Lachman test,IKDC score,Lysholm score and Tegner score were compared between groups before and after surgery.The mean follow -up period was 16 months,ranged from 6 to 24 months. Results Both two groups received significant improvement after surgery and met the requirements of ligament reconstruction.However,those patients received autologous tendon had less complications,better knee stability.There were significant differences in Lachman score,ADT/PDT score,IKDC score[(83.43 ±4.37)points vs.(81.05 ± 4.41)points],Lysholm score [(90.59 ±3.43)points vs.(89.03 ±3.25 )points],and Tegner score [(7.79 ± 0.94)points vs.(7.37 ±0.90)points]between the two groups in 12 -month(χ2 =9.509,9.080,t =3.237,2.770, 2.729,all P <0.05).Conclusion The efficacy of autologous tendon is better than tendon allograft in anterior and posterior cruciate ligaments reconstruction,which should be considered has highest priority in treating patients with anterior or posterior cruciate ligaments fracture.
7.Infection after Ophthalmic Operation in 276 Patients with AIDS:An Observation
Jianguang ZHONG ; Huicheng ZHANG ; Jianhua QIU ; Georges YAYA
Chinese Journal of Nosocomiology 2009;0(22):-
OBJECTIVE To observe the infection after ophthalmic operation in 276 patients with AIDS.METHODS This trial involved 276 patients(276 eyes) with AIDS.They were divided into 2 groups according to surgical sites:112 patients(112 eyes) were in the first group who were undergone eyelid or conjunctival operation and 164 patients(164 eyes) were in the second group who were undergone cataract or glaucoma operation.There were 325 patients(325 eyes) who did not suffered with AIDS in the control group: 130 patients(130 eyes) were in the third group who were undergone eyelid or conjunctival operation and 195 patients(195 eyes) were in the fourth group who were undergone cataract or glaucoma operation.The infections were observed after operation.RESULTS There were 30 cases(26.79%),8 cases(4.88%),12 cases(9.23%) and 8 cases(4.10%) suffered with infection after operation in four groups respectively.There were 38 infected cases(13.77%) in patients with AIDS and more than that in patients who did not suffered with AIDS(20 cases and 6.15% ?2=9.07,P
8.Surgical technique in treatment of displaced acetabular fracture
Yufeng ZHANG ; Zhigang ZHONG ; Xueli QIU ; Bendan LIN ; Shuxin CHEN
Chinese Journal of Trauma 2011;27(10):924-928
Objective To discuss the method and surgical technique in treatment of the displaced acetabular fracture.Methods The study involved 66 patients with displaced acetabular fracture treated operatively with reconstruction plates from August 2005 to June 2009.Based on the fracture typing,the surgical techniques including anterior ilioinguinal,posterior Kocher-Langenbeck,combined ilioinguinal and Kocher-Langenbeck and Y shaped approach were performed in 12,30,22 and 2 patients,respectively.Results The operation time was mean 3.4 hours(1.5-6.5 hours),with mean blood loss of 550 ml(range,350-1 200 ml).All patients were followed up for average 29 months(range,12-46 months).According to Matta evaluation standard,the reduction of acetabular fracture was anatomical in 34 patients,imperfect in 25 and unsatisfactory in seven.According to the modified Merled' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as excellent in 23 patients,good in 29,fair in eight and poor in six.Conclusion The factors key to successful operation include correct fracture classification,good approach anatomy,proficient technique of reduction and fixation,and reasonable perioperation measures.
9.I-stage combination operation of anterior and posterior approaches for anterior and posterior compression of cervical spinal cord
Xueli QIU ; Bendan LIN ; Zhigang ZHONG ; Yishan HU ; Yufeng ZHANG
Chinese Journal of Trauma 1993;0(05):-
Objective To explore the surgical treatments through anterior and posterior approaches for anterior and posterior compression of cervical spinal cord. Methods The clinical data of 25 cases of anterior and posterior compression of cervical spinal cord from June 1999 to November 2003 were summarized retrospectively. There were 18 males and seven females with age range of 28-56 years (average 36.4 years). Of all,18 cases were with tricolumnae fractures of cervical spine caused by traffic injury,five with cervical herniation and two with malignant macrophage tumor in vertebral body and annex and vertebral lamina. Results All 25 cases underwent internal fixation decompression with I-stage combination operation of anterior and posterior approaches. Of 18 cases with tricolumnae fractures,one died and 17 recovered in various degrees. In five cases with cervical herniation,the positive sign disappeared basically. Two cases of malignant giant-cell tumor appeared metastatic carcinoma in the lungs 10 months after operation. Conclusions The I-stage combination operation of anterior and posterior approaches is an ideal way for the patients suffering from anteropsterospinal compression in cervical spinal cord. It can not only decompress completely the cervical spinal cord,stabilize the wounded cervical vertebra,but also facilitate nursing and function training and be beneficial to the recovery of spinal cord function.
10.Feasibility of simultaneous cardiac catheterization and 2D echocardiogram in the measurement of right rentricular pressure-volume loops
Xiaoke SHANG ; Rong LU ; Shuna XIAO ; Changdong ZHANG ; Qiu QIU ; Xi YU ; Yousan CHEN ; Lijun WANG ; Liang ZHONG ; Gangcheng ZHANG
Chinese Journal of Interventional Cardiology 2015;(11):626-630
Objective To investigate the feasibility of the simultaneous measurement of right ventricular pressure-volume loops by cardiac catheterization and 2D electrocardiogram. Methods Patients referred for pulmonary hypertension underwent right heart catheterization in our hospital between June 1st, 2015 and June 1st, 2017 are to be enrolled in this study. The right ventricular volume was measured simultaneously by catheter and electrocardiogram. The pressure-volume loops were constructed by the parameters of the pressure and volume in the same cardiac cycle. Results The study completed in four cases and their pressure-volume loops were drawn. The obtained images were irregular and there was no relationship among them. As a result, the construction was a failure. Conclusions The construction of the right ventricular pressure-volume loops of pulmonary hypertension patients by simultaneous catheterization and 2D electrocardiogram is difficult to overcome the technology defects.