OBJECTIVETo investigate the clinical results and influence factors in surgical treatment of the Lisfranc joint injury.

METHODSFrom Jan. 2009 to Nov. 2011 ,13 patients (14 feet) with Lisfranc joiat injury received open reduction and screw or wire or external fixation including 9 males and 4 females with an average age of 42 years old ranging from 18 to 61 years. According to the Myerson classification,there were 1 case of type A, 9 of type B and 4 of type C. All the patients received open reduction and internal (1 with external) fixation with screw or Kirschner wire within 22 days after injury. The postoperative function was estimated by mid-foot scoring scale of AOFAS. X-ray were used in radiography estimation.

RESULTSAll the patients were followed up for 5 to 30 months (averaged 20 months). According to mid-foot scoring scale of AOFAS,there were 8 feet with excellent results,4 with good and 2 with fair results. The anatomical reduction was observed in 12 feet and all the patients obtained bony union according to the results of X-ray.

CONCLUSIONOpen reduction and internal fixation is a good choice for the treatment of Lisfranc joint injury. A preoperative estimate,proper reduction during operation and maintainence after operation may influence the clinical results.

Adolescent ; Adult ; Female ; Foot Injuries ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tarsal Joints ; injuries ; surgery

OBJECTIVETo evaluate the therapeutic effects of three different intervertebral fusion with bone graft and internal fixation in the treatment of cervical spondylotic myelopathy.

METHODSIn the retrospective study, 83 patients (38 males and 45 females, with an average age of 69 years) with cervical spondylotic myelopathy were divided into three groups. The patients in three groups were treated by autogenous iliac bone grafting (Robingson grafting) with anterior cervical plate-screw fixation, Pyramesh with anterior cervical plate-screw fixation and BAK fixation respectively. JOA scores and the bony fusion time were recorded and the results were evaluated by numeric computer system.

RESULTSThe JOA scores of all the patients were higher than those before surgery (t = 1.55, P < 0.05). There were no statistical difference of JOA scores in the three groups (F = 2.51, P > 0.05).

CONCLUSIONIt is concluded that internal fixation of the three types is promising to the treatment of cervical spondlotic myelopathy. Robingson grafting with anterior cervical plate-screw fixation provides good stability and bony fusion. BAK is better technically required but there was height loss in clinic. Pyramesh with anterior cervical plate-screw fixation combines the merits of both two techniques above but the cost is higher.

Aged ; Aged, 80 and over ; Bone Transplantation ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spondylosis ; surgery

Objective To evaluate the clinical efficacy and safety of oxaliplatin combined with 5 -fluorouracil ( 5 -FU ) in the treatment of advanced esophageal cancer.Methods Sixty -five patients with advanced esophageal cancer were randomly divided into control group (n=32) and treatment group(n=33).The patients in two groups were treated with conventional fractionated radiotherapy at 2.0 Gy, with a total dose of 56-66 Gy.Chemotherapy was delivered on the first day of radio-therapy.Control group was received 52.5 mg · m-2 · d -1 cisplatin on day 1 +500 mg · m-2 · d -1 5 -Fu on day 1 -5 through intravenous drip.Treatment group was received 85-100 mg · m-2 · d-1 oxaliplatin through intravenous infusion two hours on day 1 +500 mg · m -2 · d -1 5-FU on day 1 -5 through intravenous drip.Every 4 weeks was a cycle, all received two cycles of chemotherapy.The clinical efficacy and incidence of adverse drug reactions between two groups were compared.Results After treatment, total effective rates were 81.80% and 75.00%in treatment group and control group, disease control rates were 96.97% and 93.75% in treatment group and control group, one year survival rates were 77.30%and 68.20%in treatment group and control group, with no statistical difference between the two groups( P>0.05).After treatment, the occurrence rate of nausea and vomiting in treatment group was signifi-cantly lower than that in control group(34.60%vs 62.50%, P<0.05) .The occurrence rate of sensory neuropathy in treatment group was significantly higher than that in control group(24.00%vs 0, P<0.05).Conclusion Concurrent chemoradiation with oxaliplatin and 5-FU for the treatment of advanced esophageal cancer exhibited a definitive clini-cal efficacy with clinical manageable adverse drug reactions.

OBJECTIVETo observe the treatments on the patients with acute methamidophos dichlorvos (DDV) and omethoate poisoning and provide the reliable basis for the rational treatments on these three organophosphorus pesticides poisoning.

METHODS101 patients with AOPP in 7 hospitals were divided into three groups: Group A, 59 patients with acute methamidophos poisoning, Group B, 32 patients with acute DDV/dipterex (DEP) poisoning, Group C, 10 patients with acute omethoate/dimethoate poisoning. The levels of erythrocyte AChE and the therapeutic efficacies of pralidoxime chloride (PAM-Cl) were compared among the three groups.

RESULTSThe AChE activities of all the three groups were inhibited on level of (9.12 +/- 7.99) U/g Hb (group A), 7.32 +/- 4.62 U/g Hb (group B) and (12.01 +/- 9.53) U/g Hb (group C), among which no significant difference was found (P > 0.05). All the patients recovered from acute cholinergic excitation or crisis after the treatment of PAM-Cl. The erythrocyte AChE activities were obviously reactivated in group A three hours later after admission to hospital, each on level of (11.37 +/- 8.67) U/g Hb, (12.51 +/- 6.98) U/g Hb, (15.90 +/- 7.31) U/g Hb, (18.33 +/- 4.78) U/g Hb and (18.91 +/- 7.00) U/g Hb at the 12th, 24th, 48th, 72nd hour and discharge (P < 0.05), and the upgrade tendency was continuous. AChE activities in group B were also reactivated after treatment, each on level of (8.91 +/- 5.89) U/g Hb, (1.31 +/- 6.61) U/g Hb, (13.00 +/- 7.55) U/g Hb, (14.22 +/- 7.80) U/g Hb, (12.78 +/- 7.07) U/g Hb and (16.87 +/- 7.06) U/g Hb at the 3rd, 12th, 24th, 48th, 72nd hour and discharge, but the upgrade tendency turned slowly after 12 hours, the inhibited AChE activities were not reactivated in group C from the beginning to the end.

CONCLUSIONAfter the treatment of PAM-Cl, the AChE activities of the patients with acute methamidophos poisoning could be continuously reactivated, the AChE activities of the patients with acute DDV/DEP poisoning could also be reactivated in 12 hours, and then keep stable, but the AChE activities of the patients with acute omethoate/dimethoate poisoning could not be reactivated. However, PAM-Cl has therapeutic efficacy against acute toxicity of all the three organophosphorus pesticides. Oximes should be vigorously used in the treatment of AOPP, including acute omethoate/dimethoate poisoning.

Acetylcholinesterase ; metabolism ; Acute Disease ; Adult ; Cholinesterase Reactivators ; therapeutic use ; Dichlorvos ; poisoning ; Dimethoate ; analogs & derivatives ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Organophosphate Poisoning ; Organothiophosphorus Compounds ; poisoning ; Pralidoxime Compounds ; therapeutic use ; Retrospective Studies

OBJECTIVETo evaluate the prognostic significance of micropapillary pattern (MPP) in adenocarcinoma of lung.

METHODSNinety-one consecutively excised cases of pulmonary adenocarcinoma, including follow-up data, were retrospectively studied. These tumors were divided into 2 major groups: those with MPP and those without MPP. The former was further subdivided according to extent of the micropapillary component, as follows: MPP + (constituting 1% to 10% of the tumor), MPP ++ (constituting 11% to 30% of the tumor) and MPP +++ (constituting more than 30% of the tumor).

RESULTSThe overall 5-year survival rate was 64.8%. The 5-year survival rates were 88.9% for stage I tumors, 46.2% for stage II tumors, and 23.8% for stage III tumor respectively (P = 0.000). The extent of micropapillary component showed no correlation with tumor stage, size and 5-year survival rate (P = 0.065, 0.358 and 0.206, respectively). On the other hand, the 5-year survival rate was 41.5% for patients in the MPP-positive group (number = 41) and 84.0% for patients in the MPP-negative group (number = 50). The percentage of nodal metastasis in MPP-positive group was also higher than that in MPP-negative group (P = 0.000). In pulmonary adenocarcinoma, this characteristic histology correlated with tumor stage and size, but not with patient's gender and smoking history. Within the same stage, the 5-year survival rates of MPP-positive and MPP-negative groups were as follows: for stage I, 78.6% versus 92.6% (P = 0.1548), for stage II, 30.0% versus 100% (P = 0.0598), and for stage III, 17.7% versus 28.6% (P = 0.4045).

CONCLUSIONSMPP in primary pulmonary adenocarcinoma, even when only constituting a minor component, predicts an aggressive clinical behavior and is associated with poor prognosis. Although it may not be an independent prognostic factor, presence of this histologic pattern should alert clinicians for more active treatment and closer follow up.

Adenocarcinoma ; pathology ; surgery ; Adenocarcinoma, Bronchiolo-Alveolar ; pathology ; surgery ; Adenocarcinoma, Papillary ; pathology ; surgery ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lung ; pathology ; surgery ; Lung Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVETo investigate the effect of intracoronary adenovirus vector encoding hepatocyte growth factor gene (Ad(5)-HGF) on hematopoietic stem cells mobilization in patients with extensive coronary heart disease.

METHODSPatients with extensive coronary heart disease were treated with intracoronary infusion of adenovirus vector encoding hepatocyte growth factor (Ad(5)-HGF 5 x 10(9) pfu) gene plus stent implantation (n = 9) or equal physiological saline plus stent implantation (n = 9). Angioplasty and stent implantation was performed according to standard clinical practice by the femoral approach and blood samples were drawn from each patient at baseline before PCI, 6 to 24 hours and 6 days post procedure. The number of CD34(+), CD38(+) and CD117(+) cells in peripheral blood was analyzed by flow cytometer.

RESULTSThe number of circulating CD34(+) cells in Ad(5)-HGF gene treatment group 6 hours after procedure and the number of circulating CD117(+) cells 6 days post procedure were significantly higher in Ad(5)-HGF gene treatment group than those in the control group (0.104 +/- 0.082 vs. 0.022 +/- 0.012, P = 0.021) and (0.058 +/- 0.058 vs. 0.012 +/- 0.009, P = 0.034), respectively.

CONCLUSIONIntracoronary administration of Ad(5)-HGF could mobilize hematopoietic stem cells into peripheral blood and the consequent role of this observation on myocardial regeneration warrants further detailed studies.

Adenoviridae ; genetics ; Aged ; Coronary Disease ; blood ; Female ; Genetic Therapy ; Genetic Vectors ; Hematopoietic Stem Cell Mobilization ; methods ; Hepatocyte Growth Factor ; genetics ; therapeutic use ; Humans ; Male ; Middle Aged ; Transfection

To analyze the academic characteristics and medication rules of traditional Chinese medical master Liu Zu-yi for treating insomnia. Totally 178 cases of insomnia treated by Professor Liu were collected,and the treatment data were input into traditional Chinese medicine inheritance support system( TCMISS) by using data mining methods,such as essential information,frequency statistics of symptoms,syndrome type statistics,extraction of syndrome elements,frequency statistics of drugs; and four properties and five tastes of drugs,distribution of meridians,regularity of prescriptions,new prescription analysis were mined. It was found that the most commonly used drugs( over 100 times) were Albiziae Cortex,Longgu,Polygoni Multiflori Caulis,Ostreae Concha,Ziziphi Spinosae Semen,Crataegi Fructus; the commonly used couplet medicines were Longgu-Ostreae Concha,Ziziphi Spinosae Semen-Polygoni Multiflori Caulis,Ziziphi Spinosae Semen-Albiziae Cortex-Polygoni Multiflori Caulis; and seven new prescriptions in treating insomnia were explored,such as prescriptions containing Hordei Fructus Germinatus,Ziziphi Spinosae Semen,Galli Gigerii Endothelium Corneum,Rehmanniae Radix,Lilii Bulbus. Based on the introduction and discussion of Professor Liu's academic views and characteristics on insomnia treatment and the illustrative evidences added to the typical case list,this paper combines the academic characteristics,data support and typical medical records to verify each other,and objectively summarizes his academic experience for treating insomnia. Treatment shall focus on the primary cause of disease in three aspects; syndrome differentiation shall distinguish between excessive disease and deficient disease; therapy shall reinforce deficiency and reduce diarrhea,regulate the five internal organs,and emphasizes the heart and liver,particularly the liver; medication shall focus on the drugs for calming the mind and protecting the stomach and spleen,which are commonly combined with three types of traditional Chinese medicine with effect in introducing Yangqi( Pinelliae Rhizoma Praeparatum,Prunellae Spica,Polygoni Multiflori Caulis) and restraining Yangqi( Longgu,Ostreae Concha,Ziziphi Spinosae Semen); nursing care focuses on preserving the body and tranquilizing the mind by means of three methods for tranquilizing the mind and three methods for preserving the body.
Data Mining ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; standards ; Meridians ; Sleep Initiation and Maintenance Disorders ; drug therapy