OBJECTIVETo explore clinical effects of manipulative reduction with minimally invasive percutaneous plate osteosynthesis in treating distal tibiofibular fractures.

METHODSFrom 2009 to 2011, 60 patients with distal tibiofibular fractures were treated by manipulative reduction with minimally invasive percutaneous plate osteosynthesis. Among them, there were 32 males and 28 females aged from 14 to 70 years old with an average of 41.22 +/- 2.06. According to AO classification of fractures,5 cases were type A1, 22 cases were type A2,21 cases were type A3 and 12 cases were type C1. Operation time, blood loss,time of callus and fracture healing were observed, Mazur scoring of ankle joint were used to evaluate therapeutic.

RESULTSFifty-eight incisions were healed at stage I ,and 2 cases were infected at distal tibial. Operation time was with an average of (62.34 +/- 5.66) min ranged 45 to 90 min;blood loss was 30 to 150 ml with an average of (80.57 +/- 5.59) ml;formation of callus appeared from 4 to 12 weeks,with an average of (8.24 +/- 2.06) weeks, and fracture healing time was from 3 to 6 months, with an average of (4.50 +/- 1.13) months. According to Mazur scoring of ankle joint 40 cases got excellent results, 18 good, and 2 fair.

CONCLUSIONManipulative reduction with minimally invasive percutaneous plate osteosynthesis can obtain reliable fixation. It is a good choice of treating distal tibiofibular fractures by protecting blood supply of fractures.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the characteristics of work needed to release adhesion in the early stage of flexor tendon healing.

METHODSEighty-four profoundus flexor tendons of the 3rd toe of Sanhuang chicken were severed and repaired by either Modified Kessler technique or Tsuge technique randomly. At 0, 1, 4, 7, 10, 14, 21 d after the operation, 6 tendons from each repair technique group were harvested and tested by biomechanical test machine. An elongation force-elongation distance curve was obtained and work of adhesion release was calculated in this curve. Whether adhesion band had been released or not was confirmed by gross inspection immediately after the test.

RESULTSWork of adhesion release: this work significantly increased at the 7th day in Modified Kessler group and at the 10th day in Tsuge group. Modified Kessler group was significantly higher than Tsuge group at the 7th day. At the 21st day after operation, adhesion could not be effectively released by full range excursion of flexor tendon profoundus.

CONCLUSIONWork of adhesion release begins to increase significantly since the 7th approximately 10th day postoperatively. At the 21st day after the operation, adhesion could not be fully released by full range of flexor tendon profoundus flexion.

Animals ; Chickens ; Male ; Stress, Mechanical ; Suture Techniques ; Tendon Injuries ; physiopathology ; surgery ; Tendons ; pathology ; physiopathology ; Tensile Strength ; Time Factors ; Tissue Adhesions ; physiopathology ; Wound Healing

Objective To observe the clinical efficacy of acupoint injection at Fenglong (ST 40) with Promethazine in treating posterior circulation ischemic vertigo (PCIV) due to turbid phlegm obstructing the middle.Method Sixty-two patients with PCIV due to turbid phlegm obstructing the middle were randomized into a treatment group and a control group, 31 cases each. The two groups both received intravenous infusion of Vinpocetine injection, based on which, the treatment group was intervened by injection at Fenglong (ST 40) with Promethazine, while the control group was given gluteal intramuscular injection of Promethazine. The traditional Chinese medicine (TCM) syndrome score and Dizziness Handicap Inventory (DHI) were observed for the two groups before and after the treatment, and the clinical efficacies were also compared.Result The TCM syndrome and DHI scores were significant changed after the intervention in both groups (P<0.05). After the treatment, the TCM syndrome and DHI scores in the treatment group were significantly different from those in the control group (P<0.05). The total effective rate was 93.5％ in the treatment group versus 80.6％ in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Injection at Fenglong (ST 40) with Promethazine is an effective method in treating PCIV due to turbid phlegm obstructing the middle.

Objective·To investigate the effectiveness of nerve transfer in repairing defecation function after spinal cord injury by the pseudorabies virus (PRV) retrograde tracing. Methods·The spinal cords were transected between L6 and S1 nerve root in 20 rats. The nerve transferring surgery was then conducted in 10 rats (Group B) and the remaining rats were control (Group A). After six months, all rats were injected with 6 μL PRV, sacrificed after 3 d and perfused with paraformaldehyde. Spinal cords were then harvested and frozen sections were prepared for observation. Results·There was no detectable infection of PRV proximal to the injury level in Group A, while infected neurons proximal to the injury level were widely observed in Group B.Conclusion·Nerve transfer has potent effect on defecation reconstruction after spinal cord injury in rats. PRV retrograde tracing can prove the existence of new neuron pathway.

Objective To analyse the cases of sudden death due to hyperthyroid heart disease,and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases.Methods Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine,China Medical University.The general information (gender and age),clinical manifestations,medical history,anatomical and histopathological findings,biochemical parameters and cause of death were analysed retrospectively.Results Most of the 6 patients had definite history of hyperthyroidism,and they all showed certain degrees of symptoms of cardiovascular disease;had obvious incentive factors of death;histopathological examination of thyroid conformed to the performances of diffuse toxic goiter;with increase of cardiac weight,dilatation of cardiac chambers,myocardial hypertrophy and focal necrosis;postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease.Conclusion The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy,histopathological examination,postmortem toxicology tests.The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary.

OBJECTIVEPatient with myocardial bridging (MB) usually has a benign prognosis, but some MB patients might experience myocardial ischemia, infarction and sudden cardiac death, especially during active physical activities. The purpose of the study was to study the stress-induced blood flow changes of the mural coronary artery in MB patients determined by intracoronary Doppler.

METHODSIn 8 patients with MB, the basic average peak velocity (bAPV), hyperemic average peak velocity (hAPV) of blood flow, coronary flow reverse (CFR) proximal and distal to the mural coronary artery were measured before and during intravenously dobutamine (10 microg kg-1 min-1, then add 10 microg kg-1 min-1 at 3 min interval till 40 microg kg-1 min-1) by intracoronary Doppler.

RESULTSThe baseline mural coronary diameter reduction was (51.7+/-21.4)% and significantly increased to (90.0+/-12.7)% (P<0.01) during dobutamine infusion. bAPV on the segments proximal and distal to the mural coronary artery significantly increased from (19.83+/-5.84) cm/s and (20.75+/-4.91) cm/s to (31.52+/-10.93) cm/s and (30.46+/-9.01) cm/s (all P<0.05 vs. baseline) respectively post dobutamine infusion. CFR measured at proximal and distal to myocardial bridging also significantly decreased from (2.91+/-0.62) and (2.46+/-0.82) to (2.17+/-0.66) and (1.83+/-0.51) (all P<0.01).

CONCLUSIONStress can significantly increase the compression of intramural coronary artery and reduce CFR on coronary segments both proximal and distal to the MB. Thus, active exercise might induce myocardial ischemia in patients with myocardial bridging.

Blood Flow Velocity ; Cardiotonic Agents ; pharmacology ; Coronary Circulation ; drug effects ; Coronary Vessel Anomalies ; physiopathology ; Coronary Vessels ; drug effects ; Dobutamine ; pharmacology ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate the safety and efficacy of individual cylindrical abdominoperineal resection (CAPR) for locally advanced low rectal cancer.

METHODSFrom June 2011 to February 2012, 11 patients with locally advanced low rectal cancer underwent individual CAPR. There were 7 male and 4 female patients, aged from 32 to 74 years with a median of 64 years. Forty-seven patients underwent classic CAPR from January 2008 to February 2012. Preoperative and postoperative parameters such as clinical information of patients, tissue morphometry and complications were compared.

RESULTSIn the individual surgical group, 6 patients were treated with one side levator ani muscle totally or partially reserved, 3 patients with sacrococcyx reserved, and 2 patients with dissection close to the anterior rectal wall. Compared with classical surgery, the individual surgical specimens of horizontal section area ((2197 ± 501) mm(2)) and intrinsic muscle layer outer area ((1722 ± 414) mm(2)) were small, but the difference was not statistically significant (P = 0.150 and 0.167). The operative time, intraoperative blood loss, circumferential resection margin, total cross sectional tissue area, cross sectional tissue area outside the muscularis propria and bowel perforation rate between the two groups were not significantly different. Individual CAPR showed less incidence of chronic perineal pain (2/11, χ(2) = 6.116, P = 0.013) and sexual dysfunction (2/9, χ(2) = 4.412, P = 0.036) compared with classic CAPR.

CONCLUSIONSIndividual CAPR has the potential to reduce the risk of chronic perineal pain and sexual dysfunction without influencing the radical effect when compare with classic CAPR for the treatment of low rectal cancer.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; epidemiology ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo observe the clinical therapeutic effects of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation.

METHODSFrom June 2010 to June 2012, 7 patients with sternoclavicular joint dislocation were treated with sternoclavicular hook plate fixation. Among the 7 patients, 5 patients were male and 2 patients were female, and the average age was 42.3 years, ranging from 38 to 54 years. The course of the disease ranged from 1 to 4 weeks. All the patients had trauma history. The clinical manifestations included: obvious swelling and pain of sternoclavicular joint, restricted shoulder joint activity. The sternoclavicular joint dislocation was proved by preoperative X-ray and CT. The postoperative curative effect was evaluated according to Rockwood scoring method.

RESULTSAccording to Rockwood scoring method, the excellent results obtained in 6 cases, good in 1. There were no complications such as internal fixation loosening or broken, second dislocation, pain in the sternoclavicular joint, and deformity. The function of shoulder joint was good, and the limb activity was free and no pain appeared.

CONCLUSIONThe sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation has follow advantages: simple procedure, stable fixation, definite therapeutic effects.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Sternoclavicular Joint ; injuries ; surgery

This present study was performed to investigate the influence of cerebral lymphatic blockage (CLB) on apoptosis of cortical neurons after subarachnoid hemorrhage (SAH) in rats in vivo. Healthy adult Wistar rats were randomly divided into normal control group, SAH group and SAH+CLB group. SAH model was made by double injection of autologous blood into the cisterna magna. On the third day after the second cisternal injection, morphological changes of cortical cells were observed by hematoxylin-eosin (HE) combined with propidium iodide (PI) staining. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method was applied to determine in situ apoptosis in the cerebral cortex. Immunohistochemistry was conducted to detect the expression of Caspase-3 and Bcl-2 in cortical neurons. HE and PI staining showed that cortical neurons of SAH rats were partly shrinkable; the nuclei showed wavy, folded or wrinkled appearance, and some nuclei had the shape of crescent. The cortical neurons in SAH+CLB group distributed sparsely and the nuclear fragmentation, apoptotic bodies were found, surrounded by the formation of vacuoles. The numbers of TUNEL-positive cells in SAH group and SAH+CLB group were higher than that in the normal control group, while the number in SAH+CLB group was significantly higher than that in the SAH group. Caspase-3 expressions in SAH group and SAH+CLB group were higher than that in the normal control group, while the expression in SAH+CLB group was significantly higher than that in the SAH group. Bcl-2 expressions in SAH group and SAH+CLB group were higher than that in the normal control group, while the expression in the SAH+CLB group was significantly lower than that in SAH group. The results obtained suggest that CLB exacerbates the apoptosis of cortical neurons in rats after SAH by up-regulating Caspase-3 expression and down-regulating Bcl-2 expression.
Animals ; Apoptosis ; physiology ; Caspase 3 ; metabolism ; Cerebral Cortex ; pathology ; Female ; Lymphatic Vessels ; injuries ; pathology ; Male ; Neurons ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Wistar ; Subarachnoid Hemorrhage ; pathology ; physiopathology