Objective To compare the clinical outcome of external fixation device with Kirschner wire or fragment fixation pin with mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture dislocation. Methods From October 2002 to March 2008, 106 patients with metacarpal and phalangeal articular fracture dislocation were randomly divided into A and B group. The 53 patients in A group were treated with external fixation device with Kirschner wire or fragment fixation pin. There were thumb injury in 24 cases, fracture-dislocation of proximal interphalangeal joint(PIP) in 36 cases, fracture-dislocation of metacarpophalangeal joint (MP) in 17 cases. The 53 patients in B group were treated with mini plate and screw fixation. There were thumb injury in 22 cases, fracture-dislocation of PIP in 30 cases, fracture-dislocation of MP in 23 cases. Duncan rating criteria were used to compare finger range of motion. Results The mean follow-up of 16.8 and 17.5 months in A group and B group. According to Duncan rating criteria, there were excellent in 33 cases, good in 16, fair in 3, and poor in 1 case. The excellent and good rate was 92.5% in A group. There were excellent in 30 cases, good in 17, fair in 5, and poor in 1 case. The excellent and good rate was 88.7% in B group. In A group, 1 case of wound infection was found. The average arc of motion of thumb joint was 134°±21° while the average arc of motion of other fingers was 248°±19°. In B group, no wound infection occurred. The average arc of motion of thumb joint was 122°±18° while the average arc of motion of other fingers was 225°±17°. Conclusion External fixation device with Kirschner wire or fragment fixation pin was better than the application of mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture-dislocation.

Adenocarcinoma ; drug therapy ; secondary ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Renal Cell ; drug therapy ; secondary ; surgery ; Diarrhea ; chemically induced ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; drug therapy ; pathology ; surgery ; Liver Neoplasms ; drug therapy ; secondary ; Lung Neoplasms ; drug therapy ; secondary ; Male ; Middle Aged ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use ; Remission Induction

Objective To explore the clinical efficacy of modified corneal ulcer debridement combining with anti-fungal agents in the treatment of keratomycosis(fungal corneal ulcer).Design Prospective case series.Participants Criteria for inclusion:1)fungal corneal ulcer was diagnosed under direct 10% KOH wet film microscopic examination;2)corneal ulcer located away from the center with superficial infiltration,or located in the center but in small size;3)depth of corneal infiltration was uncertain.From January,2007 to December,2009,141 cases of fungal corneal ulcer patients in Shandong Eye Institute affiliated to Qingdao Eye Hospital were recruited into this study.Methods All patients received modified corneal ulcer debridement including stripping off ulcer lesion as well as infiltrated tissue,and repairing ulcer fringe.For postoperative treatment,0.25% amphotercin B or 5% natamycin and 0.5% fluconazol eye drops were topically administrated with high frequency to the diseased eye.In the meantime,itraconalzole was orally taken as systematic treatment.Clinical efficacy of the above therapy was evaluated at last.Main Outcome Measurs Corneal ulcer infiltration,corneal epithelium reparation and recovery of vision acuity were closely observed following surgery.Results 10% KOH wet film examination showed that hypha was found in all of the 141 cases.The average time for postoperative follow-up was 29 days(from 14 to 60 days).All 141 cases of fungal corneal ulcer were completely healed,of which 127 cases were healed by taking corneal ulcer debridement surgery and anti-fungal medication,and the other 14 cases had to take penetrating keratoplasty(10 cases) or lameller keratoplasty(4 cases) due to uncontrolled infection.No recurrence was found during follow-up.The average time for healing in the 127 cases was 8.5 days,and among these cases,29 cases had a preoperative visual acuity below 0.05,80 cases between 0.05 and 0.3,and 32 cases between 0.3 and 1.0.Postoperative evaluation showed that 6 cases had a visual acuity below 0.05,42 cases between 0.05 and 0.3,93 cases(65.96%) between 0.3 and 1.0,and among 93 cases,81 cases(57.45%) had a visual acuity between 0.5 and 1.0.Conclusions The modified corneal ulcer debridement combining with anti-fungal agents has proved to be an effective treatment for fungal corneal ulcer.It greatly improves patient's visual acuity and shortens the disease duration.For cases of superficial or uncertain infiltration,corneal ulcer debridement enables better ulcer observation and provides guidance for further treatment.

ObjectiveTo explore the childhood trauma experience and its relation to the eye emotion recognition ability in patients with schizophrenia.MethodsSeventy-one schizophrenic patients and fifty-two healthy subjects were assessed with the Childhood Trauma Questionnaire (CTQ) and the Eye Basic Emotion Discrimination Task (EBEDT).ResultsThe CTQ total score in the patients group was significantly higher than those in the control group (47.86 ± 13.26 vs 34.27 ± 7.27,P ＜ 0.01 ).The subscores in emotional abuse,physical abuse,sexual abuse,emotional neglect and physical neglect of CTQ in the patients group were also significantly higher than those in the control group.(all P＜ 0.01 ).Compared with controls,the patients had significantly lower total accuracy( (86.74 ± 6.16vs73.42 ± 11.86) ％,P ＜ 0.01 ) and longer total reaction time ( (2776.75 ± 703.42 vs 4321.40 ± 1956.83 )ms,P ＜ 0.01 )of EBEDT.The significant difference were also found on the accuracy and reaction time of the EBEDT six basic emotion between the two groups ( all P ＜ 0.01 ).Correlation analysis indicated that CTQ total score were negatively correlated with the EBEDT total accuracy ( r=-0.390,P＜0.01 ),and its sub-accuracy of happiness,surprise,sadness,and anger ( respectively r =- 0.419,r =- 0.451,r =- 0.391,r =- 0.344,P ＜ 0.01 ) in the patients group.The correlation between CTQ total score and EBEDT total accuracy was also found in the control group.ConclusionChildhood trauma is related to eye basic emotion recognition in schizophrenia patients,suggesting that the trauma during childhood can affect the social recognition ability.

Objective To investigate the effect of bone marrow stem cells (BMSCs) transplantation combined with body weight supported treadmill training on neural functional recovery of rats with spinal cord injury.Methods T11 complete spinal cord injury (SCI) was introduced into 40 Sprague-Dawley male rats using an improved simple device,imitating the Allen method.The rats were randomly divided into a stem cell transplantation group,a body weight support treadmill training group,a combined treatment group and a control group,each of 10 assigned according to a random number table.One week after the SCI operation,stem cell transplantation was performed on the rats in the stem cell transplantation group and the combined treatment group.One day before their transplantation,the third passage BMSCs were labeled with 5-ethynyl-2'-deoxyuridine (Edu).The rats in body weight support treadmill training group and combined treatment group were received body weight support treadmill training,while the other two groups were not given any training.At the 1 st,2nd,3rd,4th and 5th week after SCI modeling,Basso-Beattie-Bresnahan (BBB) movement function score was used to evaluate the motor function recovery of all rats.At the 5 th week after SCI,immunohistochemical staining and immunofluorescence staining was applied to detect neural specific markers including the neuron specific enolase (NSE),microtubule associated protein (MAP-1 β) and vimentin (VIM).The survival and differentiation of the transplanted cells,as well as the nerve fiber recovery in the lesion were also observed.Results The average BBB score of the combined treatment group was (6.60 ± 0.97) at the 2nd week after SCI operation,significantly higher than the other 3 groups,while that of the stem cell transplantation group and the body weight support treadmill training group was (5.00 ± 0.67) and (4.80 ± 0.63) respectively,both higher than that of the control group but without significant differences (P ＞ 0.05).In the third week after modeling,however,the value of the stem cell transplantation group rose to (8.00 ± 0.67),significantly higher than that of the body weight support treadmill training group (6.80 ± 0.79).The immuohistochemical staining showed that a variable degree of neural specific markers (NSE,MAP-1 β,VIM) positive cells were observed in the SCI tissues of all groups,with those in the combined treatment group significantly higher than the other 3 groups.The immunofluorescence also found significantly higher fluorescence expression of neural specific protein markers including NSE,MAP-1 βand VIM in the combined treatment group than the rest group,with obvious proliferation and differentiation of nerve fibers.Conclusions Stem cell transplantation combined with partial body weight supported treadmill training can effectively promote the recovery of neural function of rats with spinal cord injury,and the effect is better than solely stem cell transplantation or the weight loss training.

Objective To determine the diagnostic value of shoulder MR arthrography in revealing the injuries of anterior glenoid labrum,and to compare MR arthrography with arm in neutral position with MR arthrography with arm in abduction and external rotation(ABER)position.Methods MR arthrography of the shoulder,including additional oblique axial sequences with the patient in the ABER position,was performed in 44 patients.The injuries of anterior glenoid labrum of these patients were retrospectively evaluated.The result was compared with that of arthroscopy.Results For displaying the abnormalities of anterior glenoid labrum,the sensitivity,specificity,and accuracy of axial MR images with arm in neutral position were 79.3%(23/29),100%(15/15),and 86.4%(38/44),respectively.While the results of ABER position oblique axial images were 93.1%(27/29),100%(15/15),and 95.5%(42/44), respectively.The difference of sensitivity between axial and ABER-position scans was statistically significant (P

Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.

Object To study the chemical constituents of GINSENG SINI TANG Methods The active constituents were isolated and purified by chromatographic methods and their structures were identified by physicochemical properties and spectral data Results Seven compounds were obtained and they are ginsenoside Rb 1, Rb 2, Rc, Rd, Re, Rg 1 and uracil respectively Conclusion All these compounds were first obtained from GINSENG SINI TANG

Objective To investigate the correlation between apparent diffusion coefficient (ADC)of diffusion weighted imaging (DWI)and prognostic factors in rectal cancer.Methods 5 5 patients with rectal cancer were confirmed pathologically.Conventional pelvic MRI and DWI examination were performed,and the mean ADC values of tumor were measured preoperatively.The patients were divided into two groups with or without lymph node metastasis,and were also divided into four groups with negative,weakly positive,positive or strongly positive expression of EGFR in rectal cancer.The ADC values were calculated in each group,and the correlation of ADC values with the lymph node status and EGFR expression classification were analyzed.Results In 5 5 patients with colorectal cancer,there were 13 lesions with lymph node metastasis and the positive expression rate of EGFR was 67.2%.There were no significant difference in mean ADC value between the groups with and without lymph node metastasis (P=0.342).The number of lesions with negative,weakly positive,positive and strongly positive EGFR expression were 18,15,12 and 10.The difference in the mean ADC values among negative,weakly positive,positive and strongly positive expression groups of prognostic factor EGFR was not significantly different (P=0.412).There were also no correlations in the prognostic factors mentioned above (r=0.183 and -0.324,all P>0.05).Conclusion The ADC value can not be used to predict the prognosis and to provide more valu-able information for individualized therapy in patients with rectal carcinoma,which needs further studiy in the future.

OBJECTIVETo observe the effectiveness of Bushen Huoxue Decoction in improving the erectile function of male patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) with stent implantation.

METHODSEighty male CHD patients after PCI with stent implantation were equally assigned to receive conventional Western medicine (control group) and combination of Western medicine with Bushen Huoxue Decoction (treatment group), both for 3 months. Then we compared the pre- and post-medication IIEF-5 scores between the two groups of patients.

RESULTSCompared with pre-medication, the total IIEF-5 score was significantly increased after 3 months both in the treatment group (8.19 ± 2.87 vs 17.83 ± 4.92, P <0.05) and in the control (7.98 ± 2.96 vs 12.18 ± 3.69, P <0.05), even higher in the former than in the latter group (P <0.05), and so were the scores on the 5 specific items (all P <0.05). The total effectiveness rate was 72.5% in the treatment group, significantly higher than 47.5% in the control (P <0.05). No obvious adverse reactions and events were observed during the treatment in either of the groups.

CONCLUSIONBushen Huoxue Decoction can obviously improve the erectile function and the quality of the sexual life of CHD patients after PCI with stent implantation.

Coronary Disease ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Penile Erection ; drug effects ; physiology ; Percutaneous Coronary Intervention ; Phytotherapy ; Stents