1.Digital simulation surgery in the limited open reduction and intramedullary nail fixation for treatment of proximal humeral fractures
Kunming REN ; Yanmei WANG ; Jie ZHAO ; Xiaoming YANG ; Maoyuan XIN ; Xuecheng SUN
Chinese Journal of Orthopaedic Trauma 2024;26(12):1062-1068
Objective:To explore the clinical benefits of digital simulation surgery in the limited open reduction and intramedullary nail fixation for treatment of proximal humeral fractures.Methods:A retrospective study was conducted to analyze the clinical data of 40 patients who had been treated by limited open reduction and intramedullary nail fixation at Department of Trauma and Orthopedics, The People's Hospital of Weifang from June 2020 to September 2022 for 3-part proximal humeral fractures by Neer classification. The patients were assigned into 2 groups according to different preoperative strategies. In the observation group of 17 patients [4 males and 13 females with an age of (66.9±8.6) years], the angle of intramedullary nail placement into the humeral head and the sequence of reduction and fixation were simulated in the preoperative digital simulation surgery. In the control group of 23 patients [7 males and 16 females with an age of (63.0±8.6) years], routine reduction and fixation were performed based on the preoperative shoulder joint CT images and intraoperative fluoroscopy without preoperative digital simulation surgery. The 2 groups were compared in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, incidence of postoperative complications, fracture healing time, active range of motion of the shoulder joint at the last follow-up, as well as the intramedullary nail heights, humeral neck-shaft angles, Constant shoulder function scores, and visual analogue scale (VAS) pain scores at 3 days, 12 weeks, and 24 weeks postoperatively.Results:The 2 groups were comparable because there were no statistically significant differences in the preoperative general data between them ( P>0.05). The operation time in the observation group [(57.5±6.2) min] was significantly shorter than that in the control group [(71.3±10.2) min], and the intraoperative fluoroscopy frequency in the former [(28.5±4.4) times] significantly lower than that in the latter [(45.4±2.6) times] ( P<0.05).The 2 groups were followed up for (15.0±1.6) months. For the observation and the control groups, respectively, the fracture healing time was (10.5±2.4) weeks and (10.0±2.0) weeks, showing no statistically significant differences between groups ( P>0.05). There were no statistically significant differences between the 2 groups in the intraoperative blood loss, or in the intramedullary nail heights, humeral neck-shaft angles, Constant shoulder function scores, or VAS pain scores at 3 days, 12 weeks, or 24 weeks postoperatively, or in the active range of motion of the shoulder joint at the last follow-up ( P>0.05). Complications such as infection, humeral head necrosis, and screw removal occurred in none of the patients. Conclusion:In the treatment of proximal humeral fractures, before the routine limited open reduction and intramedullary nail fixation, digital simulation surgery can be performed to reduce the operation time and fluoroscopy frequency without sacrifice of the therapeutic efficacy.
2.Digital simulation surgery in the limited open reduction and intramedullary nail fixation for treatment of proximal humeral fractures
Kunming REN ; Yanmei WANG ; Jie ZHAO ; Xiaoming YANG ; Maoyuan XIN ; Xuecheng SUN
Chinese Journal of Orthopaedic Trauma 2024;26(12):1062-1068
Objective:To explore the clinical benefits of digital simulation surgery in the limited open reduction and intramedullary nail fixation for treatment of proximal humeral fractures.Methods:A retrospective study was conducted to analyze the clinical data of 40 patients who had been treated by limited open reduction and intramedullary nail fixation at Department of Trauma and Orthopedics, The People's Hospital of Weifang from June 2020 to September 2022 for 3-part proximal humeral fractures by Neer classification. The patients were assigned into 2 groups according to different preoperative strategies. In the observation group of 17 patients [4 males and 13 females with an age of (66.9±8.6) years], the angle of intramedullary nail placement into the humeral head and the sequence of reduction and fixation were simulated in the preoperative digital simulation surgery. In the control group of 23 patients [7 males and 16 females with an age of (63.0±8.6) years], routine reduction and fixation were performed based on the preoperative shoulder joint CT images and intraoperative fluoroscopy without preoperative digital simulation surgery. The 2 groups were compared in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, incidence of postoperative complications, fracture healing time, active range of motion of the shoulder joint at the last follow-up, as well as the intramedullary nail heights, humeral neck-shaft angles, Constant shoulder function scores, and visual analogue scale (VAS) pain scores at 3 days, 12 weeks, and 24 weeks postoperatively.Results:The 2 groups were comparable because there were no statistically significant differences in the preoperative general data between them ( P>0.05). The operation time in the observation group [(57.5±6.2) min] was significantly shorter than that in the control group [(71.3±10.2) min], and the intraoperative fluoroscopy frequency in the former [(28.5±4.4) times] significantly lower than that in the latter [(45.4±2.6) times] ( P<0.05).The 2 groups were followed up for (15.0±1.6) months. For the observation and the control groups, respectively, the fracture healing time was (10.5±2.4) weeks and (10.0±2.0) weeks, showing no statistically significant differences between groups ( P>0.05). There were no statistically significant differences between the 2 groups in the intraoperative blood loss, or in the intramedullary nail heights, humeral neck-shaft angles, Constant shoulder function scores, or VAS pain scores at 3 days, 12 weeks, or 24 weeks postoperatively, or in the active range of motion of the shoulder joint at the last follow-up ( P>0.05). Complications such as infection, humeral head necrosis, and screw removal occurred in none of the patients. Conclusion:In the treatment of proximal humeral fractures, before the routine limited open reduction and intramedullary nail fixation, digital simulation surgery can be performed to reduce the operation time and fluoroscopy frequency without sacrifice of the therapeutic efficacy.
3.Surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision by small bone window craniotomy approach assisted by the deep cold light suction
Zhi LIU ; Jun HE ; Qifu REN ; Fangping LI ; Huxiang LAN ; Maoyuan TANG ; Minruo CHEN
China Modern Doctor 2015;(11):48-51
Objective To discuss the clinical results and surgical method in treatment of hypertensive intracerebral hemorrhage in basal ganglia. Methods From January 2007 to June 2013, the use of surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision assisted by the deep cold light suction in 104 cases,all the cases were done through lateral fissure-brain island approach,removing the hematoma with bipolar coagulation and hemostasis at sametime. This paper analyzed the group of patients with surgical methods and clinical efficacy. Results CT scan of intreatment group showed that there were 6 cases of secondary operation because of recurrent hemorrhage, and the hematoma-cleared rate>80% in 73 cases,50%-80% in 21 cases,<50% in 10 cases before operation within 6 hours. According to ADL classification,the 92 cases were alive after operation, good recovery in 65 cases, moderate disability in 22 cases, 5 cases of severe disability, death and give up treatment 12 cases. There was 12 cases of sec-ondary operation because of recurrent hemorrhage in control group, and the hematoma-cleared rate>80% in 16 cases,50%-80%in 23 cases,<50%in 24 cases before operation within 6 hours. According to ADL classification,the 45 cases were alive after operation in control group, good recovery in 14 cases,moderate disability in 16 cases,15 cases of se-vere disability,death and give up treatment 18 cases. There were significant differences between the two groups in op-eration time, intra-operative blood loss, the volume of blood transfusion, hematoma clearance rate, postoperative sur-vival rate and the survival quality ADL grading at half a year, and the indexes mentioned above in treatment group were better than those in control group. Conclusion Surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision by lateral fissure-brain island approach assisted by the deep cold light suction will shooter the operation time and lower the surgical injury,increase hematoma-cleared rate,it aslo has reliable hemostasis and more effective,so this method is worthy of clinical use.
4.Impact of precipitation and water level on acute schistosomiasis in Dongting Lake area
Guochu LIU ; Zhengyuan ZHAO ; Maoyuan REN ; Zongchuan LIU ; Jie ZHOU
Chinese Journal of Schistosomiasis Control 1991;0(05):-
Objective To study the impact of precipitation and water level on acute schistosomiasis for providing reference to control acute schistosomiasis in advance. Methods The historical data on precipitation and water level as well as acute schistosomiasis from 2003 to 2007 in Eastern, Southern and Western Dongting Lake regions were collected and analysed for the correlation between acute schistosomiasis and precipitation and water level in local areas. Results Acute schistosomiasis gradually decreased year by year from 2003 to 2007. Compared with 2003, the number of acute schistosomiasis in 2007 reduced by 95.37%. There was no outbreak of acute schistosomiasis from 2005 to 2007.In the period of peak acute schistosomiasis, the average monthly rainfall reduced from year to year for the successive 5 years. There was a significantly correlation between acute schistosomiasis and monthly average water level. Conclusions The acute schistosomiasis is directly affected by nature factors and has a close correlation with the rainfall and water level in Dongting Lake regions.
5.EVALUATION ON FUNCTIONING STATUS OF MODIFIED SLUICES IN DONGTING LAKE REGIONS
Chinese Journal of Schistosomiasis Control 1991;0(05):-
Objective To evaluate the fun ct ioning status and the effects of snail control in the different kinds of sluices in Dongting Lake regions. Methods Field invest igation was conducted for 85 modified sluices which aimed to preventing snails f rom spreading from 2000 to 2001 in Dongting Lake regions. The survey was used fo r the collection of data in terms of snails' situation in the irrigation canals and ditches inside the embankments where those modified sluices served as the in tervention of schistosomiasis control. The field trials of 85 sluices in 4 kinds (the abandoned, the equipped with lengtlened and lowered underwater pipes, the affiliated by snails retention tanks and the equipped with nets). were carried out to observe their effects of filtering snails, during which a g iven number of snails were cast in the front of the projects and recollected in the rear of the ones by means of the nets framed 40 holes per 25.4 mm.Results Eight sluices with the lengthened an d lowered underwater pipes were on trial for 22-28 hours and during which 2000 dyed snails was cast, yet no snails were detected in the rear. In 10 abandoned s luices, 9 were firmly sealed according to their design, and their functions of d rainage and irrigation inside embankment were replaced by other water conservanc y facilities. Up to 2003, 67 of 85 modified sluices have shown an effect on tra pping snails after 4-10 years of the running, and its effective rate arr ived at 78.8%. Conclusion Three kinds of sluices, i .e. the abandoned, the equipped with the lengthened and lowered underwater pipes , and the affiliated by snails retention tanks, show the capacity of trapping sn ail s, yet the one equipped with nets was unsuitable for application because of its difficulties in the long term maintenance. [
6.EXPERIMENTAL STUDY ON SUSCEPTIBILITY OF PRAZIQUANTEL AGAINST SCHISTOSOMA JAPONICUM IN REPEATED CHEMOTHERAPY AREAS IN DONGTING LAKE REGION
Mengzhi SHI ; Dongbao YU ; Wangyuan WEI ; Chushuang ZHANG ; Hongbin HE ; Guifen YANG ; Guangping LI ; Maoyuan REN
Chinese Journal of Schistosomiasis Control 1989;0(03):-
Objective To explore susceptibility of praziquantel(PQT) against Schistosoma japonicum in the repeated chemotherapy areas in Dongting Lake region of China. Methods Sixty mice were divided into two groups, and infected respectively by cercariae released from the infected snails which were collected from new and old endemic areas. After 5 weeks, the mice in each group were divided into control groups and treatment groups (PQT group). The mice in each PQT group were treated with a single oral dose of praziquantel (600 mg/kg). Three weeks post treatment, mice were dissected, and the number of adults, the stool eggs per gram (EPG), the liver EPG and the hatching rates were observed. Results The worm reduction rates of the PQT groups of new and old epidemic areas were 98.24% and 98.71% respectively, and the stool egg reduction rates 99.94% and 99.64%, the liver egg reduction rates 75.85% and 73.10%,and there were no significant differences between the new and old endemic areas. The stool hatching test was positive in the control groups, and negative in the PQT groups. Conclusion Susceptibility of praziquantel against Schistosoma japonicum does not decrease in repeated chemotherapy areas in Dongting Lake region.

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