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Objective To explore the efficacy of two treatment methods for thoracic tuberculosis.Methods According to the different surgical methods,61 patients with thoracic tuberculosis were randomly divided into A group (31 cases) and B group (30 cases).A group was treated with simple thoracic tuberculosis soft tissue lesions removed,and B group was treated with focus removal + rib resection + muscle flap packing.The operation time,pain time,extubation time,hospital stay,wound fluid,cure rate and recurrence rate were compared between the two groups.Results The operation time,pain time,hospital stay time of A group were shorter than those of B group [(35.0 ± 11.0)minvs.(50.0 ±9.5)min,(1.8±1.3)d vs.(4.2 ±2.4)d,(12.5 ±3.4)d vs.(18.8 ±5.7)d],the differences were statistically significant (t =6.257,4.275,5.334,all P ＜ 0.05).There were no statistically significant differences in the extubation time,wound effusion,cure rate and recurrence rate between the two groups [(5.8 ± 3.1) d vs.(5.5 ± 2.8) d,2 cases vs.1 case,100.0％ vs.100.0％,6.4％ vs.3.3％,t =8.691,x2 =9.867,13.674,15.871,all P ＞ 0.05].Conclusion Analysis of the specific situation should be individualized on the chest wall tuberculosis,in the case of rib destruction,the focus should be removed + rib resection + muscle flap packing,if there is no rib destruction,simple chest wall tuberculosis soft tissue lesions removal is more safe,because it is less traumatic for patients.
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<p><b>OBJECTIVE</b>To study the mechanism of protective effect of Jinqiaomai (JQM) on lung injury induced by Klebsiella pneumonia in rats.</p><p><b>METHOD</b>The model of rats with Klebsiella pneumonia was established. The male SD rats were randomly divided into control group, model group, JQM (6, 3, 1.5 g x kg(-1)) three groups, levofloxacin (25 mg x kg(-1)) group, JQM (3 g x kg(-1)) + levofloxacin (25 mg x kg(-1)) group. The contents of IL-1beta, ICAM-1 and INF-gamma in the lung tissue homogenate were measured by radio-immunoassay and Elisa. TLR2/4 mRNA and MyD88 mRNA expression were detected by RT-PCR. IkappaB-alpha expression was detected by Western Blot.</p><p><b>RESULT</b>The rats of model group had obvious lung injury, but those of JQM, JQM + levofloxacin and levofloxacin groups had less injury. The contents of IL-1beta, ICAM-1 and INF-gamma in lung tissue homogenate and the expressions of TLR2/4 mRNA, MyD88 mRNA and IkappaB-alpha in lung of model group were significantly higher than those in the control group (P < 0.05 or P < 0.01), while IL-1beta, ICAM-1 and INF-gamma of JQM groups were significantly lower than those of model group (P < 0.05 or P < 0.01). The expressions of TLR2/4 mRNA, MyD88 mRNA and IkappaB-alpha of JQM (6.3 g x kg(-1)) groups were significantly lower than those of model group(P <0. 05 or P <0. 01).</p><p><b>CONCLUSION</b>The lung injury induced by Klebsiella pneumonia is related to TLR2/4, MyD88 mRNA and IkappaB-alpha. To decrease the excessive expression of TLR2/4, MyD88 mRNA and IkappaB-alpha might be the main mechanism of protective effect of Jinqiaomai on lung injury.</p>
Subject(s)
Animals , Humans , Male , Rats , Disease Models, Animal , Drugs, Chinese Herbal , Gene Expression , I-kappa B Proteins , Genetics , Metabolism , Klebsiella Infections , Drug Therapy , Genetics , Metabolism , Microbiology , Klebsiella pneumoniae , Physiology , Lung , Metabolism , Microbiology , Myeloid Differentiation Factor 88 , Genetics , Metabolism , NF-KappaB Inhibitor alpha , Random Allocation , Rats, Sprague-Dawley , Toll-Like Receptor 2 , Genetics , Metabolism , Toll-Like Receptor 4 , Genetics , MetabolismABSTRACT
@#ObjectiveTo compare the effect and prognosis of two kinds of internal fixation (improved Giebel blade plate and traditional straddle nail) after high tibial osteotomy (HTO) on osteoarthritis of knee with genu varus deformity. Methods37 knees of 32 cases were treated with straddle nail (25 knees) or Giebel blade plate (12 knees). All the cases were followed up for 6～28 months. ResultsThe clinical bone healing time of osteotomy was 8～12 weeks. There was no significant differences between 2 groups in the increased score in HSS Standard and in the clinical bone healing time. ConclusionBoth internal fixation with improved Giebel blade plate and traditional straddle nail get similarly satisfactory prognosis, while the former shows more advantages to allow early functional exercises.
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Objective To explore the feasibility of the small figure-L unilateral transternal incision for the treatment of anterior mediastinal tumor and cyst.Methods Eighteen patients with anterior mediastinal tumor or cyst were enrolled in the study.Under general anesthenia,after a 8to 10 cm middle skin incision was made,a unilateral figure-L partial sternotomy on the side occupied by the tumors was made in the third or forth intercostals space,taking into account the tumors size and location.Tumors were resected with excellent exposure.Results All but one tumors were completely resected during the operation.In 3 cases,tumors encroached on the adjacent lung tissue,and lung tissue was partially resected.In 2cases,tumors invaded the pericardium,and the pericardium was partially removed.Mean operating time was 120 minutes(80~140 minutes).The mean time of hospital stay was 10 days after the operation,and there was no complications.All patients were alive with a mean follow-up period of 24months(8~36 months).Conclusions The figure-L unilateral sternotomy is an effective and useful minimally invisive approach for anterior mediastinal tumors.
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Objective To explore a reasonable treatment for intertrochanteric hip fractures in the aged patients by comparing the fixation effects of cannulated compression screws and intramedullary fixation nails. Methods From January 1998 to December 2004, in our department 123 old patients with intertrochanteric hip fracture were fixed with cannulated compression screws or intramedullary nails. They were followed up and their complete clinic data kept. According to the Evans classification, of the 51 patients who received treatment with cannulated compression screws for their anterograde intertrochanteric hip fracture, 14 were type Ⅰ , 24 type Ⅱ , 10 type Ⅲ and three type Ⅳ , while of the 72 patients who received treatment with intramedullary nailing, 10 were type Ⅰ , 12 type Ⅱ , 28 type Ⅲ , 14 type Ⅵ , and eight retrograde intertrochanteric hip fractures. A retrospective comparison was made between the old patients treated with the two different fixation devices in terms of operative time, blood loss, transfusion, average hospitalization time, intraoperative and postoperative complications, functional recovery one year postoperatively and treatment expenses. Results The differences between the two groups in operative time, blood loss, transfusion, treatment expenses were of statistical significance (P0.05). Conclusions Cannulated compression screws should be chosen for old patients with anterograde intertrochanteric hip fractures of Evans types Ⅰ & Ⅱ or of Evans types Ⅲ & Ⅳ who are at a high risk, in a poor health or severely osteoporotic state. For patients with unstable Evans types Ⅲ & Ⅳ or with retrograde intertrochanteric hip fractures, intramedullary nails are suitable.