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Total 786 cases of acute uncomplicated appendicitis(UCAA) were included for analysis.All the cases were given antibiotics as a main treatment.Clinical cure rate and the number of cases requiring surgery were observed.Patients with conservative treatment were followed up and the recurrence was observed.Logistic regression was applied to analyze the risk factors of recurrence.Among 786 cases,774 (98.5％) were treated conservatively and achieved clinical cure;68 cases (9.0％) had recurrence during follow-up,the median time to recurrence was 11 months (1-33 months).Logistic regression analysis showed that age(OR =1.124,95％ CI:1.067-3.790,x2 =2.767,P =0.041) and appendix bezoar (OR =1.649,95％ CI:1.281-4.055,x2 =3.935,P =0.027) were independent risk factors for recurrence.Non-operative treatment for acute uncomplicated appendicitis shows a good short and long term effects.Surgical excision may be a better choice for the patients with high risks of recurrence.
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BACKGROUND:In recent years, in-depth studies that single Chinese herbs or extracts, compound traditional Chinese medicine and medicated serum are used to regulate the directional differentiation of bone marrow mesenchymal stem cels into myofibroblasts, chondrocytes, osteoblasts, myocardial cels and nerve cels, which have become a highlight in the tissue engineering research. OBJECTIVE:To review the latest progress in the directional differentiation of bone marrow mesenchymal stem cels induced by Chinese herbs or their extracts. METHODS:The first author searched the CNKI, Wanfang and PubMed databases using the keywords of “Chinese herb, directional differentiation, mesenchymal stem cels” in Chinese and English, respectively, to retrieve relevant articles published from January 2010 to January 2016. Repetitive articles or those with no originality were eliminated. Totaly 99 articles were searched initialy, and then 43 articles were included in result analysis. RESULTS AND CONCLUSION:As the strongest seed cels in the bone differentiation system, bone marrow mesenchymal stem cels have a wide range of directional differentiation potential, and highlight the important value in combination with Chinese herbs for clinical treatment of various refractory diseases, especialy for treatment of metabolic bone diseases, bone defects, nonunion and delayed union, which is not only conducive to in-depth, multi-angle studies on effects and mechanisms of Chinese herbs, but also to clinical treatment of various refractory diseases using bone marrow mesenchymal stem cels. Cite this article:Li N, Li YF, Xie XW, Song M, Xu SH, Li DP.Directional differentiation of bone marrow mesenchymal stem cel induced by traditional Chinese Medicine. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):135-139.
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Objective To simulate the process of lag screw insertion on intact pelvises under guidance of conventional fluoroscopes or 2D and Iso-C3D computer-assisted navigations and evaluate the accuracy and practicability of the computer-assisted navigation. Methods Six dried intact adult pelvic specimens were selected and divided into three groups randomly. A total of 54 hollow screws were placed in bilateral pedicles of S1 and S2, anterior column of bilateral acetabulum, anterior column of bilateral acetabulum and pubic symphysis of intact adult dried pelvic specimens of three groups under guidance of conventional fluoroscopy, 2D and Iso-C3Dcomputer assisted navigations, respectively. The accuracy of the screw positions, the average operating time of each screw insertion and the average time of radiation exposure during the insertion of each screw were compared among three groups. Results There were significant differences in the accuracy of the screw positions, the average operating time and the average time of radiation exposure among three groups (P＜0.01). The navigation with Iso-C3D appeared to provide the highest accuracy and the shortest operating time of all guidance techniques. The mean operating time and the average time of radiation exposure of the conventional fluoroscope were the longest among three groups. The average time of radiation exposure of the 2D computer-assisted navigation was the shortest.Conclusions Iso-C3D computer-assisted navigation is the most accurate and expeditious means of all guidance techniques. The time of radiation exposure can be significantly reduced by both 2D and Iso-C3D computer-assisted navigations.
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Objective To discuss the timing and methods of operative treatment of acetabular fractures of AO Type C (double- column fractures). Methods From February, 1999 to January, 2004, we treated operatively 46 cases of AO Type C acetabular fractures, including 23 cases of C- 1 type, 14 cases of C- 2 type, and 9 cases of C- 3 type. 15 cases were treated through ilioinguinal approach, 10 cases through improved Kocher- Langenbeck approach, and 21 cases through combined anterior and posterior approaches. There were 3 groups of patients according to the time from injury to operation: 15 cases got operation within 1st week after injury (Group A); 23 cases within 2nd week (Group B); 8 cases within/after 3rd week (Group C). All of them were checked with radiography and 3D CT scan before and after operation. Results 34 cases( 73.9% ) obtained anatomical reduction, 8 cases( 17.4% ) got imperfect reduction, and 4 cases( 8.7% ) had unsatisfactory reduction. All the patients were followed up for 1 year to 4 years, averaging 31 months. According to D' Aubigne and Postel Hip Score, joint function was rated as excellent in 32 cases( 69.6% ) , good in 5 cases( 10.9% ) , fair in 5 cases ( 10.9% ) and poor in 4 cases ( 8.7% ) . As far as reduction was concerned, there was a significant difference (P0.05). As far as joint function was concerned, there was a significant amelioration in Groups A and B compared with Group C (P0.05) between group A and Group B. Conclusions Good knowledge of AO classification of acetabular fractures combined with particular radiological data can result in correct diagnosis of Type C acetabular fractures. Operations should be carried out within 2 weeks after injury and efforts should be made to ensure anatomical reduction. To achieve good clinical results in treatment of Type C acetabular fractures, suitable approaches and correct reduction and internal methods are essential