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Objective:To compare the clinical efficacy between hand plating system (HPS) and classic suture anchor fixation in the treatment of patellar inferior pole fractures.Methods:The clinical data were analyzed retrospectively of the 56 patients who had been treated for patellar inferior pole fractures at Department of Orthopaedics, General Hospital of Northern Theatre Command from January 2018 to December 2019. They were assigned into 2 groups according to their internal fixation methods. In group A of 30 cases subjected to HPS fixation, there were 18 males and 12 females with an age of (61.7±11.3) years; in group B of 26 cases subjected to suture anchor fixation, there were 16 males and 10 females with an age of (60.0±10.5) years. The incision length, operation time, intraoperative bleeding, fracture union time, pain visual analog scale (VAS)and knee function one year postoperation, and follow-up complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability( P>0.05). The operation time in group A [(59.4±10.8) min] was significantly shorter than that in group B [(66.5±12.3) min] ( P<0.05). There was no significant difference in the incision length or intraoperative bleeding between the 2 groups ( P>0.05). The bone union time was respectively(11.2±1.8) weeks and (12.1±2.4) weeks and the postoperative VAS respectively 0.85±0.12 and 0.91±0.14 for groups A and B, showing no significant difference between the 2 groups ( P>0.05). The knee flexion angle (124.5°±14.6°) and knee Bostman score (29.3±3.5) in group A were significantly better than those in group B (113.2°±11.1° and 26.2±2.9) one year postoperation( P<0.05). Follow-up revealed no complication in group A but 2 cases of implant failure in group B. Conclusion:Compared with the classical anchor suture fixation, HPS may obtain stronger fixation, shorter operation time and better knee function.
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Background Coal workers are inclined to report multi-site work-related musculoskeletal disorders (WMSDs) due to their specific working environment and extensive exposure to occupational hazards, which seriously affect the physical and mental health of coal workers. objective To investigate the prevalence of multi-site WMSDs among workers in coal mining enterprises in Xinjiang, and analyze the related factors influencing multi-site WMSDs. Methods Using stratified cluster random sampling method, Musculoskeletal Disorders Questionnaire, Job Burnout Questionnaire, and Brief Occupational Stress Questionnaire were distributed in six Xinjiang coal mining enterprises to collect data on general information, prevalence of WMSDs in the past year, work-related information, job burnout, and occupational stress among coal miners with a working experience ≥ 1 year. A multiple logistic regression model was used to analyze the influencing factors of multi-site WMSDs. Results A total of 1730 questionnaires were distributed in this survey, 1448 valid questionnaires were recovered, and the valid recovery rate was 83.7%. Among the 1448 coal miners, 93.2% were males and 6.8% were females; 39.2% were aged ≤ 35 years, 31.1% were aged 35-45 years, and 29.6% were aged > 45 years; 58.4% reported ≤ 10 years of working experience, 20.0% reported 10-20 years, and 21.6% reported > 20 years. The total prevalence rate of WMSDs in the coal miners was 75.6% (1095/1448), the prevalence rate of multi-site WMSDs was 58.4% (846/1448), and the prevalence rate of one-site WMSDs was 17.2% (249/1448). The results of multiple logistic regression analysis showed that working experience > 20 years (OR=2.245, 95%CI: 1.655-3.045), severe burnout (OR=2.644, 95%CI: 1.549-4.516), and multiple repetitive operations per minute very often (OR=2.038, 95%CI: 1.339-3.101), often bending at larger angles (OR=1.467, 95%CI: 1.111-1.938), long-time bending the neck forward (OR=1.671, 95%CI: 1.294-2.159), and slipping or falling down (OR=2.459, 95%CI: 1.908-3.168) were positively correlated with multi-site WMSDs; sufficient rest time (OR=0.718, 95%CI: 0.565-0.913) was negatively correlated with multi-site WMSDs. Conclusion Multi-site WMSDs is common among workers in coal mining enterprises, and the prevalence rate of multi-site WMSDs is higher than that of one-site WMSDs. Working experience, job burnout, frequent multiple repetitive operations per minute, often bending at larger angles, long-time bending the neck forward, slipping or falling down, and sufficient rest time are influencing factors of multi-site WMSDs in coal workers.
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Nowadays,more and more studies on mini-invasive treatment of clavicle fractures have been reported.Firstly,based on the newly published literature about intramedullary fixation for midshaft clavicle fractures,this paper reviews its indications and advantages.Next,the design characteristics,surgical procedures,therapeutic effects and latest treatment advances concerning the intramedullary implants are systemically demonstrated and compared.Intramedullary fixation can be used in most midshaft clavicle fractures except those with neurovascular lesions or with comminuted segments,or obsolete ones.The commonly used intramedullary implants include Kirschner wires,cannulated screws,titanium elastic nails,threaded nails,and second-generation intramedullary nails.Intramedullary fixation has potential advantages of a smaller incision,fewer complications,a lower refracture risk and faster bone healing but also limitations in strength and stability.However,more and more intramedullary implants,from cannulated screws to second-generation intramedullary nails,have been used in clinic,leading to fine therapeutic effects.New products are being developed to overcome the previous shortcomings.
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Objective To investigate the effect of X-ray fluoroscopy and CT guided technique in sacroiliac screw fixation for type Tile B or C sacrum pelvic fractures or dislocations.Methods A retrospective case control study was conducted to analyze the clinical data of 103 patients with type Tile B or C posterior pelvic ring fracture or dislocation admitted to the General Hospital from Northern Theater of PLA from January 2007 to December 2017.There were 58 males and 45 females,aged 28-69 years,with an average age of 43.8 years.Among the patients,84 had normal sacrums while 19 had dysmorphic sacrums.The accuracy and placement time of two kinds of sacroiliac screw were compared by X-ray fluoroscopy(46 patients with normal sacroiliac screw placement and 11 with dysmorphic sacroiliac screw placement)or CT guidance(66 patients with normal sacroiliac screw placement and 18 with dysmorphic sacroiliac screw placement)were compared.Matta standard was used evaluate the imagelogical healing and clinical prognosis 9 months after operation.Results In normal sacrum group,there was no statistical difference in placement accuracy between X-ray fluoroscopy [89％(41/46)] and CT guided technique [94％(62/66)](P＞0.05).In dysmorphic sacrum group,the placement accuracy of CT guided technique [89％(17/18)] was significantly higher than that of X-ray fluoroscopy [55％(6/11)](P＜0.05).The screw placement time of X-ray fluoroscopy [(39.1±4.9)minutes] was significantly shorter than that of CT guided technique(54.7±3.8)minutes for normal sacrums(P＜0.05),and there was no significant difference in terms of placement time by CT guided technique for dysmorphic sacrums(P＞ 0.05).Nine months after operation,in normal sacrum group,the X-ray fluoroscopy had the excellent rate of 74％(34/46),good rate of 26％(12/46)for healing and the excellent rate of 83％(38/46),good rate of 17％(8/46)for clinical prognosis,showing no significant difference from those of CT guided technique [83％(55/66),17％(11/66); 92％(61/66),8％(5/66)](P＞0.05).In dysmorphic sacrum group 9 months after operation,the excellent and good rate of X-ray fluoroscopy [excellent 9％(1/11),good 64％(7/11)] was significantly lower than that of CT guided technique in terms of imageological healing [excellent 56％(10/18),good 39％(7/18)](P＜0.05),while no signtficant difference was found in terms of clinical prognosis [excellent 55％(6/11),good 36％(4/11)vs excellent 78％(14/18),good 22％(4/18)](P＞0.05).Conclusions X-ray fluoroscopy for the fixation of type Tile B or C posterior ring fractures or dislocations of the normal sacrum takes much shorter time,although the comparable effect with CT guidance in aspects of placement accuracy and bone healing rate.For the dysmorphic sacrum,CT guidance allows more accurate screw placement and has better healing rate than X-ray fluoroscopy.
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Objective@#To investigate the effect of X-ray fluoroscopy and CT guided technique in sacroiliac screw fixation for type Tile B or C sacrum pelvic fractures or dislocations.@*Methods@#A retrospective case control study was conducted to analyze the clinical data of 103 patients with type Tile B or C posterior pelvic ring fracture or dislocation admitted to the General Hospital from Northern Theater of PLA from January 2007 to December 2017. There were 58 males and 45 females, aged 28-69 years, with an average age of 43.8 years. Among the patients, 84 had normal sacrums while 19 had dysmorphic sacrums. The accuracy and placement time of two kinds of sacroiliac screw were compared by X-ray fluoroscopy (46 patients with normal sacroiliac screw placement and 11 with dysmorphic sacroiliac screw placement) or CT guidance (66 patients with normal sacroiliac screw placement and 18 with dysmorphic sacroiliac screw placement) were compared. Matta standard was used to evaluate the imageological healing and clinical prognosis 9 months after operation.@*Results@#In normal sacrum group, there was no statistical difference in placement accuracy between X-ray fluoroscopy [89%(41/46)] and CT guided technique [94%(62/66)](P>0.05). In dysmorphic sacrum group, the placement accuracy of CT guided technique [89%(17/18)] was significantly higher than that of X-ray fluoroscopy [55%(6/11)] (P<0.05). The screw placement time of X-ray fluoroscopy [(39.1±4.9)minutes] was significantly shorter than that of CT guided technique (54.7±3.8)minutes for normal sacrums (P<0.05), and there was no significant difference in terms of placement time by CT guided technique for dysmorphic sacrums (P>0.05). Nine months after operation, in normal sacrum group, the X-ray fluoroscopy had the excellent rate of 74% (34/46), good rate of 26% (12/46) for healing and the excellent rate of 83% (38/46), good rate of 17% (8/46) for clinical prognosis, showing no significant difference from those of CT guided technique [83%(55/66), 17%(11/66); 92%(61/66), 8%(5/66)] (P>0.05). In dysmorphic sacrum group 9 months after operation, the excellent and good rate of X-ray fluoroscopy [excellent 9%(1/11), good 64%(7/11)] was significantly lower than that of CT guided technique in terms of imageological healing [excellent 56%(10/18), good 39%(7/18)](P<0.05), while no significant difference was found in terms of clinical prognosis [excellent 55%(6/11), good 36%(4/11) vs. excellent 78%(14/18), good 22%(4/18)](P>0.05).@*Conclusions@#X-ray fluoroscopy for the fixation of type Tile B or C posterior ring fractures or dislocations of the normal sacrum takes much shorter time, although the comparable effect with CT guidance in aspects of placement accuracy and bone healing rate. For the dysmorphic sacrum, CT guidance allows more accurate screw placement and has better healing rate than X-ray fluoroscopy.
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Objective:To investigate the effect of concentrated growth factor (CGF) on proliferation and differentiation in Beagle adipose-derived stem cells (ADSCs).Methods:ADSCs were isolated from adipose tissue of healthy Beagles and cultured.The multidirectional differentiation potential of ADSCs was identified.The ADSCs were assigned to a CGF group and a control group.The rate of proliferation was analyzed by CCK-8 assay.The osteogenic differentiation capability was detected by ALP staining after the osteoinduction.Bone formationrelated gene expression was detected by RT-PCR.Results:CGF promoted the proliferation of ADSCs in vitro.ADSCs in the CGF group showed higher level of ALP activity than that in the control group (P＜0.05).CGF stimulated the expression of the genes associated with osteogenesis,such as Col-I and Runx2.Conclusion:CGF can promote the proliferation and osteogenic differentiation in ADSCs in vitro.
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Objective@#To investigate the diagnosis and management of laryngeal cleft.@*Method@#The clinical data of 13 cases of laryngeal cleft treated between 2007 and 2015 was analyzed retrospectively.@*Results@#The children with laryngeal cleft were classified according to the classification of Benjamin-Inglis, as type Ⅰ(11 cases), typeⅡ(1 case) and type Ⅲ(1 case). All patients were confirmed by microlaryngobronchoscopy under general anaesthetic. Eleven typeⅠ and 1 type Ⅱ clefts were managed conservatively, with which all type Ⅰ patients were successfully managed, while the type Ⅱ patient was resolved by surgical endoscopy. The type Ⅲ patient was treated by open repair but the results was poor.@*Conclusions@#Patients who suffered with choking on feeding or recurrent aspiration pneumonia, especially coexisted with other congenital malformation, needed detailed evaluation for laryngeal cleft, although which was a rare congenital abnormality. Electronic laryngoscope could be the first step to screen the cleft, while microlaryngobronchoscopy is the gold standard for diagnosis of laryngeal cleft. The majority of children with lower type clefts can be managed conservatively. Surgical endoscopy has high success rate when strictly following the indication. Type Ⅲ and Ⅳ clefts have high mortality for usually combining with severe complications and abnormalities.
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Objective@#To analyze the causes and management plan of pediatric spontaneous tonsillar haemorrhage(STH).@*Methods@#According to the criteria of STH difined by Griffies, patients with STH from December 2013 to January 2016 were included in this retrospective study.@*Results@#A total of 11 patients were reviewed. The etiological diagnosis included 3 pediatric Epstein-Barr virus associated infectious mononucleosis(EBV-IM), 3 suspected pediatric EBV-IM to 3 acute suppurative tonsillitis, 1 acute viral tonsillitis and 1 hemophilia A. The management strategies included antiviral, antibacteria, transfusion, surgical examination followed with bipolar coagulation hemostasis under general anesthesia. No patient treated with tosillectomy.@*Conclusions@#STH is now a rare condition, the causes of which in child are more or less different from adult.This emergency can be treated in time if a detailed management plan for pediatric STH is formulated.
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BACKGROUND:Open fractures often present soft-tissue defects, high-risk infection, and fracture with bone defect, often lead to more postoperative complication, defect of limb function, and bring great difficulties to clinical treatment. There is some controversy in the treatment of such fracture. Relevant animal experiment and clinical study become the hotspot in recent years. OBJECTIVE:To review some controversy about open fracture treatment and latest research. METHODS:A computer-based online search of China National Knowledge Infrastructure database and PubMed was performed for articles published from January 2005 to January 2015. Key words included “Open fracture, Evaluation and prognosis of injury, Antibiotics, Debirdement, Treatment of fracture, Wound repair”. More than 100 literatures were retrieved, and 47 articles met the inclusion criteria. RESULTS AND CONCLUSION:After a large number of animal experiments and clinical application, open fracture debridement, prevention of infection, implant selection and evaluation of prognosis had been deeply studied, especialy the study of implant treatment of bone defects. Metal three-dimensional printer has changed the traditional concept of implant. Nano titanium dioxide /PEEK bioactive composite materials have become a hot research in recent years.
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OBJECTIVE@#To explore the clinical manifestations in pediatric laryngopharyngeal reflux and to provide more information on diagnosis and treatment.@*METHOD@#Sixty-two cases with recurrent respiratory infections, hoarseness and chronic cough were examined with reflux symptom index (RSI), reflux finding score (RFS), and 24-hour pH monitoring. Those who had at least two positive test for reflux were given PPI for diagnostic therapy.@*RESULT@#All patients completed reflux symptom index (RSI) questionnaire and underwent fiberoptic laryngoscopy, and reflux finding score (RFS) was evaluated. The positive rate of RSI and RFS was 91.94% and 79.03% differently. 24-hours pH monitoring and diagnostic therapy was about 30.76% and 85.48% differently. The symptoms show hoarseness 90.32%, postnasal drip 77.42%, difficulty swallowing 74.19%, abdominal pain and chest pain 72.58%, throat clearing 64.52%, chronic cough 56.45%, dysphagia 51.61%, throat abnormal feeling 48.39%. Laryngoscope examination shows inter-arytenoid erythema 100%, vocal mucosal oedema 75.81%, diffuse laryngeal edema 50.00%, posterior commissure hypertrophy 33.87%, subglottic edema 4.84%, no granuloma case. There was 16 cases showing positive in 24-hours pH monitoring test. The positive rate was 30.76%. All cases accepted diagnostic therapy. Fifty-three cases were effective. The positive rate was 85.48%.@*CONCLUSION@#There are no clinical presentations specific to pediatric laryngopharyngeal reflux. Patients often present with a wide range of atypical symptoms and signs. RSI questionnaire and RFS may provide diagnostic datas. Primary treatment includes lifestyle and medical therapy.
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Laryngopharyngeal Reflux , Diagnosis , Pathology , TherapeuticsABSTRACT
Objective To evaluate the efficacy of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery.Methods A retrospective concurrent comparative study included 60 patients with vaginal recurrence after surgery in early stage cervical cancer.30 cases of the experimental group were treated with intensity-modulated radiotherapy (IMRT),and 30 cases of the control group were treated with conventional radiotherapy.The efficacy and complications between two groups were compared after 3 treatment cycles.Results Of 30 patients in experimental group,22 patients achieved complete remission,7 had partial and 1 progressed.But in the control group,14 had complete remission,5 reached partial remission,7 were stable and 4 progressed.The effective rates were 96.67 ％ (29/30) and 63.33 ％ (19/30),respectively,in the experimental and control group,which showed statistical significance (P =0.009).In the experimental group,there were 1 case with grade 1 radiation cystitis and 1 case with grade 1 radiation proctitis.In the control group,there were 3 cases of vaginal-rectal fistula,1 case of grade 3 radiation proctitis,2 cases of grade 2 radiation cystitis and 2 cases of grade 1 radiation proctitis.Conclusions IMRT for treating vaginal recurrence of early cervical cancer achieves satisfactory short-term effect.In comparison with conventional radiotherapy,IMRT has higher efficacy but less side effects.
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Epidemiology studies have demonstrated inconsistent associations between type 2 diabetes mellitus and the risk of malignant melanoma. To this end, the aim was to perform a meta-analysis of cohort studies. Medline, PubMed, Embase and the Cochrane Library were searched up to February 2014. Cohort studies addressing the relative risk of type 2 diabetes mellitus on malignant melanoma were included in this meta-analysis. The Newcastle-Ottawa Scale was applied for quality evaluation. The pooled relative risks with the corresponding 95% confidence intervals [95% CIs] were calculated by using random-effects or random-effects model. Heterogeneity and publication bias were evaluated by I[2] and funnel plot analysis, respectively. Data was analyzed using STATA 11.0. A total of 9 independent cohorts from 8 manuscripts were entered this meta-analysis. Type 2 diabetes mellitus was slightly associated with an increased risk of malignant melanoma, and the pooled relative risk was 1.15 [95% CI, 1.00-1.32] in diabetes compared with non-diabetes with significant evidence of heterogeneity among these studies [P=0.016, I[2] =57.6%]. For the studies adjusted for age, gender and obesity, the relative risks were 1.21[95% CI, 1.03-1.42], 1.17 [95% CI, 1.01-1.35] and 1.11 [95% CI, 1.00-1.24], respectively. For the population-based studies in which case cohort established, the relative risk was 1.85 [95% CI, 1.31-2.62]. Type 2 diabetes might be an independent risk factor for malignant melanoma. Further studies are needed to specifically test the effect, and fully elucidate the underlying pathophysiologic mechanisms