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Objective To investigate the principles and effects of cancellous bone wrapping grafting for treatment of segmental defects of long bone.Methods From January 2008 to December 2015,50 patients with segmental long bone defect were treated by various wrapping grafting with rich autogenous cancellous bone.They were 31 males and 19 females,aged from 13 to 69 years (average,34.6 years).The cancellous bone was wrapped by titanium mesh in 8 cases,by wire mesh in 10,by line binding in 13,and by induced membrane in 19.The bone defect was located at tibia in 22 cases,at radius in 10,at humerus in 8,at ulna in 7 and at femur in 3.The length of bone defect ranged from 3 to 9 cm,averaging 5.9 em.Bone healing,complications and functionary recovery of adjacent joint were recorded.The bone defect healing and functionary recovery of adjacent joint were evaluated according to the Paley criteria.Results The incisions healed by the first intention in 48 cases and by the second in 2.All were followed up for 12 to 48 months (average,19.1 months).All the bone defects healed by the first intention but one treated by induced membrane wrapping which was healed 15 months later by the secondary grafting due to nonunion at ends.The total clinical healing time ranged from 3 to 16 months (average,6.1 months).The last follow-ups showed that all the affected limbs resumed weight-bearing activities.The healing of bone defects was graded as excellent in all but one in the group of induced membrane wrapping.Totally,the functionary recovery of adjacent joint was excellent in 18,good in 22,fair in 7 and poor in 3 cases (an excellent and good rate of 80.0％).Conclusions Cancellous bone wrapping grafting can avoid or significantly reduce loosening and absorption of cancellous bone graft after traditional bone grafting.Although it is effective for treatment of large segmental bone defect,its methods should vary according to the specific conditions of the patient.
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Objective To investigate the principles and effects of cancellous bone wrapping grafting for treatment of segmental defects of long bone.Methods From January 2008 to December 2015,50 patients with segmental long bone defect were treated by various wrapping grafting with rich autogenous cancellous bone.They were 31 males and 19 females,aged from 13 to 69 years (average,34.6 years).The cancellous bone was wrapped by titanium mesh in 8 cases,by wire mesh in 10,by line binding in 13,and by induced membrane in 19.The bone defect was located at tibia in 22 cases,at radius in 10,at humerus in 8,at ulna in 7 and at femur in 3.The length of bone defect ranged from 3 to 9 cm,averaging 5.9 em.Bone healing,complications and functionary recovery of adjacent joint were recorded.The bone defect healing and functionary recovery of adjacent joint were evaluated according to the Paley criteria.Results The incisions healed by the first intention in 48 cases and by the second in 2.All were followed up for 12 to 48 months (average,19.1 months).All the bone defects healed by the first intention but one treated by induced membrane wrapping which was healed 15 months later by the secondary grafting due to nonunion at ends.The total clinical healing time ranged from 3 to 16 months (average,6.1 months).The last follow-ups showed that all the affected limbs resumed weight-bearing activities.The healing of bone defects was graded as excellent in all but one in the group of induced membrane wrapping.Totally,the functionary recovery of adjacent joint was excellent in 18,good in 22,fair in 7 and poor in 3 cases (an excellent and good rate of 80.0％).Conclusions Cancellous bone wrapping grafting can avoid or significantly reduce loosening and absorption of cancellous bone graft after traditional bone grafting.Although it is effective for treatment of large segmental bone defect,its methods should vary according to the specific conditions of the patient.
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Objective To investigate the correlation between the level change of serum homocysteine (HCY) and vascular endothelial growth factor (VEGF) with the degree of the coronary artery stenosis in the patients with acute coronary syndrome (ACS) .Methods A total of 157 ACS patients were divided into the ST‐elevation myocardial infarction (STEMI) group ,non‐ST el‐evation myocardial infarction (NSTEMI) group and unstable angina pectoris(UA) group based on the symptoms ,cardiac enzymes level and electrocardiogram changes .The cases were induded into the mild ,moderate and severe stenosis lesion groups according to the coronary arteriography examination;meanwhile the enzyme‐linked immunosorbent assay (ELISA) was used to detect the change of the serum VEGF concentration .The HCY level was determined by enzymatic cycling methods with the biochemical analyzer (BXC800 ,Beckman ,USA) .The differences in the concentrations of VEGF and HCY compared among different groups .Results The VEGF level had statistical differences among the mild ,moderate and sever stenosis groups(F=39 .9 ,P=0 .00) ,and between the UA group with the NSTEMI group and STEMI group(F=123 .3 ,P=0 .00) .The HCY level had statistically significant differ‐ence between the severe stenosis group with the mild and moderate stenosis groups (F=39 .7 ,P=0 .00);the HCY level had statis‐tically significant difference among the UA group ,NSTEMI group and STEMI group(F=102 .65 ,P=0 .00) .The VEGF and HCY levels in the mild stenosis group ,different degrees of coronary stenosis groups and different clinical diagnosis groups were positively correlated with the Gensini scores(r=0 .723 ,0 .716) .Conclusion The serum VEGF and HCY levels are correlated with the degree of the coronary artery lesion and myocardial necrosis in ACS patients ,furthermore are related with the Gensini scores .
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Objective To discuss the surgical techniques and results of internal fixation supplemented with soft tissue repair of triad injury of the elbow via the combined anterior-lateral approach.Methods A retrospective analysis was done on 15 patients with triad injury of the elbow treated from January 2011 to August 2014.There were 10 males and 5 females,aged 38.4 years (range,20-61 years).Injury resulted from traffic accidents in nine patients,high-level falls in three and groundlevel falls in three.Radial head fractures were Mason type Ⅰ in five patients,type Ⅱ in eight,and type Ⅲ in two.Fractures of the coronoid process of the ulna were Regan-Morrey type Ⅰ in four patients,type Ⅱ in ten and type Ⅲ in one.Time interval between injury and operation was 8.5 d.All patients were firstly operated on through the anterior approach to have Herbert screw fixation or anterior capsule suture lasso fixation of the coronoid fracture as well as Herbert screw fixation of the radial head fracture.And then,elbow lateral incision was made to repair lateral collateral ligament complex and common extensor tendon by 2-0 Ethibon suture.Elbow flexion-extension,forearm pronation-supination and Mayo elbow performance score (MEPS) were used to evaluate the clinical elbow functions.Complications were recorded after operation.Results All patients were followed up for mean 19.6 months (range,12-30 months).All coronoid fractures healed.Radial head fractures in 14 patients healed.Comparison of preoperative to final follow-up variables presented significant differences in elbow flexion-extension [(45.1 ± 5.6) °:(129.5 ± 9.3) °],forearm pronation-supination [(55.4 ±.8.7) °:(140.5 ± 10.3) °] and MEPS [(25.1 ± 9.6) points:(91.2 ± 5.2) points] (P ＜ 0.01).Complications included heterotopic ossification in one patient and nonunion of radial head fracture in one patient.No neurovascular injury of the elbow,elbow residual instability,dislocation,elbow stiffness and active pain occurred.Conclusion Combined anterior-lateral approach with internal fixation and soft tissue repair is a simple and safe method that effectively restore the elbow joint function.
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This paper introduces the history of Ilizarov technology,led to the design and application of Bone Lengthening Growth Diary,and describes the specific application effect.On this basis,to think about Bone Lengthe-ning Growth Diary’ clincial application:constantly improve the nurses’ professional level; follow the basic princi-ples of medical ethics;strengthen the doctor-patient communication and humanstic care.
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Objective To evaluate the safety of new-generation of antidepressants and amitriptyline in the treatment of depression in patients with coronary heart disease (CHD). Methods A total of 194 patients with first-episode depression with CHD were divided into amitriptyline group(n=40), venlafaxine group(n=40), mirtazapine group(n=48)and escitalo?pram group(n=66). The blood routine test, liver function, blood lipids and blood glucose (GLU) were monitored after treat?ment for six weeks, and which were compared before and after treatment. Results The levels of white blood cells (WBC) and neutrophil count (NE) were significantly lower in amitriptyline group after 6-week treatment (P<0.05), but the levels of acid alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (T-CHO) and GLU were significant?ly increased after treatment than those before treatment (P<0.05). The levels of WBC, NE and GLU were significantly de?creased in venlafaxine group after 6-week treatment (P<0.05). The levels of ALT, AST, low density lipoprotein (LDL) were significantly increased in mirtazapine group after six-week treatment (P<0.05). In escitalopram group, the level of three ac?yl glycerin (TG) was significantly increased after six-week treatment than before treatment ( P<0.05). There was a signifi?cant difference in AST change after treatment between venlafaxine group and mirtazapine group (P<0.05). There was a sig?nificant decrease in WBC in amitriptyline group than that of mirtazapine group after six-week treatment ( P<0.05). There was a significant decrease in NE in amitriptyline group than that of mirtazapine group and escitalopram group ( P<0.05). The increase level of AST was significant higher in amitriptyline group than that of venlafaxine group (P < 0.05). Conclusion Three different kinds of new-generation of antidepressants have fewer influence in routine blood test, liver function, blood lipids and blood glucose than those of amitriptyline in the treatment of depression in patients with CHD.
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Objective To explore the application and effects of bone lengthening growth diary in self management of patients after lower limb lengthening. Methods A total of 54 cases applying lower limb lengthening were divided into the experimental group (n=28) and the control group (n=26) with random digit table. The basic treatment was consistent, the control group was given routine guidance, the experi-mental group implemented self- management with bone lengthening growth diary. Self- recognition of disease was assessed and compared between the two groups 12 weeks after operation. Self- efficacy and self- manage ment were assessed and compared between the two groups 2 and 12 weeks after operation. Results The self- recognition of disease in the observation group was better than that of the control group, for patients with higher self- recognition degree (21 cases vs. 10 cases), χ2=8.64, P<0.05, the difference was significantly different. The total scores of self- efficacy and self- management in the observation group were higher than those of the control group,(48. 42±3.43) vs.(34.14±4.13),t=11.750, P<0.01;(55.35±2.69) vs.(42.15±3.67), t=15.130, P<0.01, the difference was significantly different. Conclusions Bone lengthening growth diary plays a beneficial role on self-management of patients with lower limb lengthening.
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Objective To investigate the effect of hosphocreatine therapy on the plasma cardiotrophin-1(CT-1) and N terminal probrain natriuretic (NT-proBNP) in elderly hypertensive patients with heart failure. Methods A total of 76 hy-pertensive patients with heart failure, aged 65 or over, were randomly divided into treatment group and control group (n=38 for each group). The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 2 weeks. The plasma levels of CT-1 and NT-proBNP were determined in two groups. The plasma CT-1 level was measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The plasma level of NT-proBNP was tested by Rui Pu fluorescent dry quantitative analyzer. Results The plasma levels of CT-1 and NT-proBNP were significantly lower after treatment in two groups (P＜0.01). The plasma levels of CT-1 and NT-proBNP were significantly decreased in treatment group than those in control group (P＜0.05). The total effective rate was 89.47%in treatment group, which was significantly higher than that of control group (71.05%, P＜0.05). Symptoms of heart failure improved in one week (21 cases in treatment group/9 cases in control group) and in two weeks (13 cases in treatment group/18 cases in control group). Conclusion The conventional therapy plus creatine phosphate sodium can decrease the plasma CT-1 and NT-proBNP levels in elderly hypertensive patients with heart failure, which improves symptoms of heart failure in a shorter period of time.
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Objective To investigate the clinical effects,feasibility,points for attention and complications of treating distal radial fractures through minimally invasive palmar locking plate.Methods A total of 22 patients with distal radial fractures managed by minimally invasive palmar locking plate from August 2009 to August 2010 were enrolled in the study.According to AO classification,there were five patients with type A2 fractures,three with type A3,four with type B1,seven with type B3,two with type C1 and one with type C2.Two vertical or parallel palmar incisions of 2 cm long were performed.The distal transverse incision was along the proximal wrist crease,while the distal and proximal vertical incisions were close to the radial side of flexor carpi radialis.Then,palmar locking plate was inserted through deep pronator quadratus.Results Follow-up period was 10-18 months(mean,12 months).According to Dienst function evaluation criteria,the results were excellent in 13 patients,good in six,fair in three and poor in zero,with excellence rate of 86％.Complications were as follows:one patient had delayed healing of proximal wrist crease incision;one patient had numbness of thenar eminence and the symptom was disappeared three months postoperatively;two patients remained pain on ulnar side of the wrist joint;two patients had limited function of the wrist joint.Conclusions Minimally invasive palmar locking plate is safe,mini-invasive and reliable when treating distal radial fractures,which is conducive to early functional exercise.Furthermore,the method achieves satisfactory appearance of the incision which meets the minimal invasion and thus deserves clinical practice.