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Objective:To compare the short-term clinical effect of arthroscopic and open reduction and internal fixation with Herbert screws in treatment of Mason type II radial head fractures.Methods:A retrospective case-control study was conducted to analyze the clinical data of 38 patients with unilateral radial head fractures (Mason type II) admitted to Shanghai Zhongye Hospital from January 2017 to December 2018, including 22 males and 16 females, aged from 20 to 65 years [(37.4±12.6)years]. Twenty patients were treated by arthroscopic reduction and internal fixation with Herbert screw (Group A), and eighteen by open reduction and internal fixation with Herbert screw (Group B). The operation time and fracture healing time were recorded. The visual analogue scale (VAS), elbow flexion and extension range, forearm rotation range and Mayo elbow function score were compared between the two groups before and at 1, 3, 6, and 12 months after operation. The results of Mayo elbow performance score (MEPS) and upper limb function assessment using the disabilites of the arm, shoulder, and hand (DASH) score were compared between the two groups. Complications including screw breakage or fracture displacement were also evaluated.Results:All patients were followed up for 12-14 months [(12.3±2.3)months]. There was no significant difference in operation time between the two groups ( P>0.05). The fracture healing time was (8.9±0.6)weeks in Group A and (8.7±0.6)weeks in Group B ( P>0.05). There was no significant difference in VAS between the two groups before operation ( P>0.05). The VAS was (4.8±0.5)points at 1 month after operation in Group A, lower than (6.0±0.7)points in Group B ( P<0.05). There was no significant difference in VAS between Group A and Group B at 3, 6, and 12 months after operation ( P>0.05). There was no significant difference in elbow flexion and extension range between the two groups before operation ( P>0.05). The elbow flexion and extension range in Group A was (110.4±3.8)° and (137.1±4.0)° at 1, 3 months after operation, which was significant greater than (90.6±4.7)° and (125.1±3.5)° in Group B ( P<0.05). There was no significant difference in elbow flexion and extension range between the two groups at 6 and 12 months after operation ( P>0.05). There was no significant difference in the range of forearm rotation between the two groups before operation ( P>0.05). The range of forearm rotation in Group A was (107.1±2.8)° and (138.1±2.9)° at 1, 3 months after operation, significantly greater than (95.5±3.9)°, (121.5±3.0)° in Group B ( P<0.05). There was no significant difference in forearm rotation range between the two groups at 6 and 12 months after surgery ( P>0.05). There was no significant difference in MEPS between the two groups before operation ( P>0.05). The MEPS in Group A was (50.4±3.8)points at 1 month after operation, higher than (40.6±4.7)points in Group B ( P<0.05). There was no significant difference in MEPS between the two groups at 3, 6, and 12 months after operation ( P>0.05). There was no significant difference in DASH score between the two groups before operation ( P>0.05). The DASH score was (57.1±2.8)points at 1 month after surgery in Group A, higher than (42.5±3.9)points in Group B ( P<0.05). The DASH score was not significantly different between the two groups at 3, 6, and 12 months after operation ( P>0.05). There was no screw loosening or fracture after operation, and one patient in each group had fracture displacement ( P>0.05). Conclusion:For Mason type II radial head fractures, arthroscopic Herbert screw fixation has the advantages of less trauma, less pain and faster functional recovery of the affected limb compared with open reduction and Herbert screw fixation.
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Objective To compare the efficacy between percutaneous compression plate (PCCP) and cannulated compression screw for undisplaced femoral neck fracture among the elderly.Methods A retrospective case-control study was made on 46 elderly patients with undisplaced femoral neck fracture between August 2011 and September 2015.There were 14 males and 32 females,with the age of (76.9 ± 12.1) years (range,60-85 years).The fracture types included Garden Ⅰ in 12 patients and Garden Ⅱ in 34.These patients were divided into PCCP group (PCCP for undisplaced femoral neck fracture in 23 patients) and cannulated screw group (three cannulated compression screws for undisplaced femoral neck fracture in 23 patients),according to different surgical fixations.The following data were compared between two groups,namely,operation time,intraoperative blood loss,postoperative hemoglobin decline,postoperative length of hospital stay,postoperative partial time of weight-bearing and full weight-bearing,fracture healing time,Harris hip score (HHS) as well as postoperative complications.Results All 46 patients were followed up,with follow-up duration for (34.6± 15.3)months (range,12-60 months) in PCCP group and for (32.9 ±17.3) months (range,12-60 months) in cannulated screw group (P ＞ 0.05).There were no statistically significant difference between two groups in terms of operation time,intraoperative blood loss,postoperative hemoglobin decline,postoperative length of hospital stay,fracture healing time,and postoperative full weight-bearing time (P ＞ 0.05).The partial weight-bearing time of patients in PCCP group was earlier than that in cannulated screw group (P ＜ 0.05).The HHS of patients at postoperative 3 months in PCCP group was better than that in cannulated screw group (P ＜ 0.05),but the HHS at the final follow-up had no statistically significant difference between two groups (P ＞ 0.05).There was no statistically significant difference in the incidence of postoperative complications between PCCP group (9％) and the cannulated screw group (13％) (P ＞ 0.05).Conclusions Usage of PCCP or cannulated compression screw can obtain satisfactory clinical results for the undisplaced femoral neck fracture among the elderly.But PCCP has the advantages of earlier partial weight-bearing time and faster recovery.
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Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.
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BACKGROUND:The therapeutic regimen of intraarticular calcaneal comminuted fractures commonly selects plate and screw fixation. However, for case of posterosuperior calcaneal fracture, the weakness of achil es tendon stretch and plate screw fixation results in difficulty or maintenance of reduction. OBJECTIVE:To investigate the therapeutic effects of open reduction and internal fixation with steel screw and Steinmann pins for comminuted calcaneal intra-articular and posterosuperior fractures. METHODS:From December 2009 to December 2013, forty patients with fractures of comminuted calcaneal posterosuperior fractures were randomly divided into two groups. In the control group, patients were treated by open reduction and internal fixation by plate screw only. In the experimental group, patients were treated by open reduction and internal fixation by combination of plate screw and Steinmann pin. The Gissane and Bohler angles of the calcaneus were measured from lateral radiograph before and 4 weeks after surgery, and the MARYLAND score was assessed at the last fol ow-up. Gissane and Bohler angle and MARYLAND score were compared in each group and among different groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 9-23 months. BOHLER and GISSANE angles were significantly bigger at 4 weeks after surgery compared with pre-treatment in both groups (P<0.05). BOHLER and GISSANE angles were significantly bigger in the experimental group than in the control group at 4 weeks after surgery (P<0.05). During final fol ow-up, the average score by MARYLAND Foot Score was 78 in the experimental group and 67 in control group, with their excellent and good rate of 80%and 73%. The excellent and good rate was significantly higher in the experimental group than in the control group (P<0.05). These data indicated that open reduction and internal fixation with combination of plate screw and Steinmann pin has better efficacy in treatment of the comminuted calcaneal intra-articular and posterosuperior fractures compared with plate and screw fixation alone. Their fixation is firm. Functional exercise can be performed earlier. Postoperative recovery of function of the affected limbs is better than plate and screw fixation alone.
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Objective To investigate the safety of treatment of symptomatic middle cerebral artery stenosis with Gateway-Wingspan system by reviewing the data on complications.Methods Forty-seven patients with symptomatic middle cerebral artery stenosis treated with Wingspan system were respectively analyzed and emphasis was paid to cases with complications.Relevant data was collected such as characteristics of patients and lesions,selection of ballon and stent and radiographic information.Results Complications were found in 4 patients (8.5％),which were due to cerebral vasospasm,heperperfution syndrome,artery branch rupture and subacute stent thrombosis respectively.Two patients experienced symptomatic intracranial hemorrhage (4.3％)and one of them died (2.1％).The morbidity of severe complications was 6.4％.The success rate of stent implantation was 100％.Mean artery stenosis reduced from (83.5 ± 10.0)％ to (19.8 ± 9.2)％ after Wingspan stent implantation.Conclusion Middle cerebral artery stenting angioplsty greatly improved the stenosis with high technical success rate.However,the rates of cerebral vascular complications and symptomatic intracranial hemorrhage were relatively high in this study,which needs to be widely verified in practice.
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The study on the buds of Jasminum officinale L. var. grandiflorum was carried out to look for anti-HBV constituents. The isolation and purification were performed by HPLC and chromatography on silica gel, polyamide and Sephadex LH-20 column. The structures were elucidated on the basis of physicochemical properties and spectral analysis. Six iridoid glycosides were identified as jasgranoside B (1), 6-O-methy-catalpol (2), deacetyl asperulosidic acid (3), aucubin (4), 8-dehydroxy shanzhiside (5), and loganin (6). Jasgranoside B (1) is a new compound. Compounds 2-6 were isolated from Jasminum officinale L. var. grandiflorum for the first time.