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Objective:To compare the medium-term clinical effects of arthroscopic double row repair between traumatic and degenerative medium supraspinatus tear.Methods:A retrospective study was conducted to analyze the clinical data of 23 patients who had been treated for traumatic or degenerative medium supraspinatus tear by the same arthroscopic double row repair and postoperative rehabilitation at Sports Medicine Center, The First Hospital Affiliated to Army Medical University between January 2015 and August 2020. They were assigned into 2 groups according to different tears. In the traumatic group of 8 cases of traumatic medium supraspinatus tear, there were 5 males and 3 females with an age of (46.1±4.3) years and a tear size of (1.3±1.0) cm 2. In the degenerative group of 15 cases of degenerative medium supraspinatus tear, there were 4 males and 11 females with an age of (59.9±8.1) years and a tear size of (4.1±1.1) cm 2. At preoperation and the last follow-up, the shoulder pain was evaluated by visual analogue scale (VAS), and the shoulder function by American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and Simple Shoulder Test (SST); the improvements in active range of motion (ROM) of the shoulder were recorded at the last follow-up. Results:The 2 groups were comparable because there was no significant difference between them in the general clinical data ( P>0.05). The traumatic and degenerative groups were followed up for (40.3±11.2) and (36.4±12.4) months, respectively. At the last follow-up, the improvements in range of anterior flexion and internal rotation vertebral rank in the degenerative group [55.3°±33.6° and (4.1±1.3) ranks] were significantly greater than those in the traumatic group [27.5°±22.5° and (2.3±1.9) ranks] ( P<0.05). At the last follow-up, the VAS, ASES, Constant-Murley, and SST scores in the degenerative group were improved respectively by (3.7±0.8), (40.9±14.0), (38.4±9.4), and (6.5±1.4) points compared with their preoperative values, significantly greater than those in the traumatic group [(2.3±0.7), (19.6±14.6), (19.2±7.9), and (3.8±0.7) points] ( P<0.05). Conclusion:Arthroscopic double row repair can achieve significant medium-term improvements in shoulder function for both traumatic and degenerative medium supraspinatus tears, but the improvements may be grater for the degenerative ones.
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Objective:To investigate the mid-term clinical outcomes of arthroscopic vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity.Methods:A retrospective case series study was performed on the clinical data of 11 patients with recurrent anterior shoulder dislocation combined with joint laxity admitted to the First Affiliated Hospital, Army Medical University from January 2018 to September 2021. The patients included 10 males and 1 female, aged 18-38 years [(22.8±5.5)years]. All the patients received treatment with arthroscopic vertical mattress suturing. The Oxford shoulder instability score, Rowe shoulder instability score, and simple shoulder test (SST) score were compared before operation, at 6 months after operation and at the final follow-up. The degree of joint capsule laxity and length of capsular redundancy (evaluated by MRI) were compared before operation and at the final follow-up. The results of the supine apprehension test, re-dislocation and postoperative complications such as iatrogenic vascular and nerve injuries were observed at the final follow-up. Also, the correlation between the radiological changes in the joint capsule and the shoulder function was analyzed by Spearman correlation coefficient.Results:All the patients were followed up for 20-64 months [(40.7±18.6)months]. Before operation, at 6 months after surgery and at the final follow-up, the values of Oxford shoulder instability score were (41.2±4.7)points, (49.5±3.0)points and (57.6±3.0)points; the values of Rowe shoulder instability score were (28.6±9.5)points, (77.7±7.2)points and (94.1±10.9)points; and the values of SST score were (7.6±1.3)points, (9.8±1.0)points and (11.6±0.9)points, respectively. The Oxford shoulder instability score, Rowe shoulder instability score and SST at 6 months after operation and at the final follow-up were significantly better than those before operation, and those at the final follow-up were significantly better than those at 6 months after operation (all P<0.05). The MRI showed that the degree of joint capsular laxity and length of capsular redundancy were 1.5±0.2 and (19.7±2.5)mm before operation and were 1.3±0.2 and (12.9±3.7)mm at the final follow-up, respectively ( P<0.05 or 0.01). The supine apprehension test was negative at the final follow-up, with no re-dislocation or postoperative complications such as iatrogenic vascular or nerve injuries. Correlation analysis showed a negative correlation between the degree of joint capsular laxity and the Oxford shoulder instability score ( r=-0.62, P<0.05) and that of the length of capsular redundancy with the Oxford shoulder instability score ( r=-0.80, P<0.01), the Rowe shoulder stability score ( r=-0.73, P<0.01) and the SST score ( r=-0.75, P<0.01). Conclusions:Arthroscopic vertical mattress suturing has good mid-term clinical outcome for recurrent shoulder anterior dislocation combined with joint laxity, improving the shoulder function and reducing complications, wihch is associated with decreased joint capsule laxity and length of capsular redundancy.
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Objective:To compare the mid-term clinical outcomes between traumatic stiff shoulder and frozen shoulder after arthroscopic capsule release combined with subacromial space recovery.Methods:From January 2014 to December 2019, 55 patients were treated at Sports Medicine Center, The First Affiliated Hospital, Army Medical University for limited range of shoulder motion. Of them, 22 suffered from traumatic stiff shoulder (7 males and 15 females) (group A) and 33 from frozen shoulder (10 males and 23 females) (group B). All patients were treated with arthroscopic 270° capsule release combined with subacromial space recovery. Shoulder pain was evaluated by visual analogue scale (VAS) and shoulder function by Constant score before operation and at the final follow-up. The 2 groups were compared in improvements in flexion, abduction, external rotation and internal rotation of the shoulder.Results:No significant difference was observed between the 2 groups in gender, age, course of disease, preoperative internal rotation or external rotation of the shoulder ( P>0.05). Preoperative VAS score [2.5(2.0, 3.3) points] and Constant score [(33.7±9.6) points] in group A were significantly lower than those in group B [4.0(3.0,5.5) points and (45.8±12.3) points] ( P<0.05). No complication like infection or nerve injury was found during follow-ups. All the incisions healed at the first stage. The follow-up time averaged 37.0 months (from 20 to 79 months). At the last follow-up, VAS scores [1.0(1.0, 1.0) points and 1.0(1.0, 1.0) points] and Constant scores [(87.0±3.2) points and (85.7±4.3) points] for both groups were significantly improved compared with their preoperative values [2.5(2.0,3.3)分points and 4.0(3.0,5.5) points for VAS; (33.7±9.6) points and (45.8±12.3) points for Constant score] ( P<0.05). Compared with preoperation, the improvements at the last follow-up were 99.3°±19.9° and 83.3°±27.7° in shoulder anteflexion and 102.0°±21.5° and 83.9°±32.8° in abduction for groups A and B, with greater improvements in group A; the improvements in VAS score for groups A and B were 1.0(1.0, 2.3) points and 3.0(2.0, 4.5) points, with greater improvements in group B; the improvements in Constant score were (53.3±9.5) points and (39.8±12.9) points for groups A and B, with greater improvements in group A. The above comparisons all showed a significant difference between the 2 groups ( P<0.05). Conclusions:Arthroscopic 270° capsule release combined with subacromial space recovery can lead to good mid-term clinical outcomes similar for both traumatic stiff shoulder and frozen shoulder. However, the improvements in flexion, abduction and Constant score may be greater for traumatic stiff shoulder than for frozen shoulder.
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Objective:To understand the status and tendency of coal-burning-borne endemic fluorosis after implementation of prevention and control measures in Jiangxi Province.Methods:According to the requirements of the national "Coal-burning-borne Endemic Fluorosis Monitoring Program", 3 fixed monitoring villages and 5 non-fixed monitoring villages in Luxi, Shangli were selected as monitoring sites every year from 2014 to 2018, respectively, 10 households were selected by simple random method in each village to survey the usage of stove and health behavior related to the consumption of pepper. At the same time, dental fluorosis and urinary fluoride were monitored in children aged 8 - 12 years in fixed monitoring villages.Results:There were significant differences in the utilization rate of improved stoves, the utilization rate of electric cookers and the qualified rate of improved stoves in fixed monitoring villages between each year (χ 2 = 111.70, 83.96, 36.64, P < 0.05), but there was no significant difference in the correct utilization rate of qualified improved stoves(χ 2 = 2.35, P > 0.05). There were significant differences in the utilization rate of improved stoves, the utilization rate of electric cookers, the qualified rate of improved stoves and the correct utilization rate of qualified improved stoves in non-fixed monitoring villages between each year (χ 2 = 132.32, 42.63, 50.03, 15.29, P < 0.05). There was no significant difference in pepper correct drying rates between fixed monitoring villages and non-fixed monitoring villages between each year (χ 2 = 4.068, 3.436, P > 0.05), the rate of pepper correct keeping and washing methods was 100% in monitored villages each year. From 2014 to 2018, the detection rate of dental fluorosis in children aged 8 - 12 years decreased from 17.04% (106/622) to 6.68% (90/1 347), and showed a downward trend year by year (χ 2trend = 72.60, P < 0.01). The annual geometric mean of urinary fluoride of children was 0.77, 0.74, 0.71, 0.74 and 0.72 mg/L, respectively. There was no significant difference among years ( H = 4.142, P > 0.05). Conclusion:Remarkable achievements have been made in the prevention and control of coal-burning-borne endemic fluorosis in Jiangxi Province.
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Objective:To study the iodine nutritional status of pregnant women in Jiangxi Province, and to provide basis for iodine supplementation scientifically.Methods:In 2019, 100 counties (cities, districts, referred to as counties) of 11 cities in Jiangxi Province were selected by systematic sampling. Each county was divided into five sections according to five directions: east, west, south, north and middle. One township (street) was taken in each section, and 20 pregnant women (balanced early, middle and late pregnancy) were taken from each township (street) to detect their family salt iodine and urinary iodine levels in order to compare the levels of salt iodine and urinary iodine of different cities and the distribution of urinary iodine in different stages of pregnancy.Results:A total of 10 000 edible salt samples were collected from the families of pregnant women, the median of salt iodine was 24.53 mg/kg, the consumption rate of qualified iodized salt was 97.05% (9 705/10 000), and the iodized salt coverage rate was 99.80% (9 980/10 000). There was no significant difference in the iodine content of edible salt of pregnant women in different cities ( H = 3.42, P > 0.05). A total of 10 000 urine samples were collected from pregnant women, the median of urinary iodine was 175.58 μg/L. There was a statistically significant difference in the urinary iodine content of pregnant women in different cities ( H = 28.80, P < 0.01). There was no statistically significant difference in urinary iodine distribution of pregnant women in different stages of pregnancy (χ 2 = 5.73, P > 0.05). Conclusion:The iodine nutritional status of pregnant women in Jiangxi Province is in a suitable state, but the distribution of iodine nutritional status of pregnant women in different regions is uneven, iodine nutritional status of pregnant women in key regions should be paid attention to.
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Objective To explore the surgical skill and curative effect of Scarf combined with modified Mcbride osteotomy for treating moderate to severe hallux valgus.Methods Thirty-eight patients (47 feet) with moderate to severe hallux valgus in the Southwest Hospital of Army Military Medical University from July 2014 to June 2015 were selected and treated by Scarf combined with modified Mcbride osteotomy,among them,31 cases(38 feet) were followed up.The cases of phalanx proximal articular angle(PAA) enlargement were added with Akin osteotomy hallex proximal phalanx,and 2,3 plantar Weil osteotomy was used in the patients with 2,3 plantar bone metastasis pain.The hallux valgus angle (HVA),1,2 intermetatarsal angle (IMA),distal metatarsal joint fixed angle(DMAA),PAA were compared between before and after surgery by the erect position,anteroposterior position and lateral X-ray films.The therapeutic effects were assessed by adopting the American Orthopedic Foot and Ankle Society(AOFAS) scoring system.Results The follow-up time was 12～18 months(average 16.42 months).HVA was decreased from preoperative(41.82±5.28)° to postoperative(17.03±4.04)°,IMA was decreased from preoperative(19.00 ± 3.78)°to postoperative(9.24 ± 1.98)°,DMAA was decreased from preoperative(19.42±5.65)°to postoperative(8.71±2.74)°,PAA was decreased from preoperative (5.66± 3.27) ° to postoperative (3.82 ± 2.09) °,and AOFAS score was increased from preoperative (41.47 ± 6.29) to postoperative (84.82 ± 6.43),the differences were statistically significant (P＜0.05).Conclusion Scarf combined with modified Mcbride osteotomy has satisfactory effect for treating moderate to severe hallux valgus.
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Objective To evaluate the clinical effect of treating the medial osteochondral lesions of the talus (OLTs) using the malleolar osteotomy and bone grafting with periosteum.Methods A total of 28 patients who underwent medial malleolar osteotomy,lesions debridement and bone grafting with periosteum between January 2014 and August 2015 were reviewed retrospectively.The oblique medial mal leolar osteotomy was performed to expose the talar lesion,followed by cyst debridement and bone grafting with periosteum,then the medial malleolus fracture was fixed.X-rays and MRI examination were conducted before and after the operation.MRI was used for the measurement of radiographic parameters such as the length,width and depth of the edema area.The patients were also evaluated using the American orthopaedic foot and ankle society (AOFAS)-ankle and hindfoot score questionnaires.Results Twenty-three subjects completed the follow-up over a mean period of 15 months (range,10～28 months).According to X-rays,the mean time for osseous union was 11 weeks (range,9-14 weeks).MRI results showed significant reduce in the bone marrow edema area after the operation,except for one case of fibrous cartilage higher than the surrounding articular cartilage,and two with the chondro cyst not disappearing completely.The arthroscopy of 6 patients revealed 5 good integrations with similar color and smoothness.The AOFAS ankle-hindfoot scores increased significantly after the surgery (P＜0.05).No wound pain,infection,and failure of internal fixation were observed during the follow-up period.Conclusions The combination of medial malleolar osteotomy,lesions debridement and bone grafting with periosteum can be used to treat patients with stage Ⅲ～Ⅴ OLTs,as this technique can effectively relieve pain and enhance the joint function.
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BACKGROUND: Poly-lactic glycolic acid (PLGA) is a promising cell scaffold material. However, its hydrophilicity and cellular affinity is poor, so it is necessary to modify its performance.OBJECTIVE: To explore the hydrophilic ability of the modified PLGA scaffold compounded with type Ⅰ collagen, and the cellular biocompatibility with chondrocyte of rabbit ear.METHODS: PLGA scaffold was modified with Poly-L-Lysine and compounded with type I collagen. The gross structure of scaffold was observed by inverted microscopy. The modified PLGNtype-Ⅰ collagen scaffold (experimental) and PLGA scaffold (control) were immerged in distilled water for 0.5, 1, 2, 4, 8, 12 and 24 hours. Chondrocytes were cultured by enzyme digestion method, and the second passage cells were seeded on surfaces of two scaffolds. Cell morphology was observed by phase contrast microscopy; cell attachment rate 24 hours after seeding was calculated, and the cell proliferation was determined by MTT assay at 1, 2, 4 and 6 days.RESULTS AND CONCLUSION: Modified composite scaffold exhibited high porosity and increased surface roughness compared with control group. Water uptake of two scaffolds displayed statistically significance at the same time point (P < 0.01), indicating the modification improved the hydrophilicity. The attachment rate of chondrocytes was 0.908 0+0.019 2 in modified compound scaffolds and 0.733 2±0.047 5 in control scaffold after 24 hours (P < 0.05), indicating the improved cellular affinity following modification. After 1, 2, 4 and 6 days, the absorbance between two groups was significantly different (P < 0.05), indicating the modified scaffold improved cell proliferation.
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Objective To investigate the clinical outcome of arthroscopic percutaneous cannulated screw fixation with subtalar fusion in the treatment of post-traumatic subtalar arthritis. Methods The study involved 12 patients (five males and seven females) with severe post-traumatic subtalar arthritis admitted to our hospital from April 2006 to December 2009. The patients were at age range of 28-68 years ( mean 45.6 years). All patients had the history of conservative treatment but failed in pain alleviation.Then, the percutaneous cannulated screw fixation plus subtalar fusion was selected. The ande and hind foot of all patients were evaluated preoperatively and postoperatively by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Imaging assessment was carried out by X-ray examination.Results The patients were followed up for mean 21.2 months (range 6-48 months), which showed thatthe mean AOFAS ankle-hindfoot scale was increased from (54.67 ± 5.28 ) points (range 43-61 points)preoperatively to (89.17 ±3.56) points (range 78-95 points) at final follow-up, with excellence rate of 93%. Eleven patients got good fusion with the mean time of 12.4 weeks (range 9-15 weeks). Only one patient had nonunion, with the pain in the lateral malleolus. The subtalar joint of the patient got union after plaster immobilization for three months, which was proved by X-ray examination. Conclusions The arthroscopic percutaneous cannulated screw fixation and subtalar fusion can acquire good clinical outcomes and hence is a recommended procedure for post-traumatic subtalar arthritis.
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A total of 26 patients comprising 14 with delayed fracture healing and 12 with bone nonunion were treated via subperiosteum and fractured spatial injection of osteoblasts. Bone marrow was extracted from posterior superior lilac spine to obtain osteoblasts following in vitro induction, culture and amplification. Subsequently, 5-8 mL osteoblasts at a density of 1 ×105 cells/mL was sterilely injected into subperiosteum and fractured interspace in injured region using X-ray positioning. At 4, 6, 10 and 14 weeks after injection, callus formation was checked using X-ray. All cases followed up for 3-12 months, with the means of 5.3 months. Callus was formed after 4 weeks, fractured ends were wrapped up by callus after 6 weeks, and fracture line was unclear after 10 weeks and disappeared after 14 weeks. Bone fracture was healed, with the mean healing time of 12.1 weeks, suggesting that percutaneous subperiosteum injection of osteoblasts is an effective method to treat delayed fracture healing and bone nonunion.
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Objective To describe a new technique with mini-open reconstruction of lateral ligaments of ankle with partial tendon of its peroneus brevis and evaluate its effect in treatment of chronic lateral ankle instability. Methods A total of 11 cases of chronic lateral ankle instability;at mean age of 27.6 years(16-42 years),were treated with mini-open reconstruction of the lateral ligaments of the ankle with partial tendon of its peroneus brevis.The mean delay between the initial episode of ankle sprain and the surgery was 10.3 months(4-32 months).Postoperatively,all cases were examined with MRI,stress X-rays and comparative stability of bilateral ankle inspection at clinical follow-up.The function of the ankle were evaluated bv American Orthopaedic Foot & Ankle Society (AOFAS)score and ankle-hind foot scale. Results The average duration of follow-up was 17.5 months(12-37 months).The mean AOFAS ankle-hindfoot score was 88.3 points(72-96 points)at the time of the latest follow-up,including excellent result in 6 cases(55%),good in 4(36%)and fair in 1(9%).MRI results showed that the ruptured lateral collateral ligaments of the ankle were repaired and remodeled very well in all patients.There was no recurrence of the ankle instability or other complications. Conclusion Mini-open reconstruction of the lateral ligaments of ankle with partial tendon of its peroneus brevis is safe and effective for treatment of chronic lateral ankle instability.
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Objective To raise the vigilance for pregnancy complicated with acute abdominal diseases and to reduce the maternal mortality rate. Methods A retrospective study was done. Results (1) The maternal mortality of pregnancy complicated with acute abdominal diseases was 1 31/10 5 in the period of 1989～1993, which was significantly higher than that in the period of 1994～1998 (0 71/10 5). (2) The main cause of maternal deaths was misdiagnosis and the rate of misdiagnosis was 72 7%.(3) Among the acute abdominal diseases, pregnancy complicated with pancreatitis ranked the first that accounted for 54 6%. Conclusions For the purpose of reducing the mortality rate of pregnancy complicated with acute abdominal diseases, the correct diagnosis and proper treatment especially for those with acute pancreatitis are important.
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Objective To study the correlation between serum level of antiendothelial cells auto-antibodies (AECA) and anticardiolipin antibodies (ACA) and the roles in the pathogenesis of Behcet′s disease (BD). Methods Thirty two BD patients were randomly selected from our outpatients and inpatients. Thirty-three healthy controls were studied in parallel. AECA/ACA were examined by indirect immunoflourescence technique and enzyme linked immunosorbent assay (ELISA) respectively, IgG-AECA and IgM-AECA antibodies were detected, too. Results The positivity rates of AECA, IgG-AECA and IgM-AECA in BD patients were 81.3%, 71.9% and 53.1%, respectively. Increased serum AECA levels were observed in all BD patients compared with those of normal controls. There was some significant positive correlation in the positivity rate of AECA between erythema nodosum, nodular vasculitis and rapid erythrocyte sedimentation rate. The positivity rate of ACA was 53.1%, A significant difference in the positivity rate of ACA compared with those of normal controls. Neither of these two kinds antibodies was significantly correlated with oral ulcers, clinical manifestations of skin and external genital organ, anemia or erythrocyte sedimentation rate. Conclusion The detection of AECA level is useful to identify cutaneous vasculitis and the activity of disease in BD, but the value of ACA in the diagnosis of the condition of BD needs further study. [