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Objective To investigate the clinical values of serum amyloid A (SAA) and hypersensitivity C reactive protein(hs-CRP) in the diagnosis of postoperative infection in patients with ovarian tumor.Methods Clinical data of 679 patients with ovarian tumor were retrospectively analyzed.According to the development of postoperative infection or not,all patients were assigned into infection group(n =45) or non-infection group(n =634).The primary outcomes indicators were SAA,hs-CRP,C reactive protein(CRP) and white blood cell.Results Compared with the non-infection group,the infection group got a significantly higher levels of SAA [(104.73 ± 34.74) mg/L vs.(6.12 ±0.74) mg/L,t =25.546,P =0.000] and hs-CRP [(142.35 ± 43.84) mg/L vs.(18.45 ± 5.39) mg/L,t =24.595,P =0.000] and white blood cell [(11.48 ± 3.59) × 109/L vs.(7.49 ± 2.83) × 109/L,t =6.305,P =0.000] and CRP [(32.58 ± 10.48) mg/L vs.(16.34 ± 8.47) mg/L,t =8.496,P =0.000].The area under the Receiver Operating Characteristic of SAA,hs-CRP,white blood cell and CRP were 0.879 (95％ confidence interval:0.825 ～ 0.920,P =0.000),0.858(95％ confidence interval:0.792 ～0.925,P =0.000),0.737(95％ confidence interval:0.658 ～0.817,P =0.000) and 0.767 (95 ％ confidence interval:0.713 ～ 0.822,P =0.000).Z tests showed that the areas under the curve of SAA and hs-CRP in the diagnosis of postoperative infection in patients with ovarian tumor were higher than white blood cells and CRP(all P ＜ 0.05).Conclusion SAA and hs-CRP have better diagnostic values in the postoperative infection of ovarian tumor,and it is worth to be popularized.
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BACKGROUND:A single hemostatic material has been proved not to facilitate wound healing or to produce certain adverse reactions; while composites composed of two or three different materials can improve the advantage and histocompatibility of hemostatic materials. OBJECTIVE:To investigate the effect of gelatin sponge impregnated with hemocoagulase solution on amount of bleeding in patients with lumbar fractures undergoing posterior spinal decompression. METHODS: Fifty patients with lumbar fractures who were scheduled for open reduction, pedicle screw fixation and laminectomy were enroled, including 25 cases treated with gelatin sponge impregnated with hemocoagulase before surgical incision closure as test group and 25 cases treated with single gelatin sponge before surgical incision closure as control group. Postoperative drainage volume, drainage time, length of stay, number of re-admissions and postoperative complications were compared between the two groups. RESULTS AND CONCLUSION:The postoperative drainage volume, drainage time and length of stay in the test group were significantly less than those in the control group (P re-admission of patients was found, and there was no hemocoagulase-impregnated absorbable gelatin sponge- related adverse reaction. These findings indicate that posterior laminectomy with hemocoagulase-impregnated gelatin sponge can significantly reduce patients’ postoperative wound drainage and shorten the length of stay.
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BACKGROUND:Canada Montreal Scholar Mutch et al have recently proposed a new morphologic classification of fracture of greater tuberosity of humerus. They divided these fractures into three typeavulsion, split and depression. OBJECTIVE:To compare the recovery of shoulder function after conventional plate-screw and hol ow-screw fixation for the repair of the split fracture of greater tuberosity of humerus. METHODPatients with greater tuberosity of humerus, who were treated in the Department of Orthopedics of Yichang Yiling Hospital, China from January 2010 to January 2014, were classified according to Mutch’s classification. A total of 83 patients with split greater tuberosity of humerus after complete fol ow-up were retrospectively analyzed. Of them, 23 cases received plate-screw fixation as plate-screw group, and 60 cases received hol ow-screw fixation as hol ow-screw group. Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems were utilized to assess the therapeutic outcomes. Patient’s pain and changes in shoulder function were analyzed before and after treatment. RESULTS AND CONCLUSION:A total of 83 patients were fol owed up. Fixator was obtained at 1 year after surgery in al patients. No significant difference in Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems was detected in both groups before treatment (P>0.05). Significant differences in Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems were detectable in both groups at 16 months after removal of the fixator (P<0.05). Data were better in the hol ow-screw group than in the plate-screw group. Above results suggested that hol ow-screw fixation in the repair of split fracture of greater tuberosite of humerus is simple to be operated, with smal trauma, and is an ideal fixation method. Clinical repair effect is better than plate-screw fixation.
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BACKGROUND:Which an ideal method to treat type Rockwood Ⅲ acromioclavicular joint dislocation is,traditional or surgical therapy,is still controversial.OBJECTIVE:To investigate the clinical effect of clavicular hook plate implantation on type Rockwood Ⅲ acromioclayicular joint dislocation.METHODS:A total of 56 patients with type Rockwood Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopaedics of Yiling Hospital between December 2005 and June 2008.There were 42 males and 14 females,aged 16-65 years and mean age of 32 years.All patients were treated with clavicular hook plate implantation.Indicators including visual analogue scale (VAS),the United States shoulder and elbow surgeon score (ASES),and Constant and Murley scoring system were tested pre-operatively,one year postoperatively,before internal fixation,and 3 months after internal fixation;additionally,functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation.RESULTS AND CONCLUSION:The surgery and following-up were successfully achieved in 56 cases.The following-up lasted for 15-30 months,with the mean time of 20 months.The internal fixation was taken out at about 1 year after implantation.Coracoclavicular ligament was repaired in 32 cases but not in the 24 cases.Two patients with acromioclavicular joint dislocation recurrence were excluded,and coracoclavicular ligament therapy was not performed.Shoulder pain,foreign body sensation,and internal fixation failure occurred in two cases.One year after operation,VAS was decreased compared with that before operation,but ASES and Constant and Murley score were significantly increased (P＜0.01).At three months after internal fixation,VAS was decreased compared with that at 1 year after operation,but ASES and Constant and Murley score were increased (P＜0.05).The results demonstrated that clavicular hook plate implantation for treating type Rockwood Ⅲ acromioclavicular joint dislocation is simple and less invasive,thus it is an ideal internal fixation.