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This was a case of 32-year-old HAN woman admitted to psychiatric hospital presenting for social withdraw,deluded ideas,unexplained runaways and suicide behaviors.She was diagnosed as schizophrenia and brought to the psychiatrist for unbearable behavior problems by her family.When admitted to hospital the patient showed significant depressive symptoms and delusions with influent speech,hypotonia,involuntary movements of distal limb and ataxia.Cognitive tests revealed multiple deficits.Consulted with the neurologist,a diagnosis of organic mental disorder was suggested.Magnetic resonance imaging showed slight widen of lateral ventricles and mild atrophy of caudate nucleus and cortex of frontal lobe.The family history was re-collected and found three family members shared the influent speech and ataxia.Then the clinical diagnose of Huntingdon Disease was made and validated with gene tests.
ABSTRACT
Objective To explore the effects of internal fixation in surgical treatment of intertrochanteric fractures by proximal femoral locking compression plate (PFLCP) and proximal femoral nail anti-rotation (PFNA) on fracture morphological fea-tures. Methods 43 patients with femoral intertrochanteric fractures were treated with PFLCP or PFNA from January 2013 to De-cember 2015. There were 23 patients treated with PFLCP and 20 cases with PFNA. There were 29 males and 14 females, the aver-age age was 62.6 years old (ranged from 46-85 years). Observed the fracture type (AO/OTA, Evans, the lateral trochanteric wall in-jury), the direction of key fracture line (lateral superior to medial inferior/medial superior to lateral inferior), preoperative days, pre-operative bone mineral density value, operation time, the volume of intraoperative blood loss, the supportive contact rate at the me-dial cortex of proximal femur after surgery, the surgical intervention rate for medial cortical fracture, postoperative partial load bearing time, full weight bearing time, complications of internal fixation and Harris scores. And analyzed the relationship between the direction of key fracture line and the internal fixation failure. SPSS13.0 software was used for statistical analysis. Results No statistical significance was found in age distribution, fracture types, preoperative days, preoperative bone mineral density value, the internal fixation failure rate (loss of fracture reduction, screw cutting or plate fracture). The operative time of PFLCP group was obviously longer than that of PFNA group and the difference was statistically significant (t=2.216, P=0.032). The intraoperative blood loss was more in PFLCP group than PFNA group and significant difference was found between the two groups(t=4.142, P=0.000).Though the initial postoperative partial load bearing time is earlier in the PFNA group than PFLCP group, but no statistical difference bewtween the two groups (t=0.833, P=0.902). Full weight bearing time had no statistical difference between the two groups. Harris scores in the PFNA group was slightly lower than in the PFLCP group, but there was no statistical difference ( t=0.833, P=0.902). The postoperative medial cortical support rate was higher in the PFLCP group than PFNA group, but no statisti-cal difference between them. The surgical intervention rate for medial cortical fracture was higher in the PFLCP group and differ-ence was statistically significant (χ2=4.768, P=0.029). No correlation had found between invalid support at medial cortex and the direction of key fracture line in all internal fixation failure cases. Distribution of the direction of key fracture line in the two groups had no statistical difference, while the relative risk ratio in terms of internal fixation failure between 2 types of the direction of key fracture line (OR=lateral superior to medial inferior/ medial superior to lateral inferior) had statistical difference (χ2=6.081, P=0.014;OR=9.600, P=0.037). Conclusion The direction of key fracture line can foresee the underlying displacement direction of intertrochanteric fractures at postsurgical load bearing, combining with restore the supportive contact at the medial cortex of the proximal femur and timing of load bearing may be determined to avoid internal fixation failure.
ABSTRACT
Objective To explore the effects of internal fixation in surgical treatment of intertrochanteric fractures by proximal femoral locking compression plate (PFLCP) and proximal femoral nail anti-rotation (PFNA) on fracture morphological fea-tures. Methods 43 patients with femoral intertrochanteric fractures were treated with PFLCP or PFNA from January 2013 to De-cember 2015. There were 23 patients treated with PFLCP and 20 cases with PFNA. There were 29 males and 14 females, the aver-age age was 62.6 years old (ranged from 46-85 years). Observed the fracture type (AO/OTA, Evans, the lateral trochanteric wall in-jury), the direction of key fracture line (lateral superior to medial inferior/medial superior to lateral inferior), preoperative days, pre-operative bone mineral density value, operation time, the volume of intraoperative blood loss, the supportive contact rate at the me-dial cortex of proximal femur after surgery, the surgical intervention rate for medial cortical fracture, postoperative partial load bearing time, full weight bearing time, complications of internal fixation and Harris scores. And analyzed the relationship between the direction of key fracture line and the internal fixation failure. SPSS13.0 software was used for statistical analysis. Results No statistical significance was found in age distribution, fracture types, preoperative days, preoperative bone mineral density value, the internal fixation failure rate (loss of fracture reduction, screw cutting or plate fracture). The operative time of PFLCP group was obviously longer than that of PFNA group and the difference was statistically significant (t=2.216, P=0.032). The intraoperative blood loss was more in PFLCP group than PFNA group and significant difference was found between the two groups(t=4.142, P=0.000).Though the initial postoperative partial load bearing time is earlier in the PFNA group than PFLCP group, but no statistical difference bewtween the two groups (t=0.833, P=0.902). Full weight bearing time had no statistical difference between the two groups. Harris scores in the PFNA group was slightly lower than in the PFLCP group, but there was no statistical difference ( t=0.833, P=0.902). The postoperative medial cortical support rate was higher in the PFLCP group than PFNA group, but no statisti-cal difference between them. The surgical intervention rate for medial cortical fracture was higher in the PFLCP group and differ-ence was statistically significant (χ2=4.768, P=0.029). No correlation had found between invalid support at medial cortex and the direction of key fracture line in all internal fixation failure cases. Distribution of the direction of key fracture line in the two groups had no statistical difference, while the relative risk ratio in terms of internal fixation failure between 2 types of the direction of key fracture line (OR=lateral superior to medial inferior/ medial superior to lateral inferior) had statistical difference (χ2=6.081, P=0.014;OR=9.600, P=0.037). Conclusion The direction of key fracture line can foresee the underlying displacement direction of intertrochanteric fractures at postsurgical load bearing, combining with restore the supportive contact at the medial cortex of the proximal femur and timing of load bearing may be determined to avoid internal fixation failure.
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Objective: To observe the influence of acupuncture at Zusanli (ST 36) and Xuanzhong (GB 39) on cerebral vasomotoricity of ischemic stroke and its possible mechanism.Methods: All the appropriate cases were randomly divided into treatment and control groups with 80 cases in each group. The routine treatment of cerebral apoplexy was given to the two groups. Zusanli (ST 36) and Xuanzhong (GB 39) were added to the treatment group. The change of velocity of blood blow of the cerebral central artery was observed by transfrontal Doppler ultrasound detecting method before and after treatment to evaluate the cerebral basomotoricity of the patients. Results: The cerebral vasomotoricity in the treatment group was greatly improved compared with pre-treatment (P＜0.05) and there was a significant difference compared with the control group (P＜0.05). Conclusion: Acupuncture at Zusanli (ST 36) and Xuanzhong (GB 39) could obviously improve the cerebral vosomotoricity of the patients with cerebral ischemic stroke, which might be one of the action mechanisms of acupuncture treatment for cerebral ischemic stroke.
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OBJECTIVE: To study the expression of angiopoietin receptor Tie-2 in the renal tissue of diabetic rats and the effects of Astragalus. METHODS: SD rats were randomly divided into normal control group, diabetes group and Astragalus-treated group. The expression of receptor Tie-2 in the renal tissue was assessed by using real-time quantitative polymerase chain reaction and immunohistochemical method. RESULTS: Glomerule Tie-2 protein expression was significantly elevated in the diabetes group as compared with the normal control group (P<0.01). Glomerule Tie-2 protein expression in the Astragalus-treated group was decreased as compared with the diabetes group (P<0.01). CONCLUSION: Tie-2 may play an important role in the pathogenesis of the early stage diabetic renal injury. The reno-protection effect of Astragalus may be mediated by down-regulating the expression of Tie-2 in the kidney tissue of diabetic rats.