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Objective To propose time-effect standards and standard treatment measures for battlefield extremity injuries.Methods By conducting retrospective analysis of battlefield extremity injuries in the militariy in different countries using literature retrieval and comparative analysis,time-effect standards and standard technical measures of battlefield extremity injuries were outlined.Results In wars of conventional weapons,extremity injuries are the most prevalent.Such treatment should give top priority to the timing of rescue and be implemented in conjunction with the injury classification.Conclusion Time-effect standards and standard treatment measures for battlefield extremity injuries are proposed to strengthen the time-effect treatment capacity of battlefield extremity injuries.
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<p><b>OBJECTIVE</b>To study the clinical efficacy of double bundle posterior cruciate ligament (PCL) reconstruction with remnant preservation.</p><p><b>METHODS</b>From January 2007 to November 2011, 50 patients with PCL rupture met the inclusion criteria were divided into two groups: remnant preservation group (RP group) and remnant resection group (RR group). There were 19 males and 7 females in the RP group, ranging in age from 18 to 55 years, with a mean of (32.250 +/- 11.085) years old. The duration from injury to operation ranged from 2 to 66 months, with an average of (17.481 +/- 3.568) months. Among the RR group, 17 patients were male and 7 patients were female, ranging in age from 20 to 54 years old, with an average of (31.458 +/- 9.569) years. The duration from injury to operation ranged from 3 to 72 months, with a mean of (19.354 +/- 3.950) months. The patients in both groups suffered from instability of knee joint, got a positive result of posterior drawer test. In the RP group, the intercondylar notch remnant fiber, scar tissue and synovial were preserved in operation, only the free ligament in the intercondylar notch was resected. In the RR group, the remnant fiber, scar tissue and synovial tissue of adhesive parts were resected. In both groups, autologous semitendinosus and gracilis tendon double-bundle PCL reconstruction were carried out, the tibia was fixed with an absorbable interference screw with post-tie fixation, and the femur side was compositely fixed with absorbable interference screws and suspending fixation. Each patient received both subjective assessment (IKDC subjective evaluation, Lysholm scoring and Cincinnati rating) and objective clinical assessment (IKDC objective evaluation and Kneelax 3 tibia backward measurement) before operation and two years after operation.</p><p><b>RESULTS</b>IKDC subjective evaluation: 92.167 +/- 4.177 in the RP group,which was higher than 87.542 +/- 5.687 in the RR group (P = 0.010). Lysholm scores: 90.917 +/- 4.413 in the RP group, which was higher than 87.083 +/- 5.149 in the RR group (P = 0.027). Cincinnati knee scores: 92.125 +/- 4.003 in the RP group, which was higher than 87.791 +/- 6.665 in the RR group (P = 0.027). IKDC objective evaluation:no significant statistical differences between RP group and RR group. Kneelax 3 assessment : tibia backward test with Kneelax 3 under 132 N showed no significant statistical difference between RP group and RR group, which were (3.958 +/- 0.693) mm and (4.029 +/- 0.846) mm respectively (P = 0.795).</p><p><b>CONCLUSION</b>The study shows a significant advantage of remnant fiber preservation than remnant fiber resection in double-bundle PCL construction in terms of subjective knee function recovery after operation. There is no significant difference in postoperative knee stability.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Arthroscopy , Case-Control Studies , Knee Joint , General Surgery , Posterior Cruciate Ligament , General Surgery , Plastic Surgery Procedures , MethodsABSTRACT
@#ObjectiveFollow-up of the clinical outcome of prosthetic disc nucleus replacement on patients with lumbar intervertebral disc herniation. Methods16 patients with lumar intervertebral disc herniation were implanted prosthetic disc nucleus from June to August 2003, including 10 males and 6 females. The operation levels were at L4-5 in 10 patients and L5～S1 in 6 patients. All patients were followed up from 28 to 32 months (averaged 30 months). The contents include pain, physical examination, Short-form of McGill Pain Questionnaire investigation, Visual Analogue Scales(VAS) and Present Pain Intensity(PPI), X-ray and MRI examination, etc. ResultsAfter surgery, 16 patients experienced clinical symptom relief, the displacement of PDN in 1 case and dislocation in 1case, the height of intervertebral space becoming narrower in 5 cases and endplate subsiding in 1 case. ConclusionProsthetic disc nucleus replacement acquired satisfactory after operation, but some complication may occurre in long-term.
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@#ObjectiveTo investigate the gene expression changes in normal and degeneration lumbar intervertebral disc in humans, providing information for clinical. MethodsThe PCR products of 4096 human genes were spotted onto a kind of chemical-material-coated-glass slides. The total RNAs were isolated from the tissues. Both the mRNAs from the degeneration and normal lumbar intervertebral disc in humans were reversely transcribed to the cDNAs, which used as the hybridization probes with the incorporations of fluorescent dUTP. The mixed probes were then hybridized to the cDNA microarray. After high-stringent washing, the cDNA microarray was scanned for the fluorescent signals and analyzed with computer image analysis. ResultsAmong the 4096 targets, there were 706 genes whose expression levels differed between the degeneration and normal lumbar intervertebral disc in all cases, comprising 298 up-regulated and 358 down-regulated ones. ConclusionDNA microarray technology is an effective technique in screening for differently expressed genes between the degeneration and normal lumbar intervertebral disc. Cell apoptosis plays an important role in the process of lumbar intervertebral disc degeneration.