Case control study on clinical effects of arthroscopic treatment for stenosing tenosynovitis of radial styloid process / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect of arthroscopic treatment for stenosing tenosynovitis of radial styloid process.</p><p><b>METHODS</b>Ninety nine patients diagnosed as stenosing tenosynovitis of radial styloid process from August, 2009 to July, 2013 were divided into three groups, including arthroscopic treatment group(32 cases), traditional operation group (34 cases) and local blocking therapy group(33 cases). Ache, tenderness, swollen situations and movement degrees of wrist joints and thumbs were observed before treatment and one week and one month after treatment. Total effective rates were calculated.</p><p><b>RESULTS</b>Pain score of the wrist and thumb in activity state was lower in arthroscopic treatment group and traditional operation group than that in local blocking therapy group one week and one month after treatment(=0.044, 0.039). Local pain score was lower in arthroscopic treatment group and traditional operation group than that in local blocking therapy group one month after treatment(=0.017). The total symptom score was lower in arthroscopic treatment group and traditional operation group than that in local blocking therapy group one week and one month after treatment(=0.007, 0.015). The effective rates one week after treatment in arthroscopic treatment group, traditional operation group and local blocking therapy group were respectively 96.9%, 94.1% and 84.8%, without significant differences(=0.213). The effective rates one month after treatment in these three groups were respectively 93.8%, 97.1% and 72.7%, with significant differences(=0.006).</p><p><b>CONCLUSIONS</b>Compared with traditional operation and local blocking therapy, arthroscopic treatment has certain effects for the treatment of stenosing tenosynovitis of radial styloid process, with less operation trauma and complications, and it is worthy of clinical promotion.</p>

Effect of combination therapy with alginate dressing and mouse epidermal growth factor on epidermal stem cells in patients with refractory wounds / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The aim of this research was to determine the efficacy of combination therapy using an alginate dressing and mouse epidermal growth factor (mEGF) on proliferation and differentiation of epidermal stem cells (ESCs) in patients with refractory wounds.</p><p><b>METHODS</b>Eighteen patients (12 males and 6 females, aged from 18 to 61 years (mean 36.4 years)) with various skin wounds, were treated by dressing changing for one month. The wounds were located in the foot (11), calf (3), thigh (2) and forearm (2). The patients were randomly divided into 3 groups: alginate dressing and mEGF (group A; n = 6), mEGF (group B; n = 6) and control (group C; n = 6). Wound closure indexes were measured at 7, 14, 21 and 28 days. Samples were harvested for pathologic examination, at 7 and 14 days following treatment. Cytokeratin 10 (CK10) and cytokeratin 15 (CK15) positive cells were evaluated using the super-sensitivity (SP) immunohistochemical staining technique.</p><p><b>RESULTS</b>Wound healing was promoted in groups A and B. In group A, the wound closure index was increased significantly (P < 0.05), and in one case the maximum cure area reached 102 cm(2). Pathological examination identified a thicker epidermis, active angiogenesis and enhanced granulation in group A compared with groups B and C. Using the SP immunohistochemical staining technique, we showed that ESCs in group A were bigger in size and larger in number than in groups B and C. Overall, there was a significant difference in ESCs proliferation and differentiation between group A and group B (or C).</p><p><b>CONCLUSIONS</b>Combination therapy using an alginate dressing and mEGF shows increased proliferation and differentiation of ESCs in patients with refractory wounds compared with those treated with mEGF alone.</p>

Comparative study on treatment of midshaft tibial fracture with expandable and interlocking intramedullary nails / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the clinical results of treatment of midshaft tibial fracture with expandable intramedullary nails compared with interlocking intramedullary nails.</p><p><b>METHODS</b>From June 2003 to August 2005, 46 patients (27 males and 19 females, aged 20-74 years, mean=38.4 years) with midshaft tibial fracture were treated surgically in our department. The causes of fractures were traffic injury in 21 patients, fall injury in 6, tumbling injury in 11 and crushing injury in 8. According to AO/ASIF classification, Type A fracture was found in 16 patients, Type B in 11, Type C(1) in 5, and Type C(2) in 2. Open fractures were found in 12 patients, according to Gustilo classification, Type I in 9 patients and Type II in 3 patients. Based on the patients'consent, 24 patients were treated with expandable intramedullary nails (Group A) and 22 with interlocking intramedullary nails (Group B). The operation time, blood loss during operation, X-ray fluoroscopic times, hospitalization time, weight bearing time after operation, healing time of fracture and complications of all the patients were recorded. The clinical effects of all the cases were evaluated according to the criteria of Johner-Wruhs.</p><p><b>RESULTS</b>All the patients were followed up for 12-34 months (mean equal to 16.2 months). The time of operation, the blood loss, X-ray fluoroscopic times, hospitalization time and healing time of fracture of Group A significantly decreased (P less than 0.05) compared with those of Group B, but the time for weight bearing after operation, the Johner-Wruhs degree of clinical effects and complications had no significant difference between Group A and Group B (P larger than 0.05).</p><p><b>CONCLUSIONS</b>Expandable intramedullary nail can shorten operation time, decrease blood loss and reduce invasion, which is a safe and effective treatment method for tibial midshaft fracture.</p>