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Objective:To evaluate the efficacy and safety of acupuncture-moxibustion in the treatment of cerebral palsy-related speech impairment.Methods:A systematic literature search of 7 electronic databases was conducted between January 7,2000 and January 12,2021 to find randomized controlled trials(RCTs)examining the benefits of acupuncture-moxibustion combined with rehabilitation training to cerebral palsy-induced speech impairment.The included trials'quality was assessed using the Cochrane Reviewers'Handbook as a guide,and statistical analysis was carried out using the RevMan 5.3 software.Results:A total of 17 RCTs with 1238 subjects were finally recruited and analyzed.When acupuncture-moxibustion was combined with rehabilitation training,the results showed a considerable improvement in speech impairment compared with the rehabilitation training alone.The most commonly used points for the treatment of speech disorders are Baihui(GV20),Speech Area,Zhisanzhen[Shenting(GV24)and bilateral Benshen(GB13)],Niesanzhen[2 Cun above the ear tip as the first point,with 1.0 Cun anterior and posterior to the current point as the second and third points],and Sishenzhen[1.5 Cun anterior,posterior,and bilateral to Baihui(GV20)].Conclusion:Acupuncture-moxibustion has a stronger effect on children's development of receptive and expressive language,as well as the developmental quotient.Acupuncture-moxibustion in combination with rehabilitation training is not only more successful than the control treatment,but also safer and more dependable.Baihui(GV20),Speech Area,Zhisanzhen,Niesanzhen,and Sishenzhen are the most widely used points for speech impediment.
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Objective To investigate the clinical application and effect of autogenous costal car-tilage in rhinoplasty repair surgery .Methods From July 2015 to June 2018 ,112 cosmetic patients were treated with costal cartilage nasal tip prosthesis in the Department of Cosmetic Surgery ,Shang-hai Yixing Medical and Beauty Hospital .By using the straight part of the ribs ,the nasal columella was made with mortise groove and then septal expanded graft prepared by using two pieces of expanded grafts .The cap-like ,shield-like cartilage and perichondrium were combined for completing nasal tip prosthesis .Results A total of 112 patients were treated after rhinoplasty repair surgery .After 6-24 months of follow-up ,100 (accounting for 89 .3％ ) cosmetic seekers were satisfied with the shape of the nasal tip ,5 (accounting for 4 .5％ ) of those patients were not being satisfied due to unexpected na-sal tip point ,3 (accounting for 2 .7％ ) surgical infection cases after rhinoplasty and underwent pros-thesis removal ,2 (accounting for 1 .8％ ) had slight deviation of nasal tip and 2 had partial necrosis of nasal septum mucosa .No pneumothorax or chest wall deformities were found .Conclusions Rib carti-lage is an excellent material for nasal tip formation in rhinoplasty .The use of autogenous costal carti-lage to repair aesthetic defects in the lower nose can achieve a more effective ,safe and lasting effect .
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Objective To observe and discuss the application and clinical effect of different forms of ear cartilage in nasal tip plasty.Methods Auricular cartilage was used to prune it as "halberd" shape at first,and then the extended transplantation and the cartilage fornix reconstruction were carried out by using single or combined septum cartilage.Meanwhile,nasal tip plasty was performed by using "cap shape" or "shield shape" cartilage grafting.Results 136 patients were followed up for 6 to 24 months after operation.119 cases were satisfied,accounting for 87.5％,of which 11 cases (ear cartilage weakness) were not improved obviously,accounting for 8％.However,there were only 6 cases with the unsatisfactory feedback as the nasal tip that was decreased by 1～2 mm one year after the operation,accounting for 4.41％.Conclusions The auricular cartilage is pruned as "halberd" shape singly or combined with septal cartilage as an extended graft,reconstructing the cartilage fornix in the meantime,which is the way better than the traditional way of making nasal tip plasty to obtain the ideal nasal tip protrusion.
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s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.
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Objective To investigate the effect of treating tibial plateau fractures involving the posterior column via anterolateral approach.To discuss its merit and demerit,indications and contraindications.Methods From Jan 2012 to Jan 2015,37 patients with closed tibial plateau fractures involving the posterior column were treated by 3.5mm proximal tibial plate with narrow plate head through standard anterolateral approach.The group included 25 males and 12 females,aged from 23 to 65 years old (average 44.6 years old).During the treatment and follow-up period,the curative effect was evaluated by using Rasmussen's radiological grading for early radiological outcomes and HSS grading,Lysholm grading,Lachman test and Pivot-shift testfor clinical examination at the 1 year follow-up.Results The average time for the operation was 98 min (range,55-170 min).1 year follow-up was completed in 37 patients.The average fracture union time and full weight bearing were 10.6 weeks (range,8-16 weeks) and 11.2 weeks (range,8-20 weeks) respectively without reduction loss.No statistical difference was found in either the tibial plateau angle (TPA) or posterior slope angle (PA) when comparing the results at instant,3rd month,6th month and 12 month.The mean score of the Rasmussen' s radiological grading was 15.6(range,12-18) and the mean score of the HSS grading was 88.6 (range,80-100).The average range of motion of the knee joint was 128.6°(range,110°-150°).The mean score of the Lysholm grading was 91.6±3.9. The Lachman test and the Pivot-shift test were negtive.Conclusion Treating tibial plateau fractures involving the posterior column by 3.5 mm proximal tibial plate with narrow plate head through standard anterolateral approach is an effective method.The protocol is simple and safe,the approach is familiar by most clinicians.Good reduction and fixation,earlier functional exercise can be achieved easily.The knee function recovered well and earlier curative effect was satisfied.
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Objective To investigate the morphological properties of posterior Monteggia lesion with associated elbow dislocation,to propose its injury mechanism,and to present its surgical methods and its outcomes.Methods The injury mechanism,radiographs and surgical records of patients with posterior Monteggia fractures and associated elbow dislocation were retrospectively reviewed from January 2011 to December 2013.11 patients were included,with 43.3 years old on average.10 were resulted from high-energy injuries.According to the Jupiter classification,Ⅱ A fracture-dislocation 9 cases,Ⅱ B fracture-dislocation 1 case and Ⅱ C fracture-dislocation 1 case.The general medical data,morphological properties,and the surgical methods.Functional outcomes were followed up.Results These cases had several intrinsic morphologic features:fractures of the coronoid tip and its anteromedial aspect;dislocation of the olecranon from the trochlear notch;fracture of the radial head and disruption of the lateral collateral ligament;a normal proximal radioulnar joint.Operation was carried out with emphasis on elbow stability restoration.All patients underwent the primary operations in the supine position and a routine posterior approach was used.An additional anterior approach was used in 1 case (Ⅱ B).The coronoid tip was first fixed,followed by the anteromedial coronoid fragment,the radial head,the olecranon,and then the LCL.An anatomic olecranon plate was used as the fundamental fixation device.Anteromedial coronoid fractures were mostly fixed with a T-shaped metacarpal plate.The coronoid tip fractures were fixed with screw,Kwire or suture,and the injured LCL was repaired with suture anchors.Ten of the 11 patients were followed up with a mean period of 22.7 months.The extension-flexion motion ranged from 45°-140° (104° average),and the pronation-supination motion ranged from 45° 180° (128° average).According to the Broberg and Morrey functional index,the excellent to good ratio was 70％.Conclusion Patients with posterior Monteggia fracture and associated ulnohumeral dislocation have small and comminuted coronoid fractures,and mostly have a normal PRUJ relationship.It might experience a different mechanism to those of the posterior Monteggia fracture without elbow dislocation.Emphases should be address to restore the rotation stability of the elbow when operation.
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Background Retinal microglia (RMG) plays an important role in the pathogenesis of retinal degenerative diseases,while chemokine CX3CL1 participates in the regulation of steady-state of microglia.It has been determined that bone marrow-derived mesenchymal stem cells (BMSCs) have a remarkable role to modulate the immune response and protect the central nervous system through the release of soluble factors in a paracrine fashion and further affect the functional behavior of cells.However,whether BMSCs are able to interact with RMG and activate related signaling pathway for the maintaining of homeostasis in the retina is still unclear.Objective The aim of this study was to investigate the interaction between BMSCs and lipopolysaccharide (LPS)-activated RMG in vitro,and dissect the effects of CX3CL1/CX3CR1 signaling pathway on the biological behavior of BMSCs and RMG.Methods RMG was isolated from SD rats,cultured with mixed culture of retinal glial cells and purified by shaking.The cells were identified by detecting the expression of CD111b,Iba1 and glutamamine synthetase (GS) with indirect immunofluorescence assay.LPS (1 mg/ml,2 μl) was added in the medium for 24 hours to stimulate RMG,and then the cells were divided into LPS control group,BMSCs group (cocultured with BMSCs for 24 hours) and CB-BMSCs group (cocultured with CX3CL1-blocking-BMSCs for 24 hours).The cells without LPS stimulation served as the blank control group.The functions of RMG,including the release content of tumor necrosis factor-α (TNF-α) and interleukin-1 β (IL-1β),the proliferation,phagocytosis,and migration of RMG were examined.Results RMG was successfully isolated and harvested from SD rats by using mixed culture of retinal glial cells and purified by shaking.CD11b and Iba1 showed the positive expression with the green fluorescence in the cells and GS was absent.The contents of TNF-αt in the cell supernatant were (2.55 ±0.97) ng/ml,(24.91 ±3.07) ng/ml,(20.38 ±2.97) ng/ml and (24.90 ± 1.88) ng/ml in the blank control group,LPS control group,BMSCs group and CB-BMSCs group,respectively,showing a significant difference among the groups (F=119.90,P＜0.05).The contents of IL-1 β in the cell supernatant were (1.12±0.36) ng/ml,(10.40±2.76) ng/ml,(7.00± 1.75) ng/ml and (9.55 ± 1.11) ng/ml in the blank control group,LPS control group,BMSCs group and CB-BMSCs group,respectively,showing a significant difference among the groups(F =34.96,P＜0.05).The secretory volume of TNF-α and IL-1 β were evidently lower in the BMSCs group than those in the LPS control group (both at P＜0.05),and no significant differences were found in the secretory volume of TNF-α and IL-1β between CB-BMSCs group and LPS control group (both at P＞0.05).The proliferative rate of RMG was lower in the BMSCs group than that in the LPS control group (P＜0.05),while there was no statistical difference between BMSCs group and CB-BMSCs group (P＞0.05).The mean fluorescence intensity (MFI) and the number of migrated RMG were considerably different among the four groups (F=70.55,15.49,both at P＜0.05),and those in the BMSCs group were significantly increased in comparison with the LPS control group (both at P＜0.05),while there was no significant difference between CB-BMSCs group and LPS control group (both at P＞0.05).Conclusions BMSCs could suppress the proliferation of LPS-activated RMG.Moreover,BMSCs might inhibit proinflammatory cytokines releasing,enhance phagocytosis and migration capabilities of RMG via CX3CL1/CX3CR1 signaling pathway.
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Objective To evaluate the frequency and morphological characteristics of the posterolateral articular fracture in tibial plateau fractures.Methods A retrospective analysis of CT images and clinical data was taken among 309 cases of tibial plateau fractures from 2008 May to 2013 January.There are total 264 patients were recorded excluding 45 cases with which the CT image is missing or not compatible with the medical Picture Archiving and Communication Systems (PACS).To determine the occurrence rate of the posterolateral articular fracture in tibial plateau fractures and measure morphological parameters such as the axial angle of fracture line,articular surface area,sagittal fracture angle,fracture height,and amount of displacement.Results 39 cases of posterolateral articular fragments were found in 264 cases of tibial plateau fractures with the 14.8％ incidence (39/264).There were 18 males and 21 females,aged from 31-70 years (mean,52 years).17 left cases and 22 right cases.The mechanism of injury were traffic accident in 22 patients,blow by a heavy object in 2 patients,a fall in 11 patients,and other causes (unknown) in 4 patients.The posterolateral plateau articular fracture fragment has morphological characteristics of a conical shape fragment and the major articular fragment angle was 22° (range,-43°-62°),and an average accounted for 14.1％ of the articular surface of the total tibial plateau (range,8％-32％).The posterolateral fragment exhibits a vertical fracture pattern and an average sagittal fracture angle was 76° (range,58°-97°),suggestive of shear instability and vertical displacement.Maximum posterior cortical height was 28 mm (range,18-42 mm),and average size of the displacement was 10.48 mm (range,2-19 mm).Conclusion The posterolateral plateau articular fracture fragment has morphological characteristics of a conical shape fragment,relative small articular surface area and sagittal fracture angle.
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Objective To investigate the value of external fixator in the treatment of posttraumatic elbow stiffness.Methods From January 2007 to December 2009,25 patients with posttraumatic elbow stiffness received surgical arthrolysis with assistance of external fixator.There were 10 patients with grade 1 stiffness,12 patients with grade 2 stiffness and three patients with grade 3 stiffness.The range of motion (ROM) was 0°-75° ( average 33.4°) preoperative,with ＜ 30° in 12 patients.For the patients with grade 1 stiffness,intraoperative distraction with an external fixator rather than open arthrolysis was performed ; for the patients with grade 2 stiffness,the heterotopic ossification was removed through a limited approach before the external fixator was applied; for the patients with grade 3 stiffness,additional osteotomy and internal fixation before arthrolysis were performed.After operation,there was a rehabilitation phase,followed by mobilization of the elbow joint under protection of the external fixator for a mean period of six weeks.Results The intraoperative mean ROM was 105.6°,which was significantly improved than that before operation (P ＜0.05).The maximal flexion degree was above 110°in all patients.No instability occurred.Two patients were excluded from the follow-up:one had ulna fracture two weeks after operation due to an incorrect placement of the pin,and additional internal fixation was then carried out;another patient had numbness in the ulna side when flexed the elbow after arthrolysis,and the ulna nerve transposition was performed through another operation.Other patients were followed up for a mean period of six months.At the latest follow-up,the mean ROM was 97.4°( range,70°-130°),significantly improved than that before operation (P ＜ 0.05 ),and lest 8.2°on average (0°-15 °) compared with the intraoperative ROM (P ＞ O.05).The maximal flexion in all patients was above 100° Conclusion With the advantages of minimal invasive or noninvasive,indirect capsular traction,stability maintenance during the movement,and prevention of the motion loss during the rehabilitation,arthrolysis of the elbow joint with the use of external fixation frame can be a good alternative in the treatment of posttraumatic elbow stiffness.
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Objective To explore the surgical treatment strategy for tibial pilon fractures.Methods Forty-seven patients with tibial pilon fractures surgically treated in our hospital from May 2005 to March 2008 were retrospectively studied. There were 37 males and ten females, at mean age of 42 years (range 23-46 years). There were 51 sides of tibial pilon fractures, for four patients were with bilateral tibial pilon fractures. Injury causes included traffic accidents in 34 patients, fall from height in 12 and bruise by heavy objects in five. Open fractures were determined in seven patients and close fractures in 44 patients. According to Ruedi-Allgower classification, there were six sides of type Ⅰ fractures, 28 type Ⅱ fractures and 17 type Ⅲ fractures. According to Tscherna-Grotzen tissue injuries classification,open fractures were determined as 1° in two patients, 2° in three and 3° in two; close injuries were defined as 0° in two patients, 1° in 27 and 2° in 15. Distal tibia was partitioned as anterolateral column,anteromedial column and posterior column in order to select reasonable internal fixation. Eighteen fractures were treated with DePuy T plate, 10 with AO cloverleaf pattern plate, two with AO small T plate,two with locking plate, four with Link anterolateral anatomic plates and 15 with Orthofix overtake-anklejoint outside-fixed frame combined with limited internal fixation. Results The patients were followed up for a mean time of 23 months (range 12-44 months). According to Mazur ankle evaluation grading system, 29 patients were graded as excellent, 13 good, seven fair and two poor, with an excellence rate of 82.4%. Conclusions Correct operation time and treatment plans on the basis of Ruedi-Allgower classification and Tscherne-Gotzen classifications of soft tissues and reasonable internal fixation according to the condition of the involved three column in distal tibia can decrease postoperative complications and achieve good and satisfactory clinical effect.
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Objective To compare the clinical results of percutaneous compression plating (PCCP)and Trigen short reconstruction intramedullary nail for intertrochanteric hip fractures. Methods During 2005 and 2008, the patients suffered with AO/OTA Al and A2 intertrochanteric hip fractures were divided into two groups; 36 fractures were treated with PCCP and 48 fractures with Trigen short reconstruction nail.During an average of (16.3±3.2) months follow-up, clinical evaluation involved visual analogue scale(VAS)score for pain in the 1st week, the 1st month, the 3rd month, the 6th month and the 12th month, and a Harris hip score one year post operation. Radiographs were examined for fracture healing-time, displacement scale of the neck screws and fracture impaction scale. All the complication in both groups was recorded. Results There were no difference in blood loss and operation time in both groups. The postoperative pain was significantly lower in the PCCP group in the initial three months after the surgery. Larger scale of fracture impaction and screw telescoping were seen in PCCP group. Also shorter healing time, higher Harris score results were achieved in PCCP group than those of Trigen short reconstruction nail group. Four peri-implant fractures occurred in Trigen short reconstruction nail group, which included one in the greater trochanter and three in the femoral shaft, but only one case need revision for bone displacement. In PCCP group, it was found that the superior neck screw was slightly displaced for tendency to cut-out in one patient. Conclusion Both PCCP and Trigen short reconstruction intramedullary nail can be successfully used to treat Al and A2 intertrochanteric hip fractures with minimal invasive technique. And the PCCP showed more rapid pain relief and bone healing, easily bony reduction and fewer complications.
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<p><b>OBJECTIVE</b>To introduce an operation for fingertip reconstruction.</p><p><b>METHODS</b>The vascularity of the reverse dorsal island flap is augmented by performing an arteriovenous anastomosis between the dorsal vein in the flap and a digital artery at the fingertip. The flap was used in ten patients for reconstruction of their fingertip defects.</p><p><b>RESULTS</b>All the ten flaps survived and the appearance was good.</p><p><b>CONCLUSION</b>The method is easy except for the necessity of performing standard microvascular surgery. The flap is a good option for repairing fingertip defects.</p>
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Adult , Female , Humans , Male , Fingers , General Surgery , Microsurgery , Methods , Surgical FlapsABSTRACT
Objective To study ADFR with statin programmed therapy of osteoporosis in ovariectomized rats.Methods Fifty female rats were randomly allocated into 2 groups:sham operation (S, n =10) and OVX ( n =40) group.After operation for one month,OVX were randomly allocated into 4 groups (each n =10):OVX,statins (T),bisphosphonates (B) and statins+bisphosphonates+calcium+vitamin D (ADFR).After feeding statins or bisphosphonates or ADFR for 100 days,all rats were sacrificed.The effects of T or B or ADFR on bone histomorphology or osteocalcin in sera or deoxypyridoxine in urea were studied.Results The data showed that osteocalcin and deoxypyridine in OVX group were significantly improved compared with S group ( P 0 05) ,in B group was decreased,and in ADFR group was increased compared with OVX group.The histomorphometric date showed that TOS,MOSW,STS/DTS,TBOS,TBSC and iMAR in OVX were significantly increased,and TBV,MLT and ? in OVX were decreased,compared with S group.TBV in B,T and ADFR groups was larger than that in OVX group.TOS,MOSW,TBOS and TBCS in B group were smaller than those in OVX group,? in B group was longer than that in OVX group,TBCS and ? in T group were increased compared with OVX group.Conclusion Statins promote bone turnover,increase osteoblast activity and osteoid production,and reduce the bone construction.Bisphosphonates inhibit bone absorption,while ADFR acelerate bone formation and reduce bone loss,suggesting that polytherapy is preferable to monotherapy.