Prognostic analysis of plantar fasciitis treated by pneumatic ballistic extracorporeal shock wave versus ultrasound guided intervention / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the medium- and long-term effect of pneumatic ballistic extracorporeal shock wave versus ultrasound-guided hormone injection in the treatment of plantar fasciitis.</p><p><b>METHODS</b>The clinical data were collected from patients with plantar fasciitis admitted to PLA General Hospital pain department from September, 2015 to February, 2017. The patients were randomly divided into ultrasound-guided drug injection group and shock wave group. The therapeutic parameters including the numerical rating scale (NRS) scores in the first step pain in the morning, American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, and thickness of the plantar fascia were monitored before and at 1 week, 1 month, 3 months, and 6 months after the treatment. The recurrence rate, effectiveness, and patient satisfaction were compared between the two groups at 6 months after the treatment.</p><p><b>RESULTS</b>Thirty-nine patients were enrolled in shock wave group and 38 patients in ultrasound group. The NRS scores in the first step pain in the morning were lowered after treatment in both groups (P<0.05), and the scores were significantly lower in ultrasound group than in shock wave group at 1 week and 1 month (P<0.01), but significantly higher in ultrasound group than in shock wave group at 3 and 6 months after treatment (P<0.05). The AOFAS functional scores were increased in both groups (P<0.05) at 6 months after treatment, was significantly lower in ultrasound group than in shock wave group than group B (90.44∓13.27 vs 75.76∓21.40; P<0.05). The effective rates in shock wave group and ultrasound group were 92.31% and 76.32%, respectively (P<0.05). Recurrence was found in 1 patient (2.56%) in shock wave group and in 8 (21.05%) in ultrasound group (P<0.05). The patient satisfaction scores were significantly higher in shock wave group than in ultrasound group (8.13∓2.67 vs 6.63∓3.75, P=0.048).</p><p><b>CONCLUSION</b>Pneumatic ballistic extracorporeal shock achieves better medium- and long-term outcomes than ultrasound-guided hormone injection in the treatment of plantar fasciitis.</p>

Clinical research of treating the avulsed fracture of humerus greater tuberosity using an arthroscopic double-row suture anchor fixation technique / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the early clinical effects of treating the avulsed fracture of humerus greater tuberosity using the double-row suture anchor fixation technique.</p><p><b>METHODS</b>Total 20 patients with the avulsed fracture of the greater tuberosity of the humerus were treated from September 2009 to January 2013. There were 12 males and 7 females, with an average age of 46.8 years old(24 to 69 years old). Eleven patients had injuries on right shoulder joint and 8 patients had injuries on left side. The injury mechanism included 10 cases of traffic accident, 6 cases of sports injury, and 3 cases of falls. The mean interval from injury to surgery was 34.9 d (ranged, 3 to 72 d). The affacted arm was suspended and fixed within 3 weeks after operation. The swing exercise of shoulder joint was performed from the 2nd day after operation. The strap was removed 3 weeks after operation, and painless active exercise was performed 6 weeks after operation. The patients were followed up in the outpatient department 6, 12 and 24 weeks after operation, and then every 6 months. AP and lateral X-ray films were taken at each follow-up time. At the latest follow-up, protractor was used to measure activity of patients; and VAS pain score, California University of Losangeles(UCLA) standard, American Shoulder and Elbow Surgeons (ASES) score were used to evaluate therapeutic effects.</p><p><b>RESULTS</b>All the patients were followed up, with a mean duration of 35.2 months (ranged, 24 to 48 months). All the incisions were healed on the first stage without secondary acromion impingement and other complications. All the patients had bony union within 12 weeks. The movements of shoulder joints including flexion, abduction, external rotation, internal rotation were increased obviously(<0.05). The UCLA score was increased from preoperative 15.2±5.3 to 35.6±6.1 at the latest follow-up. The ASES score was increased from preoperative 31.2±5.4 to 91.2±6.8 at the latest follow-up (<0.05).</p><p><b>CONCLUSIONS</b>It has satisfactory curative effects for the avulsed fracture of humerus greater tuberosity using the double-row suture anchor fixation technique, especially the cases of small or comminuted fractures. It has several advantages such as firm fixation, simple and secure operation as well as quick postoperative recovery. Finally, patient should take exercises actively after operations.</p>

Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone.</p><p><b>METHODS</b>This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test.</p><p><b>RESULTS</b>All patients were followed up for an average of 57.6 months (range: 17-108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris' scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = -7.21, P = 0.001) than Group B with mean Harris' scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = -9.47, P = 0.037) (significantly different: t = -2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02).</p><p><b>CONCLUSION</b>For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.</p>

Preparation of Platelet-Rich Plasma from the White Slurry and Its Effect on MSC Proliferation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To isolate platelet-rich plasma(PRP) from the white slurry(WS), a depleted fraction of the clinical blood supply, so as to provide an easier method to harvest PRP for related studies and clinical use.</p><p><b>METHODS</b>The protocols preparing PRP from whole blood and WS were compared. The morphological characteristics of the different PRPs were observed under transmission electron microscope; the expression of the platelet markers CD41a and CD42b were detected by the flow cytometry. Moreover, the ingredients of the PRPs were measured by using cytoanalyzer. for detecting the physiological function of the PRP, the harvested PRP were added to MSC culture and the cell proliferation was detected by using CCK-8 method.</p><p><b>RESULTS</b>a large amount of PRP from WS was easier harvested. the WS-derived PRP shared similar morphological characteristics and ingredients as compared with whole blood-derived PRP. Importantly, the WS-derived PRP exhibited a higher expression of CD41a and CD42b than that of traditional PRP, which indicate that the WS is a promising reservoir for PRP.</p><p><b>CONCLUSION</b>The WS can be used to prepare PRP, and the novel PRP share similar biological characteristics as traditional PRP prepared from whole blood. The present study provides an easier and economical method to harvest PRP and this findings may be helpful for PRP related studies.</p>

Effects of Shock Wave on the Proliferation and Osteogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the effects of the shock wave on the capacity of mesenchymal stem cells(MSCs) to proliferate and differentiate into osteoblasts.</p><p><b>METHODS</b>MSCs were isolated from the bone marrow of healthy donors. The human bone marrow MSCs(BM-MSCs) were divided into 3 groups including blank control group,osteoinduced group and shock wave group. The MSCs in blank control group were cultured with common mediam; the MSCs in osteoinduced group were treated with osteogenic agents and cultured; the MSCs in shock wave group were cultured with common medium and stimulated by shock wave. The morphology of MSCs in each groups were observed by micoscopy; the CCK-8 was used to detect the proliferation ability of MSCs; the alkaline phosphatase staining and von Kossa staining were used to evaluale the differentiation potential of MSCs in each groups.</p><p><b>RESULTS</b>The results of CCK-8 revealed the shock wave could promote cell proliferation as compared with blank control group. The results of alkaline phosphatase and Von Kossa staining showed that the shock wave displayed a stronger ability to promote the human BMMSC differentiation into osteoblasts cells in comparison with the osteoinduced group. The blank control group was weakly positively stainined.</p><p><b>CONCLUSION</b>The shock wave treatment can promote proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.</p>

Clinical research on suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the early clinical effects of suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy.</p><p><b>METHODS</b>From July 2012 to January 2015, 22 patients with the avulsion fracture of tibial intercondylar eminence were treated with arthroscopic suture anchor fixation. There were 12 males and 10 females, with an average age of 22.8 years old(ranged, 18 to 33 years old). Nine patients had the fractures in the right knee and 13 patients had the fractures in the left knee. The mean duration from injury to surgery was 6.8 days(ranged, 3 to 11 days). According to the improved Meyers-McKeever classification, 13 cases were type II, 7 cases were type III, and 2 cases were type IV. The clinical outcomes were evaluated by the range of motion, the Lysholm score, the IKDC 2000 subjective knee score, the axial shift test, and the anterior drawer test.</p><p><b>RESULTS</b>All the incisions healed by first intention, and no complications occurred. All the patients were followed up, and the mean duration was 32.8 months (ranged, 18 to 42 months). The knee range of motion was improved from preoperative (49.37±7.69) ° to (126.38±5.58) °at the latest follow-up(<0.01). Lysholm score was improved from preoperative 43.4±5.6 to 79.2±6.2 at the latest follow-up(<0.01). And the IKDC 2000 score was improved from preoperative 52.6±6.2 to 81.4±5.7 at the latest follow-up(<0.01). At the latest follow-up, the patient underwent physical examination. One patient had a positive result of axial shift test at the 18th month after operation with grade II laxity of anterior cruciate ligament. One patient had a weakly positive result of anterior drawer test at the 24th month after operation.</p><p><b>CONCLUSIONS</b>Absorbable suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy can provide accurate reduction and stable fixation, which can be applied to treat all types of fractures including comminuted fracture, and it is not necessary to remove the implant in the second operation.</p>

Clinical research of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia.</p><p><b>METHODS</b>From February 2009 to August 2014, 52 patients with popliteal cysts were treated in our hospital, including 34 males and 18 females with an average age of 43.6 years old ranging from 14 to 62 years old; 29 cases were on the right knee and 23 on the left knee. Preoperative diagnosis was performed according to MRI findings and to determine whether other knee disorders were associated with the disease, 52 patients were diagnosed as popliteal cyst before operation; 23 cases of simple meniscus injury or cartilage injury, 18 cases of osteoarthritis, 7 cases of cruciate ligament injury, 2 cases of gouty arthritis, 1 case of rheumatoid arthritis, 1 case of pigmented villonodular arthritis. The preoperative clinical manifestations involved knee swelling in 21 cases, knee joint pain in 16 cases, joint lock in 8 cases, leg weakness in 4 cases, and knee joint snapping in 4 cases. Cyst size was 4.0 cm× 3.3 cm to 6.2 cm× 5.3 cm. According to the Rauschning and Lindgren standards, 1 case was grade I, 9 cases were grade II, 42 cases were class III. The rehabilitation plan should be made according to the patient's specific injuries and intraoperative management. During the postoperative follow-up, the postoperative curative effect was evaluated by the standard grading of Rauschning and Lindgren of popliteal cyst.</p><p><b>RESULTS</b>All the incisions healed by first intention, and no complications occurred. All the cases were followed up from 25 to 64 months (averaged 39.6 months). For the Rauschning and Lindgren grading, 43 cases were grade 0, 8 cases were grade I, 1 case were grade II.</p><p><b>CONCLUSIONS</b>Local anesthesia under arthroscopy and popliteal cyst removal knee joint cavity debridement is effective, less trauma, quick recovery, short term effect is good. The recurrence rate is also low because of the primary disease of the knee joint is also treated. After the operation, the rehabilitation plan should be made according to the intraoperative treatment and actively trained so as to recover at an early date.</p>

Clinical research on arthroscopic treatment for cruciate ligament cysts of the knee / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the early clinical effects of arthroscopic treatment for cruciate ligament cysts of the knee.</p><p><b>METHODS</b>From September 2008 to January 2014, 23 patients with cruciate cysts were treated with arthroscopic surgery. There were 11 males and 17 females, with an average age of 28.3 years old (ranged, 16 to 56 years old). Twenty patients had injuries on the right knee and 8 patients had injuries on the left knee. Eight patients had a history of injury,5 patients had a history of chronic injury,and the other 15 patients had no obvious reasons for the symptom. Before the operation, 24 patients were clearly diagnosed as the cruciate ligament cysts of knee joint,and 4 patients were diagnosed as other problems of the knee, but the diagnosis were corrected after the operation. According to the MRI before the surgery,all the patients could be divided into 3 types: 14 were type I, 6 were type II, 8 were type III. After the operation, the patients were suggested to have a rest for 2 weeks, and take exercises everyday at the same time. The knee range of motion, Lysholm score, International Knee Documentation Committee (IKDC) 2000 subjective score, GLASGOW criteria, and McMurray test, pivot shift test, and anterior drawer test were observed to evaluate clinical results.</p><p><b>RESULTS</b>All the incisions healed at the first stage without complications. Twenty-five patients were followed up, and the duration ranged from 12 to 52 months, with a mean of 26.7 months. Three patients accepted the reconstruction of ACL or tightened elongated ACL using bipolar radio frequency. The Lysholm score increased from preoperative 59.80 +/- 6.58 to 75.32 +/- 6.49 at the latest follow-up; IKDC 2000 score increased from preoperative 65.36 +/- 6.26 to 81.00 +/- 5.76 at the latest follow-up. According to GLASGOW criteria,23 patients got an excellent result and 2 good.</p><p><b>CONCLUSION</b>It has a satisfactory curative effect on ACL reconstruction using bipolar radio frequency. It has advantages of firm fixation, simple and secure operation as well as quick postoperative recovery. It's very important to check the MRI before operations, and carefully seek the cysts during the operations, avoiding the omission of any cysts,especially the cases of multiple cysts. Finally, patients should take exercises actively after operations.</p>

Accuracy evaluation of computer aided design and computer aided manufacture template for implant placement / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The computer aided design and computer aided manufacture (CAD/CAM) template was fabricated basing on CT data of completely edentulous jaws, and the accuracy of template was evaluated by assessment of the deviation between the actual and planning position of the implant after the registration of pre- and post-operative CT images.</p><p><b>METHODS</b>The CAD/CAM templates for 4 completely edentulous jaws were designed and fabricated basing on the pre-operative CT data and the stone models of the jaws sample. And 14 implants were placed in the posterior region of the jaws aided by the CAD/CAM template. The pre- and post-operative CT was registered by the point to point method, and the deviation between actual and virtual implants was measured to assess the accuracy of the template.</p><p><b>RESULTS</b>With the aid of CAD/CAM template, the deviations of the position at the tail of the implant, at the tip of the implant and the projected deviation of angle were (0.19 +/- 0.07) mm, (0.47 +/- 0.12) mm, and 1.790 +/- 0.68 degrees respectively, and the deviations of the position at the bucco-palatal, disto-mesial, vertical direction were (0.22 +/- 0.08) mm, (0.25 +/- 0.06) mm, (0.30 +/- 0.11) mm at the tip respectively.</p><p><b>CONCLUSION</b>Within the limits of this study, the results verify the accuracy of CAD/CAM template and support its use for safety implant placement.</p>

Isolation, identification, culture and bionomics of skeletal muscles satellite cells from green fluorescent protein transgenic mouse in vitro / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the green fluorescent protein (GFP) expression and the bionomics of skeletal muscles satellite cells (SMSCs) in vitro in GFP transgenic mouse.</p><p><b>METHODS</b>The newborn transgenic mice were acquired to separate skeletal muscles satellite cells with enzyme digestion method. Cells were cultured and subcultured in vitro. Morphological observation, growth curve were investigated to evaluate the proliferation and differentiation characteristics of skeletal muscles satellite cells, fluorescence microscope was used to observe the GFP expression. The cells were identified by immunocytochemical stain. In the basis of identification of anti-sarcometric actin anti-body, the combination of anti-desmin antibody and DAPI (4, 6-diamidino-2-phenylindole) were used to detect the purification of skeletal muscles satellite cells.</p><p><b>RESULTS</b>Immunocytofluorescence suggested the good retain of GFP fluorescence in skeletal muscles satellite cells. The cells showed strong proliferative ability and they were positive with immunocytochemical stain of anti-sarcometric actin antibody and anti-desmin antibody. The combination of anti-desmin and DAPI stain can be used to determine the purification of SMSCs.</p><p><b>CONCLUSION</b>Skeletal muscles satellite cells cultured in vitro showed strong proliferation and differentiation ability. They are fit to construct the cell bank of tissure engineering and to be a useful tool to explore cells fate after transplantation since these cells retain the expression of GFP.</p>

Effect of bone morphogenetic proteins-2 on mandibular distraction osteogenesis in rabbits / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the Effect of recombinant adenovirus vectors containing human Bone morphogenetic proteins-2 (Ad-hBMP-2) on the for mandibular distraction osteogenesis (DO) in rabbits.</p><p><b>METHODS</b>Twenty-four New Zealand white rabbits were randomly divided into experimental group, and control group and underwent mandibular distraction osteogenesis. After 5 days latency, the distracters were activated at a speed of 0.5 mm every 12 hours for 7 days, then on the first day in the consolidation period, the distraction gaps of experimental group were injected with 0.2 ml Ad-hBMP2 10(12) pfu/L, while the animals of control group were injected with 0.2 ml Ad-EGFP 10(12) pfu/L. At the 7 th and 28 th day of consolidation period, specimens were obtained, X-ray and histomorphology were performed. The bone density and the quantity of new bone formation in the distraction gaps were observed and compared between the two groups at different consolidation period.</p><p><b>RESULTS</b>Ad-hBMP-2 treated specimens demonstrated an increased amount of new bone formation</p><p><b>CONCLUSIONS</b>Adenovirally-mediated delivery of BMP-2 can locally increase bone deposition during DO, which may potentially shorten the consolidation period.</p>

Primary study of the method for repair of severe unilateral complete cleft lip / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the probability of repairing the severe cleft lip and nose in one time.</p><p><b>METHODS</b>35 patients were included. A revised method was presented based on the popular methods used.</p><p><b>RESULTS</b>Among 35 patients, the length of lip in two sides was equal in 33 patients, and the appearance of the nose shape was satisfactory in 31 patients evaluated by third expert group.</p><p><b>CONCLUSION</b>The method presented in this paper could repair the abnormalities of the lip and nose effectively in severe cleft lip patients in one time and was adapted in the patients who could not be treated with serial methods because of a bad economic state.</p>