ABSTRACT
Objective To investigate the effect of minimally invasive plate osteosynthesis combined with locking compression plate fixation on postoperative fracture healing and serum levels of and serum nerve growth factor (NGF),vascular cell adhesion molecule (s VCAM),alkaline phosphatase (ALP) in patients with limb comminuted fracture.Methods From January 2014 to May 2016,seventy-four patients with limb comminuted fracture in the Eighth People's Hospital of Shanghai were enrolled in this study and randomly divided into the control group (37 cases) and the study group (37 cases).The traditional incision and reduction fixation were used in the control group.The study group was treated with locking compression plate internal fixation combined with minimally invasive plate bone grafting technique.The patients were followed up for 1 ～ 4 months after operation.The clinical efficacy,perioperative indicators (operation time,intraoperative blood loss,fracture healing time),serum (nerve growth factor,vascular cell adhesion molecule,alkaline phosphatase) levels change at the time of admission and after first D and complications rate were statistically compared.Results The total effective rate of the study group was 97.30％ (36/37),higher than that in the control group (78.38％ (29/37)),and the difference was statistically significant (x2 =4.554,P＜0.05).The operation time of the study group was (84.76 ± 11.08) min,longer than that of the control group ((71.89 ± 10.54) min),the intraoperative blood loss of the study group ((108.52 ± 21.33) ml) was less than that of the control group ((245.30±24.61) ml),and the fracture healing time of the study group ((9.04 ± 1.81) weeks) was shorter than that of the control group ((12.79 ±2.02) weeks),and the difference was statistically significant (t =5.119,t =25.547,t =8.410,P＜ 0.05).The levels of serum NGF,s VCAM and ALP in the two groups after operation were higher than those before operation,and the levels of serum NGF ((1.33±0.19) ng / L) and ALP ((312.04±31.07) U/L) in the study group were higher than those in the control group ((0.85 ± 0.22) ng/L,(181.28±30.45) U/L),and the level of serum s VCAM ((502.18±40.07) μg/L) was lower than that in the control group ((579.28 ± 41.15) μg/L),and the difference was statistically significant (t =10.044,18.283,8.165,P＜0.05).The incidence of complications in the study group was 8.11％ (3/37),lower than that in the control group (27.03％ (10/37)),the difference was statistically significant (x2 =4.573,P ＜ 0.05).Conclusion Minimally invasive plate osteosynthesis combined with locking compression plate fixation in the treatment of limb comminuted fracture can shorten the healing time of the fracture,improve the treatment effect,improve the levels of serum NGF,s,VCAM and ALP,and it have lower complication rate with higher safety.
ABSTRACT
Objective To observe the state of endemic flurosis in Qinghai province in 2008 and to provide scientific basis for endemic flurosis control and prevention. Methods All the endemic fluorosis villages in Qinghai province was divided into slight,medium and heavy degree according to the water fluoride content before improving water,and 2,4,4 villages were collected from each degree,respectively. Water samples were collected from each direction of east,west,south,north and centre,and fluoride concentration were determined from each surveyed villages with unimproved-water. At the same time,3 copies of the peripheral water samples and a sample of source water were collected to determine fluoride concentration. In all the village children aged 8 to 12 were tested for dental fluorosis by Dean method. Six copies of the urinary fluoride were randomly sampled in different age groups. The fluorine content in urine was determined with F-ion selective electrode. The situation of clinical skeletal fluorosis of adults over 16 years of age was examined,and 20 adults in the villages of medium and heavy levels were filmed for skeletal fluorosis. Results The detectable rate of dental fluorosis of children aged 8-12 years old was 43.59% (245/562),that of skeletal flurosis of adults aged above 16 years was 50.32% (1582/3144) and detectable rate of X-ray was 29.45% (48/163). Fluoride content in urine was 1.52 mg/L. Conclusions Endemic fluorosis is still very serious in Qiaghai province in a rising trend,so the control measures need to be strengthen.
ABSTRACT
[Objective]To analyze the factors of post-operative deformity after posterior approach vertebral pedicle fixation in treatment of dorso-lumbar spinal fractures.[Method]Between 2000.10～2005.11,32 patients of single dorso-lumbar spinal fracture were hospitalized.compressive type 5 cases,explosive type 27 cases.T11 12 cases,T12 11 cases,L1 5 cases,L2 3 cases,L3 1 case.The patients were devided into 3 groups according to the severity of related chondral plates injuly,group 1: without chondral fracture 11cases,group 2: with upper chondral plate fracture 15 cases,group 3: with both upper and lower chondral plate fractures 6 cases.By the formula to measure the average height of fractured vertebral body and its kyphotic Cobb's angle before operation,after operation and at time of follow-up,and calculate the result stastically.[Result]All 32 patients were followed-up for 10～56 months(average 23 months).The results indicated that the patient's preoperative condition was negatively correlated with the average vertebral height which is followed-up.The worse condition was,and the greater loss of postoperative vertebral height was.Furthermore,the patient's situation before operation had a positive correlation with the Cobb's angle of vertebral followed-up.When the patient's condition was worse,the postoperative angle of deformity was larger.[Conclusion]Posterior approach vertebral pedicle fixation in treatment of dorso-lumbar spinal fractures may result in reccurence of vertebral deformity,which is related to the severity of injury of vertebra and its chondral plates,so that to those patients related with chondral plates injuries,the vertebral pedicle fixation should be combined with anterior bone grafting,or with bone grafting into vertebral body after reduction.