ABSTRACT
A patient with paraquat poisoning was followed up for five years, and it was showed that the interstitial lesion areas in chest CT of this patient gradually decreased after acute period of the poisoning and no significant changes were found six months later. After that the density of the lesions gradually reduced, while the cystic air cavities slowly increased. In addition, the patient's exercise endurance gradually improved over time, and the lung function was close to the normal level five years after poisoning. The follow-up report helps clinicians to have a deeper understanding of the long-term outcome of paraquat poisoning.
Subject(s)
Humans , Follow-Up Studies , Lung/pathology , Paraquat , Poisoning , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE@#To investigate the method and clinical effects of the treatment of recurrent anterior dislocation of shoulder with Hill-Sachs injury by arthroscopic Bankart repair and Remplissage.@*METHODS@#From March 2016 to March 2019, 106 patients with recurrent anterior dislocation of shoulder with glenoid bone defect less than 20% underwent arthroscopic Bankart repair, including 76 males and 30 females, aged from 18 to 45 (27.3±8.6) years, 59 cases of left shoulder and 47 cases of right shoulder. Range of motion (ROM), American Shoulder and Elbow Surgeons(ASES) score, Constant-Murley score and Rowe score were used to evaluate shoulder functionand stability before and after operation.@*RESULTS@#All patients were followed up, and the duration ranged from 21 to 60 months, with a mean of (41.5± 8.5) months. One patient developed infection after operation, and the infection was controlled after arthroscopic debridement again. The remaining patients did not have clinical complications such as infection, intra articular hematocele and redislocation. Shoulder flexion and lifting increased from (158.33±15.72) ° preoperatively to (169.43±10.04) ° at the latest follow up, and internal rotation changed from T7 (T4 to T10) preoperatively to T8 (T5 to T10) at the latest follow up;the average lateral external rotation and abduction 90 ° external rotation decreased from (58.46±15.51) ° preoperatively and (99.37±14.09) ° to (53.18±14.90) ° and (92.52±13.10) ° at the latest follow up, respectively. The ASES score, Constant -Murley score and Rowe score were significantly improved.@*CONCLUSION@#The clinical effect of rehabilitation of Bankart repair combined with Remplissageunder arthroscopy in the treatment of recurrent dislocation of shoulder joint in adults with Hill-Sachs defect is satisfactory. Although the external rotation function is weaker than that before operation, it can effectively reconstruct the shoulder function and avoid the occurrence ofdislocation after operation.
Subject(s)
Adult , Female , Humans , Male , Arthroplasty , Arthroscopy , Joint Instability/surgery , Range of Motion, Articular , Recurrence , Shoulder/surgery , Shoulder Dislocation/surgery , Shoulder Joint/surgeryABSTRACT
BACKGROUND: In the treatment of unicompartmental knee osteoarthritis, unicompartmental knee arthroplasty (UKA) has the advantages of less blood loss, less trauma, quick recovery, maximum retention of bone mass, low cost, few complications and high patient satisfaction. However, it has not been extensively accepted by orthopedic surgeons. OBJECTIVE:To investigate the clinical effect and imaging changes of UKA versus total knee arthroplasty(TKA)in the same patient with bilateral unicompartment knee osteoarthritis. METHODS: A total of 38 patients with bilateral unicompartment knee osteoarthritis undergoing UKA and TKA were selected, and all the cases were performed by the same surgeon. Among them, 10 cases were replaced at the same time, and 28 cases were in staging surgery. The clinical data of the patients were collected, including the preoperative and postoperative Knee Society Score sores, the range of motion of the knee, and limb alignment, and postoperative complications. Comparison between bilateral knee joints was conducted by paired t test. RESULTS AND CONCLUSION: (1) All patients were followed up for 3-36 months, and no aseptic prosthesis loosening, unexplained pain or other complications occurred. (2) The postoperative Knee Society Score sores in UKA and TKA were significantly higher than those before surgery, and the scores did not differ significantly between UKA and TKA at each time point (P > 0.05). (3) The range of motion of the knee in the UKA group was significantly larger than that in the TKA group at the last follow-up postoperatively (P < 0.05). (4) The limb alignment was improved in both groups, which showed no significant difference at different time points (P > 0.05). (5) Totally 20 patients felt preference for UKA, 18 patients preferred TKA, and most patients were satisfied with the surgical efficacy. (6)There were no significant differences in the Knee Society Score, range of motion of the knee, hip-knee-ankle angle and femorotibial angle at the last follow-up between staging and same time arthroplasties. (7)These findings imply that for patients with bilateral unicompartment knee osteoarthritis, both UKA and TKA can correct the lower limb force line, correct the limb alignment similarly, but UKA holds advantages in less trauma, high patient's satisfaction, and good functional recovery, so it should be selected firstly. Notably, staging or same time surgery makes no effect on the clinical effectiveness.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the early prognostic values of arterial lactate and base excess (BE) in patients with paraquat poisoning.</p><p><b>METHODS</b>Seventy-five patients with paraquat poisoning were divided into sudden death group (n = 10) who died within 24 h after admission, recent death group (n = 31) who died more than 24 h after admission, and survival group (n = 34). Arterial lactate and BE were measured on admission and at 24 h after admission. The prognostic values of arterial lactate and BE were analyzed.</p><p><b>RESULTS</b>The arterial lactate measured on admission was significantly higher in the sudden death group than in the recent death group and survival group (P < 0.01), but there was no significant difference in arterial lactate between the recent death group and survival group (P = 0.309). The BE measured on admission was significantly lower in the sudden death group than in the recent death group and survival group, and it was significantly lower in the recent death group than in the survival group (P < 0.01 or P < 0.05). At 24 h after admission, the recent death group had a significantly higher arterial lactate (P < 0.01) and a significantly lower BE (P < 0.01), as compared with the survival group. The logistic regression analysis showed that the two indices were significantly associated with prognosis (P < 0.01). On admission, the areas under the receiver operating characteristic (ROC) curve (AUCs) of arterial lactate and BE for predicting death were 0.692 and 0.787, respectively, and the cut-off values were 3.25 mmol/L and -1.75 mmol/L, respectively; the AUCs of arterial lactate and BE for predicting sudden death were 0.995 and 1, respectively, and the cut-off values were 7.1 mmol/L and -12.8 mmol/L, respectively. At 24 h after admission, the AUCs of arterial lactate and BE for predicting death were 0.743 and 0.822, respectively, and the cut-off values were 2.15 mmol/L and -5.55 mmol/L, respectively.</p><p><b>CONCLUSION</b>Arterial lactate and BE have certain values in predicting the death, especially the sudden death, in patients with acute paraquat poisoning.</p>