Comparison of curative effect between Tianji robot assisted screw placement and traditional cannulated screw internal fixation for femoral neck fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy and advantages of Tianji orthopedic robot assisted cannulated screw internal fixation for femoral neck fracture.@*METHODS@#The clinical data of 41 patients with femoral neck fracture who underwent internal fixation with cannulated screws from January 2019 to January 2022 were retrospectively analyzed. According to different surgical methods, they were divided into Tianji robot group and traditional cannulated screw fixation group (traditional operation group). Among them, there were 18 patients in Tianji robot group including 8 males and 10 females with age of (56.00±4.22) years old, Garden typeⅠ (4 cases), type Ⅱ (11 cases), type Ⅲ (2 cases), and type Ⅳ (1 case). There were 23 patients in the traditional operation group, including 10 males and 13 females, aged (54.87±4.81) years old;there were 5 cases of Garden typeⅠ, 14 cases of type Ⅱ, 3 cases of type Ⅲ and 1 case of type Ⅳ. The operation time, intraoperative blood loss, fluoroscopy times, guide needle placement times, operation costs and other indicators were observed and compared between two groups. Harris score was used to evaluate hip joint function 12 months after operation.@*RESULTS@#The wounds of all patients healed in Grade A without complications. There were significant differences between two groups in terms of operation time, times of intraoperative fluoroscopy, times of guide needle placement, amount of intraoperative bleeding, and operation cost (P<0.05). All 41 patients were followed up for at least 12 months. The fractures of both groups were healed. There was no infection, screw loosening, fracture displacement and femoral head necrosis in Tianji robot group during follow-up;Screw loosening occurred in 2 patients in the traditional operation group during follow-up. At 12 months after operation, Harris hip joint function score of Tianji robot group was higher than that of traditional operation group in daily activity, lameness, joint activity score and total score (P<0.05).@*CONCLUSION@#Tianji robot assisted nail placement is a better method for the treatment of femoral neck fracture, which improves the surgical efficiency, is more accurate, has higher success rate of one-time nail placement, shorter operation time, less radiation, and has better hip joint function recovery after surgery.

Application and safety of hydroxychloroquine sulfate in rheumatic diseases:a multicenter retrospective study in Suzhou / 中国实用内科杂志

OBJECTIVE: A multicenter survey is conducted to study the application,the long-term effect and safety of hydroxychloroquine(HCQ)in the treatment of rheumatic diseases in Suzhou. METHODS: Retrospectively collect the data of outpatients and inpatients from Rheumatology Department of four general hospitals in Suzhou(the First Affiliated Hospital of Suzhou University, and Suzhou Hospital of Traditional Chinese Medicine, the First People's Hospital of Kunshan, the First People's Hospital of Changshu)from June 2017 to July 2018. A special questionnaire was used to collect data on general information, diagnosis, methods and courses in the use of hydroxychloro-quine, duration, efficacy and compliance, combined medication, adverse reactions of ophthalmology and other systems, and the use of hydroxychloroquine(HCQ)during pregnancy.Result Totally there were 856 cases, including 68 males(7.9%)and 788 females(92.1%).Classification of diseases: 147 cases of RA(including secondary SS of RA), 425 cases of SLE,12 cases of APS, 167 cases of PSS,104 cases of others, and 1 case of overlap syndrome(RA with SLE)The treatment course of HCQ: minimum 0.5 years, maximum 22.75 years, with an average of 3.59(SD=3.08)years.Dosage: 0.2 g/day in 604 cases, 0.4 g/day in 424 cases, 193 cases of using 0.4 and 0.2 successively, and 21 in other cases;721 cases used continuously. There were adverse reactions in 183 cases(7 males and 176 females), which were distributed in 30 cases of RA, 105 cases of SLE, 2 cases of APS, 31 cases of SS and 15 other cases. Ophthalmological adverse reactions occurred in 70 cases, with positive correlation in 4 cases. Ophthalmological examination: 121 cases(14.1%)every year;68 cases(7.9%)every two years. There were 92 cases of adverse skin reactions, with 8 cases of positive correlation. Other systems had few adverse reactions and there was no positive correlation. Continuous medication, combination of anti-rheumatic drugs and adverse reactions were associated, and continuous medication or combination of anti-rheumatic drugs were significantly associated with adverse reactions in ophthalmology and skin, respectively. The adverse reactions of ophthalmology were related to the course of treatment, and the adverse reactions of fundus increased after taking medicine for more than 7 years.There were 37 pregnancies and HCQ was used in 17 cases throughout pregnancy, and only 1 case had non-drug-related neonatal defects. CONCLUSION: HCQ is mainly used in the treatment of SLE, SS, RA and APS in Rheumatology Department in Suzhou. HCQ medication is standardized, but ophthalmic follow-up monitoring is not. Adverse reactions are mainly in skin and ophthalmology. Continuous medication and combination of antirheumatic drugs are associated factors of adverse reactions.Long-term treatment with HCQ is safe and well-toleratrd.

Comparison of early clinical effects between Activ C cervical disc replacement and anterior cervical discectomy and fusion for single-level cervical spondylosis / 中国骨伤

<p><b>OBJECTIVE</b>To compare the early clinical effects of Activ C cervical disc replacement (ACDR) and anterior cervical discectomy and fusion (ACDF) in treating single-level cervical spondylosis.</p><p><b>METHODS</b>The clinical data of 76 patients with single-level cervical spondylosis underwent surgery from July 2009 to September 2012 were retrospectively analyzed. Among them, 28 patients were treated with ACDR (ACDR group), including 18 males and 10 females, aged from 32 to 62 years old with an average of (45.2±6.2) years; and 48 patients were treated with ACDF (ACDF group), including 28 males and 20 females, aged from 33 to 60 years old with an average of (45.8±6.4) years. Visual analogue scale (VAS), Japanese Orthopedics Association (JOA) score, Short Form-36 (SF-36), imaging data were used to assess the clinical effects after operation.</p><p><b>RESULTS</b>A total of 76 patients were followed up from 6 to 24 months with an average of 13.2 months. VAS of neck pain and brachialgia were improved in all patients after operation (P<0.05), there was no significant difference between two group (P>0.05). Somato-score and psycho-score of SF-36 of two groups were obviously increased (P<0.05), ACDR group was better than that of ACDF group (P<0.05). In ACDR group, there was no significant difference in the range of motion of surgical segments and adjacent segments between preoperative and postoperative (P>0.05); heterotopic ossification around the edge of vertebral body occurred in 1 case on the 6th month after operation, no fusion was found on the 1st year after operation. In ACDF group, the adjacent vertebral disease occurred in 1 case and the patient underwent the reoperation.</p><p><b>CONCLUSION</b>Activ C cervical disc replacement can reduce the degeneration of adjacent segments and its early outcomes for the treatment of single-level cervical spondylosis are satisfactory, but the long-term effects still need study.</p>

Delayed gastric emptying after laparoscopic versus open pancreaticoduodenectomy: a comparative study / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect on postoperative delayed gastric emptying (DGE) after laparoscopic versus open pancreaticoduodenectomy (PD).</p><p><b>METHODS</b>Data from 67 consecutive PD procedures performed between October 2010 and October 2012 were retrospectively analyzed. Among them, 20 patients underwent laparoscopic PD (LPD group), and 47 patients underwent open PD (OPD group; 22 patients underwent pylorus-preserving PD, 25 patients underwent standard PD).</p><p><b>RESULTS</b>The LPD group had significantly longer operative times ((494 ± 46) minutes vs. (391 ± 70) minutes, t = -4.40, P = 0.000), reduced blood loss ((294 ± 158) ml. vs. (399 ± 68) ml, t = 2.73, P = 0.008) and shorter postoperative hospital stay (13.0 days vs. 16.3 days, t = 3.01, P = 0.009) compared to the OPD group. However, there was no difference in terms of DGE occurrence and postoperative complication rates. There was one postoperative death in the OPD group and none in the LPD group. Multivariate analysis by Logistic regression showed that DGE was significantly more frequent among patients with longer operative times (OR = 1.01, 95%CI: 1.000 - 1.024, P = 0.048), increased intraoperative blood loss (OR = 1.01, 95%CI: 1.000 - 1.022, P = 0.040) and postoperative intraabdominal complications (OR = 6.22, 95%CI: 1.400 - 27.700, P = 0.017). Mean postoperative hospital stay was longer among patients who developed DGE (19.7 days vs. 13.6 days, t = -6.50, P = 0.000) than those without DGE.</p><p><b>CONCLUSIONS</b>Longer operative time, increased intraoperative blood loss and postoperative intraabdominal complications appear to be risk factors for DGE development. Meanwhile, the laparoscopic approach PD is safe and feasible, and outcomes appears comparable with those undergoing an open approach.</p>

The epidemiological features of blast injury of lungs caused by gas explosion / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the clinical epidemiological features. of blast injury of lungs caused by gas explosion.</p><p><b>METHODS</b>A retrospective analysis of 132 cases of blast injury of lungs caused by gas explosion injuries in our hospital from 1990 to 2010 were made, including the information of lung injury, associated injuries, treatment and mortality.</p><p><b>RESULTS</b>56 patients were conscious on admission, during 1 ∼ 5 days, 30 patients got cough, hemoptysis and other pulmonary symptoms, 7 patients had hemothorax, 11 cases combined with pneumothorax, 86 cases of patients with burns, 96 cases with pulmonary aspiration compound injury, 41 cases with abdominal organs blast injuries, 76 cases with pulmonary infection, 31 cases with shock, Seven patients died of respiratory failure, two patients died of respiratory failure.</p><p><b>CONCLUSION</b>Blast injury of lung featured with serious internal injuries, combined with many injuries, The incidence of compound injury was high, and it was difficult to diagnose. Chest X-ray were varied. The mortality was high, and the predominant causes of death were respiratory failure, shock, sepsis. Most patients with blast injury of lung need tracheotomy and mechanical ventilation. Timely tracheotomy, mechanical ventilation were the major prognostic measures.</p>

The surface biomarkers of sputum cells in coal mine workers and patients with pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the significance of intercellular adhesion molecule -1 (CD54 or ICAM-1), epidermal growth factor receptor (EGFR) and platelet-derived factor (PDGF) in sputum cells of workers exposed to dust and patients with pneumoconiosis for the early diagnosis of pneumoconiosis.</p><p><b>METHODS</b>The subjects included 62 workers exposed to dusts, 51 workers not exposed to dusts, 22 patients with pneumoconiosis and 10 healthy controls. The respiratory sputum technique was used to collect the sputum samples and the biomarkers (ICAM-1, EGFR and PDGF) of the sputum samples were detected with the sputum samples.</p><p><b>RESULTS</b>When the exposure group was compared with non-exposure group, there were no significant differences of surface biomarkers (ICAM-1, EGFR and PDGF) in sputum cells (neutrophil leucocytes, macrophages, lymphocytes and acidophilic/basophil leucocytes). As compared with other workers exposed to dusts, the surface CD54 and EGFR expression levels increased significantly and the surface PDGF expression level decreased significantly in workers exposed to dusts for 10 years (P<0.05). As compared with controls, the CD54 and EGFR expression levels of sputum cells increased significantly and the PDGF expression level of sputum cells decreased significantly in patients with pneumoconiosis at the stages of I and II + mI (P<0.05).</p><p><b>CONCLUSION</b>The expression levels of the surface CD54, EGFR and PDGF of sputum cells in workers exposed to dusts and patients with pneumoconiosis changed, which may be useful for early detecting pneumoconiosis.and patients is changed, which may be meaningful for early detection of pneumoconiosis.</p>

Combination of effective components, the new pattern of drugs derived from modern Chinese herbal medicine / 中国中西医结合杂志

The thinking of research on developing Chinese herbal medicine (CHM) has turned from the traditional exploration for active ingredients to develop microcosmic compound drug based on TCM and/or modern medical theories, which leads to the emerge of combination of effective components (CEC), a new pattern of developing modern Chinese herbal medicine. Meanwhile its researching targets and methods, including objectivization of treated diseases, optimization of compatibility proportion, standardization of component types, definition of synergistic and antagonistic effects, and minimization of toxic and side effects, have also been renewed. The existent problems in need of improvement were put forward on the basis of current researching situation of CEC pattern in order to construct new drugs, enrich the theoretical connotation of TCM and promote the process of TCM modernization.