ABSTRACT
Objective To explore the effect of iliac bone flap combined with cancellous bone graft in the treatment of traumatic avascular necrosis of the femoral head (TFHIN). Methods The patients were treated with iliac bone flap and cancellous bone graft. The operation time, intraoperative blood loss, fracture healing time, follow-up time and the postoperative complications were recorded.The degree of hip movement (flexion, external rotation, internal rotation, abduction and adduction) was recorded;the hip functions of patients with different stages were analyzed;the long-term curative effect of postoperative was analyzed. Results The operation time was (68.36 ± 6.81) min, intraoperative blood loss was(93.65 ± 10.42)ml, fracture healing time was(4.31 ± 1.25)months, follow-up time was 35-62 (48.92 ± 2.61)months, and the postoperative complication was 1.42%(3/212).The scores of hip function were significantly improved in each postoperative stage, joint flexion, external rotation, internal rotation, abduction and adduction range was significantly expanded: (94.86 ± 12.37)° vs. (118.24 ± 15.25)°, (32.07 ± 10.34)° vs. (43.64 ± 10.82)°, (28.33 ± 9.61)° vs. (33.41 ± 11.85)°, (19.44 ± 8.37)° vs. (24.36 ± 7.65)°, and the differences were statistically significant (P<0.05). At the last follow-up, the total excellent and good rate of hip function recovery was 88.74%(205/231).The stability rate of imaging was 80.09%(185/231). Conclusions In patients with TFHIN, treatment with the iliac bone flap pedicled with cancellous bone could the blood pressure of the femoral head, restore the blood supply to the damaged site, participate in the bone induction, and improve the hip movement and function,which has a good effect.
ABSTRACT
Objective To compare the value of NBI with magnify endoscopy (NBI-ME) and Lugol chromoendoscopy (LCE) in preoperative assessment of early esophageal cancer, and assess whether the former can replace the latter. Methods 59 patients, sampled in the Second Hospital of Lanzhou University, the First Hospital of Lanzhou University and the Second Hospital of Lanzhou City from January 2014 to December 2015, were examined respectively by NBI-ME and Lugol chromoendoscopy not only to distinguish the lesion boundaries but also predict the pathological types as well for statistical analysis with the combination of the final postoperative pathological results. Results Only 64.4 % (38/59) of lesion boundaries can be well-distinguished by NBI-ME, which is significantly lower than that distinguished by Lugol chromoendoscopy (91.5 %, 54/59), with its kappa value 0.208 0.05 (0.369), Kappa > 0.4 (0.429), P 0.05 (0.475), Kappa <0.4 (0.286), P < 0.01 (0.001), showing the poor concordance instead. Conclusions To some extent, pathological type predicted by NBI-ME indeed had an concordance with postoperative pathology, which was also superior to the results examined by Lugol chromoendoscopy, while there was no denying that Lugol chromoendoscopy had an obvious advantage over NBI-ME in terms of distinguishing lesion boundaries, therefore, it can not be completely replaced with NBI-ME at present.