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Objective:To investigate the therapeutic effects of antibiotic articular cement spacer on shoulder joint infection in the elderly patients during stage-one operation.Methods:The data of 3 patients were analyzed retrospectively who had been treated at Department of Orthopaedics, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University for shoulder infection from May 2018 to December 2019. They were one man and 2 women with an average age of 65.3 years (from 64 to 67 years). One case of infection followed shoulder puncture, another proximal humeral fracture and another shoulder prosthesis replacement. All the 3 patients underwent radical debridement and implantation of antibiotic shoulder cement spacer in stage-one operation but no stage-two operation. The therapeutic effects were evaluated by American Shoulder and Elbow Surgeons (ASES) scoring, Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scoring, Visual Analog Scale (VAS), and range of shoulder motion.Results:The 3 patients were followed up for 18 to 28 months (mean, 22.7 months). There was no recurrence of infection and the spacers were in good position. The microorganisms detected were Bifidobacterium brevis in one case and methicillin-resistant Staphylococcus aureus in 2 cases. At the final follow-up, the ASES scores averaged 54.4 (from 46.3 to 60.0), Quick-DASH scores 45.1 (from 40.8 to 50.0), VAS scores 2.3 (from 2 to 3), ranges of elevation 65.7 °, ranges of abduction 43.8° and ranges of external rotation 21.7°.Conclusion:For the elderly patients with shoulder infection, implantation of antibiotic shoulder cement spacer after radical debridement can well control infection, relieve pain and improve shoulder functions, sparing them secondary operation.
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According to the literature and expert experience, a comprehensive index system of subjective and objective was established, including the patient's condition, the treatment information for the same kind of patients, technical level of the medical team, and the medical conditions. Secondly, in the light of the heterogeneous evaluation information, the comprehensive index weight was computed by combining subjective weight and objective entropy weight. Furthermore, the VIKOR method was applied to deal with heterogeneous evaluation information and obtain the priority of potential surgical treatments. Taking a rectal cancer patient in a general hospital in Hunan Province as an example, the optimal surgical treatment obtained by this method was consistent with the actual treatment. The reliability and effectiveness of the heterogeneous VIKOR method based on probabilistic linguistic term sets are verified by an experimental example of rectal cancer, and the method can be used to help doctors, patients and family members to select the surgical treatments for rectal cancer effectively.
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Humans , Body Weight , Rectal Neoplasms , General Surgery , Reproducibility of ResultsABSTRACT
The anterior cruciate ligament (ACL) injury in sports is a common knee joint injury.It is widely accepted to reconstruct ACL under arthroscopy with autologous patellar ligament or popliteal ligament fixed in tibial or femoral tunnel with interference screws.Interference screws are widely used as intra-articular fixation devices in ACL reconstruction.The ideal materials for interference screw provide rigid fixation of graft with high mechanical strength,long-lasting stiffness and the bioactivity to stimulate osteointegration and tendon-bone healing.Current interference screws are made of metals and bio-absorbable polymers.Metallic interference screws provide high mechanical strength and stiffness for tendon graft fixation,but require a second surgery for removal.Bioabsorbable interference screws made of polymers avoid second surgery for removal,but have lower mechanical strength and might cause aseprtic inflammation during its degradation as well as screw slip,tunnel enlargement and many other complications.Magnesium (Mg) has been investigated as a novel and potential biomaterials for biodegradable interference screws.Mg is essential nutrient element and has good biocompatibility.Its mechanical strength and related stiffness are much higher than that of biodegradable polymers and are close to cortical bone.Furthermore,the degradation rate of Mg in vivo could be modulated via techniques such as alloying.In previous studies,the relationship between screw design and its pull-out force has been investigated,based on which the design of interference screw is optimized.The mechanical properties (the ultimate load to failure and the related stiffness) of interference screws proved to be higher than that of bioabsorbable interference screws sharing the same design both in vitro and in vivo.Furthermore,Mg performs good biocompatibility without severe intra-articular inflammatory reactions,as well as unique bioactivities to promote osteointegration,mineral deposition and the regeneration of fibrocartilaginous entheses.The present study reviews the researches of Mg interference screws both in vitro and in vivo,gives reference for further research and has great importance for the application of Mg interference screws in ACL reconstruction.
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Objective To observe the influence of large dose of mecobalamin combining with breviscapin injection on the levels of serum tumor necrosis factor-α(TNF-α)and C-reactive protein (CRP)and the antithrombin Ⅲ(AT-Ⅲ)activity in the patients with diabetic foot(DF).Methods 240 cases of DF were divided into 4 groups according to the random number table method,60 cases in each group:the large dose of mecobalamin plus breviscapin injection group (group Ⅳ);the routine dose of mecobalamin plus brevis-capin injection group (group Ⅲ);the simple breviscapin injection group (group Ⅱ)and the routine dose of mecobalamin group (groupⅠ).4 weeks were taken as a course of treatment.The TNF-α,CRP levels and the AT-Ⅲ activity before and after the treat-ment were detected and performed the comparative analysis.Results The levels of TNF-α,CRP and AT-Ⅲ before treatment had no statistically significant differences among in the four groups (P >0.05).Compared with the results before treatment,the levels of TNF-αand CRP after treatment in 4 groups were obviously decreased and the AT-Ⅲ level was significantly increased,the differ-ences had statistical significance (P <0.05);compared with the group Ⅰ,Ⅱ and Ⅲ,the difference in the group Ⅳ had statistical significance(P <0.05).Conclusion Mecobalamin combined with breviscapin injection is able to decrease the serum inflammatory factors such as TNF-αand CRP,and increase the AT-Ⅲ activity in the patients with DF,which is more significant when increasing the mecobalamin concentration.Therefore,adopting the therapeutical scheme of increasing the mecobalamin concentration combined with breviscapin injection could obviously decrease the inflammatory reaction of DF with good safety,which is one of effective meas-ures for increasing the curative effect of DF.
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0.1 ?mol?L-1), inducing differentiation through enhancement of melanogenesis and increase of the activity of tyrosinase at lower doses(