Biliary Cast Syndrome: Hepatic Artery Resistance Index, Pathological Changes, Morphology and Endoscopic Therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Biliary cast syndrome (BCS) was a postoperative complication of orthotopic liver transplantation (OLT), and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index (HARI), and to observe pathological changes and morphology of biliary casts.</p><p><b>METHODS</b>Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks 1, 2, 3 shown by color Doppler flow imaging. The compositions of biliary casts were analyzed by pathological examination and scanning electron microscopy.</p><p><b>RESULTS</b>HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 (P < 0.05). Odds ratio (OR) analysis of HARI 1, HARI 2, HARI 3 following the operation was >1 (OR = 1.300; 1.223; and 1.889, respectively). The OR of HARI 3 was statistically significant (OR = 1.889; 95% confidence interval = 1.166-7.490; P = 0.024). The compositions of biliary casts were different when bile duct stones were present. Furthermore, vascular epithelial cells were found by pathological examination in biliary casts.</p><p><b>CONCLUSIONS</b>HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of biliary casts and bile duct stones are different.</p>

Internal fixation with T type titanium plate for volar Barton's fracture / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the operative method and the clinical efficacy of volar Barton's fracture treated by internal fixation with T type titanium plate.@*METHODS@#We performed the operation of the open reduction and internal fixation with T type titanium plate in 18 patients with volar Barton's fracture.@*RESULTS@#The 18 patients were followed up after the operation at the average time of 13 months (6 to 31 months). X radiographs showed that all patients achieved solid bone union. Mehara's evaluation for volar Barton's fracture revealed excellent outcome in 12 patients, good in 5 patients, and fair in 1 patients. The excellent and good rate of clinical results was 94.4%. X-radiographs showed that the volar tilting angle was 8-18 (mean=11.0) degree, and the ulnar inclining angle was 16-26 (mean=22.4) degree. There was no shortening of the radius.@*CONCLUSION@#The operative treatment with titanium T type plate fixation for volar Barton's fracture is in favor of fracture anatomic reduction, solid internal fixation, and catagmatic concrescence. It is beneficial for functional recovery of the wrist at the utmost. The outcome in the near future is satisfactory. It is an ideal method for volar Barton's fracture.

Protein expression of Skp2 in osteosarcoma and its relation with prognosis / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression of Skp2 and its relation with P27 expression, clinic pathologic features, and prognostic indicator in osteosarcoma.@*METHODS@#We collected osteosarcoma specimen from 52 patients (29 males and 23 females), who were all treated by radical resection of tumor. The expression of Skp2 and P27 was determined by SP immunohistochemistry. Forty-four patients were followed up for 4 to approximately 84(mean = 31.2)months, while the other 8 patients were lost. Twenty of them survived over 5 years and 24 died.@*RESULTS@#In osteosarcoma, Skp2 highly expressed (mean value was 1.74). Expression intensity of Skp2 at the stage III was obviously higher than that of the stage II(IIa and IIb) (P 0.05). The expressions of skp2 and P27 were negative correlation in osteosarcoma (r = -0.907, P < 0.05).@*CONCLUSION@#Skp2 plays an important role in the occurrence and development of osteocarcoma by causing the degradation of P27, and can be an important prognostic indicator in osteosarcoma.

Design and manufacture of the static 3 dimensional screw-plate system and its matching tools / 中南大学学报(医学版)

OBJECTIVE@#To design and manufacture a new type instrument and its matching tools for the proximal femur.@*METHODS@#A new type instrument of subtrochanterical fracture-static 3-dimensional screw-plate system(STDSP)was designed and manufactured. The different types of accessory instruments which adapted to STDSP,the aiming guide, and the accessory tools were also designed and manufactured, and they were tested on bones.@*RESULTS@#STDSP included 3 special lag screws and 1 anatomic plate. The lag screws distributed in femoral neck like "or"shape. There was 135 degree between the lag screws and femoral shaft. The shape of the plate was similar to the anatomic structure of the proximal thighbone. The posterior screw was stably connected to the plate. The plate was affixed crosswise to the lateral and anterior side by bicortical screws. The aiming guides and all kinds of accessory tools could help to install STDSP exactly and conveniently,which was verified on cadavers and X-ray photographs.@*CONCLUSION@#STDSP has the function of dynamic compressing in 3-dimensional space, and can match with the structure of the proximal femur preferably. STDSP may be a suitable instrument to the subtrochanteric fractures. The accessory apparatus of STDSP has simple configuration,and can let the STDSP be installed accurately, conveniently and rapidly.

Integrity of lumbar facet joint and curative effect after a lumbar intervertebral disc operation / 中南大学学报(医学版)

OBJECTIVE@#To analyze the relation between the clinical outcome and the integrity of the facets after a lumbar operation,and to provide a reference for choosing operative method and clinical prognosis.@*METHODS@#Forty-three patients with complete data underwent uni-segment discectomy were enrolled. There were 3 surgical interventions: open-window discectomy, full or semi-laminectomy. Groups were divided based on the integrity of the facets after the operation, and the clinical symptoms and signs were evaluated using the Japanese Orthopaedic Association Back (JOA) scores at 24-month follow-up.@*RESULTS@#Preoperative JOA scores were not significantly different among the groups (P>0.05). Compared with the facet intact group at 24-month follow-up,JOA scores were descended statistically in total uni-facetectomy group and total uni-facetectomy plus partial opposite facetectomy group (P<0.01).@*CONCLUSION@#Keeping facets integrated plays an important role in achieving good clinical results,and the damage of facet should be avoided in the lumbar operation.

Clavicular hook plate in the treatment of dislocation of acromioclavicular joint and fracture of distal clavicle / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the curative effects of AO clavicular hook plate in the treatment of dislocation of acromioclavicular joint and fracture of distal clavicle.@*METHODS@#We retrospectively analyzed the clinical data of 39 patients with acromioclavicular joint dislocation or distal clavicle fractures treated with clavicular hook plate: 16 suffered from dislocation of acromioclaviculr joint, 18 suffered from far end collarbone fractures, and 5 patients had both symptoms.@*RESULTS@#The 39 patients were followed up for 12 months averagely. All patients got good reduction and fixation. The acromioclavicular joint subluxation, breakage, and loosening of the clavicular hook plate were not observed. The acromioclavicular joint recovered quickly.@*CONCLUSION@#AO clavicular hook plate is a good choice for acromioclavicular joint dislocation and distal clavicular fracture.

Clinical analysis of the treatment of reserving limb for patients with malignant bone tumor / 中南大学学报(医学版)

OBJECTIVE@#To investigate the curative effect of the treatment of reserving limb for patients with malignant bone tumor.@*METHODS@#Forty patients with bone neoplasms underwent the operation of reserving limbs. The neoadjuvant chemotherapy was given to all the patients before the operation. After the ablation of the tumor we used the artificial prosthetic replacement,tumor tissue deactivation and reimplant, variant bone and joint transplantation to reserve the limb.@*RESULTS@#All the patients were followed up. The average follow-up time was 34.8 months. Eight patients got complications. And the fineness rate was 72.5% according to functional evaluation standard of Enneking after surgical treatment of bone tumor.@*CONCLUSION@#The operation of reserving limb was an ideal method to cure the malignant bone tumor. The proper operative treatment with neoadjuvant chemo-therapy is helpful to extend the life of the patients and increase the quality of life.