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Objective:To analyze the surgical method and clinical effect of modified anterolateral approach in the treatment of posterolateral tibial plateau fractures.Methods:From January 2014 to December 2017, 21 patients with posterolateral tibial plateau fractures were treated by the modified anterolateral approach in the second people's Hospital of Tangshan, Hebei Province were retrospectively analyzed.The outpatient department conducted regular reexaminations 1, 3, 6 and 12 months after the operation.Rasmussen radiology score, hospital for special surgery (HSS) score of knee function and Lysholm score were used to evaluate the postoperative knee function, and the score results were statistically analyzed.Results:The Rasmussen radiological score of 21 patients immediately after surgerywas (16.96±1.67), ranging from 15.00 to 18.00, with excellent in 15 cases, good in 6 cases, and the excellent and good rate was 100%.Rasmussen radiology score (16.57±1.51) in the last follow-up, ranging from 15.00 to 18.00, showed no significant difference between the last follow-up and the immediate postoperative ( t=0.935, P>0.05). At the last follow-up, the HSS score of knee joint function was (88.55±7.25), ranging from 80.00 to 9.00.At the last follow-up, Lysholm score (86.64±4.34), ranging from 82.00 to 90.00, was excellent in 15 cases, good in 6 cases, and excellent in 100%. Conclusion:The modified anterolateral approach for the treatment of posterolateral tibial plateau fractures is effective and simple, and can achieve good clinical results.
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Objective To investigate the characteristics of five hormone levels of hypertension in patients with essential hypertension,and explore the correlation between them and essential hypertension.Methods The clinical data of 1 731 patients with essential hypertension and 305 healthy people in General Hospital of Heilongjiang Province Land Reclamation Bureau from April 2018 to March 2019 were analyzed retrospectively.The levels of renin,angiotension Ⅱ (AT Ⅱ),aldosterone,adrenocorticotropic hormone (ACTH) and cortisol were measured by magnetic particle chemiluminescence,and the ratio of aldosterone to renin (ADRR) was calculated.Results The renin,AT Ⅱ,aldosterone,ACTH,cortisol and ADRR in patients with essential hypertension were significantly higher than those in healthy controls:(13.58 ± 9.78) ng/L vs.(9.20 ± 2.12) ng/L,(181.06 ± 89.82) ng/L vs.(133.49 ± 5.47) ng/L,(174.96 ± 103.14) ng/L vs.(136.04 ± 15.48) ng/L,(76.39 ± 61.43) ng/L vs.(26.98 ± 5.10) ng/L,(176.4 ± 88.8) μg/L vs.(145.1 ± 18.9) μg/L and 27.71 ± 18.37 vs.15.18 ± 1.77,and there were statistical differences (P＜0.01).The renin and AT Ⅱ in male patients with essential hypertension (904 cases) were significantly higher than those in female patients with essential hypertension (827 cases):(16.04 ± 10.67) ng/L vs.(10.34 ± 8.59) ng/L and (194.28 ± 96.22) ng/L vs.(166.37 ± 83.42) ng/L,the aldosterone was significantly lower than that in female patients with essential hypertension:(166.31 ± 101.91) ng/L vs.(184.68 ± 104.37) ng/L,and there were statistical differences (P＜0.01 or ＜0.05);there were no statistical difference in ACTH,cortisol and ADRR (P＞0.05).The renin and AT Ⅱ in patients aged 51 to 60 years (610 cases) and ＞60 years (572 cases) were significantly lower than those in patients aged ＜ 50 years (549 cases):(12.67 ± 10.76),(12.43 ± 8.29) ng/L vs.(16.05 ± 10.29) ng/L and (172.62 ± 81.63),(166.04 ± 79.09) ng/L vs.(208.94 ± 108.75) ng/L,and there were statistical differences (P＜0.05 or ＜0.01);there were no statistical difference in aldosterone,ACTH,cortisol and ADRR (P＞0.05).Multivariate linear regression analysis result showed that renin and AT Ⅱ were negatively correlated with systolic blood pressure and diastolic blood pressure (P＜0.01 or ＜0.05),and aldosterone,ACTH and cortisol were positively correlated with systolic blood pressure and diastolic blood pressure (P＜0.05 or ＜0.01).Conclusions Renin and AT Ⅱ are negatively correlated with systolic blood pressure and diastolic blood pressure;aldosterone,and ACTH and cortisol are positively correlated with systolic blood pressure and diastolic blood pressure.The five hormone levels of hypertension can reflect the function of renin-angiotension-aldosterone (RAAS) system and hypothalamus pituitary adrenocortical axis (HPA axis),which are the influencing factors of essential hypertension.
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Objective To investigate the variation of lymphocyte subgroup,lymphocyte and C-reaction protein in patients with acute and chronic Brucellosis,for auxiliary reference in differential diagnosis of acute and chronic Brucellosis.Methods All the blood samples were come from clinical laboratory of Heilongjiang Agricultural Reclamation Bureau General Hospital,which including 35 acute patients(acute group),62 chronic patients(chronic group) and 30 healthy people(control group).Flow cytometric method was used to determine the T lymphocyte subgroup(CD3+,CD19+,CD3+/CD4+,CD3+/CD8+) and the lymphocyte.Application of rate scattering turbidimetric method was used for determination of C-reactive protein.Results Percentages of CD3+ cells in acute and chronic groups were increased compared with that of control group(％:74.71 ± 6.79,70.61 ± 8.99 vs.65.00 ±7.50; F =12.40,P ＜ 0.05),and the acute group was higher than the chronic group(P＜ 0.05).Percentages of CD19+,CD3+/CD4+ cells in acute and chronic groups were decreased compared with that of control group(CD19+,％:7.79 ± 3.93,9.94 ± 4.53 vs.11.50 ± 3.25; CD3+/CD4+,％:30.56 ± 6.38,35.56 ± 8.22 vs.39.00 ± 4.00; F=18.62,13.03,all P＜ 0.05),and the acute group was lower than the chronic group (P＜ 0.05).Percentage of CD3+/CD8+ cells in the acute group was higher than those of the chronic and control groups(％:4.06 ± 8.35,29.50 ± 7.25 vs.28.72 ± 8.30; F =12.06,P ＜ 0.05).The lymphocyte counts in acute and chronic groups were higher than that of the control group(％:34.29 ± 10.91,39.12 ± 12.08 vs.30.84 ± 6.45; F=13.78,P ＜ 0.05),but the acute group was lower than the chronic group(P ＜ 0.05).C-reactive protein levels in acute and chronic groups were increased compared with that of the control group(mg/L:27.43,15.87 vs.0.60; H =19.42,P ＜ 0.05),and the acute group was higher than the chronic group(P ＜ 0.05).C-reactive protein positive rates in acute and chronic groups were increased compared with that of the control group(65.7％,61.3％ vs.3.3％; x2=27.54,23.16,all P ＜ 0.01).The difference between groups was statistically significant(x2 =9.94,P ＜ 0.01).Conclusion Lymphocyte subgroup,lymphocyte and C-reactive protein are changed differently in patients with acute and chronic Brucellosis which have a certain reference value in differential diagnosis and treatment of acute and chronic Brucellosis.
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Objective To evaluate the operation and review the clinical effectiveness of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon.Methods From January 2010 to January 2013,55 patients (25 men,30 women) with the mean age of 52.4 (range,37-65) years old who underwent arthroscopic tenodesis through double-needles positioning portal to treat proximal lesions of Biceps tendon were retrospectively analyzed.Shoulder pain of all the patients occurred in pre-operation and aggravated at the time of abduction shoulder joint,which affected the normal life for reasons of weakness.Diagnosis of magnetic resonance imaging (MRI) was proximal lesions of Biceps tendon,which was failed to respond to conservative management of six months.All patients underwent biceps tenodesis under arthroscopy with fixation of two suture anchors through bone,and removed tendon stump finally.All the portals of operation and observation of tendon fixation used double-needles positioning portal.We recorded the general condition of shoulder as the level of pain,sphere of activity,active forward flexion and intensity of adduction in pre-operation,3 months,6 months,12 months and 18 months after operation with American Shoulder and Elbow Surgeons (ASES),shoulder function score of Constant-Murley (Constant) and University of California,Los Angeles (UCLA).Then all data were analyzed statistically.Results All patients were operated successfully and got the mean follow-up of 20 months (range,18-24).The result of MRI showed well healing of tendon without rupture.The shoulder function had basically recovered.In pre-operation,ASES,constant and UCLA scores was 10.22±3.02,35.89±7.25,8.53±2.07 respectively.In 18 months after operation,the scores were 32.07± 1.26,89.75±4.07,31.87±2.07 respectively.The outcomes demonstrated that all scores in 18 months after operation had significantly improved,compared to pre-operation.Conclusion The technique of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon is reliable and simple,and can achieve satisfactory clinical outcomes.
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Objective To study the male reproductive ability of male rats with Toxoplasma gondii ( Tg) infection and investigate the variation of Toxoplasma infection in seminal plasma of infertile patients and explore its mechanism. Methods Thirty SD rats were randomly divided into 3 groups. The rats in the Toxoplasma infection group were administrated intraperitoneally with tachyzoites of Tg. in a dosage of 2 × 10~ 5/ml(2ml) , the rats in the treated group were administered with the same dosage of the tachyzoites and from the second day after the infection they were treated with 200 mg/kg azithromycin for 7 days, and the normal group was given physiological saline. Nine weeks after the infection, the serum sex hormone level, number,vitality, activity and quantity of spermatozoa and activities of enzymes in testa's of the testicular tissues were determined in the male rats. The female rats infected with Tg were matched with normal female rats at a ratio of 1: 2 for one week, and on the 21st day of pregnancy, the number of corpora luteum, sex ratio and the weight, body length and tail length of fetus were measured. The ELISA method was used todetermine the seminal plasma's anti-Tg IgG antibody of the 169 patients with infertility and 35 males with normal fertility. Meanwhile the NO levels in their semina were determined by means of nitric acid reducase. Results The number, activity .vitality, serum level of sex hormones were all lower in the infected rats than those in the normal and treated groups. The number of fetus in the pregnant rats matched with the infected male rats was significantly fewer, but the average body weight, body length, tail length of the fetuses and sex proportion showed no significant difference in comparison with those of the control group. The anti-Toxoplasma gondii antibody positive rate in the masculine infertility patients was 18.35% , being significantly higher than 2. 86% in the normal fertility group(P < 0.05 ). The mean NO level in the semina from the infertility group was (146.68 ± 38. 87) μnol/L , which was significantly higher than (84.92 ± 26.72) μnol/L( P < 0.01) in the fertility group. Conclusion Toxoplasma gondii infection can cause certain influences on the male reproductive ability.