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Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.
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Objective:To evaluate the clinical efficacy of modified all-arthroscopic reconstruction of medial patella femoral ligament (MPFL) for the treatment of recurrent patellar dislocation.Methods:A retrospective case series study was conducted to analyze the clinical data of 38 patients (46 knees) with recurrent patellar dislocation, who were treated at First Affiliated Hospital of Shenzhen University from January 2017 to January 2020. The patients included 12 males (12 knees) and 26 females (34 knees), aged 14-40 years [(24.6±5.4)years]. All patients underwent the modified all-arthroscopic MPFL reconstruction procedure. The femoral tunnel locations were assessed by 3D-CT immediately after surgery. The MRI was performed at 6 and 12 months after operation to assess the healing morphology of the reconstructed MPFL. The Lysholm score and Kujala score were used to assess the knee function before operation, at 6 months after operation, at 12 months after operation and at the last follow-up. The time to return to sports as well as complications were observed.Results:All patients were followed up for 26-48 months [(32.4±8.6)months]. Postoperative 3D-CT examination showed that the femoral tunnels were located in the groove area of the medial epicondyle of the femur and the adductor tubercle. At 6 and 12 months after operation, MRI T2 images showed that the reconstructed MPFL had a low signal and well tensioned ligament tissue, indicating that the MPFL was healed well. The Lysholm scores at 6 and 12 months postoperatively and at the last follow-up were (81.1±12.0)points, (91.2±3.8)points, and (92.2±9.8)points, respectively, being significantly higher than the preoperative (52.4±10.6)points (all P<0.01). The Kujala scores at 6 and 12 months postoperatively and at the last follow-up were (85.4±3.9)points, (91.4±3.6)points, and (93.1±8.5)points, respectively, being significantly higher than the preoperative (55.2±6.8)points (all P<0.01). Compared with 6 months postoperatively, the Lysholm score and Kujala score were significantly improved at 12 months postoperatively and at the last follow-up (all P<0.05). All patients returned to sports, with the time to return to sports for 3-12 months [(8.7±2.3)months] after operation. One patient had poor wound healing but was healed after dressing changes. No wound infection, nerve injury, joint stiffness, patella re-dislocation or other complications occurred. Conclusion:For recurrent patellar dislocation, the modified all-arthroscopic MPFL reconstruction has advantages of accurate bone tunnel positioning, good ligament healing, good function recovery, early return to sports, and less postoperative complications.
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OBJECTIVE To study the characteristics of clinical distribution and drug resistance in patients with vancomycin-resistant Enterococci（VRE），and to provide reference for clinical prevention and control of infection. METHODS From May 1，2017 to May 1，2020，a total of 290 patients with Enterococci cultured from the samples submitted by inpatient department of our hospital were included. They were divided into VRE group （24 cases）and vancomycin-sensitive Enterococci （VSE）group（266 cases）according to the results of sensitivity tests. The basic information of patients （gender，age，submitting department，etc.）， basic diseases （hypertension，diabetes，chronic obstructive pulmonary disease ，etc.）， clinical events （catheterization，endotracheal intubation ，deep venous catheterization ，etc.），use of antibiotics （utilization and utilization time of antibiotics before and after detection ），clinical manifestations （abnormal inflammatory indicators ，clinical symptoms ，etc.）， clinical outcomes （length of stay ，improvement，etc.），drug sensitivity spectrum were all collected. Clinical distribution and drug resistance were compared and analyzed between 2 groups. RESULTS There were significant differences in the type of Enterococci， mixed infection strains and clinical manifestations between 2 groups（P＜0.05）. In VRE group ，two natural drug-resistant bacteria were detected in 66.7％ and 20.8％ of the patients ，i.e. Enterococcus gallinarum and E. casseliflavus . E. faecium was only sensitive to linezolid ，teicoplanin and tegacyclin （the drug resistance rate was 0），and was resistant to other antibiotics （the drug resistance rate was 100％）；E. faecalis was not detected. E. faecium and E. faecalis were detected in 51.9％ and 44.7％ of patients in VSE group. The resistance rates of E. faecium to other antibiotics were more than 55％ except linezolid ，teicoplanin and tegacyclin （resistance rate ≤0.72％）；the resistance rates of E. faecalis to clindamycin and erythromycin were all more than 60％，and the sensitivity to other antibiotics was more than 60％. CONCLUSIONS The VRE infection strains in our hospital are mainly natural drug-resistant bacteria such as E. gallinarum and E. casseliflavus ，and vancomycin-resistant E. faecium is found. The resistance rates of different strains to antibiotics are quite different.
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Objective:To investigate the effect of arterialised Flow-through venous flap with palmaris longus tendon in repairing dorsal digit composite tissue defect.Methods:From March, 2010 to December, 2018, 23 cases (23 digits) of dorsal digit composite tissue defect were repaired with arterialised Flow-through venous flap with palmaris longus tendon. There were 17 males and 6 females aged between 23 to 53 (average, 37.2) years old. Causes of injury: 15 cases of strangulation, 5 of electric plane and 3 of thermal crush. Number of injured digit were 1 thumb, 11 index fingers, 9 middle fingers and 2 ring fingers. All of the injured digits had skin and extensor tendon defects with an area of 2.0 cm×1.8 cm-4.2 cm×2.6 cm, and the length of extensor tendon defect was 1.6-2.6 cm. One case had terminal and central tendon insertion defects and 5 suffered with terminal tendon insertion defect. Three cases were repaired by emergency surgery, and 20 were repaired by sub-emergency surgery. All donor sites were directly sutured. The shape, colour, texture, sensation, recovery of digit function and donor site appearance were followed-up at outpatient clinic.Results:The patients were followed-up for 8 to 23 (average, 11) months. The flap was soft, with mild pigmentation and recovery of protective sensation. The range of motion of the proximal and distal interphalangeal joints was 145°-170° (average,162.6°). According to Strickland hand function evaluation method, the results were excellent.Conclusion:The arterialised Flow-through venous flap with palmaris longus tendon is an ideal method in repair of the dorsal digit composite tissue defect.
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Gout is a common metabolic disease. Gouty arthritis is associated with the deposition of urate crystals in the synovial fluid or para-articular soft tissues, which often affects the hands, feet, wrists, ankle and knees joints. However, the shoulder joint is unusual involved. In the present study, a 49-year-old male patient complained of right shoulder pain for 9 months and aggravating with limited range of motion for 2 weeks. Physical examination showed that the external rotation was 10° and hand back was S 5 of the right shoulder. The MRI showed shoulder joint effusion and intra-articular loose bodies. The patient was admitted to the hospital with the diagnosis of "loose bodies of the right shoulder with synovial chondromatosis possibly". Arthroscopic examination revealed that a lots of urate crystals were deposited on synovium, cartilage and rotator cuff. Loose bodies removal and joint debridement were performed. Histopathologic examination of the specimen demonstrated synovitis hyperplasia with urate crystals deposition. Shoulder gouty arthritis characterized by pain and limited movement. The imaging of tophi depends on the calcium-containing deposits. Tophus with calcium deposits can be found on X-ray and CT. MRI can not only evaluate the tophus but also the evaluate the other intra-articular pathologies. Due to no typical manifestations and specific images of shoulder gouty arthritis, pathological diagnosis is the "gold standard". Shoulder arthroscopy provide a minimal invasive technique in diagnosing and treating of the shoulder disease. Undoubtedly, it could be a reliable diagnosis and treatment method for shoulder gouty arthritis.
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Objective To investigate the differences in expression of Mohawk (MKX) transcription factors and collagen of types Ⅰ and Ⅲ in anterior cruciate ligament (ACL) gratis between 2 remodeling outcomes under arthroscopy.Methods Enrolled for this study were 17 patients who had undergone arthroscopic single-bundle ACL reconstruction with autogenous hamstring tendons and secondary arthroscopic exploration 48 to 131 months (average,83.1 months) after removal of tibial internal fixator at Department of Sports Medicine,The First Affiliated Hospital to Shenzhen University from March 2017 to December 2017.They were divided into a good remodeling group (11 cases) and a fair remodeling group (6 cases) according to the graft quality under arthroscopy (synovial and vascular coverage,and apparent tension,thickness and retear of the grafts).During the secondary arthroscopic procedures,biopsy of the central ACL grafts was performed.Moreover,normal ACL tissues were harvested from 8 contemporary controls of ＜ 60 years old who underwent total knee replacement.Immunohistochemical assay and quantificational real-time polymerase chain reaction were conducted to detect the expression of transcription factors and collagen of types Ⅰ and Ⅲ in all the samples.Results In the samples from good remodeling and control groups,there were abundant well-arranged collagen fibers of types Ⅰ and Ⅲ and MKX-positive cells;in the fair remolding group,the collagen fibers of types Ⅰ and Ⅲ and MKX-positive cells were much decreased in number and the fibers were not well arranged.The former 2 groups scored in immunohistochemical assay significantly higher than the latter one (P ＜ 0.05).qRT-PCR showed that the expression levels of MKX gene (0.44 ± 0.30),COL1A1 gene (0.52 ± 0.27) and COL3A1 gene (0.60 ± 0.22) in the fair remolding group were significantly lower than in the control group (1.00 ± 0.00,1.00 ± 0.00 and 1.00 ± 0.00) and than in the good remolding group (0.97 ± 0.67,0.99 ±0.38 and 1.00 ± 0.35) (P ＜ 0.05).Conclusion Good remodeling ACL grafts with histological maturation under arthroscopy are more similar to normal ACL than fair remodeling ACL grafts in expression of MKX transcription factors and collagen of types Ⅰ and Ⅲ.
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Objective To explore the application of 3D printing technology in the second staged revision of infection after hip replacement.Methods From July 2014 to July 2016,21 patients with postoperative infection after hip replacement needed for phase Ⅱ revision surgery were selected as the 3D printing group,while 21 patients who underwent hip replacement without 3D printing technique were selected as the control group.The acetabulum,femoral and other related data were obtained by CT scanning,using computer simulation and modeling in vitro,3D printing technology was used to print the model,showed the hip joint model and done the operation,after 2 to 3-year-follow-up,compared the effect and the Harris hip joint function score.Results Compared the operation time of the two groups,3D printing group average operation time was (86.4±31.5) min,while the control group was (131.7±29.6) min,the difference was statistically significant (P＜0.05);the Harris hip joint function score of 3D printing group was (41.4±7.8) point before operation,and after three years follow-up the score was (91.2 ± 6.9) point,the difference was statistically significant (P＜0.05).Conclusion 3D printing technology can be applied in the second stage revision surgery of infection after hip replacement,which has effective result.
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Objective To study the accuracy of preoperative planning and postoperative satisfaction of prosthesis posi?tion by applying the personal surgical cutting guide (PSCG) to total knee arthroscopy (TKA) based on 3D printing technique. Meth?ods In this randomized study, 20 patients were selected from August 2014 to October 2015, who were randomly divided into two groups. In PSCG group, 4 males and 6 females were enrolled, with a mean age of 70.9±6.69 (from 59 to 78) years. In con?ventional instrumentation group, 2 males and 8 females were enrolled, with a mean age of 69.9 ± 6.35 (from 58 to 77) years. The conventional instrumentation group was treated with conventional TKA, while the PSCG group was treated with personal surgical cutting guides. Then the knee valgus angle of patients, the angle between prosthesis components on the coronal and the sagittal plane of two groups were evaluated. Subsequently the correlation of the actual osteotomy amount, the valgus angle, caster angle, external rotation angle between intra? and preoperative planning were compared in the PSCG group. Results Compared with the ideal value of each angle, the mean deviation of the hip?knee?ankle angle 0.77°±0.51°, frontal femoral compo?nent angle 0.37° ± 0.53° and frontal tibial component angle 0.11° ± 0.24° showed statistically significant difference between two groups (P0.05). The actual osteotomy amount, the valgus angle, caster angle, external rotation angle corre?lated well between intra?and preoperative planning (t=-2.547, 3.864, 0.537,-0.040,-1.290, P>0.05). Conclusion TKA assist?ed by PSCG can make lower extremity alignment and accuracy of prosthesis implantation more accurate compared with convention?al TKA, especially in hip?knee?ankle angle, frontal femoral component angle and frontal tibial component angle.
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Objective To establish a thin-layer chrometograrrgy(TLC)method for the identification of quercetin and chloro?genic acid in Ramulus mori,and to screen their antioxidant activity. Methods The quercetin and chlorogenic acid were extracted by ultrasonic method with methanol as a solvent. The effect of different developed system,reagent,temperature,view methods and differ?ent silica gel plate on the TLC of quercetin and chlorogenic acid in Ramulus mori were tested to select the best TLC conditions. The antioxidant activity of quercetin and chlorogenic acid was screened with DPPH as a reagent. Results The ethyl acetate∶water∶formic acid∶toluene(17∶2∶2∶0.8)was used as a developing system and 1%AlCl3 as a chromogenic reagent. Quercetin and chlorogenic acid in Ramulus mori were identified under 366 nm,with blue and blue-green spots on silica gel G plate,and yellowish spots under purple background by the test of TLC-bioautography. Both were proven to have antioxidant activity. Conclusion The method is simple,accu?rate and reliable,and can be used for quality control of Ramulus mori.
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Objective To compare the clinical and radiographic outcomes of 3 kinds of lumbar interbody fusion (ALIF,PLIF,TLIF) for adult low-grade isthmic spondylolisthesis at L4.5 and L5S1 levels.Methods Data of seventy patients with lowgrade isthmic spondylolisthesis who had undergone different lumbar interbody fusion (LIF) procedures according to the assessment of the clinical manifestation,neurological symptoms,plane of the common iliac vessels and the width of vascular window by three-dimensional computed tomography angiography between May 2004 and May 2014 were retrospectively reviewed.21 patients had undergone anterior LIF (ALIF)(13 males and 8 females with an average of 43.29±8.15 years old (range,29-53 years old);L4,5 in ten,L5S1 in 11;Meyerding grade Ⅰ 10 cases,grade Ⅱ 11 cases);25 patients had undergone posterior LIF (PLIF) (12 males and 13 females,with an average of 44.04±12.71 years old (range,25-64 years old);L4.5 in 12,L5S1 in 13;Meyerding grade Ⅰ 15 cases,grade Ⅱ 10 cases) and 24 patients had undergone transforaminal LIF (TLIF) (12 males and 12 females with an average of 45.00± 9.36 years old (range,34-62 years old);L4,5 in 12,L5S1 in 12;Meyerding grade Ⅰ 11 cases,grade Ⅱ 13 cases).Results All patients were followed up for 24-37 months (average,25.6±8.7 months).The visual analogue scale (VAS) in all groups were decreased from 7.05±0.87 (ALIF),6.60±1.39 (PLIF),6.75±1.11 (TLIF) pre-operation to 0.90±0.70,0.96±0.68,1.04±0.62 24 months after operation.Oswestry disability index (ODI) scores were decreased from 78.53％±6.25％,79.80％±6.55％,79.92％±8.10％ preoperation to 17.14％±3.01％,21.32％±4.40％,22.46％±3.87％.Perioperative data including operation time,blood loss,postoperative blood drainage,length of stay showed no significant difference between ALIF group and TLIF group,but showing significant difference comparing with PLIF group.The imageological results showed that ALIF procedure increased whole lumbar lordosis (WL) and disc height (DH),showing no significant difference comparing with PLIF group,but showing significant difference comparing with TLIF group.The ALIF procedure increased segmental lordosis angle (SL),showing significant difference comparing with PLIF group and TLIF group.The PLIF procedure decreased spondylolisthesis index (SI),showing significant difference comparing with A/TLIF group,but showing no significant difference between ALIF group and TLIF group.There was no significant difference showed comparing the L1 axis S1 distance (LASD) and sacral slope (SS),in three groups.The graft fusion was achieved in all patients after 6-8 months postoperatively without instrument failure or displacement.Conclusion Three surgical procedures of lumbar interbody fusion for adult low-grade isthmic spondylolisthesis showed silimar clinical efficacy.The ALIF procedure is superior in its capacity to restore WL,DH,and SL,and the P/TLIF procedure are superior in correcting the vertebral slippage and spinal cord decompression.
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BACKGROUND:Studies have reported that the bone bridge and bone plug for meniscal alograft transplantation show better outcomes than simple soft tissue suture, but there are rare studies concerning the comparison of their fixation effects. OBJECTIVE:To compare the clinical effects of bone bridge and bone plug in meniscal alograft transplantation. METHODS:Eighteen patients undergoing arthroscopy-assisted meniscal alograft transplantation were enroled, including nine cases of bone plug fixation and nine cases of bone bridge fixation. Symptoms, physical examination, visual analog scale, Lysholm and Tegner scores were used to evaluate the clinic outcome. Every 6 months post operation, the signal and morphological changes of alograft meniscus was observed with MRI for each patient. RESULTS AND CONCLUSION:Al of the 18 patients were folowed up for 12-36 months after transplantation. No complications, absence of knee pain and effusion, and disappearance of the discomfort within the meniscectomy compartments after prolonged activity during folow-up period were found in al patients. The patients were competent of daily life and sports activity. The visual analog scale, Lysholm and Tegner scores were significantly increased after transplantation. MRI showed that the vicariousness and livability of the alograft menisci appeared within 1 year post operation. The safety and feasibility of the arthroscopy-assisted meniscal alograft transplantation were approved. Knee pain, knee effusion and joint stability and function were improved after arthroscopic-assisted alograft meniscus transplantation, and there was no difference between the clinical curative effects of the two kinds of fixed methods.
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Objective To investigate the changes and significances of peripheral blood CD34,KDR/CD34,CD133/CD34,and CD117/CD34 positive cell levels in patients with hemorrhagic stroke at the acute phase. Methods Thirty patients with acute hemorrhagic stroke admitted to the Department of Neurosurgery, Jiangsu Haimen People’s Hospital from September 2013 to April 2014 were enrolled retrospectively. At the same time,20 healthy subjects were selected as a control group. CD34 +,KDR+ /CD34 +,CD133 + /CD34 +, and CD117 + /CD34 +cell levels in peripheral blood were detected in patients with hemorrhagic stroke at day 1 to day 7 after cerebral hemorrhage and the day of physical examination of the control group using FACSCalibur flow cytometry. The data were obtained and analyzed using CELLQuest software. Results Peripheral blood CD34 + cells and KDR+ /CD34 +, CD133 + /CD34 +, CD117 + /CD34 + cells at day 1 to day 7 after ischemic stroke were all lower than control group (all P<0. 05). CD34 + and CD117 + /CD34 + cells decreased firstly at day 1 and 2, then increased gradually;KDR+ /CD34 + and CD133 + /CD34 + cells increased gradually at day 1 to day 5,they were all reached the peak at day 5,which were (14. 8±3. 5) í105 and (16. 7±3. 3) í105 respectively. Compared with that at day 1,CD34 + cells at day 5 and 6 were (27. 4 ±6. 3) í105 and (25. 4 ±5. 7) í105 respectively;KDR+ /CD34 + and CD133 + /CD34 + cells at day 4,5,and 6 were (10. 2±3. 1) í105,(14. 8±3. 5) í105,(12. 1±3. 4) í105 and (14. 3±3. 6) í105,(16. 7±3. 3) í105,and (13. 1±4. 0) í105,respectively;CD117 + /CD34 + cells at day 5 was (21. 3 ±4. 2) í105,which were all higher than the first day after cerebral hemorrhage (P<0.05). In the CD34 + cells,the proportion of KDR+ /CD34 + cells at day 1 to day 7 all decreased compared with the control group (all P<0. 05);the proportion of CD133 + /CD34 + cells at day 4 was (65±4)%,it was higher than the control group (P<0. 05);the proportion of KDR+ /CD34 + cells at day 5 was (55±6)% compared with day 1;the proportion of CD133 + /CD34 + at day 4 was (65 ±4)%;the proportions of CD117 + /CD34 + cells at day 4 and day 5 were (69 ±6)% and (72 ±6)% respectively,and they all increased (all P <0. 05). Conclusion Peripheral blood CD34 + cells and their cell subsets are change in patients with hemorrhagic stroke in acute phase. Speculating the different cell subsets may have different functions and potential. KDR+ /CD34 + and CD133 + /CD34 + may be the early sensitive indicators of acute hemorrhagic stroke,and CD117 + /CD34 + is largely mobilized in early stage.
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Objective To investigate the clinical effect of total hip replacement in patients with hip fusion .Methods 31cases (43 hips) with hip fusion underwent total hip replacement from January 2006 to December 2012 ,To retro-spective analysis on clinical curative effect and operation related issues .Results The mean time of follow-up was 14 .2 months(12 to 72 months) in 26 cases (37 hips) .All patients had good relief postoperative on hip pain ,knee pain and low back pain ,and the gait was closed to normal ,and the activities of daily living improved in part of cases ,including 16 cases went back to work .The assessment of X-ray showed that had not found any complications ,such as dislocation ,Osteolysis and loosening ,the excellent rate was 89 .19% .Conclusion For pa-tients with hip fusion ,Total hip replacement can improve the function of the hip fusion and relieve pain .
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BACKGROUND:Nano-hydroxyapatite helps to improve the mechanical properties of bone implants. OBJECTIVE:To study the clinical effect of nano-hydroxyapatite artificial bone on col apsed fracture of the tibial plateau. METHODS:Fourteen cases of col apsed fracture of the tibial plateau combined with bone defects from March 2010 to September 2012 were analyzed retrospectively. The bone defect range was from 1.5 cm×1.0 cm to 3.1 cm×4.5 cm. Al patients were treated with nano-hydroxyapatite artificial bone at an implant amount of 5-14 g. Clinical and X-ray observations were applied at 1 week, 1 month and 3 months postoperatively. Hospital for Special Surgery scores were employed for recovery of knee function. RESULTS AND CONCLUSION:The patients were fol owed up for 12-27 months. Except for one case of a smal amount of wound exudates, no general side effects occurred in 13 cases. X-ray photo showed an integrity interface between nano-hydroxyapatite artificial bone and host bone at 3 months after treatment. Primary healing was obtained in al cases without any complications. Hospital for Special Surgery score was increased to (88.7±4.3) points at 1 year later. These findings indicate that the nano-hydroxyapatite artificial bone has a good biocompatibility and biomechanics, and it may be an ideal artificial bone for repairing col apsed fractures of the tibial plateau.
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Objective To discuss the formation mechanism of teardrop fracture of the axis and observe the clinical efficacy of anterior or posterior induction operation according to the fracture type.Methods Thirteen patients with teardrop fracture of the axis treated from May 2001 to October 2010 were involved in the study.There were 10 males and 3 females,at age range of 18-55 years (mean,35.5 years).Four patients were combined with cervical spinal cord injury (one patient with grade C and two with grade D according American Spinal Injury Association,ASIA).Injury causes included traffic injury in 11 patients and fall from height in two.After admission,the anteroposterior,lateral and mouth X-ray films,spiral CT sagittal reconstruction and MRI examination of the cervical vertebra were performed in all the patients.According to the injury mechanism,there were 10 patients with extension fractures treated with C2,3 intervertebral bone fusion and internal fixation through submandibular retropharyngeal approach and three with flexion fractures treated with posterior C2,3 intervertebral bone fusion and pedicle screw fixation.The clinical efficacy was also observed. Results All patients received complete exposure and effective reduction and fixation.The average time of anterior exposure and posterior exposure was 77 minutes and 125 minutes,respectively.No surgical complications occurred.All patients were followed up for 9-34 months (mean,13 months).Reexamination at four months after operation displayed bone healing in all patients.There was no lessening or breakage of the internal fixators.The spinal function of three patients with ASIA grade D injury and that of one patient with ASIA grade C injury recovered to normal at postoperative 1.5 and 6 months respectively. Conclusion The surgical approaches for teardrop fracture of the axis developed in the light of the fracture formation mechanism are beneficial and safe.
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Objective To observe the operation methods and curative effect of sacroiliac joint screw fixation by using traditional imaging monitoring technique in combination with sacral slope position imaging monitoring technique. Methods After bone traction and enema cleansing, 37 patients with pelvic fractures were fixed with sacroiliac joint screws, which was monitored under C-armed X ray machine at slope position, inlet and outlet views. There were 23 males and 14 females, at average age of 30. 8 years (18-63 years). Results All the patients were followed up for 4-23 months (average 9. 8 months) , which showed basic anatomical restoration in 28 patients, coronal section dislocation for 2 mm in seven and dislocation for 5 mm in two. All fractures were healed, with no nerve or blood vessel complications found. According to Majeed scoring, the excellence rate was up to 94. 5%. Conclusions Combined use of traditional imaging monitoring and sacral slope position imaging monitoring can help improve the safety of percutaneous iliosacral screw fixation, simplify operation process and shorten operation time.
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Objective: To observe the clinical efficacy of combined tuina manipulations with Qi Zheng Qing Peng paste for herniation of the lumbar intervertebral disc. Method: All 568 cases were randomly allocated into an observation group (189 cases), control Ⅰ group (187 cases) and control Ⅱ group (192 cases). Combined tuina with Qi Zheng Qing Peng paste, combined tuina with diclofenac diethylamine emulsions and tuina alone were adopted in the above three groups respectively. The efficacies in the three groups were compared after 4 weeks of treatment. Results: The total effective rates in the observation group, control Ⅰ group and control Ⅱ group were 89.9%, 86.6% and 84.9% respectively, showing a significant difference (P ＜0.05) . Conclusion: Combined tuina manipulations with Qi Zheng Qing Peng paste works well for herniation of the lumbar intervertebral disc.
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From the visual angle of mechanics, bone remodelling plays an important role in adapting to load environment and repairing microcracks. In order to describe the process of bone remodelling explicitly, we introduced a bone remodelling model representing the biological features of damage/repair in bone. Based on Basic Multicellular Units (BMUs), the model embodies not only the mechano-transduction of osteocytes' response to mechanical stimuli, but also the biological process of the randomly ocurring microcracks that are resorbed by osteoclasts and then refilled by osteoblasts. A 2-D trabecular bone finite element model was used as an initial configuration in the research. The developments in bone microstructure and material properties have been monitored in the course of 10 simulated years. The conclusions are: (1) Initially, trabecular bone changes prominently, but it tends to be stable later on; (2) The material properties of trabecular bone in compression are much better than in tension.
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Humans , Biomechanical Phenomena , Bone Remodeling , Physiology , Bone and Bones , Wounds and Injuries , Pathology , Physiology , Models, Biological , Stress, Mechanical , Wound HealingABSTRACT
BACKGROUND:Few reports are found about the effect of ovariectomized rats' bone histomorphometry parameters using non-destructive dynamic loading system.OBJECTIVE:To observe the effect of different loads situations on the bone histomorphometry parameters in ovariectomized rats.DESIGN,TIME AND SETTING:A controlled observation on the bone histomorphometry was performed in the Biomedical Engineering Laboratory of Jilin University from April 2007 to August 2007.MATERIALS:A total of 35 9-month-old Sprague-Dawley female rats were randomly divided into five groups,including sham operation group,ovariectomized (OVX) control group,OVX loading 1 N group,OVX loading 2 N group,OVX loading 4 N group.There were 7 rats in each group.METHODS:Rats in OVX control group and castration load group were processed into bilateral OVX on the back. The sham operation group only underwent the excision of fat tissues on back,and then sutured. After castration for 1 week,rats were loaded with non-destructive dynamic loading system in the two sides of the tibia,15 minutes a day. The mechanical loads would continue for 4 weeks and the loads were 1N,2N and 4N.MAIN OUTCOME MEASURES:Changes of proximal tibia bone histomorphometry parameters.RESULTS:The area,number and thickness of trabecular bone in OVX loading group were all higher than OVX control group (P＜0.05,P＜0.01).The trabecular bone area and thickness in OVX 4 N and OVX 2 N groups were significantly higher than OVX control group (P ＜ 0.001).There was a downward trend of trabecular separation in OVX 4 N group compared with OVX control group (P ＜ 0.05). With the increasing loads,there was an increasing trend of the area,number and thickness of trabecular bone,which were close to sham-operated group. The trabecular separation was declined. Single fluorescent labeled surface and double fluorescent labeled surfaces in sham operated group were all lower than that in OVX control group. With the increase in loads,the single fluorescent labeled surface,double fluorescent labeled surface,interlabeled width and mineral apposition rate had been shown to increase. The OVX 2 N and OVX 4 N groups exhibited a remarkably higher level of mineral apposition rate than OVX control group (P ＜ 0.05).CONCLUSION:With the increase in load at the range of 1-4 N,all parameters of bone histomorphometry improve in the OVX rats,the bone microstrcture is greatly ameliorated,bone mass loss is reduced and the process of osteoporosis is delayed.
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Objective: To observe the clinical effects of frozen shoulder treated by penetrating needling and manipulation Methods: 336 cases of frozen shoulder were randomly divided into treatment group, treated with needling Jianyu (LI 15) toward Jianqian (Ex) and Manipulation, and control group, treated with needling Jianyu (LI 15) toward Jianqian (Ex). The scores of shoulder movement and the changes of infrared image were observed before and after treatment. Results: The therapeutic effects were better in the treatment group than that in the control group (P<0.05). Conclusion: Penetrating needling combining with manipulation is effective in treating frozen shoulder.