Treatment of dislocation of acromioclavicular joint with TightRope fixation through a small incision in the base of coracoid process / 中国骨伤

OBJECTIVE@#To explore the method and effect of small incision TightRope fixation in the treatment of fresh acromioclavicular joint dislocation.@*METHODS@#From January 2016 to May 2018, 28 cases of fresh acromioclavicular dislocation were treated, including 20 males and 8 females, aged 26 to 87 years with an average age of 51.3 years. The modified Rockwood classification included 1 case of typeⅡ, 22 cases of typeⅢand 4 cases of type V. The average time from injury to operation was 2.4 days. The operative time, shoulder function recovery time and postoperative complications were recorded, and the immediate reduction effect and Karlsson function of shoulder joint were evaluated.@*RESULTS@#In 28 patients, only one Rockwood typeⅡ was used to reconstruct the pyramidal ligament, and the other 27 were used to reconstruct the pyramidal ligament and the trapezoid ligament. The average operation time was (66.50±12.62) min (including intraoperative fluoroscopy time). Twenty-eight cases were followed up for 11 to 20 (16.7±4.6) months. The recovery time of shoulder function was 2 to 7 months with an average of 4 months. During the follow-up period, 1 case had osteolysis and loss of reduction at the clavicular plate site, and the rest had no complications such as re-dislocation and button plate prolapse. Immediate reduction effect after operation:6 cases with reduction insufficiency, 17 cases with complete reduction and 5 cases with excessive reduction;Karlsson function evaluation of shoulder joint in the last follow-up:excellent in 21 cases, good in 6 cases and poor in 1 case;Pearson analysis =0.060, suggesting that the immediate reduction effect of fresh acromioclavicular dislocation operation has no significant correlation with Karlsson function evaluationof shoulder joint in the last follow-up.@*CONCLUSION@#TightRope fixation through a small incision in the base of coracoid process is a simple and effective method for the treatment of dislocation of acromioclavicular joint. There was no significant correlation between the slight difference of immediate reduction effect within 5 mm and Karlsson function evaluation of shoulder joint in the last follow-up. It is suggested to pay attention to the loss of reduction and osteolysis of clavicular plate in clinical follow-up.

Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the causes and prevention of the complications about treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II) with clavicular hook plate.</p><p><b>METHODS</b>From January 2001 to December 2011, 246 patients with acromioclavicular joint dislocation (Tossy III) and 222 patients with unstable distal clavicular fracture (Neer II) were treated with acromioclvicular hook plate fixation,including 348 males and 120 females with an average age of 45.4 years old ranging from 21 to 80 years old. The mean time from injury to operation was 30.8 hours (ranged from 1 h to 15 d). All patients had normal shoulder function before injury. According to Karlsson evaluation standard, the cases with excellent and good function of the shoulder joint were regarded as the normal group, and the cases with poor function of shoulder joint as the abnormal group. The comparison of the range of forward flexion,backward stretch, adduction, abduction and elevation of shoulder joints between two groups was performed. The data of impingement, subacromial osteolysis, acromioclavicular arthritis, clavicular stress fracture, downward acromioclavicular joint subluxation, hook cut-out and hook break were summarized.</p><p><b>RESULTS</b>All patients were followed up from 8 to 48 months with an average of 12.5 months. The results were excellent in 308 cases,good in 76,and poor in 84 according to Karlsson evaluation. The excellent and good rate was 82.1%. The difference of the range of forward flexion, backward stretch, adduction, abduction and elevation of shoulder joints between two groups had a statistically significant difference (P < 0.01). Among 84 poor cases, there were 41 (8.76%) in acromial impingement or inadequate place of plate hook, 12 (2.56%) with subacromial osteolysis or/and bursitis, 10 (2.14%) with acromioclavicular arthritis or painful shoulder caused by delayed dirigation,7 (1.50%) with clavicular stress fracture or interal plate upward, 6 (1.28%) with downward acromioclavicular joint subluxation, 5 (1.07%) with hook cut -out and 3 (0.64%) in hook break.</p><p><b>CONCLUSION</b>The clavicular hook plate is useful for the treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II). The correct place and suitable preflex of plate hook,the restoration of fiber structure around the acromioclavicular joint and the advisable dirigation contribute to the modified rate of complications.</p>

Proportion of intermediate epithelial cells and human prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the different proportions of intermediate epithelial cells in human prostate cancer tissue and their clinical significance.</p><p><b>METHODS</b>We performed immunohistochemical staining for Cytokeratin 5 (CK5) and Cytokeratin 8 (CK8) on 60 samples of human prostate cancer, determined the proportions of intermediate epithelial cells in the cancer tissue, and classified the samples into 2 types, one with a majority of intermediate epithelial cells (CaP-INT, n = 32), and the other composed mostly of luminal epithelial cells (CaP-LUM, n = 28). Then we compared the 2 types of prostate cancer in the expression of the androgen receptor (AR), age of the patient, serum t-PSA, prostate volume, Gleason score, clinical stage, androgen resistance, and incidence of distant metastasis.</p><p><b>RESULTS</b>CaP-INT showed a significantly lower expression of AR ([24.42 +/- 11.41] %) and a higher incidence of distant metastasis (n = 14) than CaP-LUM ([77.21 +/- 10.22] % and n = 4) (P < 0.05). In the CaP-INT group, 6 of the 26 endocrinologically treated cases developed into androgen-independent prostate cancer (AIPC), while in the CaP-LUM group, only 1 out of 23 (P < 0.05). The former also showed remarkably higher clinical stages than the latter (P < 0.05), but no significant differences were found in age, serum t-PSA, prostate volume and Gleason score between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>A higher proportion of intermediate epithelial cells may lead to increased invasiveness and metastasis of human prostate cancer.</p>

Penetrability and therapeutic effect of vancomycin to the prostates of rats with bacterial prostatitis (BP) or BPH-BP / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the penetrability and therapeutic effect of vancomycin to the prostates of rats with bacterial prostatitis (BP) or benign prostate hyperplasia (BPH)-BP.</p><p><b>METHODS</b>The experimental rats with BP or BPH-BP were injected with vancomycin through the tail vein. The prostate tissues and sera were isolated respectively from the rats at 10 min to approximately 24 h after treatment and the antibiotic activities of the samples were detected by serial dilution test and agar diffusion test. The rats with BP or BPH-BP were treated with vancomycin by intravenous injection daily for 5 days. The prostates were collected the second day after injection and bacteria were isolated and determined. One to five weeks after treatment, the prostates of the animals were isolated and pathologic tests were done.</p><p><b>RESULTS</b>No bacteria could be isolated from the prostates of the normal rats, but positive isolation was achieved from the prostates of the infected animals 28th day after infection. In the first 4 days after treatment, a decrease of bacteria could be detected in the prostate samples of the rats treated with BP or BPH-BP. After 5th day, no bacteria could be detected from 91.7% prostates of the treated groups. Obvious antibiotic activity in both sera and prostates could be detected 10 to approximately 150 min after the antibiotic injection. Antibiotic activity of the prostate tissues could be lower or higher than or equal to that of the sera in the same period. Pathologic tests detected obvious exudation and leukocyte invasion in the prostate tissues of the BP rats and gland proliferation in the BPH rats. Vancomycin treatment and the consequent reduction of bacteria obviously alleviated the inflammatory pathological changes in the prostates of the BP rats.</p><p><b>CONCLUSION</b>Vancomycin given intravenously has more penetrability to the prostates of either BP or BPH-BP rats. The antibiotic concentration in the prostate tissues may be equal to or higher than that of the sera, so that the susceptive bacteria in the prostates will be killed and the alleviation of the inflammation and repair of the tissues accelerated effectively.</p>

Study on early fluid resuscitation of patients with traumatic shock / 中华急诊医学杂志

Objective To investigate the early fluid resuscitation of patients with traumatic shock.Method Two hundred and ninty-eight patients with traumatic shock were retrospectively analyzed.Survivors within 24 hours after admission were regarded as survival group and dead patients as dead group.The comparison was made in regard to injury severity score(ISS)and volume of fluid infusion and blood-transfusion between two groups within 24 hours after admission.At the same time,the comparison in respct of mortality between operation group and non-operation group was also made.Results Of the 298 patients,230(77.2%)survived and 68 (22.8%)died within 24 hours after admission.The ISS and the volume of fluid infusion and blood-transfusion in the dead group were significantly higher than those in the surviving group(P

The treatment of benign prostatic hyperplasia by means of transurethral holmium laser enucleation / 中华男科学杂志

<p><b>OBJECTIVES</b>To evaluate the clinical effect of the holmium laser enucleation and morcellation of prostate (HoLEP) in the treatment of benign prostatic hyperplasia(BPH).</p><p><b>METHODS</b>In the treatment of 35 BPH patients, 100 watt high-powered holmium laser set was used transurethrally and a reciprocating blade tissue morcellator was introduced via a nephroscope to enucleate and morcellate the prostatic tissue.</p><p><b>RESULTS</b>Operations in all 35 cases were successful. The average operation time was 60 +/- 23.2 (range 30-180) min. The removed prostatic tissue weighed 31 +/- 9 (range 10-56) g on average. The average catheter time was 1.5 d (from 20 h to 4 d). No blood transfusion was performed in all cases. Histopathological analysis confirmed the diagnosis of BPH in all cases. In the 3-month follow up of 32 cases, IPSS dropped from 24 +/- 6.2 to 5.6 +/- 3.6; the peak urinary flow rate(Qmax) went up from 8.5 +/- 3.9 ml/s to 22.0 +/- 7.2 ml/s; the residual volume of urine dropped from 138 +/- 125 ml to 21 +/- 15 ml. No serious complications were found.</p><p><b>CONCLUSIONS</b>HoLEP is effective in treating BPH. It can completely enucleate the hyperplastic tissue with little bleeding in operation. The treatment has the advantages of short catheter time and significant clinical improvements.</p>

Expression of androgen receptor isoforms in normal human prostate / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expression of androgen receptor (AR) isoforms in normal human prostate.</p><p><b>METHODS</b>Fourteen normal prostatic specimens from donors, aged 25 on average (21-28 yr), were analyzed by high resolution isoelectric focusing (IEF). The expression of AR isoforms was demonstrated in all 14 normal human prostatic tissues.</p><p><b>RESULTS</b>Four types of AR isoforms were detected with isoelectric point value at 6.5, 6.0, 5.8 and 5.3 in 14 prostatic specimens. Binding of 3H-dihydrotestosterone (DHT) to these four AR isoforms was inhibited by the addition of 100-fold excess of DHT and testosterone. No effect of progesterone, estradiol and diethylstilbestrol on tritiated hormone binding was observed.</p><p><b>CONCLUSIONS</b>There are four AR isoforms in normal human prostate. The expression of AR isoforms is different from one another.</p>