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Objective:To evaluate the development of children 2-4 years old with autism spectrum disorders (ASDs) using the Chinese version of the Griffiths Development Scales (GDS-C).Methods:Eighty-eight children with ASD, 80 children with developmental language disorder (DLD) and 82 healthy children aged 2-4 were evaluated using the GDS-C. They were compared and their development in sports, personal and social relationships, language, hand-eye coordination and other performance were analyzed. The personal-social and language results of the ASD and DLD children were compared.Results:No significant differences were found between the ASD and DLD children in their language development. The development quotient of the ASD children was significantly lower, on average, than those of the DLD and healthy children in all fields except language. However, the ASD children′s development was not balanced. Their average developmental quotients in the language and the personal-social fields were significantly lower than in the sports, performance and hand-eye coordination fields. In the field of language, the entry loss rates of the two structural modes of receptive language and non-verbal expression of the ASD children were significantly higher than the DLD children′s averages. In the personal-social field the entry loss rates of communication and housework skills and of self-care skill were significantly higher than the DLD children′s averages. The command structure model of the ASD children was also superior, on average.Conclusions:The GDS-C can effectively assess the development of ASD children aged 2-4, especially in terms of language and personal and social skills. It can provide clinical evidence useful for early diagnosis and intervention for children with ASD.
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Objective To evaluate the efficacy of surgical procedure for tibia-fibula fracture using a combination of internal fixation and vacuum sealing drainage(VSD).Methods Totally 108 patients were enrolled in this study and these patients were from January 2012 to December 2015 divided into two groups(54 per group) according to the surgical method.Patients in the observation group were treated with locking plates or intramedullary naiis fixation combined with VSD covered the wound for the following 6 to 10 days,and then the transplantation was performed.Patients in control group received external fixation with kirschner wire and screw fixation.When granulation tissue filled the wound,flap transplantation was performed to repair tissue defect and cover the exposed bone.The average hospital stay,operation time,local infection rate,fracture healing time were recorded and analyzed.Results In the observation group,the average hospital stay was (24.8 ± 4.2) d,wound closure time was (9.4 ± 1.7) d,rate of local infection was 5.6％,rate of bone nonunion was 7.4％,rate of osteomyelitis was 1.9％,fracture healing time was (17 ±4.7)weeks;the corresponding data in the control group was (32.2 ±8.7)d,(14.1 ±3.8)d,22.2％,9.3％,0 and (16 ± 6.5) weeks.The average hospital stay,wound closure time and infection rate of the two groups were of significant difference(P ＜0.05).There was no significant difference in terms of bone nonunion rate,osteomyelitis rate and union time (P ＞ 0.05).Conclusion Tibia-fibula fracture patients can be effectively treated with a combination of internal fixation and vacuum sealing drainage (VSD).This treatment may shorten the length of hospital stay,reduce the wound-close time and lower the infection rate.
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BACKGROUND:Application of Wiltse paraspinal sacrospinalis splitting approach can reduce paraspinal muscle injuries caused by operations, but there are stil no precise criteria to determine anatomic locations of longissimus-multifidus cleavage planes. OBJECTIVE:To have an intimate knowledge of structural characteristics of Wiltse paraspinal sacrospinalis splitting approach, to determine specific locations of longissimus-multifidus cleavage planes in different lumbar segments, and to provide experiences and references for its clinical applications by observations and measurements of autopsies and magnetic resonance images in Chinese people. METHODS:Ten embalmed adult cadavers were used for anatomical observations. The natural cleavage planes between longissimus and multifidus were noted and bluntly dissected bilateraly. Measurements were done between these planes and the midline at levels of spinous processes of L2 and L4. 400 patients’ images of lumbar spines were also used for observations. Measurements were taken bilateraly between longissimus-multifidus cleavage planes and the midline at levels of discs from L2/L3 to L5/S1. The correlations between these distances and sex or age were analyzed. RESULTS AND CONCLUSION:No important vessels or nerves were found in the longissimus-multifidus cleavage planes of al 10 cadavers. Superior facets and roots of transverse processes could be exposed at the bottom of the planes. At L2, the mean distance was (2.3±0.3) cm; at L4, (3.4±0.6) cm. Of al 400 images, the mean distances from L2/L3 to L5/S1 were respectively (19.71±1.93) mm, (23.49±2.49) mm, (27.49±2.84) mm and (31.36±3.15) mm. No strong correlation was discovered between sex or age with respect to measured distances. This study provides valuable references for clinical application of Wiltse paraspinal sacrospinalis splitting approach. We suggest routine measurements of magnetic resonance imaging before surgeries to reduce iatrogenic injuries.
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BACKGROUND:Clavicular hook plates have been used widely to treat acromioclavicular dislocations in recent years. However, it remains controversial whether coracoclavicular ligament should be repaired during the surgery. OBJECTIVE:To study the clinical effect and MRI manifestations after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate, and to discuss the necessity of repairing coracoclavicular ligament during the surgery. METHODS:A total of 44 patients with type III and V acute acromioclavicular Rockwood dislocations were treated with clavicular hook plates without repair of coracoclavicular ligaments, and underwent plate removal operations later. At 24 months after the second surgery, X-rays were taken to measure the width of coracoclavicular joints in both normal and affected limbs, Constant-Murley scores were calculated in both sides, and MR images were used to observe the healing of coracoclavicular ligaments. RESULTS AND CONCLUSION:39 patients (89%) were fol owed up for 36.9±3.1 months (range, 30 to 45 months). The mean duration for retaining clavicular hook plates was 12.9±3.1 months (range, 6 to 21 months). The mean width of coracoclavicular joints was 6.04±1.21 mm (range, 4.3 to 8.8 mm) in normal limb, while 5.09±1.18 mm (range, 3.4 to 7.8 mm) in affected side without significant difference (P>0.05). The mean Constant-Murley score was 98.9±1.2 (range, 96 to 100) in normal limb, while 96.7±3.4 (range, 90 to 100) in affected side without significant difference (P>0.05). MRI showed healing of the coracoclavicular ligaments and the presence of continuous scar tissue in 38 patients, excluding one patient with recurrence of acromioclavicular joint dislocation. The clinical effects after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate are satisfactory, and it is unnecessary to repair coracoclavicular ligament during the surgery. MR images reveal scar healing of the coracoclavicular ligaments without operative repair.
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Objective To observe the effects of lentivirus-mediated RNA interference silencing IL-1 type Ⅰ receptor on the expression of mitogen-activated protein kinase (MAPK) in a rat model of osteoarthritis (OA), and to explore the role of IL-1 and MAPK in OA. Methods Forty SD rats were randomly divided into four groups(A-D, each group: n = 10). The rats (A-C group) were underwent unilateral anterior cruciate ligament transaction and partial excision of the medial meniscus. At day 7 and 9 after operation, the rats of group A were respectively received 40 μL of lentivirus-mediated RNAi silencing IL-1 type Ⅰ receptor by intra-articular injection, while the rats of group B were received lentivirus-mediated RNAi non-silencing IL-1 type Ⅰ receptor, and the rats of group C were received saline. The rats of group D were taken for normal control. All rats were sacrificed four weeks after the surgery. The knees were harvested to observe macropathologic changes of the joint cartilage. ERK1/2, JNK1/2 and p38 proteins in the cartilage were detected by Western blot. Results Cartilage degradation in group A was milder than that in group B and C (P<0.05),but was worse compared to group D (P<0.05). Level of p38 expression in cartilage in group A was lower than that in group B and C (P<0. 05), but had no significant difference compared to group D (P>0.05). Levels of ERK1/2 and JNK1/2 expressions in cartilage in group A were lower than that in group B and C(P<0.05),but was significantly increased compared to group D(P<0.05). Conclusions Lentivirus-mediated RNAi silencing IL-1 type Ⅰ receptor can inhibit the expression of MAPK, in particular,p38 protein was strongly inhibited.