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Objective:To investigate the combination of internal fixation for periprosthetic fractures of the proximal femur (PFFF) after hip arthroplasty.Methods:The data of 58 patients with periprosthetic fractures after hip arthroplasty from May 2008 to March 2022 were retrospectively analyzed, including 31 males and 27 females. The average age was 75.5±18.2 years (range, 35-95 years). There were 39 total hip arthroplasty and 19 hemiarthroplasty; 37 biological prosthesis and 21 cemented prosthesis. Intraoperative periprosthetic fractures occurred in 6 cases and 52 cases postoperatively. Unified classification system (UCS): UCS IV.3A1 type 2 cases, 3A2 type 1 case, 3B1.1 type 19 cases, 3B2.1 type 25 cases, 3B3 type 2 cases, 3C type 9 cases. Fracture site: 3 cases in zone A (greater trochanter), 46 cases in zone B (around the femoral stem), and 9 cases in zone C (distal to the tip of the femoral stem. Internal fixation is composed of primary and secondary fixation, the main fixation method was the cerclage of steel wire or titanium cable, locking compression plate, and locking attachment plate fixation. The secondary fixation method was the cerclage of titanium cable, which was required to cover three zones A, B and C to form an overall balanced fixation. The modified Harris hip scores (mHHS), plate length, working length and screw number of different internal fixation combinations were compared.Results:The follow-up time was 54.2±21.6 months (range, 11-86 months). All patients showed signs of fracture healing at 10.2±1.5 weeks (range, 7-13 weeks) after operation, and bony union was observed at 19.6±1.3 weeks (range, 17-22 weeks) after operation. No delayed union or nonunion was observed. After operation, one case had a stress fracture and was revised with double-plate internal fixation; one case had a failed internal fixation and was revised with double-plate internal fixation and a large allograft bone graft. The mHHS score of UCSIV.3B2.1 group (80.3±4.6) was the lowest at 6 months after operation, and the difference between the groups of different types was statistically significant ( F=256.72, P<0.001). The score of simple internal fixation group (91.6±4.2) was higher than that of revision combined with internal fixation group (81.9±4.1), and the difference was statistically significant ( t=8.32, P<0.001). The plate length and working length were 24.9±2.5 cm and 12.6±1.7 cm for UCS IV.3B1.1, 25.4±2.6 cm and 13.6±1.8 cm for 3B2.1 and 28.1±2.5 cm and 4.9±1.9 cm for 3C, respectively ( F=5.33, P=0.005; F=6.78, P<0.001). The number of screws in zone A was significant difference among different UCS types ( F=52.67, P<0.001); UCS IV.3B1.1 (6.5±2.3) and 3B2.1 (6.7±2.2) were more than 3B3 (3.5±1.5) and 3C (3.7±1.6). The number of screws in zone B was significant difference among different UCS types ( F=42.15, P<0.001); The number of UCS IV.3B1.1 (2.3±1.6) and 3B2.1 (2.8±1.9) were significantly more than that of 3B3 (1.0±0.5) and 3C (1.2±0.6). The number of screws in zone C was significant differences among different UCS types ( F=39.62, P<0.001); The number of UCS IV.3B1.1 (3.8±1.9) and 3B2.1 (3.9±1.7) were more than that of 3B3 (2.0±0.5), the difference was statistically significant ( P<0.05). Conclusion:The function of hip after simple internal fixation of proximal femoral periprosthetic fractures was better than that of those who underwent revision at the same time; the number of screws of UCSIV.B1 and B2 is more than that of B3.
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OBJECTIVE@#To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults.@*METHODS@#Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing.@*RESULTS@#All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results ( Z=23.167, P<0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results ( P<0.05).@*CONCLUSION@#For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient's knee joint function recovers well.
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Adult , Female , Humans , Male , Middle Aged , Anterior Cruciate Ligament Injuries/surgery , Arthroscopy/methods , Knee Joint/surgery , Posterior Cruciate Ligament/injuries , Suture Techniques , Sutures , Tibial Fractures/surgery , Treatment OutcomeABSTRACT
Objective:To evaluate the clinical efficacy of medial patellofemoral ligament (MPFL) reconstruction with autologous long fibular muscle tendon assisted by arthroscope for treatment of patellar dislocation.Methods:A retrospective case series study was carried out to analyze data of 15 patients with patellar dislocation treated from February 2016 to June 2018 at Affiliated Hospital of Nantong University. There were 6 males and 9 females with an average age of 26.8 years (range, 14-46 years). All patients had lateral patellar dislocation, including 14 patients with recurrent patellar dislocation and 1 with habitual dislocation. All patients underwent arthroscopic exploration and MPFL reconstruction with autologous long fibular muscle tendon, among which 12 underwent arthroscopic lateral retinacular release simultaneously, 3 underwent MPFL reconstruction only. Operation duration, incision healing, function of ankle joint, extrapolation test, extrapolation apprehension test, and complications were recorded. Knee joint function was assessed using Lysholm score, Kujala score, and International Knee Documentation Committee (IKDC) score before operation, at postoperative 6 months and at latest follow-up.Results:All patients were followed up for 9-33 months with an average of 24.2 months. The operation duration was 65-85 minutes (average 71.2 minutes). All incisions healed by first intention. Ankle joint function was satisfying without pain and discomfort. At the latest follow-up, no recurrent dislocation of patella occurred, with negative results of the extrapolation test and extrapolation apprehension test at 20 degrees flexion of knee. Six months after surgery, the patients completely returned to normal activities. The Lysholm scores, Kujala score and IKDC score were improved from preoperative (51.7±2.5)points, (52.8±3.3)points, (47.1±3.3)points to (84.6±3.2)points, (85.0±3.3)points, (82.5±2.0)points respectively at postoperative 6 months, and to (89.5±1.9)points, (89.2±2.8)points, (87.5±2.2)points respectively at the latest follow-up ( P<0.01). Conclusions:MPFL reconstruction with autologous long fibular muscle tendon assisted by arthroscope, supplemented by lateral retinacular release, can attain curative effect for patellar dislocation and ameliorate knee function.
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Objective To study the association, clinical presentation, and diagnosis and treatment of bile duct cancer as a late complication of biliary-enteric anastomoses for benign diseases. Methods A retrospective study was carried out on 5 patients and the medical literature was reviewed. Results They were 3 males and 2 females. The average age was ( 66. 0 ± 0. 7 ) years. The average time period was ( 14. 0 ± 6. 1 ) years after biliary-enteric anastomosis. The clinical presentations included right upper quadrant pain, fever, chills and jaundice. CA19-9, CT and MRI were valuable in diagnosis. There were two patients with distal and three patients with perihilar cholangiocarcinomas (type IIIa, n=2, and type IV, n=1). Local resection with lymphadenectomy was carried out in one patient. Another patient underwent pancreaticoduodenectomy. The remaining three patients only underwent percutaneous transhepatic cholangial drainage ( PTCD). The 2 patients who underwent surgery died of progressive tumor disease at 8 and 13 months postoperatively. The other three patients who underwent palliative biliary drainage died within 6 months of PTCD. There was no significant difference between the two types of treatment ( P ＞0. 05). Conclusions Chronic cholangitis caused by reflux and bacterial infection was properly a predisposing factor leading to late development of bile duct cancer after biliary-enteric anastomosis for benign diseases. Patients treated with biliary-enteric anastomosis should be closely monitored for late development of cholangiocarcinoma. Some procedures such as choledochoduodenostomy and jejunum interposition choledochoduodenostomy should be abandoned because of their poor outcomes and severe complications. Proper indications of biliary-enteric anastomosis should strictly be followed and the Oddi's sphincter should be protected if possible to prevent late development of bile duct cancer.
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Objective: To explore the lipid-lowering effect and potential mechanism of the couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris on hyperlipidemia rats. Methods: Forty-eight Sprague-Dawley rats were randomly divided into 6 groups, normal control group, high-fat model group, simvastatin group, Tribulus terrestris group, Flastem Milkvetch Seed group, and couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group, with 8 rats in each group. The normal control group was fed with basal diet, and the other groups were fed with high-fat diet to establish a hyperlipidemia rat model. At the same time, different group rats were treated with different drug respectively. 6 weeks later, the body weight and visceral index of the rats were measured. Levels of serum cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer. The mRNA and protein expression of HMG coenzyme A reductase (HMGCR), cholesterol 7-alpha hydroxy-lase (CYP7A1) and low density lipoprotein receptor (LDL-R) were detected by RT-PCR and western blot. Results: Compared with model group, the serum levels of TC, TG, and LDL-C were significantly decreased in all Chinese medicine groups, and the serum level of HDL-C was significantly increased in Flastem Milkvetch Seed group and couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group. Moreover, the mRNA and protein expression of HMGCR, CYP7A1, and LDL-R in rat liver also significantly increased in all Chinese medicine treatment groups. And couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group shows more significantly effect. Conclusion: Couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris significantly regulate the serum lipid levels on hyperlipidemia rat model, and its mechanism may be related to the regulating expressions of HMGCR, CYP7A1, LDL-R gene.
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Objective To observe the efficacy of lowering blood pressures and TCM syndrome on the mild to moderate hypertension via the treatment of auricular syndrome differentiation combined with magnetic point application;To provide reference for clinical treatment of hypertension by non-pharmaceutical therapy. Methods Totally 260 patients with mild to moderate hypertension were randomly divided into control group and treatment group, 130 cases for each. The control group was given Norvasc by conventional oral dosage, and the treatment group was given auricular syndrome differentiation and Yongquan (KI1) magnetic point application additionally. SBP, DBP and TCM syndrome scores of the two groups were observed before and after treatment to evaluate the antihypertensive efficacy and TCM syndrome efficacy. The side effects were also observed. Results After treatment, SBP of the two groups decreased significantly (P0.05). DBP of the treatment group decreased significantly (P0.05). TCM syndrome of treatment group improved significantly compared with the control group (P<0.05). The total effective rate of TCM syndromes in treatment group was better than the control group (P<0.05), without side effects. Conclusion Auricular syndrome differentiation combined with magnetic point application can not only significantly improve the TCM syndrome of patients with mild to moderate hypertension, but also has synergistic hypotensive efficacy and high safety.
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Aim To investigate the vasorelaxation effects of saponins from flower of Panax notoginsen on the isolated thoracica aorta ,and to explore its possible mechanism.Methods Total saponins were extracted and high phase liquid chromatography was utilized to describe saponins ingredients;SD rat thoracic aortas were isolated.In vitro vascular ring experiment was used to observe,basal state of saponins on vascular ring,and high concentrations of K+solution pre-con-traction and phenylephrine (PE ) pre-contraction caused by systolic and diastolic function of the re-sponse.And different inhibitors were combined to ex-amine the possible mechanism of notoginsenoside in vascular ring.Results Cumulative concentration of saponins had no significant effect on the basis of state vessels,but had significant effect on endothelium-in-tact aortic (MAX Relaxation 23.6%) rings pre-con-tracted by high concentrations of K+;endothelium and endothelial aortia had significant effect on PE pre-con-traction, and endothelium MAX relaxation was 55.5 1%.Calcium-free solution and saponin cultivated aortic rings significantly inhibited pre-contraction.Af-ter nitric oxide synthase inhibitor L-NAME and indom-ethacin incubating vascular ring ,it could significantly inhibited vasodilatory effect of saponin.Conclusion Saponins have concentration dependent diastolic func-tion on rat thoracic aorta,and its main ways cause vas-odilation.Endothelial dependent diastolic function is related to activation of nitric oxide synthase and cy-clooxygenase pathway.
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Objective To compare three different internal fixations using dual plates in treatment of type C distal humerus fractures.Methods A total of 59 patients with type C distal humerus fractures fixed with dual plates between January 2004 and December 2008 were enrolled in the study,including 34 patients managed by perpendicular dual plate internal fixation (Group A),14 patients by dorsal dual plate internal fixation (Group B),and 11 patients by parallel dual plate internal fixation (Group C).Functional outcomes of injured elbow joints were assessed using Mayo elbow performance score (MEPS).Fisher' s exact probability,chi-square test and variance analysis were used to compare the perioperative variables among groups.Results The patients were followed up for average 28 months (range,12-55 months),which showed that all fractures were smoothly healed with satisfactory curative effects in each group.There were no significant differences with respect to functional outcomes among three groups.The patients with surgery difficulty in Group C were more than those in other two groups.Besides,an additional intercondylar screw was always required in Groups A and B,but rarely in Group C.Conclusions All internal fixations with three dual plates are effective in management of type C distal humeral fractures.The location of plates is determined by experiences of orthopedic surgeons and specific fracture type.
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Traditional Chinese medicine (TCM) exhibits a broad range of effects on biological activity that is probably due to interactions of complex chemical constituents with multiple targets in the body. Understanding the active chemical constituents in TCM is very important in providing rationales for the clinical usage of TCM. The zebrafish (Danio rerio) has recently become a popular model in the field of drug screening, specifically emerging as an important vertebrate model for in vivo high-content drug screening of multiple efficacy parameters and whole-organism toxicity. The authors also discussed the advantages of the zebrafish model for evaluating drug metabolism. Zebrafish usage in TCM screening should be a viable approach that helps identify active chemical markers, biological pathways and mechanistic actions of TCM.
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Objective To investigate the expression of Foxo3a and p27kip1 in lumbar dorsal root ganglia (DRG) after injury of sciatic nerve in rats. Methods Adult rats were randomly divided into control group and experimental group. The rats in experimental group were subjected to sciatic nerve clamp.Expression and distribution of Foxo3a and p27kip1 and cellular proliferation and axon regeneration in DRG was detected by western blot and immunohistochemistry. Results Foxo3a protein levels begined to reduce at 1 day (7.0 ± 3.5), reached valley at 2 day (6.0 ± 3.8) after injury, and following Foxo3a downregulation, p27kip1 protein levels begined to decrease at 2 day (29.0 ± 3.5), reached valley at 7 day (21.0± 3.0) after injury. Down-regulation of Foxo3a and p27kip1 was expressed predominantly in neurons and glial cells by double immunolabelling. Foxo3a and p27kip1 were expressed in neurons [(37.8 ± 5.7)%, (43.3 ±4.3)%] and glial [(22.4 ± 3.9)%, (13.8 ± 3.2)%] cells in sections of DRG at 2 day after injury less than neurons [(73.6 ± 2.5)%, (84.1 ± 3.7)%] and glial [(61.3 ± 4.4)%, (68.7 ± 5.6)%] cells in sections of normal DRG. Proliferating cell nuclear antigen (PCNA) and GAP-43 were up-regulation from 2 day, and PCNA reached peak at 7 day after injury.The glial cells were the main type of cellular proliferation.Conclusion Down-regulation of Foxo3a and p27kip1 in lumbar DRG is correlated with the proliferation of glial cells and axonal regeneration after sciatic nerve injury.
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Objective To investigate the expression of Foxo3a in the lumbar dorsal root ganglia (DRG) after sciatic nerve injury in rats. Methods Forty-two adult rats were randomly divided into control group and experimental group. Rats in experimental group were subjected to sciatic nerve clamp. Expression and distribution of Foxo3a, growth associated protein (CAP) and axon regeneration in DRC were detected by Western blot and immunofluorescent staining. Results (1) After sciatic nerve injury, Foxo3a protein levels began to reduce at day 1, reached the lowest level at day 2 and then gradually rose to nomal level at four weeks after sciatic nerve injury. Proliferating cell nuclear antigen (PCNA) and GAP-43 were up-regulated from day 2, and the level of PCNA reached peak at day 7 after sciatic nerve injury in DRC. (2) Down-regulation of Foxo3a was observed predominantly in neurons and glial cells. PCNA mostly expressed in glial cells and hardly in neurons. Conclusion Down-regulation of Foxo3a in lumbar DRG may correlate with axonal regeneration and the proliferation of glial cells after sciatic nerve injury.
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<p><b>OBJECTIVE</b>To investigate the effects of Naoxinduotai capsule on the markers of prothrombotic state as plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF) and alpha-granular membrane protein (CD62p) in essential hypertension patients of yang hyperactivity and blood stagnation.</p><p><b>METHOD</b>The 62 essential hypertension patients of yang hyperactivity and blood stagnation were divided into Naoxinduotai capsule + perindopril group (treatment group, 30 subjects) and Perindopril group (control group, 32 subjects). Clinical symptoms, blood pressure and the blood plasma PAI-1, vWF, CD62p of the patients were observed. The blood plasma PAI-1, vWF and CD62p were measured by enzyme-linked immunosorbant assay (ELISA).</p><p><b>RESULT</b>After 8 weeks treatment, in treatment group the clinical symptoms became better, and there was a significant difference with control group (P < 0.05). Blood pressure was significantly degraded, but there was not a significant difference with control group. The blood plasma PAI-1, vWF, CD62p level was degraded ,and there were significant differences with control group in all the three makers (P < 0.05).</p><p><b>CONCLUSION</b>Naoxinduotai capsule can treat the essential hypertension patients of Yang hyperactivity and blood stagnation, and it has conspicuous advantages in improving the clinical symptoms and the makers of prothrombotic state.</p>
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Aged , Female , Humans , Male , Biomarkers , Blood , Blood Pressure , Capsules , Hypertension , Blood , Drug Therapy , P-Selectin , Blood , Plasminogen Activator Inhibitor 1 , Blood , Platelet Membrane Glycoproteins , Metabolism , Thrombosis , Blood , Treatment OutcomeABSTRACT
BACKGROUND:Recent studies have demonstrated that surgical trauma leads to lipid peroxidation in erythrocytes.However,injured erythrocytes play an important role in thrombosis following replacement.OBJECTIVE:To evaluate the influence of artificial total knee replacement on the lipid peroxdation in erythrocytes,and the prophylactic treatment of vitamin E and fructose 1,6 diphosphate(FDP)on it.DESIGN,TIME AND SETTING:Contrast clinical study,which was carried out in the Department of Otthopaedics,Affiliated Hospital of Nantong University from January 2003 to June 2006.PARTICIPANTS:Sixty patients with knee osteoarthritis who underwent artificial total knee replacement by anesthesia of epidural block were divided into four groups,including control group,vitamin E group,FDP group and vitamin E+FDP group,with 15 cases in each group.METHODS:Vitamin E was orally taken in the vitamin E group three days before replacement,three times a day,100 mg for each.The administration was performed until the surgical morning.Thirty minutes after the operation,FDP(10 g)was intravenously dripped in the FDP group.Additionally.vitamin E was also orally taken in the vitamin E+FDP group three days before replacement,three times a day,100 mg for each;on the surgical morning,FDP(10 g)was intravenously dripped on the first 30minutes.Blood samples were taken for biochemical determination before and after the operation at 1,3,5,and 7 days.MAIN OUTCOME M[EASURES:Corltents of malonaldehyde(MDA)and cuprum/zincum/superoxide dismutase (Cu-Zn-SOD)in the erythrocytes.RESULTS:MDA level in the vitamin E group and FDP group was significantly higher than that in the vitamin E+FDP group before and 5 and 7 days after replacement(P<0.05);while,Cu-Zn-SOD level was significantly lower(P<0.05).Otherwise,there were no significant differences in vitamin E+FDP group before and after replacement(P>0.05).CONCLUSION:The artificial total knee replacement can enhance lipid peroxidation and decrease antioxygen capability.However,the combination of vitamin E and FDP can prevent and relieve lipid peroxidation and antioxygen capability after replacement.
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BACKGROUND:The anatomical morphology of the distal end of humerus is an important factor for restricting the treatment of fracture at the site, also for designing and improving of internal fixator and prosthesis. It is very significant to determine the anatomical parameters of the distal end of humerus for correcting the deformation, fixation of internal fixator and replacement of prosthesis.OBJECTIVE: To measure 17 anatomical parameters of the angles and structural width or depth related to the distal end of the humerus, verify their fitness with bone after implantations of internal fixator and prosthesis, and identify the association between the characteristics and the mechanical properties of the internal fixator and prosthesis.DESIGN: A repetitive measurement and comparative observation.SETTING: Affiliated Hospital of Nantong University.MATERIALS: The experiments were carried out in the Trauma Research Room, Affiliated Hospital of Nantong University from October 2005 to February 2006. Fifty-four pairs of humerus samples from adult antisepsis corpses were randomly selected (provided by the Department of Human Anatomy, Medical College of Nantong University), including 30 pairs from males and 24 pairs from females, while those with deformation and degeneration of elbow joint were excluded. METHODS: The soft tissues adhered to the humerus samples were all rejected, and the anatomical parameters of the distal end of humerus were measured with slide gaud (0.01 mm in precision, produced by Shanghai Measuring and Cutting Tool Works), calipers and goniometer. ① Measurement of angles related to the distal end of humerus: The measured parameters included the anteverted angle of the distal humerus, the lateral rotation angle of humerus trochlea,the anteverted angulation of humerus capitulum, the anteverted angulation of humerus trochlea, the condyle-shaft angle of humerus, and the internal rotation angle of the line of lateral-medial humerus epicondyle. ② Measurement of structural width and depth related to the distal end of humerus: The measured parameters included the horizontal diameter of the anterior end of humerus trochlea, the horizontal diameter of the inferior end of humerus trochlea, the sagittal diameter of humerus trochlea, the width between medial epicondyle and external epicondyle, the width between medial trochlea and lateral capitulum, the width of olecranon fossa, the depth of olecranon fossa, the width of medial epicondyle, the depth of sulcus for ulnar nerve, the width of humerus capitulum, and the sagittal diameter of humerus capitulum..MAIN OUTCOME MEASURES: Results of the angles and structural width or depth related to the distal end of the humerus.males and females in the anteverted angle of the distal humerus [(35.62±5.21)°, (96.22±5.29)°], the lateral rotation angle of humerus trochlea [(5.22±1.15)°, (5.46±1.33)°], the anteverted angulation of humerus capitulum [(48.35±8.78)°,(49.65±9.12)°], the anteverted angulation of humerus trochlea [(33.08±7.15)°, (34.45±7.52)°], the condyle-shaft angle of humerus [(80.12±5.22)°, (80.17±5.45)°], and the internal rotation angle of the line of lateral-medial humerus humerus: There were no significant differences between males and females in the horizontal diameter of the anterior end of humerus trochlea [(21.40±4.21), (21.12±4.34) mm], the horizontal diameter of the inferior end of humerus trochlea [(23.54±4.52), (23.31±4.43) mm], the sagittal diameter of humerus trochlea [(23.91 ±4.85), (23.55±4.63) mm], the width between medial epicondyle and external epicondyle [(58.23±6.44), (55.32±6.55) mm], the width between medial trochlea and lateral capitulum [(45.36±5.21), (42.15±5.03) mm], the width of olecranon fossa [(24.56±4.25), (25.34±4.42) mm],the depth of olecranon fossa [(13.43±2.52), (12.95±2.13) mm], the width of medial epicondyle [(14.35±3.32), (13.02±2.96) mm], the depth of sulcus for ulnar nerve [(8.53±2.96), (7.90±2.54) mm], the width of humerus capitulum [(18.05±2.87), (16.51±2.75) mm], and the sagittal diameter of humerus capitulum [(19.59±3.84), (19.12±3.55) mm] (P＞0.05).CONCLUSION: The anatomical parameters of the distal end of humerus should be considered in performing correction of elbow joint, internal fixation and prosthesis replacement in order to get better recovery of elbow joint function.
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Traditional Chinese medical case records in the previous dynasties are vital to the development of traditional Chinese medical theory, but the tremendous amount of data are far beyond a person's ability for comprehension. According to information science, traditional Chinese medical case record data are complicated and intricate experiential data. New technology and methods are needed to solve this difficulty. Knowledge discovery technology plays an important role in analyzing data and uncovering important data patterns, and it will be a useful method in processing such data. This paper briefly presents the methods of knowledge discovery in traditional Chinese medical case record study, and puts forward some necessary academic methods.
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[Objective] To evalvate the influence of total knee replacement(TKR)on the lipid peroxdation in erythrocytes,and the prophylactic treatment of Vitamin E and fructose 1,6-diphosphate(FDP)on it.[Method]Totally 60 patients of knee osteoarthritis were divided into control group,Vitamin E group,Fructose 1,6-diphosphate(FDP)group and Vitamin E added FDP group.Blood samples were taken for biochemical determination of MDA and Cu-Zn-SOD before and after the operation at 1,3,5 and 7 days.[Result]MDA level in erythrocytes increased singnificantly after TKR compared with that before operation(P
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Objective To evaluate the safety of dynamic anterior plate fixation for cervical distractive flexion injuries and compare its rigidity between different types of plate design. Methods Twelve sets of cadaveric calf spine were used in this test. All the specimens were made into distractive flexion injury models (C4-C5) ac- cording to Allen's method. After discectomy and grafting, they were randomized into three groups in which Orion, Codman, and Window instrumentations were used respectively. The stiffness of each construct was tested in flexion, extension, lateral bending and axial torsion conditions sequentially. Results Compared with an intact cervical spine, the range of motion (ROM) of an injured cervical spine increased whatever plate was applied. Orion in- strumentation presented stiffness the closest to that of the normal control, except for less torsional stiffness. Codman instrumentation provided stiffness close to that for normal and Orion groups only in lateral bending. Window's was the weakest mad not enough in all kinds of movement. Conclusions Static anterior fixation is the first choice for cervical injuries. Dynamic plate fixation may sacrifice stiffness to some extent, especially when a shifting kind of design is to be chosen.
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Objective To study the classification, management and outcome of the fracture of ulna coronoid process. Methods Retrospective analysis was carried out in 31 patients with fracture of ulna coronoid process. There were 19 males and 12 females with an average age of 29.8 years old (range, 18-52 years old). The fractures of ulna coronoid process were classified into 4 major groups based on the condition of the injury of ulna coronoid process, the anterior bundle of the ulnar collateral ligaments(UCL) and the elbow stability. The fracture of coronoid process within half of the height was defined as type Ⅰ. The half of coronoid process fracture with the injury of UCL was defined as type Ⅱ. The base of coronoid process fracture with the dislocation of elbow joint was defined as type Ⅲ, sometimes with the injury of UCL. The severe comminute fracture of coronoid process with elbow instability was defined as type Ⅳ. There were 11 cases in typeⅠ, 9 typeⅡ, 6 type Ⅲ and 5 type Ⅳ in our group. According to the type of injury we choose correlative treatment. Results The follow-up was 18-72 months(average 28.6 months). All the patients got fracture union, and without inflammation, neural injuries and elbow instability. 1 type Ⅲ and 2 type Ⅳ had traumatic osteoarthritis, and 2 type Ⅲ and 2 type Ⅳ occurred heterotopic ossification. There was a statistical significance when the motion range of two-side joints was compared in type Ⅳ. Conclusion We choose conservative treatment in the fracture of typeⅠ. But if the piece of bone affected motion of elbow joint, we can choose operative treatment, and elbow stability is not affected. The fracture of type Ⅱ and type Ⅲ with elbow instability should be reduced internal fixation and the ligament must be repaired or reconstructed. In cases of type Ⅳ, bone reconstruction is necessary to recover of elbow stability. Proper post-operative rehabilitation can decrease the rate of traumatic osteoarthritis.
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Objective To evalvate the influence of elbow joint stability following ulna coronoid process fractures. Methods Three cadaveric upper extremities were used. The height, width, thickness, diameter and opening angle of ulna coronoid process were measured in six arms, while the coronoid process fragments at the level of 2 mm, quarter, half, three quarter and whole height were resected consecutively, the changes of the range of the elbow joint movement were recorded. Another sixteen specimens were divided into two groups: the anterior bundle of the ulnar collateral ligaments (UCL) in one group was unrepaired; While the other repaired, then the angle of cubitus valgus between two groups was compared. Results If the osteotomy bone was within quarter of ulna coronoid process, the elbow joint function was good. However, in cases of osteotomy on half of coronoid process, the elbow extension function was limited and the elbow became unstable. After reduction with internal fixation, the angle of cubitus valgus was greater in the second group, and the difference of elbow joint in flexion 0?, 30?, 60?, 90? and 120? had statistical significance(P