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1.
Article in English | WPRIM | ID: wpr-929022

ABSTRACT

OBJECTIVES@#Hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) is the most common type of liver failure in China, with a high mortality. Early rapid reduction of HBV-DNA load can improve the survival rate of HBV-ACLF patients. At present, the commonly used drugs are nucleoside (acid) analogues, such as entecavir (ETV), tenofovir, and so on. The newly listed tenofovir alafenamide fumarate (TAF) has attracted great attention of clinicians because of its stronger antiviral effect, higher transaminase normalization rate, better bone and kidney safety, and zero drug resistance. However, there are few clinical research data on the efficacy and safety of TAF in the treatment of Chinese HBV-ACLF patients, and there is a lack of pharmacoeconomic evaluation. This study aims to compare the efficacy, safety, and cost-effectiveness between TAF and ETV in patients with HBV-ACLF.@*METHODS@#The data were collected from 196 HBV-ACLF patients (80 patients in the TAF group and 116 patients in the ETV group) who were hospitalized in Xiangya Hospital, Central South University from May 2020 to March 2021. Biochemistry and virology were detected before and after treatment (at baseline, Week 2, 4, and 12). Clinical features, disease prognosis, and cost-effectiveness were compared between the 2 groups. According to the baseline, HBV-ACLF patients were divided into 4 stages including pre-liver failure stage, early stage, medium stage, and end stage. And the liver transplantation rate and mortality was also compared. Pharmacoeconomic evaluation was taken using cost-effectiveness analysis and cost minimization analysis..@*RESULTS@#After 4 weeks of treatment, there were no significant differences in the efficacy (liver function, viral load) between the 2 groups (all P>0.05). The TAF group showed lower creatinine [(80.35±18.77) μmol/L vs (105.59±82.32) μmol/L, P<0.05] and higher estimated glomerular filtration rate (eGFR) levels [(95.65±23.21) mL/(min·1.73 m2) vs (82.68±26.32) mL/(min·1.73 m2), P<0.05] than the ETV group. After 12 weeks of treatment, the analysis of overall the liver transplantation rate and mortality between the 2 groups showed similar conclusion. However, the TAF group had a lower the liver transplantation rate and mortality than the ETV group in patients with pre-liver failure (0vs13.89%, P<0.05). No evident distinction was found in the liver transplantation rate and mortality during the early, medium, or end stages of liver failure (13.04% vs 17.65%, 37.50% vs 37.04%, and 54.55% vs 68.42%, respectively). Ratio of cost to effectiveness in the ETV group was higher than that in the TAF group.@*CONCLUSIONS@#TAF is not more efficient than ETV group in improving liver function and reducing viral load for HBV-ACLF patients and they also show similar safety. However, TAF has a greater advantage over ETV not only in preserving renal function, but also in reducing the liver transplantation rate and mortality in patients with pre-liver failure. TAF can provide economic benefit to patients with HBV-ACLF.


Subject(s)
Acute-On-Chronic Liver Failure/drug therapy , Alanine/therapeutic use , Antiviral Agents/therapeutic use , Guanine/analogs & derivatives , Hepatitis B virus/genetics , Hepatitis B, Chronic/drug therapy , Humans , Tenofovir/analogs & derivatives , Treatment Outcome
2.
Article in Chinese | WPRIM | ID: wpr-928312

ABSTRACT

The proximal medial column of the humerus is a continuous cortical region in the inner and lower part of the humerus head, which has attracted more and more attention in clinical and scientific research since it was proposed. It has been shown to increase the stability of internal fixation, maintain the height of the humeral head to prevent varus, and reduce the risk of screw penetration. Biomechanical studies have also shown that the medial column has an outstanding performance in increasing the stiffness, torsion resistance, and shear resistance of the locking plate. Although it has many benefits, there is no unified definition of its concept and specific region, and the existing classification does not include the medial column, therefore more researches are required to provide supporting information. The methods of medial column reconstruction mainly include locking plate combined with talus screw, locking plate combined with bone grafting, internal and external double plate combined support, locking plate combined with bone cement, and humeral cage. These methods have their own characteristics, however they will increase the cost of surgery and bring new complications. How to determine the best way of reconstruction is one of the focuses of future research. In this review, the concept of the proximal medial humerus column, the role of maintaining internal fixation, the role of biomechanics and the reconstruction methods are reviewed.


Subject(s)
Aged , Bone Plates , Bone Screws , Fracture Fixation, Internal/methods , Humans , Humeral Head , Shoulder Fractures/surgery
3.
Chinese Medical Journal ; (24): 2037-2044, 2021.
Article in English | WPRIM | ID: wpr-887636

ABSTRACT

With the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccines in epidemic prevention and public health has become even more obvious than ever. However, the emergence of multiple severe acute respiratory syndrome coronavirus 2 variants worldwide has raised concerns about the effectiveness of current COVID-19 vaccines. Here, we review the characteristics of COVID-19 vaccine candidates in five platforms and the latest clinical trial results of them. In addition, we further discuss future directions for the research and development of the next generation of COVID-19 vaccines. We also summarize the serious adverse events reported recently after the large-scale vaccination with the current COVID-19 vaccines, including the thromboembolism caused by the AstraZeneca and Johnson & Johnson vaccines.


Subject(s)
COVID-19 , COVID-19 Vaccines , Humans , SARS-CoV-2 , Vaccines
4.
Article in Chinese | WPRIM | ID: wpr-884258

ABSTRACT

Objective:To study the correlation between non-contact anterior cruciate ligament (ACL) injury and functional ankle instability (FAI) in young patients.Methods:A retrospective analysis was conducted of the 102 patients with non-contact ACL injury[61 males and 41 females, with an age of (31.9±6.1) years and a Tegner activity score of (6.1±1.9) points] who had been treated at Department of Orthopedics, Sun Yat-sen Memorial Hospital from January 2017 to March 2020 (injury group). Another 102 citizens without ACL injury from Guangzhou [56 males and 46 females, with an age of (30.3±7.2) years and a Tegner activity score of (6.0±2.1) points] were recruited as a control group. The Cumberland ankle instability tool (CAIT) and the Ankle Joint Functional Assessment Tool (AJFAT) were used to assess whether the subjects had self-conscious FAI or not. A correlation analysis was conducted using the data collected.Results:The 2 groups were comparable because there were no significant differences between them in general data ( P>0.05). By the CAIT score, the incidence of FAI in the injury group [52.9% (54/102)] was significantly higher than that in the control group [32.4% (33/102)] ( P<0.05); by the AJFAT score, the incidence of FAI in the injury group [59.8% (61/102) ] was significantly higher than that in the control group [39.2% (40/102)] ( P<0.05). Pearson correlation analysis showed that diagnoses of FAI by CAIT and by AJFAT were respectively correlated with ACL injury ( r=-0.159, P=0.023; r=-0.215, P=0.002). Conclusions:The incidence of FAI may be high in patients with ACL injury and there is a correlation between FAI and ACL injury.

5.
Article in Chinese | WPRIM | ID: wpr-867814

ABSTRACT

Objective To compare the outcomes of bone marrow stimulation techniques-drilling by a Kirschner needle versus microfracturing technique in the treatment of small osteochondral lesions of the talus.Methods From February 2014 to June 2017,57 patients were treated at Department of Orthopaedics,Sun Yat-sen Memorial Hospital for small osteochondral lesions of the talus.Of them,26 were treated by arthroscopic drilling with a Kirschner needle.They were 15 males and 11 females,aged from 20 to 57 years.The areas of osteochondral lesion ranged from 0.6 to 1.4 cm2.By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films,there were 9 cases of stage Ⅰ,8 cases of stage Ⅱ,6 cases of stage Ⅲ and 3 cases of stage Ⅳ.The other 31 patients of them were treated by arthroscopic microfracturing technique.They were 17 males and 14 females,aged from 24 to 55 years.The areas of osteochondral lesion ranged from 0.5 to 1.5 cm2.By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films,there were 10 cases of stage Ⅰ,11 cases of stage Ⅱ,8 cases of stage Ⅲ and 2 cases of stage Ⅳ.The 2 groups were compared in terms of visual analogue scale (VAS),the American Orthopaedic Foot and Ankle Society (AOFAS) score,the ankle activity score (AAS) and the Berndt & Harty staging of osteochondral lesions based on ankle X-ray films at the final follow-up.Results All the 57 patients were followed up for 13 to 27 mouths.The VAS,AOFAS and AAS scores and Berndt & Harty stages at the final follow-up were significantly improved in all the patients compared with their preoperative values (P < 0.05).There were no significant differences between the 2 groups in the VAS (2.2 ± 1.6 versus 2.1 ± 1.4),AOFAS (89.1 ±6.3versus 90.4±5.8) or AAS scores (6 versus 6) at the final follow-up (P > 0.05).There was no significant difference between the 2 groups either in the excellent and good rate by the AOFAS ankle-hindfoot scoring [88.5% (23/26) versus90.3% (28/31)] at the final follow-up (x2 =0.052,P=0.820).Conclusion In the treatment of small osteochondral lesions of the talus,both arthroscopic drilling with a Kirschner needle and microfracturing technique can achieve satisfactory short-term curative effects,but the long-term effects need to be further studied.

6.
Article in Chinese | WPRIM | ID: wpr-825229

ABSTRACT

Objective To investigate the efficiency of various agroforestry systems for snail control in plateau hilly schistosomiasis-endemic areas of Yunnan Province, so as to provide insights into the construction of agroforestry schistosomiasis control projects in plateau hilly regions. Methods The pilot areas of snail control forests with various agroforestry systems were built in snail-breeding farmlands in Eryuan County, Yunnan Province in 2010, and the economic benefits and snail control effect were investigated in 2018. In addition, a fuzzy comprehensive evaluation model was created to screen the agroforestry system with high comprehensive benefits. Results A total of 14 types of pilot areas of snail control forests with various agroforestry systems were built. Economic benefit analysis showed that the“walnut + garlic”pattern had the best economic benefit, with annual economic benefits of 270 000 Yuan/hm2, followed by the“walnut + chili”pattern (annual economic benefits of 120 000 Yuan/hm2) and the “walnut + vegetables”pattern (annual economic benefits of 105 000 Yuan/hm2). No snails were detected in 8 types of the agroforestry systems, including the“walnut + chili”pattern, the“walnut + tobacco”pattern and the“walnut + garlic”pattern; however, there were snail found with various densities in other types of systems. Fuzzy comprehensive evaluation showed that the“walnut + garlic”pattern had the best comprehensive control effect, followed by the“walnut + chili”pattern and the“walnut + tobacco” pattern, while the pure grassland pattern showed no effect on snail control. Conclusions The agroforestry system is a preferential approach of forestry schistosomiasis control in plateau hilly schistosomiasis-endemic areas, which not only achieves snail control effects, but also promotes economic development and ecological construction in poor hilly areas.

7.
Chinese Journal of Surgery ; (12): 105-109, 2020.
Article in Chinese | WPRIM | ID: wpr-787669

ABSTRACT

To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province. A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ(2) test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ(2) test. There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ(2)=47.028, 0.000). There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage Ⅰ to Ⅱ. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients' demon.

8.
Chinese Journal of Orthopaedics ; (12): 667-674, 2019.
Article in Chinese | WPRIM | ID: wpr-801436

ABSTRACT

Objective@#To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.@*Methods@#A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017. A total of 28 cases were treated with autologous semitendinosus tendon (autologous group), including 19 males and 9 females, with an average age of 28.5±8.03 years (range, 16-46 years). A total of 27 cases were treated with allogenic tendon (allogenic group), including 17 males and 10 females, with an average age of 27.48±7.89 years (range, 16-46 years). ATFL/CFL was reconstructed by the same method in both groups. The reconstruction methods were the same between the groups. The talus and calcaneus were fixed with absorbable compression nails.@*Results@#The operation duration in the autologous group was 94.07±7.83 min, which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51, P<0.001). Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55, P<0.001). Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01, P<0.001). In the autologous group, 28 cases were followed up for 34.54±16.04 months, and 27 cases in the allograft group were followed up for 42.74±17.79 months. The mean AOFAS score improved from 63.64±11.20 before operation to 90.21±4.48 after operation in the autologous group, and that improved from 63.93±10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506, P=0.615). The mean VAS score decreased from 5.79±1.79 before operation to 1.54±1.35 after operation in the autologous group, and from 5.89±1.78 before operation to 2.04±1.32 after operation in the allogeneic group. There was no significant difference between the two groups after operation (t=-1.396, P=0.168). Tegner score increased from 4.07±1.39 to 6.43±1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333, P=0.740). Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group, 16.99°±3.78° to 7.14°±3.34° in the allogeneic group, and there was no significant difference between the two groups after operation (t=-1.382, P=0.171). Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group, from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group, and there was no significant difference between the two groups after operation (t=-0.326, P=0.746). No donor tendon dysfunction was found in the autologous group. At the end of follow-up, there was no difference in ankle dorsiflexion, plantar flexion and hind foot mobility between autologous group and allogeneic group.@*Conclusion@#Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results. The autologous tendon group was superior to the allogeneic group in terms of fever, wound healing time. However, there was no significant difference in clinical effects between the two groups.

9.
Article in Chinese | WPRIM | ID: wpr-755885

ABSTRACT

Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P > 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.

10.
Chinese Journal of Orthopaedics ; (12): 667-674, 2019.
Article in Chinese | WPRIM | ID: wpr-755206

ABSTRACT

Objective To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.Methods A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017.A total of 28 cases were treated with autologous semitendinosus tendon (autologous group),including 19 males and 9 females,with an average age of 28.5±8.03 years (range,16-46 years).A total of 27 cases were treated with allogenic tendon (allogenic group),including 17 males and 10 females,with an average age of 27.48±7.89 years (range,16-46 years).ATFL/CFL was reconstructed by the same method in both groups.The reconstruction methods were the same between the groups.The talus and calcaneus were fixed with absorbable compression nails.Results The operation duration in the autologous group was 94.07±7.83 min,which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51,P<0.001).Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55,P<0.001).Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01,P<0.001).In the autologous group,28 cases were followed up for 34.54± 16.04 months,and 27 cases in the allograft group were followed up for 42.74± 17.79 months.The mean AOFAS score improved from 63.64± 11.20 before operation to 90.21 ±4.48 after operation in the autologous group,and that improved from 63.93± 10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506,P=0.615).The mean VAS score decreased from 5.79± 1.79 before operation to 1.54± 1.35 after operation in the autologous group,and from 5.89± 1.78 before operation to 2.04± 1.32 after operation in the allogeneic group.There was no significant difference between the two groups after operation (t=-1.396,P=0.168).Tegner score increased from 4.07± 1.39 to 6.43± 1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333,P=0.740).Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group,16.99°±3.78° to 7.14°±3.34° in the allogeneic group,and there was no significant difference between the two groups after operation (t=-1.382,P=0.171).Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group,from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group,and there was no significant difference between the two groups after operation (t=-0.326,P=0.746).No donor tendon dysfunction was found in the autologous group.At the end of follow-up,there was no difference in ankle dorsiflexion,plantar flexion and hind foot mobility between autologous group and allogeneic group.Conclusion Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results.The autologous tendon group was superior to the allogeneic group in terms of fever,wound healing time.However,there was no significant difference in clinical effects between the two groups.

11.
Chinese Journal of Immunology ; (12): 230-235, 2019.
Article in Chinese | WPRIM | ID: wpr-744640

ABSTRACT

Interleukin ( IL) -38 is the most recently discovered cytokine, which is the tenth member of IL-1 cytokine family. IL-38 shares a high homology with IL-1 receptor antagonist ( IL-1 Ra) and IL-36 Ra. IL-36 R is the specific receptor of IL-38 which is the partial receptor antagonist of IL-36. Now, research has shown that IL-38 not only had relationship with intracellular infection and inflammation, but also with many clinical diseases such as autoimmune diseases, osteoarthritis, tumor and cardiopulmonary diseases. However, the molecular immune regulation mechanism of IL-38 is complicated, involving specific receptor recruitment, apoptosis mediated phagocyte regulation, regulation of Th17 cell differentiation and many other processes. It also provides several new clues to the treatment of diseases. IL-38 is a new cytokine research hot spot with extensive application prospects and need deep exploration.

12.
Article in Chinese | WPRIM | ID: wpr-779436

ABSTRACT

During the past 70 years since the founding of New China, Chinese public health especially the prevention and control of infectious diseases have made remarkable achievements, which benefited from the vaccination. This study is to summarize the progress of immunization and vaccines, the achievements and contributions of vaccines including polio vaccine, hepatitis B vaccine, diphtheria, tetanus and acellular pertussis combined vaccine, measles vaccine and hepatitis A vaccine to the prevention and control of infectious diseases in China in the past 70 years and to review the research and development of innovative vaccines in China in recent years, which may provide clues for the development of the expanded programe on immunization in China in the future.

13.
Article in Chinese | WPRIM | ID: wpr-816523

ABSTRACT

Traditional mastectomy requires the removal of nipple-areola complex(NAC),no matter whether the subsequent reconstruction or not,it can't meet the aesthetic needs of patients.With the development of breast reconstruction technology,immediate breast reconstruction with preservation of nipple-areola complex has superior aesthetic effect.More and more breast cancer patients can maintain the integrity and beauty of their body after operation.How to better protect the nipple-areola complex in breast reconstruction surgery has become one of the focuses of breast surgeons.The operator should have a strong sense of NAC protection,carefully grasp the characteristics of the posterior mammary duct and blood supply of NAC,reasonably design the surgical incision,and reduce the occurrence of postoperative nipple ischemia,necrosis and other complications as far as possible.

14.
Article in Chinese | WPRIM | ID: wpr-690509

ABSTRACT

Steaming method is a traditional processing method for Gastrodiae Rhizoma(GR). The current studies on the steaming method's mechanism of GR are mainly focused on facilitating softening slice, destroying the β-glycosidic bond enzymes to reduce the decomposition of gastrodia glycosides (killing enzyme and protecting glycosides). The researches on the processing mechanism are still incomplete, while revealing and analyzing the active components in the body's metabolic process are important channels and new models to clarify the mechanism of traditional medicine processing. In order to provides a reference for the in-depth study of the processing mechanism of GR, we have reviewed the relevant literature at home and abroad in recent years and briefly summarized the processing, composition analysis and in vivo metabolism of GR in this study.

15.
Article in Chinese | WPRIM | ID: wpr-852200

ABSTRACT

There is abundant processing theory in the system of traditional Chinese medicine. The deep excavation and research of that is conducive to promoting the development of science of Chinese materia medica (CMM), ensuring the quality of CMM prepared in ready-to-use forms and promoting the clinical rational use of drugs. Based on the current research status of CMM processing theory, using the representative drugs as the object, modern pharmacological research as a guide, the contents of the relevant studies of “raw and cooked different use” theory, “carbonic herbs for hemostasis” theory and theory of auxiliary material action were elaborated. The review provided reference for the further research on traditional processing theory and also provided a scientific basis for the clinical rational use of processed products of CMM.

16.
Article in Chinese | WPRIM | ID: wpr-707442

ABSTRACT

Objective To evaluate the clinical results of arthroscopic anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament for treatment of chronic ankle instability. Methods From June 2012 to August 2016, 27 patients with chronic ankle instability (28 ankles) were treated with arthroscopic anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament. All the patients were evaluated preoperatively and at the last follow-up using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score. The talar tilt angle and anterior translation were assessed radiographically in pre- and postoperative ankle stress views.Results The operations lasted for 75.8 minutes (from 72 to 104 minutes). The 27 patients received a mean follow-up of 14.8 months (range, from 12 to 25 months). All the wounds healed by the first intention. No neurovascular complications were observed and no patient reported ankle stiffness or pain in motion. On average, the anterior talar trans-lation was reduced from 10.82 ± 3.32 mm preoperatively to 4.03 ± 1.70 mm at the last follow-up, the talar tilt angle decreased from 15.60°± 3.86°to 6.01°± 2.64°, the VAS pain score decreased from 5.79 ± 1.79 to 1.54 ± 1.35, and the AOFAS ankle-hindfoot score improved from 63.64 ± 11.20 to 90.21 ± 4.48. All the above differences were statistically significant (P <0.01). Conclusion Arthroscopic anatomical re-construction of anterior talofibular ligament and calcaneofibular ligament can improve function and stability of the ankle joint effectively, providing a valid option for treatment of chronic ankle instability.

17.
China Journal of Endoscopy ; (12): 64-67, 2018.
Article in Chinese | WPRIM | ID: wpr-702908

ABSTRACT

Objective To study the clinical effect of minimally invasive resection of spleen in the upper margin of the spleen pedicle. Methods 152 patients underwent splenectomy were enrolled in this study from June 2012 to June 2017. All patients underwent laparoscopic splenectomy. Among the 118 patients, the spleen pedicle was removed from the spine pedicle of the spleen pedicle and the spleen pedicle was taken as the control group. Comparison of the two groups of patients with perioperative period, 7 d postoperative hematological indicators and complications occurred. Results The intraoperative blood loss (51.85 ± 27.14) ml, the operation time (69.39 ± 19.34) min and the transfer rate (0.84%) were lower in the observation group than those in the control group (82.67 ± 36.29) ml, (119.44 ± 23.73) min and (8.82%), the difference was statistically significant (P < 0.05). There was no significant difference in the time of first anal exhaust, food time and hospitalization time (P > 0.05). The levels of blood white blood cell count (WBC) (4.32 ± 1.14) ×109/L, hemoglobin (Hb) (125.37 ± 18.28) g/L and platelet (PLT) were significantly higher than those in the observation group (378.28±112.94) (P < 0.05) were significantly higher than those in the control group (3.28 ± 1.05) ×109/L, (97.23 ± 22.43) g/L and (239.42 ± 134.82) ×109/L, respectively. The incidence of pancreatic fistula, abdominal hemorrhage, portal vein thrombosis, infection and intestinal obstruction was significantly lower in the observation group than in the control group (P < 0.05). Conclusion Splenectomy of splenic pedicle in spleen splenectomy can reduce the intraoperative blood loss and transfer rate, reduce the operation time and reduce the incidence of postoperative complications. It can be further promoted in clinical and use.

18.
Article in Chinese | WPRIM | ID: wpr-776583

ABSTRACT

OBJECTIVE@#To investigate the effects of Deoxygedunin on Aβ deposition, learning memory, and oxidative stress induced by D-galactose combined with AlCl in model rats with Alzheimer's disease and its possible mechanism.@*METHODS@#Male SD rats were randomly divided into three groups (=12):control group, model group (AD) and intervention group (AD+Deo). Morris water maze test was used to detect learning/memory and cognitive function in rats.Glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and malondialdehyde (MDA) contents in homogenate of hippocampus were detected by enzyme-linked immunosorbent assay (ELISA).Tau protein expression in rat cerebral cortex was detected by immunohistochemistry.Western blot was used to detect the expressions of extracellular signal regulated kinase 1(ERK1), protein kinase B (PKB) and tropomyosin-related kinase B (TrkB) on TrkB signaling pathway.@*RESULTS@#The results of water maze test showed that D-galactose combined with AlCl induced a significant increase in the escape latency compared with the control group (<0.05).Deoxygedunin could reverse the increase of the escape latency of the model group (<0.05).On the 7th day after removal of the platform, the model group showed an increase in escape latency compared with the control group and the intervention group (<0.01), and the number of crossing platforms was declined (<0.05); The results of immunohistochemistry and ELISA showed that the expressions of Aβ and tau protein in the model group were increased significantly compared with those of the control group (<0.01).The activities of SOD and GSH-Px were decreased significantly and the content of MDA was increased significantly.Compared with the model group, Deoxygedunin could reverse the increase of the expressions of Aβ and tau protein (<0.01), the decrease of SOD and GSH-Px activities (<0.05) and the increase of the MDA content (<0.05).Western blot results showed that Deoxygedunin treatment reversed the decreased phosphorylation levels of TrkB, AKT and ERK1 in hippocampus of the model group.@*CONCLUSIONS@#Supplement of Deoxygedunin can significantly reverse Aβ deposition, oxidative stress and cognitive deficits by activating the TrkB signal transduction pathway, which suggest that Deoxygedunin may serve as a promising therapeutic candidate for attenuating AD-like pathological dysfunction induced by D-galactose combined with AlCl.


Subject(s)
Alzheimer Disease , Animals , Disease Models, Animal , Galactose , Hippocampus , Limonins , Male , Maze Learning , Rats , Rats, Sprague-Dawley
19.
Chinese Journal of Trauma ; (12): 408-413, 2017.
Article in Chinese | WPRIM | ID: wpr-614041

ABSTRACT

Objective To investigate the efficacy of anatomic plate internal fixation in treatment of complex proximal humeral fractures combined with humeral shaft fractures.Methods This retrospective case series study included 58 patients with complex proximal humeral fractures combined with humeral shaft fractures admitted from July 1998 to July 2015.There were 31 males and 27 females,with a mean age of 63 years (range,18-86 years).According to the Neer classification of proximal humeral fractures,three-part fractures were noted in 42 patients and four-part fractures in 16 patients.Four patients were combined with compressed or splitting fractures of the head of humerus and 38 patients with dislocation of the shoulder.According to the site classification of femoral shaft fractures,proximal 1/3 shaft fractures were noted in 36 patients,middle and distal 1/3 shaft fractures in 19,and multisegmental shaft fractures in three.All patients underwent anatomic reduction and anatomic plate internal fixation.Bone healing,Neer score of function outcome and complications were evaluated after operation.Results Mean duration of follow-up was 8.6 years (range,1-18 years).Bone union was observed in all patients after 10 to 24 weeks (mean,14.5 weeks).According to the Neer score,the outcomes were excellent in 23 patients,good in 25,fair in eight and poor in two,with the excellent rate of 83 %.Complications such as infection,nerve injury and vascular injury were not observed after operation.Six patients suffered from limitations of shoulder anterior flexion and rise,one patient had humeral head necrosis and treated by shock wave treatment,and one patient had poor incision healing with hemorrhagic effusion and cured after dressing.Conclusion Anatomic plate internal fixation can contribute to fast functional recovery and few complications in treatment of complex proximal humeral fractures combined with humeral shaft fractures.

20.
China Journal of Endoscopy ; (12): 66-70, 2017.
Article in Chinese | WPRIM | ID: wpr-612150

ABSTRACT

Objective To investigate the impact of blood glucose level on the recurrence of liver cancer after laparoscopic surgery. Methods The clinical data of 98 patients with primary hepatocellular carcinoma from January 2012 to January 2015 were retrospectively analyzed. All patients were treated by laparoscopic radical resection of hepatocellular carcinoma. Patients were divided into elevated blood glucose group (n = 23) and control group (n = 75) according to whether the fasting blood glucose was ≥6.1 mmol/L. The recurrence of liver cancer in 1 year and 2 years after operation was compared. The factors influencing the recurrence of liver cancer were analyzed by univariate and multivariate analysis. Results The recurrence rates were 47.82% and 21.33% respectively in the patients with elevated blood glucose and the control group. The recurrence rates were 73.91% and 36.00%respectively in the 2-year postoperative patients with blood glucose and 1 year and 2 years. The recurrence rate was higher than that of the control group, the difference was statistically significant (P < 0.05). Logistic multivariate analysis showed that fasting blood glucose was high, Child-Pugh grade B, intraoperative blood transfusion, lymphatic invasion, high clinical pathology stage, postoperative alpha-fetoprotein (AFP) high, no postoperative adjuvant therapy (P < 0.05). Conclusion The recurrence rate of patients with elevated liver cancer after laparoscopic surgery is high, and fasting blood glucose is high, Child-Pugh grade is B grade, blood transfusion is high, there is lymphatic invasion, high clinical pathology stage after AFP high, no postoperative adjuvant therapy for its postoperative recurrence of risk factors, should strengthen the monitoring of high-risk patients, reduce postoperative recurrence rate.

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