Cardiac autonomic function test in children with vasovagal syncope / 国际儿科学杂志

Vasovagal syncope(VVS)is a chronic recurrent disease.It is the most common cause of syncope in child and adolescents, accounting for 45%~60% of all syncopal cases.Repeated episodes of syncope severely affect the learning of children and adolescents and the quality of life of their families, which has attracted great attention from clinicians.The pathogenesis of VVS has not been clarified, and it is currently thought to be mainly related to autonomic dysfunction.Therefore, examining and evaluating cardiac autonomic function can help to diagnose VVS and prevent syncope.This article reviews the cardiac autonomic tests such as heart rate variability, QT dispersion and P wave dispersion, heart rate deceleration capacity and heart rate deceleration runs, 24-hour ambulatory blood pressure monitoring, and post-exercise heart rate recovery to explore its effectiveness in the diagnosis of VVS in children.

Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the efficacy and complications of manual reduction and external fixation for the treatment of scaphoid fractures and perilunate dislocations.</p><p><b>METHODS</b>From January 2009 to January 2013, 43 patients suffered from scaphoid fractures and perilunate dislocations were retrospective analyzed. Among them, 17 cases were treated with manipulative reduction and plaster external fixation as conservation group including 10 males and 7 females, the other 26 cases were treated with application of surgical as operation group including 15 males and 11 females. The clinical effects were assessed by Cooney function score, radiological analysis and observation of complications.</p><p><b>RESULTS</b>All patients were followed up for(45.00±8.72) months ranging from 36 to 60 months. At the final follow-up, the Cooney score of wrist function was 88.53±4.24 in conservation group and 89.58±4.59in operation group(0.455, >0.05). During the follow-up, 4 patients were found scaphoid avascular necrosis in the imaging performance in the conservation group(χ²=4.32, <0.05). The difference of other complications between two groups was not statistically significant(>0.05).</p><p><b>CONCLUSIONS</b>For patients suffered from the scaphoid fractures and perilunate dislocation, the early manipulative reduction and plaster external fixation after injury as soon as possible is necessary. Maintaining a satisfactory reduction and reliable fixation at the same time can lead to good treatment effect and there's no weakness compared to surgical treatment. But there was an increase in danger of complications. The key of conservative treatment lies in early diagnosis and maintenance of reduction, reliable fixation, and timely and appropriate functional exercise.</p>

Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures.</p><p><b>METHODS</b>We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthesis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3).</p><p><b>RESULTS</b>No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints.</p><p><b>CONCLUSION</b>Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.</p>

Anatomical study of the third palmar interosseous muscle and its dominate nerve / 中华显微外科杂志

Objective To explore the anatomical characteristic of the third palmar interosseous mus- cle as well its dominate nerve,and to investigate the anatomical basis of difficult recovery of digitus minimus adduction.Methods Twenty aduh fresh hands without deformity and trauma were obtained.Dissect and observe the third palmar interosseous muscle and its dominate nerve and adjacent structure under surgical mi- croseope,measure the size of the third pahnar interosseous muscle and its dominate nerve,the data were pro- cessed by stastistics method.Results Among palmar interosseous muscles and its dominate nerves,the third palmar interosseous muscle and its dominate nerve is the smallest.There are conspicuous tendon bundle on the surface of the third palmar interosseous muscle partly,which have a potential compression on the third palmar interosseous muscle dominting nerve.Conclusion The third palmar interosseous muscle is the smal- lest among palmar interusseous muscles and it is the only digitus minimus adduction muscle.The sominating nerve of the third palmar interosseous muscle is small anti the tendon bundle of the third palmar interosseous muscle have a potential compression.All these can cast light on diffcult recovery of digitus minimus adduction.