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Objective:To investigate the clinical outcome of arthroscopic suture-button Bristow procedure using suture-button fixation for treatment of recurrent anterior shoulder instability.Methods:A retrospective case series study was conducted to analyze 28 patients with recurrent anterior shoulder instability admitted to Shanghai Sixth People’s Hospital from March 2015 to September 2018，including 26 males and 2 females，aged 18-36 years ［（24.1 ± 3.2）years］. Preoperative MRI showed Bankart injury and three-dimensional CT showed glenoid bone defect > 15%. The Hill-Sachs injury was found in 27 patients. Arthroscopic Bristow procedure was used to fix coracoid process graft with the suture-button plate and glenoid labial complex was repaired with the suture anchor to treat anterior instability of the shoulder joint. The visual analogue scale （VAS），American shoulder and elbow surgeon （ASES） scale，Constant score and Rowe score were used to evaluate the shoulder joint function preoperatively，at postoperative 3，6，12 months and at the last follow-up. The postoperative infection，neurovascular injury，redislocation and other complications were recorded，and the incidence rate was calculated. The bone resorption and bone healing of coracoid process graft were analyzed by CT.Results:All patients were followed up for 22 - 36 months ［（24.5 ± 6.3） months］. Three months after operation，the VAS，ASES scale and Constant score were not significantly different from those before operation （ P > 0.05）. In comparison，the Rowe score was significantly higher than that before operation （ P < 0.05）. Six and twelve months after operation，the VAS，ASES scale，Constant score and Rowe score were significantly improved from those before operation （ P < 0.05）. At the last follow-up，the VAS decreased from （2.7 ± 1.5）points preoperatively to （0.8 ± 0.3）points，the ASES scale increased from （78.6 ± 12.7）points preoperatively to （92.4 ± 8.4）points，the Constant score increased from （43.4 ± 5.2） points preoperatively to （81.6 ± 6.7） points，the Rowe score increased from （52.3 ± 7.1）preoperatively to （92.7 ± 5.4） points （ P < 0.05）. During the follow-up，there was no infection，neurovascular injury，re-dislocation and other complications. In addition，24 （86%） out of the 28 patient showed healing of coracoid process grafts，and the overall bone resorption rate was （18.4 ± 6.1）%. No patients had glenohumeral joint osteoarthritis. Conclusion:Arthroscopic Bristow procedure using suture-button fixation for treatment of recurrent anterior shoulder instability has advantages of a low rate of postoperative complications and a high union rate，indicating an effective and safe surgical procedure.
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PRP (Platelet-rich plasma) is an autologous concentrate of platelets extracted from the whole blood,which has the ability of hemostasis,relieving pain and accelerating wound healing.PRP can promote tissue repairing effectively,because it not only provides concentrated nutrition,but also builds a better microenvironment.With the wide spread of PRP,it has been gradually applied to the treatment of tendon,ligament,cartilage and muscle injury in orthopedics.And meanwhile,with the rapid development of foot and ankle surgery in recent years,such applications have been introduced into this area,reports of therapeutic effects of foot and ankle disorders are also emerging.This paper makes a summary of the clinical studies of foot and ankle disorders with PRP.
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Objective To investigate the influence of Yishen granule on the expression of type Ⅳ collagen,laminin (LN)and fibroneetin (FN)in diabetic nephropathy (DN) rats.Methods DN model rats were established by unilateral nephrectomy and intraperltoneal injection of STZ.The experimental rats were divided into six groups:normal group,DN model group,Yishen granule groups in low and high dose (8.1 g/kg、16.2 g/kg) and positive control medicine group with lotensin (0.0015 g/kg).After 16 weeks of treatment,kidney tissues were sampled and pathologically observed through Masson trichrome staining.The proteins of type Ⅳ collagen、LN and FN were determined through immunohistochemical methods.Results The type Ⅳ collagen in normal group,DN model group,Yishen granule groups in low and high dose,and positive control medicine group was (1521.22 ± 415.26),(1579.22 ± 343.26),(3402.00 ± 863.39),(2984.30 ± 674.53),(2959.15 ± 561.22),(2918.04±363.96); LN was (1968.04±522.17),(2004.52±417.19),(3299.04±665.78),(3116.89±540.10),(2932.63 ± 528.38),(2815.89 ± 798.58) ; FN was (2614.67 ± 533.82),(2742.63 ± 562.80),(3311.41 ± 529.29),(2993.44±548.66),(2953.30±535.74),(2897.41 ±505.84) respectively.The level of type Ⅳ collagen、LN and FN expression in Yishen granule group obviously decreased as compared with that in DN model group (P＜0.05).The mesangial cells,basement membrane thickening and endocapillary proliferation in glomerular filtration membrane were significantly alleviated in Yishen granule group.The pathology of kidney was obviously modulated by Yishen granule.Conclusion Yishen granule can significantly inhibits the expression of type Ⅳ collagen、LN and FN in DN rats,which may be the mechanisms for Yishen granule in protecting the DN rat's kidney.
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Objective To identify the most common fungal pathogens and their antifungal drug resistance in autoimmune disease (AD) patients with fungal infection , for guiding the rational use of antifungal therapy. Methods The identification were analyzed by ATB Expression automatic microbiology analytical instrument system. The antifungal susceptibility test was done by ATB FUNGUS strip. Results Of 428 patients studied,36(8.4%) had fungal infections. The most commonly infective sites were lower respiratory tract(53.5%),urinary tract(20.9%), intestinal tract(11.6%). A total of 43 fungi strains were isolated, the most common fungi were Candida albicans (65.1%), Candida glabrata (11.6%), Candida tropicalis (7.0%),and Candida parapsilosis (4.7%).Resistance rates of Candida albicans against ketoconazole, miconazole and econazole were 35. 7% , 46.4% and 32.1% , while resistance rates to fluconazole, amphotericin B, nystain and flucytosine were much lower, being 0, 14.3% , 14.3% and 7.1% . The resistance rates of other fungi were similar to Candida albicans. Conclusion The main pathogens causing fungal infection in patients with AD is Candida albicans. It should as early as possible process the clinical antifungal therapy under the result of antifungal susceptibility test and supportive measure.
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The Qirongrunchang Mixture(QRRCM)is a prescription composed of Radix Astragali,Fructus Cannabis,etc.It is effective for habitual constipa- tion and constipation in the aged and the debilitated,It was shown in this study that oral administration of this mixture could accelerate the intestinal movement in mice with yang-deficiency in a dose-dependent manner,and exerted a cathartic effect on mice with eonstipation.It increased the volume of intestinal content in rabbits,but did not influence the absorption of water in the intestines.