Effects of higher femoral tunnels on clinical outcomes, MRI, and second-look findings in double-bundle anterior cruciate ligament reconstruction with a minimal 5-year follow-up / 中华医学杂志(英文版)

BACKGROUND@#To perform anatomical anterior cruciate ligament reconstruction (ACLR), tunnels should be placed relatively higher in the femoral anterior cruciate ligament (ACL) footprint based on the findings of direct and indirect femoral insertion. But the clinical results of higher femoral tunnels (HFT) in double-bundle ACLR (DB-ACLR) remain unclear. The purpose was to investigate the clinical results of HFT and lower femoral tunnels (LFT) in DB-ACLR.@*METHODS@#From September 2014 to February 2016, 83 patients who underwent DB-ACLR and met the inclusion and exclusion criteria were divided into HFT-ACLR (group 1, n = 37) and LFT-ACLR (group 2, n = 46) according to the position of femoral tunnels. Preoperatively and at the final follow-up, clinical scores were evaluated with International Knee Documentation Committee (IKDC), Tegner activity, and Lysholm score. The stability of the knee was evaluated with KT-2000, Lachman test, and pivot-shift test. Cartilage degeneration grades of the International Cartilage Repair Society (ICRS) were evaluated on magnetic resonance imaging (MRI). Graft tension, continuity, and synovialization were evaluated by second-look arthroscopy. Return-to-sports was assessed at the final follow-up.@*RESULTS@#Significantly better improvement were found for KT-2000, Lachman test, and pivot-shift test postoperatively in group 1 ( P >0.05). Posterolateral bundles (PL) showed significantly better results in second-look arthroscopy regarding graft tension, continuity, and synovialization ( P <0.05), but not in anteromedial bundles in group 1. At the final follow-up, cartilage worsening was observed in groups 1 and 2, but it did not reach a stastistically significant difference ( P >0.05). No statistically significant differences were found in IKDC subjective score, Tegner activity, and Lysholm score between the two groups. Higher return-to-sports rate was found in group 1 with 86.8% (32/37) vs. 65.2% (30/46) in group 2 ( P = 0.027).@*CONCLUSION@#The HFT-ACLR group showed better stability results, better PL, and higher return-to-sports rate compared to the LFT-ACLR group.

Non-operative Treatment for Acute Intra-synovial Sheath ACL Rupture / 中国运动医学杂志

Objective To evaluate the effectiveness of non-operative treatment for the acute intra-synovial sheath anterior cruciate ligament (ACL) rupture.Methods Twenty-eight patients diagnosed as the acute intra-synovial sheath ACL rupture at outpatient clinic between May 2014 and July 2016 were included.All patients were immobilized with knee braces for 6 weeks,followed by range of motion (ROM) training and partial to full weight-bearing of knees.All patients returned 3 months later for MRI scanning and those with the side-to-side difference of the anterior-posterior laxity less than 5 mm continued with non-operative treatment,followed up for MRI examination and clinical assessments 6 and 12 months later.Results Four patients dropped out because they didn't meet the stability criteria at 3 months after the treatment,3 of whom received surgical reconstruction and 1 with muscle strengthening training.Another patient received surgical reconstruction at 5 months due to re-injury.The remaining 23 patients achieved satisfactory results at 12 months after the treatment,with the average side-to-side difference of the anterior-posterior laxity of 2.1mm (0-4 mm),MRI good-to-excellent rate of 85.2％ (8 of Grade 1 and 15 of Grade 2),subjective IKDC (International Knee Documentation Committee) score of 92.71 (89.7-98.9),Lysholm score of 91.6 (86-95),and modified Larson score 96.4 (92-99).Conclusions Patients with the acute intra-synovial sheath anterior cruciate ligament (ACL) rupture showed satisfactory functional scores and objective stability and healing on MRI after the non-operative treatment.

Application of reduced glutathione in the treatment of acetaminophen poisoning / 实用医学杂志

Objective To study the effects of reduced glutathione(GSH) in the treatment of acetamino-phen poisoning. Methods A total of 60 patients with acetaminophen poisoning treated in our hospital from June 2014 to May 2016 were selected.The patients were randomly divided into the control diagnosis and treatment group (n=30) and GSH diagnosis and treatment group(n=30).The patients of two groups were treated with anti-infec-tion,correction of water electrolyte disturbance and acid-base imbalance,and nutrition support treatment accord-ing to the poisoning routine.The control diagnosis and treatment group was treated with GSH,and the GSH diagno-sis and treatment group were treated with GSH according to the use assessment table.The liver function and the lev-el of cholinesterase(CHE) of the two groups before and after treatment were observed,and the adverse reactions and economic benefits of the two groups were statistically analyzed. Results The incidence of adverse drug reac-tions in the GSH diagnosis and treatment group was 10.00%,while that in the control diagnosis and treatment group was 23.33%,and there was a significant difference in the incidence of adverse drug reactions between the 2 groups(P<0.05).There was no significant difference in the levels of AST,ALB and CHE between the 2 groups before treatment(P>0.05).After treatment,the levels of AST and ALB of the GSH diagnosis and treatment group were significantly lower than those of the control diagnosis and treatment group(P < 0.05). The CHE level of the GSH diagnosis and treatment group was significantly higher than that of the control diagnosis and treatment group (P<0.05).The GSH dose,cost of treatment and days of hospitalization of the GSH diagnosis and treatment group were significantly lower than those of the control diagnosis and treatment group(P < 0.05). Conclusions The GSH for treatment of acetaminophen poisoning is effective,in terms of improving the level of liver function and re-ducing the level of inflammatory factors.Therefore,it is worthy of popularization and application.

The short-term curative effect of anterolateral small incision total hip arthroplasty / 中国基层医药

Objective To explore the surgery way of anterolateral small incision total hip replacement and evaluate the curative effect after surgery.Methods Clinical data of 41 patients(48 hips)with anterolateral small incision total hip replacement were analyzed retrospectively.The incision length,operation time,intraoperative blood loss,postoperative volume of drainage,perioperative complications,hospitalization days,X -ray performance were recorded.Results The incision length was 7-8cm,mean (7.5 ±0.5)cm.The operation time was 60-70min,mean (65 ±5)min.The intraoperative blood loss was 165 -280mL,mean (235 ±44)mL and the postoperative volume of drainage was 85 -120mL,mean (95 ±15)mL.No perioperative complications occurred.The average follow-up time was (36 ±6)months.The preoperative hip joint Harris score was (30.3 ±28.2)points,and the last follow-up score was (98.0 ±4.0)points,the difference was statistically significant(t=15.665,P=0.000),and the excellent and good rate was 100%.Conclusion The anterolateral small incision total hip replacement has small trauma,less bleed-ing,less postoperative pain,quick recovery,better joint stability,and it is suitable for clinical promotion.

Clinical research on Traditional Chinese Medicine nursing technology to decrease postoperative complication after breast cancer surgery / 中华护理杂志

Objective To explore clinical application value of Traditional Chinese Medicine nursing technology to decrease postoperative complication after breast cancer surgery.Methods Randomized controlled trial,large sample size,multicenter study design were adopted,and 200 patients who met inclusion criteria were randomly divided into the control group and the treatment group (100 cases in each group).The control group received routine nursing methods after breast cancer surgery.The treatment group received routine nursing methods as well as Traditional Chinese Medicine nursing intervention,such as auricular application pressure,acupoint sticking,meridian moxibustion.Data of arm circumference,Athens insomnia scale(AIS),symptom in affected arm were collected a week before and after surgery,and range of motion of shoulder joint was evaluated 3 months after surgery to compare postoperative subcutaneous effusion,skin flap necrosis,limb edema,sleep disorder and occurrence of shoulder joint dysfunction in two groups.Results The cases developed postoperative subcutaneous effusion,skin flap necrosis,limb edema were different in two groups,but the differences were not statistically significant(P＞0.05).There were significant differences between two groups in affected arm pain,swelling,skin tension,sleep,and shoulder joint dysfunction after 3 months(P＜0.05).Conclusion Traditional Chinese Medicine nursing technology can effectively decrease postoperative complication after breast cancer surgery.

Clinical Observations on Moxibustion plus Acupoint Application for the Prevention and Treatment of Gastrointestinal ;Reactions During Chemotherapy for Breast Cancer / 上海针灸杂志

Objective To investigate the clinical efficacy of moxibustion plus acupoint application of Chinese herbal medicine in preventing and treating gastrointestinal reactions during chemotherapy for breast cancer. Method One hundred patients with breast cancer of stomach deficiency cold type were randomly allocated to two groups. The treatment group received moxibustion plus acupoint application of Chinese herbal medicine based on conventional treatment of western medicine and the control group, conventional treatment of Western medicine. Result Comparison of nausea and vomiting incidences and severities from the beginning day of chemotherapy to three days after it and constipation incidences and severities during three days after chemotherapy between the two groups of patients showed that the results were better in the treatment group than in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusion Moxibustion plus acupoint application of Chinese herbal medicine can effectively prevent and treat gastrointestinal reactions during chemotherapy for breast cancer. The method is convenient.

Clinical Study on Transcutaneous Electric Acupoint Stimulation for Swelling Limb after Breast Cancer Operation / 上海针灸杂志

Objective To observe the clinical efficacy of transcutaneous electric acupoint stimulation in intervening early-stage swelling limb after breast cancer operation.Method A hundred patients undergone radical mastectomy for breast cancer were divided into a treatment group and a control group, 50 cases in each group. The control group was intervened by ordinary post-operative nursing, while the treatment group was additionally given transcutaneous electric acupoint stimulation. By measuring the circumference of both upper arms, the incidence rate and degree of swelling arm in 2 weeks after operation were compared, meanwhile, the accompanied symptoms such as tightness of skin, pain in upper limb, numbness in upper limb, and heaviness of upper limb were observed.Result The occurrence rate of abnormal upper-limb sensations was 22.0% in the treatment group versus 84.0% in the control group, and the difference was statistically significant (P<0.01). The occurrence rate of upper-limb swelling was 4.0% in the treatment group, versus 24.0% in the control group, and the difference was statistically significant (P<0.01). Conclusion Transcutaneous electric acupoint stimulation can effectively prevent and release the early-stage upper-limb swelling after breast cancer surgery.

Therapeutic Observation of Transcutaneous Acupoint Electrical Stimulation for Constipation during Chemotherapy for Breast Cancer / 上海针灸杂志

Objective To observe the clinical efficacy of transcutaneous acupoint electrical stimulation in intervening constipation during chemotherapy in breast cancer patients.Method Ninety breast cancer patients undergone chemotherapy were randomized into a treatment group and a control group, 45 cases in each group. The control group was intervened by conventional nursing care, while the treatment group was additionally intervened by transcutaneous acupoint electrical stimulation. The clinical efficacies were compared between the two groups.Result The total effective rate was 93.3% in the treatment group versus 73.3% in the control group, and the difference was statistically significant (P<0.01).Conclusion Transcutaneous acupoint electrical stimulation can effectively inhibit the incidence of constipation during chemotherapy in breast cancer patients.

Intraoperative study on anthropometry and gender differences of the proximal tibial plateau at the arthroplasty resection surface / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The tibial plateau is asymmetric with a larger medial plateau. We observed from clinical practice that the shape of the tibial plateau does not always present a larger medial plateau. Tibial plateau also showed other shapes. The purpose of this study was to analyze the anthropometric data of the proximal tibia in a large group of Chinese patients undergoing total knee arthroplasty and to investigate the morphology of the resected proximal tibial surface and its gender differences.</p><p><b>METHODS</b>A total of 822 knees (164 males, 658 females) from the Chinese population were measured intraoperatively for medial anteroposterior (MAP) and lateral anteroposterior (LAP) dimensions of the resected proximal tibial surface. The difference of MAP and LAP (DML) was also calculated as MAP minus LAP. We then classified the data into three groups based on the DML (<-2, -2 to 2, and >2 mm) to analyze the morphology of the proximal tibia and its distribution between male and female.</p><p><b>RESULTS</b>The shape of proximal tibial plateau was of three types: larger medial plateau type, symmetric type, and larger lateral plateau type. There were significant differences between males and females in relation to the shape distribution of the proximal tibial plateau (P < 0.05). Most of the proximal tibial plateau was asymmetric, with 517 of 822 (62.9%) tibia having a DML >2 mm and 120 of 822 (14.6%) tibia having a DML<-2 mm. Only 185 of 822 (22.5%) tibia had a DML between -2 and 2 mm.</p><p><b>CONCLUSION</b>The results of this study can be used as a guideline to design tibial components with different DMLs to better match the different anthropometry of the resected tibial surface.</p>

Clinical analysis of paradoxical cerebral embolism from pulmonary embolism / 中华急诊医学杂志

Objective To explore the diagnosis and treatment of cerebral embolism from pulmonary embolism (PE).Methods The clinical data of 5 cases with PE accompanied by cerebral embolism covering a period from October of 2007 to July of 2011 were retrospectively analyzed.Results In this study,the average age of 5 cases (all female) was 46.5 years old.PE was diagnosed through enhanced CT and ECT in lung among all 5 cases.Moderate to severe pulmonary hypertension was confirmed by echocardiogram.Two cases was patent foramen ovale and one was congenital atrial septal defect.Each patient was diagnosed to be new-onset cerebral infarction by MRI.Three cases underwent cerebral arterial thrombolysis.All of them survived and long-term anticoagulant treatment with Warfarin.INR was adjusted between 2.0 and 2.5 by change of Warfarin dose.Among them,one patient had cerebral embolism again just 3 days after the latest cerebral embolism; the other 4 patients did not suffer from cerebral embolism during the follow-up.Conclusions Paradoxical cerebral embolism is common.For clinical patients with PE,especially pulmonary hypertension accompanied by systemic circulation arterial embolism or unexplained systemic cerebral arterial embolism,paradoxical cerebral embolism should be considered.

Treatment of the Delayed/Nonunion of Scaphoid Fracture by Short-arm Cast Immobilization Leaving All the Metacarpophalangeal Joint Free / 中国运动医学杂志

Objective To study the clinical results of the short-arm cast immobilization leaving all the metacarpophalangeal joints free in the management of the delayed/nonunion of scaphoid fracture. Methods From August 1999 to January 2008, 18 cases of delayed/nonunion of scaphoid fracture were studied, including 2 cases with avascular necrosis in the proximal fragment and 2 cases with partial sclerosis. The average time from the injury was 6.3 months (range 2～12 months). The wrist was immobilized with a short-arm cast (from 5 cm below the elbow to the middle palmar crease), leaving all the metacarpophalangeal joints free until the fracture showed radiological signs of union. The wrist was fixed in 10 degrees of dorsiflexion and 20 degrees of ulnar deviation. All cases were reviewed every one or two months, and the cast should be changed if loose. Union of fracture was determined by plain radiograph. Results Union rate confirmed by plain radiograph was 88.9%(16 of 18) and average duration of cast was 4.7 months (range 3～8 months). Two cases with avascular necrosis in the proximal fragment achieved union after 5 and 6 months immobilization respectively. Of two failure cases of nonunion, one with partial sclerosis was immobilized for 5 months without signs of union and the other abandoned treatment after 2 months immobilization. Fourteen of the sixteen healed cases were followed up(with average of 9.3 months )after cast removal. Four cases were reported of 10 degrees dorsiflexion limitation of the wrist and three cases complained of mild pain during movement. Conclusion The delayed/nonunion of scaphoid fracture within 1 year after injury and without obvious sclerosis could achieve union with the short-arm cast immobilization leaving all the metacarpophalangeal joints free. The delayed/nonunion of scaphoid fracture with avascular necrosis in the proximal fragment need long term immobilization and also had chance of union.

The effect of vaslartan and fluvastatin on the connective tissue growth factor expression in experimental diabetic cardiomyopathy / 中华内科杂志

the two drugs than using one alone.

Immunoregulation of radix tanshinone on isolated-lung preservation / 中国基层医药

Objective The study is to investigate the effect of tanshinone on lung reperfusion injury. Methods 24 New-Zealand rabbits were randomly divided into two groups. In one group, the lungs were perfused and preserved with LPD solution, the other with LPD+ tanshinone solution. The isolated lungs were preserved for 18 hours and then reperfused with rewarming whole blood. After reperfusing 30 minutes the lung samples were examined by pathology, wet/dry weight and measure of NO, SOD and MDA. Results In two groups, the reperfusion injury lungs were fresh, but had partial congestion, edema and ecchymoma under naked eye, under light microscopy the structures of the pulmonary vesiculars, branchia and capillaries were complete, but the epithelial cells of the vesicles and capillaries in the LPD group were more swelling and hypertrophy than that in LPD+ tanshinone group. The wet/dry weight ratio was significantly lower in LPD+ tanshinone group than in the LPD group. NO [(2.16±2.15)μmol/g] and SOD [(37.03±18.01NU/mg] were higher in the LPD+ tanshinone group than in the LPD group [(0.68±0.33) μmol/g, (17.63±11.04)NU/mg] (all P<0.05), MDA was lower in the LPD+ tanshinone group [(0.47±0.20)μmol/mg] than in the LPD group [(0.86±0.44)μmol/mg] (P<0.05). Conclusions Tanshinone can dean oxygen free radical and is of stronger antioxidation, results in alleriating of lung reperfusing injury. Tanshinone has positive effect on preservative quality of the reperfusion injury lung.

Content Determination of Paeonol in Shengui Tiaojing Pill by HPLC / 中国中医药信息杂志

Objective To establish a method of HPLC for determining the Paeonol in Shengui Tiaojing Pill. Method Agilent Hypersil-ODS-C18 (250 mm?4.0 mm, 5 ?m) was used, the mobile phase consisted of methanol-H2O (70∶30). The flow rate was 1.0 mL/min. The detecting wave length was at 274 nm. Results The method was linear at the range of 0.052～0.84 ?g for Paeonol (r=0.999 9). The average recovery was 99.94%. Conclusion The method is simple, sensitive, accurate and can be applied to the quality control of Paeonol in Shengui Tiaojing Pill.

Identification of Fengliaoxing Fengshi Dieda Medicinal Wines in Fake by GC and TLC / 中国中医药信息杂志

Objective To establish a method for the fake indentification of Fengliaoxing Fengshi Dieda medicinal wines by TLC and GC. Methods The column was Supelco SE-30 (30 m?0.25 mm?0.25 ?m). The flow rate was 1.4 mL/min, and gas was N2. The inlets temperature was 210 ℃;the detectors temperature was 300 ℃;the column temperature use program rising temperature. Results TLC can identify whether ephedra and erycibe were contained in the medicinal wines. GC can identify whether diclofenac sodium was contained in the medicinal wines. Conclusion The method is accurate and reproducible, and can be used for the identification of Fengliaoxing Fengshi Dieda medicinal wines.

Cloning and expression of ns5a gene of hepatitis C virus 1b strain DY in Escherichia coli / 西安交通大学学报(医学版)

Objective To clone and express the ns5a gene of hepatitis C virus(HCV) 1b strain DY.Methods By using the prokaryotic cell gene engineering,HCV ns5a gene was amplified with nested PCR from the plasmid HCV17 of HCV 1b strain DY full-length gene and inserted into the cloning pMD18-T vector.The cloned HCV ns5a gene was separated and subcloned into expression vector pET-28a and induced by IPTG in E.coli.BL21.The expressed product was identified by SDS-PAGE and Western-blot methods.Results Recombinant expression plasmid pet-28a-ns5a was constructed and expressed successfully.Conclusion HCV ns5a gene was cloned and expressed.This might be helpful for further studies on the nature and biological properties of the ns5a gene.