Comparison of intramedullary nailing combined with minimally invasive cerclage versus simple intramedullary nailing for femoral long oblique subtrochanteric fractures / 中华创伤骨科杂志

Objective To compare intramedullary nailing assisted by minimally invasive cerclage with simple intramedullary nailing in the treatment of femoral long oblique subtrochanteric fractures.Methods From April 2010 to September 2015,our department treated 39 patients with femoral long oblique subtrochanteric fracture.Of them,16 were treated by cephalomedullary nailing combined with minimally invasive cerclage (observation group of 11 males and 5 females with an average age of 42.8 ± 13.2 years) and 23 by simple cephalomedullary nailing (control group of 17 males and 6 females with an average age of 46.2 ± 10.1 years).Their operation time,intraoperative blood loss,radiologic results (union time and alignment) and functional results [Visual Analog Scale (VAS) and Harris hip score] were compared between the 2 groups.Results The 39 patients were followed up from 12 to 30 months (average,15 months).For the observation group,the varus angle (2.2°± 1.4°) was significantly smaller than for the control group(4.1°±2.2°),the VAS scores at 1 and 3 months postoperatively (3.43 ± 1.54,1.13 ± 1.20) were significantly lower than for the control group (5.61 ± 1.41,3.34 ± 1.82),and the clinical union ratio at 3 months postoperatively(87.5％,14/16) significantly higher than for the control group (47.8％,11/23) (P ＜ 0.05).There were no significant differences between the 2 groups in terms of operation time,intraoperative blood loss,Harris hip score at one year postoperatively,VAS score at 6 months postoperatively,or clinical union ratio at 6 or 12 months postoperatively(P ＞ 0.05).Conclusions Cephalomedullary nailing is effective for the treatment of femoral long oblique subtrochanteric fractures no matter it is assisted by minimally invasive cerclage or not.However,since minimally invasive cerclage has the advantage of improving reduction and mechanical stability,combination of minimally invasive cerclage and cephalomedullary nailing may be more advantageous in early pain-relieving and functional recovery.

Insulin secretion stimulating effects of mogroside V and fruit extract of luo han kuo (Siraitia grosvenori Swingle) fruit extract / 药学学报

Luo han kuo fruit (Siraitia grosvenori Swingle), a fruit native to China, has been used as a natural sweetening agent for centuries and has been reported to be beneficial for diabetic population. However, limited research has been conducted to elucidate the relationship between the sweetening action and biological parameters that may be related to potential health benefits of LHK fruit (Luo Han Kuo fruit). The present study examined the effect of LHK fruit and its chemical components on insulin secretion using an in vitro cell model system. Mogroside V is the most abundant and the sweetest chemical component among the mogrosides in LHK fruit. The experimental data demonstrated that the crude LHK extract stimulated the secretion of insulin in pancreatic beta cells; furthermore, pure mogroside V isolated from LHK fruit also exhibited a significant activity in stimulating insulin secretion by the beta cells, which could partially be responsible for the insulin secretion activity of LHK fruit and fruit extract. The current study supports that LHK fruit/extract has the potential to be natural sweetener with a low glycemic index, and that mogroside V, possible other related mogrosides, can provide a positive health impact on stimulating insulin secretion.

Useful of Three-dimensional Magnetic Rsonance Angiography and Constructive Interference in Steady State(CISS) Sequences in Patients with Hemifacial Spasm

We prospectively studied 100 patients to assess the usefulness of three-dimensional(3D) magnetic resonance(MR) angiography and constructive interference in steady state(CISS) sequences in patients with hemifacial spasm. Hemifacial spasm caused by tumors in the cerebellopontine angle was not included. 3D-short range MR angiography was performed in 50 patients, using FISP sequence. Compressive vessels were predicted in all 50 patients: anterior inferior cerebellar artery(AICA) in 23 cases, posterior inferior cerebellar artery(PICA) in 17 cases, vertebral artery(VA) and PICA in 5 cases, AICA and PICA in 3cases, VA in 1case, AICA and VA in 1case. In operative findings, offending vessels were identified in all cases : AICA in 22 cases, PICA in 17 cases, VA and PICA in 7 cases, AICA and PICA in 3 cases, VA & AICA in 1 case. Related degree of 3D-short range MR angiographic and operative findings was complete matching in 47(94.0%) cases, partial matching 2(4.0%) cases, and miss-matching 1(2.0%) case. MRI using CISS sequence was also performed in 50 patients. With this method, compressive vessels were also predicted in all 50 patients : AICA in 15 cases, PICA in 8 cases, VA in 6 cases, VA and PICA in 4 cases, AICA and PICA in 3 cases, VA and AICA in 2 cases. But, unknown compressive vessels were 12cases. In operative findings, vascular contact with the facial nerve root-exit zone(REZ) was present in all 50 cases. The vessels responsible were AICA in 20 cases, PICA in 14 cases, VA and PICA in 8 cases, VA in 3 cases, VA and AICA in 3 cases, AICA and PICA in 2 cases. Related degree of CISS images and operative findings was complete matching in 32(64.0%) cases, partial matching 5(10.0%) cases, and miss-matching 13(26.0%) cases. In conclusion, 3D-short range MR angiography and CISS are excellent and very useful for the preoperative evaluation of patients with hemifacial spasm, detection of not only the cause of hemifacial spasm but also identification of the compressive vessels and the relationship between compressive vessels and facial nerve REZ

Hemifacial Spasm Associated with Benign Cyst

Hemifacial spasm associated with benign cyst of cerebellopontine angle masses have very rarely been reported from 0.4% to 4.3% in the literature. We report two cases with benign choroid plexal cyst of cerebellopontine angle which believed to be causes of hemifacial spasm. Operating findings and results revealed that one cyst produced deviation of the ipsilateral PICA and the other cyst produced deviation of the AICA and internal auditory artery, which we re secondarily in contact with the REZ of the facial nerve. Cyst removal along with microvascular decompressions were done in these patients. Postoperatively, they were completely relieved of symptom.