Application of Nice knot technique in wound closure of Gustilo type ⅢA and ⅢB open tibial fractures / 中国修复重建外科杂志

OBJECTIVE@#To explore the effectiveness of Nice knot technique for wound closure in Gustilo type ⅢA and ⅢB open tibial fractures.@*METHODS@#A retrospective study was performed on 22 patients with Gustilo type ⅢA and ⅢB open tibial fractures, who underwent wound closure using the Nice knot technique and were admitted between June 2021 and June 2022. There were 15 males and 7 females. The age ranged from 18 to 67 years, with an average of 41.9 years. The causes of injury included traffic accident in 11 cases, falling from height in 7 cases, and heavy object injuries in 4 cases. Fractures were located on the left side in 9 cases and on the right side in 13 cases. And 9 cases were type ⅢA fractures and 13 were type ⅢB fractures according to Gustilo classification. All patients had extensive soft tissue injuries, and no vascular or neurological damage was observed. The time from injury to debridement was 3-8 hours (mean, 6.5 hours). The sizes of wounds before operation and at 2 weeks after operation were measured and wound healing rate at 2 weeks after operation were calculated. The wound healing time and wound healing grading were recorded. The Vancouver Scar Scale (VSS) score was used to assess the wound scar after wound healed and the excellent and good rate was calculated.@*RESULTS@#The wound area was 21.0-180.0 cm 2 (mean, 57.82 cm 2) before operation, and it was 1.2-27.0 cm 2 (mean, 6.57 cm 2) at 2 weeks after operation. The wound healing rate at 2 weeks after operation was 76%-98% (mean, 88.6%). After operation, 2 cases needed to adjust Nice knot due to skin cutting and 1 case occurred soft tissue infection on the wound. The other patient's wounds healed. The average wound healing time was 27.8 days (range, 18-44 days). And the wound healing were grade A in 13 cases and grade B in 9 cases. VSS score was 2-9, with an average of 4.1; 10 cases were rated as excellent, 10 as good, and 2 as poor, with an excellent and good rate of 90.9%. All patients were followed up 9-24 months (mean, 14.6 months). During follow-up, no deep infection or osteomyelitis occurred. Two cases experienced fracture non-union, and were treated with compression fixation and bone grafting. The fractures of the other patients all healed, with a healing time of 85-190 days (mean, 148.2 days).@*CONCLUSION@#Nice knot technique can be used in wound closure of Gustilo type ⅢA and ⅢB open tibial fractures effectively, which is easy to operate.

Percutaneous hollow screw internal fixation combined with cementoplasty in treatment of periacetabular metastasis / 中国修复重建外科杂志

OBJECTIVE@#To explore the percutaneous hollow screw internal fixation combined with cementoplasty in the treatment of periacetabular metastasis.@*METHODS@#A retrospective study was performed on 16 patients with periacetabular metastasis who were treated with percutaneous hollow screw internal fixation combined with cementoplasty between May 2020 and May 2021. There were 9 males and 7 females. The age ranged from 40 to 73 years, with an average of 53.6 years. The tumor involved around the acetabulum, and 6 cases were located on the left and 10 cases on the right. Operation time, frequency of fluoroscopy, bed rest time, and complications were recorded. Before operation, and at 1 weeks, 3 months after operation, the visual analogue scale (VAS) score was used to evaluate the pain degree, the short-form 36 health survey scale (SF-36) score was used to evaluate the quality of life. At 3 months after operation, the Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate the functional recovery of patients. During follow-up, the loosening of internal fixator and bone cement leakage were observed by X-ray film.@*RESULTS@#All patients were performed operation successfully. The operation time ranged from 57 to 82 minutes, with an average of 70.4 minutes. The frequency of intraoperative fluoroscopy was 16-34 times, with an average of 23.1 times. After operation, 1 case of incision hematoma and 1 case of scrotal edema occurred. All patients felt the pain relieved after operation. The patients started walking at 1-3 days after operation, with an average of 1.4 days. All patients were followed up 6-12 months (mean 9.7 months). The VAS and SF-36 scores significantly improved after operation when compared with the preoperative scores, and the scores at 3 months after operation were significant better than those at 1 week after operation ( P<0.05). At 3 months after operation, the MSTS score ranged from 9 to 27, with an average of 19.8. Among them, 3 cases were excellent (18.75%), 8 cases were good (50%), 3 cases were fair (18.75%), and 2 cases were poor (12.5%). The excellent and good rate was 68.75%. And 11 patients returned to normal walking, 3 had mild claudication, and 2 had obvious claudication. Radiological examination showed that there were 2 cases of bone cement leakage after operation, and there was no internal fixator loosening or displacement.@*CONCLUSION@#Percutaneous hollow screw internal fixation combined with cementoplasty can effectively relieve pain and improve the quality of life of patients with periacetabular metastasis.

TCM Syndrome Distribution Characteristics and Logistic Regression Analysis of Benign Prostatic Hyperplasia / 中国中医药信息杂志

Objective To explore the distribution characteristics of TCM syndrome and clinical relevant factors of benign prostatic hyperplasia (BPH).Methods Totally 781 cases of BPH patients were collected. Chi-square test, analysis of rank and inspection were used to detect the distribution characteristics of TCM syndrome. The multiple classification logistic regression was used to analyze related factors.Results BPH 14 kinds of distribution of syndromes were statistically significant (P<0.01). One of the highest incidence is qi deficiency and blood stasis syndrome (24.97%), and lung heat obstruction is the lowest (1.15%). Composite syndromes (529 cases) were more common than single syndrome (252 cases); syndromes of intermingled deficiency and excess (453 cases) were more common than simple excess (169 cases) or deficiency syndromes (159 cases). BPH single syndrome distribution was different in prostate volume, residual urine volume, maximum urine flow rate, and showed no difference in the serum PSA level. 3 logit model was established successfully. It was found that the patients with the features of 50 to 60 years old, the course < 3 years, I-PSS score for 8 to 19 points showed higher positive incidence of excess syndrome than intermingled deficiency and excess syndromes and deficiency syndrome.Conclusion This study reveals the BPH distribution characteristics and clinical related factors, which has guiding significance to improve TCM clinical level.

Research on Experienced Doctors’ Treatment of Senile Dementia Based on Association Rule / 中国中医药信息杂志

Objective To study experienced doctors’ treatment of senile dementia based on association rule. Methods Databases, such as CNKI, CSCD, CBMdisc, CPD, and Wanfang Data were searched for articles about senile dementia. SPSS17.0 and Clementine12.0 software were used for frequency and correlation analysis of prescription. Results In total of 67 articles about TCM therapy for senile dementia were included, containing 112 prescriptions, 178 Chinese herbal medicines, 1589 frequency, and 14.2 entries for each prescription. The first three frequently used herbal medicines were Acori Tatarinowii Rhizoma, Polygala Radix, and Salviae Miltiorrhizae Radix et Rhizoma. Accoring to association rule, the first three medicine pairs were Citrus Reticulatae Pericarpium→Pinelliae Rhizoma, Dioscoreae Rhizoma→Rehmanniae Radix Praeparata, and Codonopsis Radix→Citrus Reticulatae Pericarpium. The first three thriple herbal medicines were Dioscoreae Rhizoma+Lycii Fructus→Corni Fructus, Acori Tatarinowii Rhizoma+Corni Fructus→Rehmanniae Radix Praeparata, and Carthami Flos + Hirudo→Bupleuri Radix. Conclusion The results based on association rule effectively summarized all the doctors’ treatment experience in senile dementia, and provided the beneficial reference for the clinical treatment of senile dementia.

The open reduction and internal fixation of intercondylar fractures of the distal femur / 中华创伤骨科杂志

Objective To discuss the clinical value of the treatment of intercondylar fractures of the distal femur using open reduction and internal fi xation. Methods From July 1995 to December 2001, a total of 32 intercondylar fra ctures of the distal femur were treated with open reduction and internal fixatio n with a plate, 95? blade plate, a dynamic condylar screw (DCS) or a condyla r buttress plate. There were 13 cases of type-C1, 10 type-C2 and 9 type-C3 ac cording to the AO/ASIF standard. The outcomes of internal fixation were evaluate d according to preoperative and postoperative radiographs and postoperative func tions of the knee. Results 27 patients were followed-up from 8 months to 8 year s. The results were excellent in 14 cases, good in 9, poor in 4 according to San ders standard. Conclusion Open reduction and internal fixation is an ideal ch oice for intercondylar fractures of the distal femur.

Percutaneous cervical diskectomy in the management of radicular type cervical spondylosis / 中国微创外科杂志

Objective To discuss the clinical significance of percutaneous cervical diskectomy (PCD) in the management of radicular type cervical spondylosis. Methods A retrospective analysis was carried out on clinical records of 106 radicular type cervical spondylosis cases treated by PCD from July 1993 to June 2002. Results Follow-up observations for 6 months～8 years(mean 3.6 years) in 91 cases showed the outcomes were excellent in 36 cases, good in 40, and unchanged in 15, the rate of excellent-or-good results being 83.5%. Conclusions PCD has an excellent therapeutic effect for nerve-root symptoms resulted from cervical disc herniation, such as numbness and pain of the upper extremities or shoulders.