Therapeutic effect of TriVex system minimally invasive phlebectomy on lower extremity varicose veins / 心血管康复医学杂志

Objective: To study therapeutic effect of TriVex system minimally invasive phlebectomy on lower extremity varicose veins (LEVV). Methods: A total of 100 LEVV patients treated in our department were selected, randomly and equally divided into minimally invasive phlebectomy group (received TriVex system minimally invasive phlebectomy) and traditional treatment group (received high ligation and exfoliation). Therapeutic effect, treatment-related indexes and postoperative complications were assessed in two groups, and they received assessments of venous clinical severity score (VCSS), chronic venous insufficiency questionnaire (CIVIQ) and clinical-etiology-anatomic-pathophysiologic (CEAP) class on three and six months after operation. Results: There was no significant difference in therapeutic effect between two groups (P＞ 0. 05). Compared with traditional treatment group, there were significant reductions in number of incisions [(8. 6±1. 7) vs. (4. 2±1. 1)], surgery time [(70. 17±15. 92) min vs. (32. 45±11. 74) min], recovery time after surgery [(6. 82± 1. 51) h vs. (3. 93±1. 13) h], incidence rates of superficial vein thrombosis (18. 0％ vs. 0) and recurrence rate (12. 0％ vs. 0) in minimally invasive phlebectomy group, P=0. 001 all. Compared with traditional treatment group on three and six months after surgery, there was significant reduction in VCSS score [three months: (7. 23±1. 48) scores vs. (4. 16±1. 35) scores], and significant rise in CIVIQ score [three months: (67. 23±9. 47) scores vs. (81. 16±8. 38) scores]in minimally invasive phlebectomy group, P=0. 001 all; CEAP classes of two groups were significantly lower than those of before surgery (P=0. 001 all), but there was no significant difference between two groups (P＞0. 05 all). Conclusion: TriVex system minimally invasive phlebectomy possesses similar therapeutic effect with traditional surgeries on multiple-cause varicose veins. The method is simpler and therapeutic effect is definite with less pain and complications, and patients recover rapidly and accept it easily, which is worth extending.

Case-control study on modified Weaver-Dunn surgery combined with clavical hook-plate internal fixation for the treatment of Tossy type III acromioclavicular dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To compare therapeutic effects of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation in treating Tossy type III acromioclavicular joint dislocation.</p><p><b>METHODS</b>Forty-one patients with Tossy type III acromioclavicular dislocation treated by operation were retrospectively analysis from January 2012 to January 2014. The patients were divided into clavicular hook-plate fixation group (group A) and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation (group B) according to surgical procedures. In group A, there were 15 males and 6 females aged from 17 to 51 years old with an average of (31.60 ± 12.58) years old, preoperative Constant-Murley score was 40.25 ± 9.80, and treated with clavicular hook-plate fixation. In group B, there were 13 males and 7 females aged from 18 to 48 years old with an average of (29.40 ± 11.27) years old, preoperative Constant-Murley score was 41.45 ± 8.81, and treated with modified Weaver-Dunn surgery combined with clavicular hook-plate fixation. Operative time, blood loss, imaging changes before and after operation, postoperative complications were compared; Constant-Murley score at 3, 6 and 12 months after operation were evaluated.</p><p><b>RESULTS</b>In group A, operative time was 40.50 ± 24.36) min, blood loss was (75.30 ± 30.36) ml; In group B, operative time was (60.10 ± 23.55) min, blood loss was (100.70 ± 40.12) ml. Twenty-one patients in group A were followed-up from 12 to 18 months with an average of (14.8 ± 3.1) months; 20 patients in group B were followed-up from 12 to 14 months with an average of (13.6 ± 1.5) months. There were no significant differences in operative time, blood loss and follow-up time between two groups. Complications were in six patients of group A and 3 patients of group B, and there were no significant meaning between two groups. At 6 months after operation, Constant-Murley score in group A was 88.85 ± 4.23, 92.15 ± 3.82 in group B; and had significant meaning between two groups (t = -2.56, P = 0.022 < 0.05). While there were no differences in Constant-Murley score in other times.</p><p><b>CONCLUSION</b>Both of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation are effective operative methods for the treatment of Tossy type III acromioclavicular dislocation. Clavicular hook-plate fixation has advantage of less trauma, while modified Weaver-Dunn surgery combined with clavicular hook-plate fixation could reconstruct coracoclavicular ligament more stronger, clavicular hook plate could take out earlier, also improve shoulder joint function earlier.</p>

Evaluation of the effects of standard rescue procedure on severe trauma treatment in china / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China.</p><p><b>METHODS</b>This study was conducted in 12 hospitals located in geographically and industrially different cities in China. A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating prehospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and 1 year after the implementation of the SRP.</p><p><b>RESULTS</b>The outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP. Implementation of the SRP led to efficient cooperation and information sharing of different treatment services. The emergency response time, prehospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24 ± 4.32 min, 45.69 ± 3.89 min, 6.38 ± 1.05 min, 17.53 ± 0.72 min, and 33.82% ± 3.87% (n = 441), respectively, before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min, 22.39 ± 4.32 min, 3.26 ± 0.89 min, 3.45 ± 0.45 min, and 20.49% ± 3.11%, separately (n = 495, P < 0.05) after that.</p><p><b>CONCLUSIONS</b>Staff training and SRP can significantly improve the efficiency of severe trauma treatments in China.</p>

Correlation of chemokines and chemokine receptors with immunological abnormality in newly diagnosed systemic lupus erythemtosus patients / 中华风湿病学杂志

Objective To explore the association of chemokines and their receptors with immunologi- cal abnormality in newly diagnosed systemic lupus erythematosus(SLE) patients.Methods The serum con- centration of MIP-1?,MIP-1?,RANTES,IFN-?IL-4 were measured by enzyme-linked immunoabsorbent assay (ELISA) in 37 newly diagnosed.SLE patients and 20 normal controls.The expression rate of CCR1, CCR3,CCR5 on CD4~+T cells were detected by flow cytometry in 18 SLE patients and 10 normal controls.Re- suits Serum MIP-1?,MIP-1?concentrations were significantly higher in SLE patients than in normal control group (P＜0.01),the concentration of MIP-1?positively correlated with MIP-1?(r=0.609,P＜0.01);the per- centage of CD4~+CCR1~+ and CD4~+CCR5~+ cell were significantly lower in newly diagnosed SLE patients than in normal control group (both P＜0.01),the percentage of CD4~+CCRI~+ cells correlated negatively with the level of serum MIP-1?and IFN-?r=-0.525,P=-0.017;r=-0.442,P=0.045);the percentage of CD4~+CCR5~+ cell corre- lated negatively with the level of serum IFN-?(r=-0.645,P=0.001);the ratios of CD4~+CCR3~+/CD4~+CCR5~+ was significantly higher in newly diagnosed SLE patients than in the normal control group (P＜0.01).Conclusion Abnormal change and interaction of chemokines and their receptors with cytokines lead to immunologic dys- function and may participate in the initiation of SLE.

Anti-mutated citrumnated vimentin antibodies in the diagnosis of rheumatoid arthritis / 中华风湿病学杂志

Objective To determine the diagnostic value of anti-mutated citrullinated vimentin(anti- MCV)antibodies for rheumatoid arthritis(RA).Methods The anti-MCV were determined in 136 patients with RA,80 non-RA patients and 19 normal peoples.The diagnostic value of anti-MCV was assessed and compared with anti-CCP,AKA and RF.Results The sensitivity and specificity of anti-MCV in the 136 RA patients was 95.6% and 80.8% respectively,there was significanl difference between the test group and the control group(P