Reconstruction of the calcaneocuboid and calcaneonavicular ligaments with the autologous semitendinosus in patients with chronic bifurcate ligament injury / 中华创伤骨科杂志

Objective:To explore the clinical efficacy of reconstructing the calcaneocuboid and calcaneonavicular ligaments with the autologous semitendinosus for chronic bifurcate ligament injury.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients with chronic bifurcate ligament injury who had been treated by anatomical reconstruction with the autologous semitendinosus from March 2018 to January 2021 at Department of Foot and Ankle Surgery, The Fourth Hospital of Wuhan. There were 4 males and 8 females with an age of (41.4±9.6) years. Seven left and 5 right feet were affected; the time from injury to surgery was (9.3±4.3) months. The surgical efficacy was evaluated based on anteroposterior and lateral imaging assessments of foot weight-bearing at 6 months postoperation, comparison of the visual analogue scale (VAS) pain scores for foot weight-bearing walking and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scores between preoperation and the last follow-up, stress test for stability of the transverse tarsal joint, recovery of movement, and occurrence of complications.Results:All patients were followed up for (18.4±4.0) months. Their sports activities were completely resumed after postoperative (6.8±3.9) months. Primary wound healing was achieved in all patients. One patient suffered from cutaneous nerve lesion and skin numbness, the symptoms of which disappeared after conservative treatment. Double harmonic curves were observed on the anteroposterior and lateral imaging films of foot weight-bearing in all patients. The spaces in the calcaneocuboid and the calcaneonavicular joints were normal, the articular positions were matched, and the calcaneocuboid joint was stable without recurrence or worsening of displacement. The VAS decreased significantly from preoperative 6.5 (5.6, 7.0) to 0.0 (0.0, 1.0) at the last follow-up, and the AOFAS mid-foot score increased significantly from preoperative (55.6±8.8) points to (92.3±2.6) points at the last follow-up ( P<0.05). The stress test for the stability of the transverse tarsal joint showed joint stability. Conclusion:Reconstruction of the calcaneocuboid and calcaneonavicular ligaments using the autologous semitendinosus is an alternative treatment for patients with chronic bifurcate ligament injury, because it can restore the stability of the bifurcate ligament and obviously improve the foot and ankle functions with limited postoperative complications.

Observation of the curative effect of colonoscopy combined with laparoscope in the treatment of colonic polyps / 中国基层医药

Objective To explore the curative effect of colonoscopy combined with laparoscope in the treatment of colonic polyps.Methods The clinical data of 48 cases with colonic polyps were retrospectively analyzed.According to the operation pattern,the patients were divided into observation group(23 cases)and control group(25 cases).The observation group received colonoscopy combined with laparoscopy for radical surgery of colon polyps,the control group used the traditional open surgery to remove polyps.The operation time,bleeding volume, exhaust and defecation time,hospital days and cost as well as postoperative complications were observed.Results The two groups were successfully completed surgery.The operative time,bleeding volume of the observation group were (78.3 ±8.2)min and (1 3.1 ±4.5)mL respectively,which of the control group were (1 1 5.5 ±1 0.1 )min, (63.6 ±1 8.1 )mL,the differences between the two groups were statistically significant(t =1 3.93,1 3.01 ,all P 0.05).Conclusion For simple colonoscopy treatment difficulties of colon polyps,colonoscopy,laparoscopy combined treatment is minimally invasive and can improve the safety,strictly control surgical indications,can give full play to the double mirror combined advantage.

Achilles tendon extension and tibialis transfer combined with tendon transposition for cerebral palsy-induced talipes equinovarus：ankle recovery and foot function evaluation / 中国组织工程研究

BACKGROUND:It has a variety of treatments for equinovarus in spastic cerebral palsy, including physical therapy, orthotic therapy, systemic anti-spasticity drug therapy, local intramuscular injection of botulinum toxin type A and a variety of surgical operations. These treatments aim at different severity of deformities and different age in children patients, and each has its own merits. OBJECTIVE:To investigate the therapeutic effect of Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat equinovarus in spastic cerebral palsy. METHODS: Twenty-two children with spastic cerebral palsy combined with equinovarus were colected from 2012 to 2014, and then these children were subject to Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition. Postoperative plaster external fixation was done for 6 weeks, and then rehabilitation training was given. RESULTS AND CONCLUSION:Al the 22 patients were folowed for an average of 1-2 years, and then were evaluated according to the degree of patient’s satisfaction and the degree of foot deformity. Satisfactory results were obtained from al the patients. Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat spastic cerebral palsy combined with equinovarus is a good method, and it is characterized as good appearance of the ankle and favorable foot function.

Mechanisms of neurogenic pulmonary edema during intracranial hypertension / 中国病理生理杂志

The neurogenic pulmonary edema (NPE) was produced consistently in rabbits by raising intracranial pressure (ICP) with an infusion of anticoagulat rabbit blood into subarachnoid space of the bilateral parietal regions. When ICP increased from 60mmHg to 140 mmHg, There was a rapid decrease in blood flow volume of the bilateral internal carotid arteries (ICABFV). At the same time, the frequency of cervical sympathetic discharge and the concentrations of plasma noradrenaline and adrenaline increased acutly accompanied by a rapid elevation of systemic arterial pressure (SAP). There was a decline in SAP and a further decrease in ICABFV and the animal died as ICP was sustained at 140mmHg for 5-20min. Autopsy revealed severe hemorrhagic pulmonary edema and the left ventricular and atrial enlargement. In the period of ICP rising, the NPE was prevented if SAP was kept at the baseline levels by withdrawing blood from femoral artery, The results suggest that decreased cerebral blood supply due to ICP rising is responsible for the massive sympathetic discharge and catecholamine release which contribute to SAP elevtion and left ventricular overload, the NPE is mediated by hemodynamic mechanism.