A rotational support plate for posterolateral tibial plateau fractures through anterolateral approach / 中华骨科杂志

Objective To introduce the operation method of a rotational support plate through a traditional anterolateral approach for posterolateral tibial plateau fractures and analyze the postoperative outcome.Methods From May 2016 to September 2017,10 patients with posterolateral tibial plateau fractures who underwent surgery with the rotational support plate were retrospectively analyzed.There were 6 males and 4 females,aged from 23-66 years (average,46.2 years).The causes of the fractures included traffic accident in 4 cases,fall from height in 5 cases and falling injury in 1 case.According to AO-OTA classification,there were 1 case of 41-B2,8 cases of 41-B3 and 1 case of 41-C3.According to Schatzker classification,there were 6 cases of type Ⅱ,1 was of type Ⅲ,2 were of type Ⅴ,and 1 was of type Ⅵ.Four cases suffered multiple fractures.One patient suffered pelvic fracture,ipsilateral femoral shaft and medial malleolus fracture;One patient suffered ipsilateral tibiofibular fracture;1 patient suffered ipsilateral fibular head and medial femoral epicondyle fracture;One patient suffered ipsilateral fibular head fracture.Fracture healing time,complications,knee range of motion,Hospital for Special Surgery (HSS) knee score were recorded to evaluate postoperative outcomes.Results All 10 patients were followed up for 15.25 months (range,12-27 months).The bony union time ranged from 3.0-4.5 months (average,3.2 months).The range of motion of the knee joint was 105°-161.4° (average,139.9°).According to the HSS system,the score was 64-98 (average,88),including 8 of excellent and 2 of fair.No skin necrosis,incision infections,or fixation failure occurred during follow-up.Conclusion Fixation of posterolateral tibial plateau fracture was successfully achieved using the newly designed plate through a traditional anterolateral approach.It has many advantages such as reliable fixation,satisfying recovery,simplicity of operator,and small tissue damage.

Clinical research for the treatment of temporomandibular joint injury based on three-dimensional digital technology / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the accurate and individual treatment of temporomandibular joint(TMJ) injury based on 3D digital technology.</p><p><b>METHODS</b>Maxillo-mandibular model was made using rapid prototyping technology based on the pre-operation 3D CT results. According to the 3D digital measurement results, TMJ concepts were ordered and the prosthesis was used to simulate the replacement surgery on the model. Then the joint replacement surgery was performed afterward.</p><p><b>RESULTS</b>(1)After total replacement of TMJ, no pain happened and mouth open was not limited. Three months later, the joint position was normal and stable. The month open width was 4 cm. (2)After condyle replacement, primary healing was achieved with complete survival of bone graft. No edema was seen. Symmetric facial appearance was satisfactory.</p><p><b>CONCLUSIONS</b>Bilateral individual prosthesis for total TMJ or condyle replacement is an ideal method for TMJ injury.</p>

Clinical observation of acupoint application therapy on senile female bladder neck obstruction / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy on senile female bladder neck obstruction treated with acupoint application, therapy and western medication.</p><p><b>METHODS</b>Fifty cases of senile female bladder neck observation were randomized into an obstrvation group and a control group, 25 cases in each one. Tamsulosin hydrochloride capsules were taken orally in the two groups, 0.2 mg every night, continuously for 100 days. In the observation group, with radix aconiti lateralis preparata, semen brassicae and fructus ligustri lucidi contained, bushentongyu plaster was used at Shenque (CV 8), Sanyinjiao (SP 6), Pangguangshu (BL 28), Zhongji (CV 3) and Sanjiaoshu (BL 22), once every two days. Eight treatments made one session and 6 sessions were required totally. The international prostate symptom score (IPSS), the bother score (BS), the residual volume (RV) and the maximal urinary flow rate (MFR) were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups.</p><p><b>RESULTS</b>Every score in IPSS after treatment was reduced apparently as compared with that before treatment in the two groups (all P < 0.01). The improvements in feeling of incomplete, bladder emptying, intermittency < 2 h, urgency, interupted urination and nocturia in the observation group were more advantageous than those in the control group (all P < 0.05). The total effective rate was 95.65% (22/23) in the observation group, higher than 85.71% (18/21) in the control group (P < 0.05). After treatment, RV, MFR and BS were significantly different as compared with those before treatment (all P < 0.05).</p><p><b>CONCLUSION</b>The combined therapy of acupoint application of bushentongyu plaster and oral administration of tamsulosin hydrochloride capsules achieves the significant efficacy on senile female bladder neck obstruction as compared with the simple administration of tamsulosin hydrochloride capsules.</p>

The influence of different usage of dyclonine hydrochloride mucilage on hemodynamics and postoperative throat pain of laryngeal mask anesthesia patients / 中国医师杂志

Objective To investigate influence of different usage of dyclonine hydrochloride mucilage on hemodynamics and postoperative throat pain of laryngeal mask anesthesia patients.Methods Sixty patients in flexible ureteroscopic holmium laser lithotripsy with laryngeal mask anesthesia were randomly divided into three groups according to different usage of dyclonine hydrochloride mucilage (n =20).Group A was coated laryngeal mask with paraffin oil.Group B was coated laryngeal mask with dyclonine hydrochloride mucilage.Group C was coated laryngeal mask with dyclonine hydrochloride mucilage and dyclonine hydrochloride mucilage gargle.The indwelling time of laryngeal mask, postoperative recovery time of spontaneous breathing, time of hearing the call to open eyes, and the time of pulling out the laryngeal mask were recorded.Heart rate (HR), mean blood pressure (MBP) index at T1 (pre-anesthesia induction), T2 (1 min before pulling out the laryngeal mask), T3 (pulling out the laryngeal mask), T4 (5 min after removing the laryngeal mask), and T5 (10 min after removing the laryngeal mask) were recorded.The complications of throat after removing laryngeal mask were observed.The pain degree of sore-throat at the time of 30 minutes after removing the laryngeal mask was observed.The adverse reactions of the usage of dyclonine hydrochloride were observed in three groups.Results There were no statistically significant differences in indwelling time of laryngeal mask, postoperative recovery time of spontaneous breathing, time of hearing the call to open eyes, and the time of pulling out the laryngeal mask among three groups (P ＞ 0.05).There were no statistically significant differences in HR, MBP at T1 , and T5 (P ＞ 0.05).HR and MBP were higher in group A than in groups B and C at T2 ～ T4, and HR and MBP were higher in group B than in group C at T2 ～ T4, with statistically significant difference (P ＜ 0.05).The incidences of sore throat and swallowing discomfort were significantly lower in groups B and C than in group A (P ＜ 0.05).The incidences of sore throat and swallowing discomfort were significantly lower in group C than in group B (P ＜0.05).No statistically significant difference were found in incidence of hoarseness among three groups (P＞ 0.05).The pain degree of sore-throat in group C were significantly lower than in group B, and the pain degree of sore-throat in groups B and C was significantly lower than in group A (P ＜ 0.05).There were no allergic reactions and local anesthetic poisoning for three groups.Conclusions Dyclonine hydrochloride mucilage can reduce hemodynamic fluctuations during recovery period, and prevent or relieve effectively the patient's throat pain after laryngeal mask anesthesia.At the same time, dyclonine hydrochloride mucilage can improve the patient's postoperative physical comfort without adverse reactions, especially coated laryngeal mask with dyclonine hydrochloride mucilage and dyclonine hydrochloride mucilage gargle.

Comparison of surgical efficacies of transurethal enucleation of prostate with transurethal resection of prostate / 中国综合临床

Objective To compare the surgical effects of transurethal enucleation of prostate (TUEP)with transurethal resection of prostate (TURP) by a retrospective analysis of clinical data.Methods The patients in this study were divided into the groups of TUEP (enrolled in 2010 and 2011,n =77) and TURP (enrolled in 2009,n =27) with prostate larger than 60 g and smaller than 60 g respectively.Comparisons were made between the two groups in operation time,blood loss volume and weight of resected prostate.Results In the group of patients with prostate larger than 60 g,there was no significant difference in prostate weight ((88.5 ± 9.2) g vs.(107.0 ± 15.30) g,P =0.255),operation time ((91.5 ± 8.8) min vs.(118.3 ± 20.2)min,P =0.083),and weight of resected prostate ((48.0 ± 4.6) g vs.(58.4 ± 5.4) g,P =0.32) between the TUEP (53 patients) and the TURP (12 patients) groups.There was significant difference in blood loss ((110.0 ± 16.4) ml vs.(193.3 ± 22.3) ml,P =0.011) between the two groups.In the group of patients with prostate smaller than 60 g,there was no significant difference in prostate weight ((43.1 ± 3.2) g vs.(36.8 ± 3.4) g,P =0.072),operation time ((62.7 ±6.8) min vs.(69.3 ±6.2) min,P =0.431),blood loss ((56 ± 5) ml vs.(110±20) ml,P=0.082),and weight of resected prostate ((26.3 ±2.4) g vs.(23.6 ±2.1) g,P =0.291) between the TUEP (24 patients) and the TURP (15 patients) groups.Conclusion Compared with TURP,TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g.With the improvement of surgeon' s experience and development of operation techniques,TURP will be replaced by TUEP.In the treatment of patients with prostate smaller than 60 g,the operation modality can be chosen by the surgeon based on his experience and proficiency.

Identification of mutations in phenylalanine hydroxylase gene of Xinjiang minority nationality phenyiketonuria patients / 中华检验医学杂志

Objective To study the mutation characteristics in phenylalanine hydroxylase gene of Xinjiang minority nationality phenylketonuria (PKU) patients and provide a scientific basis for PKU prevention and cure strategy.Methods Mutations in phenylalanine hydroxylase gene were detected by Dolymerase chain reaction-single strand comformation polymorphism (PCR/SSCP) and gene sequencing in 12 minoritv nationality patients.Results Thirteen different mutations,including 8 missense mutations,1 nonsense mutation and 3 splice mutations were found in 24 alleles.The moat common mutations were EX696A＞G and P281 L.which were respectively prevalent in Asia and Europe populations.The common mutations were R243Q,R111X,R176X and F161S.The mutation frequency of R243Q was the highest and R111X was the third highest in Northern China.R176X and F161S were two rare mutations world wide.Especially.F161S was a Chinese-specific mutation because it was for the second time that it was found in China.The mutations detected in this study were first reported in these 3 minority nationality populations,which showed a distinct ethical characteristic.Condusions There is not only a consanguineous relation but also a distinct difference in PAH gene distribution between Xinjiang minority nationality population and yellow race and Latin-American.The results suggest that Xinjiang could probably be a special PAH gene distribution region.