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Objective@#: To explore the clinical efficacy and safety of microvascular decompression (MVD) combined with internal neurolysis (IN) in the treatment of recurrent trigeminal neuralgia (TN) after MVD. @*Methods@#: Sixty-four patients with recurrent TN admitted to the hospital from January 2014 to December 2017 were divided into two groups according to the surgical method. Twenty-nine patients, admitted from January 2014 to December 2015, were treated with MVD alone, whereas 35 admitted from January 2016 to December 2017 were treated with MVD+IN. The postoperative efficacy, complications, and pain recurrence rate of the two groups were analyzed. @*Results@#: The efficacy of the MVD+IN and MVD groups were 88.6% and 86.2%, and the cure rates were 77.1% and 65.5% respectively. There was no statistically significant difference between the two groups (p>0.05). The cure rate (83.3%) of patients in the MVD+IN group, who were only found thickened arachnoid adhesions during the operation that could not be fully released, was significantly higher than that of the MVD group (30.0%) (p0.05). For patients whose arachnoid adhesions were completely released, there had no significant difference (p>0.05) in the efficacy (87% vs. 94.7%) and recurrence rate (5.0% vs. 11.1%). The incidence of postoperative facial numbness (88.6%) in the MVD+IN group was higher than that in the MVD group (10.3%) (p0.05). In the 18–36 months follow-up, the recurrence rate of patients in the MVD+IN group (9.7%) and in the MVD group (16%) were not statistically different (p>0.05). @*Conclusion@#: A retrospective comparison of patients with recurrent TN showed that both MVD and MVD combined with IN can effectively treat recurrent TN. Compared with MVD alone, MVD combined with IN can effectively improve the pain cure rate of patients with recurrent TN who have only severe arachnoid adhesions. The combination does not increase the incidence of long-term facial numbness and other complications.
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Objective:To investigate whether the Garden indexes can serve as a criterion for rotational displacement of femoral neck fracture.Methods:Ten cadaveric specimens of healthy human proximal femur were used for this study. They came from 3 males and 2 females who had died at the age from 45 to 70 years old. A Kirschner wire of 2.0 mm in diameter was implanted into the center of the femoral head. Osteotomy was conducted perpendicular to the middle line of the femoral neck. The rotational angles were marked on the distal osteotomy surface. Each cadaveric specimen was rotated sequentially at pronation and supination angles of 0°, 10°, 20°, 30°, 40°, 50°, 70° and 90°, respectively. X-ray images of anterior-posterior and lateral views were taken to record all the rotations of the specimens. Picture Archiving and Communication Systems (PACS) were used to measure the Garden indexes and compare them among anterior-posterior and lateral X-ray films of different pronation and supination angles. Changes in the area of the femoral head fovea at different rotation angles were observed as well.Results:There were no significant differences in the auterior-posterior or latera Garden indexes from 0° to pronation or supination 30°, with all the Garden values >155° ( P>0.05); from pronation of 40° to pronation of 90°, the Garden indexes were 152.36°±1.41°, 146.04°±1.64°, 143.95°±0.60° and 141.73°±0.60° for anterior-posterior views and 172.54°±0.86°, 168.57°±0.98°, 157.18°±1.17° and 156.47°±1.63° for lateral views, showing a significant difference between rotational angles ( P<0.05); from supination of 40° to supination of 90°, the Garden indexes were 151.67°±1.06°, 147.32°±1.82°, 142.77°±0.75° and 139.88°±1.48° for anterior-posterior views and 172.28°±0.79°, 166.76°±1.02°, 155.67°±1.74° and 154.16°±1.27° for lateral views, showing a significant difference between rotational angles ( P<0.05). The area of the femoral head fovea decreased gradually with the increase in pronation angle, and increased gradually with the increase in supination angle. Conclusions:The Garden indexes cannot serve as an accurate indication of rotational displacement in reduction of femoral neck fracture when the pronation or supination angles ranges from 0° to 30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture.
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Objective To detect the expression levels of peripheral blood CXCL10 and its receptor CXCR3 and T cell subsets in of the patients with advanced vitiligo and the influence of compound Chinese medicine on it.Methods Flow cytometry was used to detect the cellular proportions of peripheral blood T cell subsets,ELISA was employed to quantify serum CXCL10 and CXCR3 expression levels before and after treatment.Results After 1 month of taking Chinese medicine,the proportions of CD3+ CD4+ cells and CD3+ CD8+ cells were increased compared before treatment(P＜0.05).The expression level of peripheral serum CXCL10 before treatment was significantly increased compare with the healthy control group(P＜0.01),and the CXCL10 level after treatment was decreased significantly compared with that before treatment(P＜0.05).The expression level of peripheral serum CXCR3 was significantly increased compared with the healthy control group(P＜0.05),while which after treatment was still significantly higher than that in the healthy control group(P＜0.05).Conclusion CXCL10,CXCR3 and T cell subsets proportion may be involved in the pathogenesis of vitiligo.The compound Chinese medicine used in this study plays the curative effect possibly by regulating T cell subsets and expression levels of CXCL10 and CXCR3.
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Objective To observe the curative effects of two traditional Chinese medicine compounds in guinea pigs models of vitiligo .Methods The dark skin of guinea pigs ,which were intragastrically administrated with vitiligo granules No .1 (No .1 group) ,vitiligo granules No .2(No .2 group) and pure water(control group) respectively ,were selected to establish vitiligo modles induced by p‐dihydroxy‐benzene(hydroquinone) .Taking physiological saline as a control(model group) .Curative effects were ob‐served by visual inspection ,and the effects of repigmentation after intragastric administration were scored .The melanocyte count of normal part of skin was compared with that of vitiligo skin by using hematoxylin‐eosin(HE) staining ,ferrous sulfate staining and Deoxy‐dyeing .Results The guinea pigs models of vitiligo were successfully induced by hydroquinone .After treatment by using vit‐iligo granules No .1 and No .2 ,the melanocyte counts of vitiligo skin in No .1 group and No .2 group were increased when compared with that in the control group(P0 .05) .Conclusion The two Chinese medicine compounds ,vitiligo granules No .1 and vitiligo granules No .2 ,both are effective for the treatment of vitiligo and without obvious effects on normal parts of skin , which could provide experimental data for clinical treatment .