Analysis of the effect of double button plate combined with strengthened anchor in the treatment of acromioclavicular dislocation / 中国骨伤

OBJECTIVE@#To evaluate the efficacy and prognosis of double button plate combined with strengthened anchor technique and clavicular hook plate internal fixation for complete acromioclavicular joint dislocation.@*METHODS@#From July 2017 to September 2020, a total of 42 patients with acromioclavicular joint dislocation treated by surgery were choosen as study objects and divided into observation group (21 cases) and control group (21 cases). In the observation group, there were 14 males and 7 females, aged 21 to 63 years old, with an average of (45.05±8.70) years old. In the control group, there were 16 males and 5 females, aged 25 to 68 years old, with an average of(45.00±9.44) years old. The patients in the observation group were treated with double button plate combined with strengthened anchor technique, whereas those in the control group received clavicular hook plate internal fixation. The two groups were compared in terms of operating time, intraoperative blood loss, postoperative hospital stay, shoulder pain(visual analogue scale, VAS) score, shoulder function Constant-Murley score and postoperative complications.@*RESULTS@#There was no significant difference between the two groups in intraoperative blood loss or postoperative hospital stay(P>0.05). The operating time of double button plate combined with strengthened anchor technique group (65.24±5.36) min was significantly longer than that of the clavicular hook plate group (48.81±4.72) min, and the difference was statistically significant (P<0.05). There was no significant difference in shoulder function or pain degree between the two groups before operation (P>0.05). After 1 month, 3 months and 6 months, the Constant-Murley score of the observation group was 73.29±2.15, 85.43±1.47, 93.86±1.24 separately, which were significantly higher than those of the control group;and the VAS score was 2.76±0.62, 1.71±0.64, 0.57±0.51 separately, which were significantly lower than those of the control group (P<0.05). One instance of shoulder discomfort was found in the observation group, while 5 cases of shoulder pain, 2 cases of restricted shoulder mobility, and 1 case of subacromial bone absorption were found in the control group. In both group, there was no loss of reduction.@*CONCLUSION@#In the treatment of complete acromioclavicular joint dislocation double button plate combined with strengthened anchor technique achieves favorable clinical result. Internal fixation does not need to be removed. The recovery of shoulder joint function and pain relief are superior than clavicular hook plate internal fixation, which is more worthy of clinical promotion.

The neutrophil-to-lymphocyte ratio in peripheral blood in patients with hepatocellular carcinoma before argon-helium cryoablation: its influence on the prognosis / 介入放射学杂志

Objective To investigate the influence of neutrophil-to-lymphocyte ratio (NLR) in peripheral blood in patients with hepatocellular carcinoma (HCC) before argon-helium cryoablation on the patient's prognosis.Methods The related clinical and pathological data of 72 HCC patients,who had received percutaneous argon-helium cryoablation,were retrospectively analyzed.Based on the preoperative NLR value,the patients were divided into low NLR group (NLR＜3.5) and high NLR group (NLR ＞ 3.5).The postoperative overall survival time of the patients in the two groups were statistically analyzed,and the risk factors that might affect the prognosis were evaluated by using univariate and multivariate analysis.Results Argon-helium cryoablation was carried out in all patients.The median overall survival time was 22.4 months;the median overall survival time of the high NLR group and the low NLR group was 13.2 months and 24.2 months respectively,the difference in the overall survival time between the two groups was statistically significant (P=0.003).Univariate analysis showed that the primary tumor size,liver function Child-Pugh classification,albumin,total bilirubin,cholinesterase and NLR value were the related factors that affected the postoperative overall survival time of HCC after argon-helium cryoablation (P＜0.05).Multivariate analysis revealed that the primary tumor size and NLR value were the independent prognostic factors that affected the postoperative overall survival time of HCC after argon-helium cryoablation (P＜0.05).Conclusion Preoperative NLR value in peripheral blood can be used as a prognostic indicator for patients with HCC undergoing argonhelium cryoablation;the larger the primary hepatic lesion is and/or the higher the NLR value is,the worse the prognosis of the patient will be.