A new method of anterior talofibular ligament reconstruction: Arthroscopically artificial ligament reconstruction with tensional remnant-repair / 中华创伤杂志(英文版)

PURPOSE@#To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese, and/or with demand for highly intensive sports, and/or with poor-quality ligament remnants.@*METHODS@#A retrospective case series study was performed on patients treated by arthroscopically anterior talofibular ligament (ATFL) reconstruction with tensional remnant repair technique from January 2019 to August 2021. General data, including demographics, surgical time, and postoperative adverse events, were recorded. The American Orthopaedic Foot and Ankle Society score (AOFAS), foot and ankle ability measure (FAAM), visual analog scale (VAS), and anterior talar translation were measured preoperatively and at 6 weeks, 3 months, and 2 years postoperatively. Ultrasonography examination was performed preoperatively and 2 years postoperatively to evaluate the ATFL. Data were analyzed using SPSS 19.0. F test was used to analyze the pre- and postoperative VAS, FAAM, and AOFAS scores. The significance was set at p < 0.05.@*RESULTS@#There were 20 males and 10 females among the patients with a mean age of (30.71 ± 5.81) years. The average surgical time was (40.21 ± 8.59) min. No adverse events were observed after surgery. At 2 years postoperatively, the anterior talar translation test showed grade 0 laxity in all patients. VAS score significantly decreased from preoperatively to 6 weeks, 3 months, and 2 years postoperatively (p < 0.001). Improvement of FAAM score and the AOFAS score from preoperatively to 6 weeks, 3 months, and 2 years postoperatively was statistically significant (p < 0.001). At 3 months postoperatively, most patients (23/30) could return to their pre-injured activities of daily living status. At 2 years postoperatively, all patients were able to return to their pre-injured activities of daily living status, and almost every patient (18/19) who expected highly intensive sports returned to sports with only 1 obese patient failing to achieve the goal. The ultrasonography examination at 2 years postoperatively showed that there was a linear band structure of soft tissue on the tension-rich fiber tape image from the fibular to the talar attachment sits of ATFL.@*CONCLUSION@#The novel arthroscopically artificial ligament reconstruction with tensional remnant-repair technique for ATFL achieved satisfactory clinical outcomes in the short and medium term after operation, and allowed early return to pre-injured activities, which could be a reliable option for patients with chronic lateral ankle instability.

Efficacy of Paishi decoction in treatment of ureteral calculi / 上海预防医学

Objective:To evaluate the efficacy of Paishi decoction in ureteral calculi treatment. Methods:Ureteral calculi patients were voluntarily divided into two groups in Shanghai Baoshan Traditional Chinese Medicine-Integrated Hospital. Patients in the control group received anti-inflammatory symptomatic treatment for 2 weeks， and patients in the treatment group received anti-inflammatory symptomatic treatment combined with Paishi decoction for 2 weeks. Results:There was no significant difference between the two groups in gender， age， body weight and stone size. Compared with the control group， after taking Paishi decoction for 2 weeks， the urinary oxalic acid and calcium in the treatment group decreased significantly， and the urine citric acid increased （P<0.05）. The difference in clinical effective rate was significant between the two groups （P<0.05）. Conclusion:Paishi decoction is superior to single anti-inflammatory symptomatic treatment in the treatment of ureteral calculi， which reflects the advantages of integrated traditional Chinese and Western medicine. However， the number of patients included in this study was limited， further studies are in need to verify the result.

Aramid nanofiber/bacterial cellulose composite separators for lithium-ion batteries.

Aramid nanofibers (ANFs) are expected to serve as new nanoscale building blocks which could improve both the mechanical performance and ionic conductivity of bacterial cellulose (BC) membranes due to their high interfacial bonding, matching of fiber size and the polar aramid groups in ANFs. Herein, composite membranes of BC and ANFs with different ANFs loadings of 2%, 4%, 6% and 8% were prepared by a traditional paper-making method after homogeneous mixing. The achieved membranes with relatively low ANFs loadings exhibited the increased tensile strength and ionic conductivity. The Li/LiFePO4 half-cells based on the 2%ANFs/BC separator demonstrated the best electrochemical performance (including discharge capacity, C-rate capability and cycling stability). Thus, the proposed ANFs/BC separators are a promising candidate for high-performance Li-ion batteries.

Comparative study on the efficacy and safety of diode laser enucleation and transurethral resection of prostate in the treatment of large-volume benign prostatic hyperplasia / 上海预防医学

Objective To compare the efficacy and safety of diode laser enucleation of prostate(DiLEP) and transurethral resection of prostate(TURP) in the treatment of large-volume benign prostatic hyperplasia(BPH).Methods A total of 80 cases of large-volume BPH patients who were treated in Shanghai Baoshan Traditional Chinese Medcine-integrated Hospital from January, 2014 to December, 2016 were selected.These patients were divided into two groups who were treated by DiLEP and TURP, respectively.The operation time, postoperative hemoglobin slippage, removed tissue weight, postoperative serum sodium slippage, postoperative complications, International Prostate Symptom Score (IPSS) before and after surgery, residual urine volume (PVR) and the maximum urinary flow-rate (Qmax),etc.of the two groups were compared.Results In the postoperative follow-up during 6 months after surgery, the IPSS before and after surgery, Qmax and Quality of Life (QOL) scores of the two groups showed no significant difference.The postoperative hemoglobin slippage, postoperative serum sodium slippage, vesical infusion time, urinary canal indwelling time and length of stay of the DiLEP group were all below those of the TURP group.The operation time: (120.5±25.2)min vs(95±21.2)min;the quality of exercised tissues: (68.5±16.2)g vs (65.2±18.5)g;the postoperative hemoglobin slippage: (0.89±0.42)g/dL vs (1.24±0.56)g/dL;the postoperative serum sodium slippage: (5.2±1.5)mmol/L vs (14.5±2.8)mmol/L;the vesical infusion time: (28.5±5.9)h vs (48.5±6.7)h;the urinary canal indwelling time: (2.6±1.8)d vs (4.8±2.2)d;the length of stay: (6.2±1.8)d vs (9.2±2.3)d of both the DiLEP group and the TURP group all showed significant differences(all P<0.05).The postoperative complications, such as postoperative hemorrhage, postoperative blood transfusion, reset urethral catheterization, irritation symptoms, retrograde ejaculation, urinary incontinence, urethral stricture, electroresection syndrome, etc.of the two groups had significant differences(P<0.05).Conclusion For the treatment of large-volume BPH, DiLEP as compared with TURP, has less hemorrhage risks, requires less time in terms of vesical infusion time, urinary canal indwelling time and length of stay, has less postoperative complications, thus having good therapeutic effect and safety.

Comparison of PFNA and InterTAN intramedullary nail in treating unstable femoral intertrochanteric fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects of PFNA and InterTAN for the treatment of unstable intertrochanteric fractures in the elderly patients.</p><p><b>METHODS</b>From April 2012 to February 2014, 113 elderly patients with unstable intertrochanteric fractures were treated by PFNA or InterTAN. There were 64 cases in PFNA group, including 25 males and 39 females with an average age of (73.3±6.5) years old (ranged, 66 to 85);while 49 cases in InterTAN group, including 20 males and 29 females with an average age of (74.2±5.4) years old (ranged, 65 to 85). According to the AO classification, there were 48 cases of type A2, 16 cases of type A3 in PFNA group and 37 cases of type A2, 12 cases with type A3 in InterTAN group. The time interval from injury ranged from 3 to 8 days with an average of 4.7±1.2. The blood loss, operation time, fluoroscopy time, lateral cortex fractures of the proximal femur, healing time of fracture, femoral shaft fractures, femoral head screw cut-out, necrosis of the femoral head, femoral neck shortening and Harris score of patients at the last follow-up were compared between the two groups.</p><p><b>RESULTS</b>Fifty-eight patients in PFNA and 44 patients in InterTAN were followed up for 14 to 18 months with an average of 16.3±1.2. Wound healing was satisfying during the follow-up. Significant differences were observed between the two groups regarding the blood loss, operation time, fluoroscopy time. The complication rate of femoral shaft fractures, femoral head screw cut-out and femoral neck shortening in InterTAN group was less than that in PFNA group, showing significant difference between the two groups (<0.05). At the latest follow-up, the average Harris scores were 90.7±5.1 in PFNA group and 90.4±3.9 in InterTAN group, there was no significant difference between the two groups(>0.05).</p><p><b>CONCLUSIONS</b>InterTAN with stronger anti-rotation function is more suitable for patients with early weight-bearing and it reduces the incidence rates of hip varus, femoral head screw cut-out and femoral neck shortening. However, for those patients with osteoporosis or unfit for surgery, PFNA is a good option. As the limited follow-up duration, long-term effects of the two surgical methods needs to be further observed and studied.</p>

Green channel channel improving efficacy and safety of the treatment of elderly patients with hip fractures / 第二军医大学学报

Objective To observe the application of the Green channel in the treatment of elderly patients with hip fracture, so as to provide a reference for the standardized treatment. Methods We retrospectively analyzed the clinical data of 115 elderly patients (≥75 years) with hip fractures treated in hospital from Jun. 2014 to Jun. 2015. The patients were treated through the Green channel (Green channel group, n=58) or received conventional treatment (normal group, n=57). The waiting time for operation, operation time, bleeding volume, hospital stay, and postoperative systemic and local complications during hospitalization were compared between the two groups. Results The waiting time for operation of patients in the Green channel group (median 43.6 h) was significantly shorter than that in the normal group (median 136.8 h, P0.05). The incidence of complications of patients in the Green channel group (11/58, 19.0%) was significantly higher than that in the normal group (29/57, 50.9%; P< 0.01). The incidences of pulmonary infection and pressure sores of patients in the Green channel group were significantly lower than those in the normal group (3.4% [2/58] vs 14.0% [8/57], P<0.05; 3.4% [2/58] vs 15.8% [9/57], P<0.05). There was no significant difference in the incidences of pulmonary embolism, cerebral infarction, deep vein thrombosis, myocardial infarction, or incision infection between the two groups. Conclusion Application of the Green channel in the treatment of elderly patients with hip fracture can allow early surgery under suitable conditions, which is conducive to reduce hospital stay and postoperative complications, and can promote the recovery of hip function, indicating that the Green channel has an important significance for standardized treatment of eldery patients with hip fractures.

Surgical treatment options for hip fractures in elderly patients aged 80 years old and over: A report of 915 cases / 第二军医大学学报

Objective To analyze the clinical data of 915 elderly patients with hip fractures (≥ 80 years old) receiving surgical treatment in our department over the past 10 years, so as to summarize the surgical strategies of hip fractures in elderly patients. Methods We included 915 patients with hip fractures aged 80 years and over from Jun. 2007 to Jun. 2016. Based on preoperative preparation and evaluation, the general condition and underlying diseases of patients were adjusted individually during the perioperation, and then the suitable anesthesia methods and reasonable internal fixation were selected and the surgery was performed as soon as possible. Active early functional exercise, specialist nursing and health education were conducted after surgery. The waiting time for operation, operation time, hospital stays, bleeding volume, postoperative systemic and local complications and 1-year mortality were analyzed. Results The mean operation time of the 915 patients was (69.5±34.2) min (range 50-120 min), the mean bleeding volume was (278.3±56.8) mL (range 150-440 mL), and the mean hospital stay was (5.6±3.2) d (range 5-31 d). There were 210 cases having systemic and local complications, with 117 cases of systemic complications and 93 cases of local complications. Fourteen patients died, accounting for 1.5% (14/915) of the total. The patients were divided into 7 d group according to the waiting time for operation. Our results showed that the waiting time for operation was longer, the mortalities and incidences of complications of patients were higher, with a significant difference found between the 3 groups (P<0.05). Conclusion Active preoperative preparation and evaluation, right anesthesia methods, reasonable internal fixation according to the fracture site and type, adjusting general condition and underlying disease drug during the perioperation, early surgery, active specialist nursing, preoperative health education and individualized diagnosis can all contribute to the treatment of elderly patients with hip fractures, improving the clinical efficacy and reduce the complications effectively.

Fibular osteotomy with autogenous iliac bone graft in treatment of postoperative nonunion of tibia / 第二军医大学学报

Objective To assess the clinical efficacy of fibular osteotomy with autogenous iliac bone graft for treatment of nonunion of the tibia. Methods A cohort of 45 patients with postoperative nonunion of tibia between Jul. 2008 and Jun. 2013 were treated by fibular osteotomy combined with autogenous iliac bone graft in Changhai Hospital of Second Military Medical University. According to anatomical classification, there were 29 cases of hypertrophic nonunion, 17 cases of atrophic nonunion and two cases of pseudoarthrosis. For primary fixation, 32 cases had plates internal fixation, 11 had intramedullary nail and two had external fixation. Eight patients with stable plate internal fixation were treated by fibular osteotomy with autogenous iliac bone graft, 35 patients with failed internal fixation and two patients with failed external fixation were treated by removing implant and exchanging compression plate with fibular osteotomy using autogenous iliac bone graft The status of fracture healing and relative complications were assessed by lateral and frontal X-ray. Functional recovery of the ankle was evaluated by Olerud-Molander Ankle Score (OMAS). Results The operation time was 1. 3-2. 5 (1. 7 ± 0. 5) h, the intra-operation blood loss volume was 200-500 (250. 0 ± 59. 6) mL, the fibular osteotomy length was 2-3 (2. 4 ± 0. 5) cm, and the volume of iliac grafting was 3-23 (7. 8 ± 1. 3) cm3. The follow-up time was 12-48 (16. 5 ± 3. 3) months and the fraction healing time was 3-11 (5. 6 ± 2. 4) months. The healing of 26(58%) patients took 3-5 months, 13(29%) patients took 6-8 months and 6(13%) patients took 9-11 months. Twenty-seven patients had no limb shortening, nine patients had limb shortening of 2 cm. The function of lower limb joints was excellent in 23 cases, good in 14 cases, common in 5 cases and bad m 3 cases at last follow-up. Conclusion The fibular osteotomy with autogenous iliac bone graft can create pressure on the broken bone end and increase the broken bone end contact area, promoting fracture healing and reducing complications.

Perspectives of breast cancer etiology: synergistic interaction between smoking and exogenous hormone use.

To explore breast cancer etiology, literature was searched using Medline. We explored the 1) plausibility of smoking in breast carcinogenesis; 2) physiological properties, susceptibility windows, and exposure timing of breast cells; 3) role of exogenous hormones in breast carcinogenesis; 4) biological mechanism of synergistic interactions between smoking and exogenous hormones in breast carcinogenesis; and 5) evidence from epidemiologic studies and the fitted secular trend between smoking rate, exogenous hormone use, and breast cancer incidence in past decades. We deduced that exogenous hormone use per se is not a significant cause and its association with breast cancer is distorted by chronic exposure to environmental carcinogens, especially smoking. We hypothesize that smoking is one of the causes of breast cancer and that this causality is strengthened by synergistic interaction between smoking and exogenous hormone use. Physicians should be cautious of prescribing exogenous hormones for those with chronic exposure to environmental carcinogens to prevent breast cancer.

Relationship between prognosis of patients with primary clear cell renal cell carcinoma after radical nephrectomy and expression of CD99 and analysis of prognostic factors / 第二军医大学学报

Objective: To investigate the relationship between prognosis of patients with primary clear cell renal cell carcinoma (ccRCC) after radical nephrectomy and expression of tumor metastasis-associated gene CD99 and to analyze the prognostic factors of ccRCC paiients. Methods: Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the expression of CD99 in primary ccRCC tissues and their corresponding adjacent tissues. The prognosis and risk factors of survival time of patients were studied by follow-up investigation, and the main risk factors were screened by Cox hazard regression model. Results: Compared with the adjacent renal tissues, 73.5% ccRCC tissues had up-regulated CD99 expression, with significant difference found between the two groups (P=0.000). Cox hazard regression model showed that high CD99 expression in ccRCC tissues was not a survival risk factor of ccRCC patients after radical nephrectomy (HR=0.14, 95%CI[0.01, 2.15]); and age (HR=1.18, 95%CI[1.01, 1.38]), TNM stages (HR=51.91, 95%CI[4.31, 625.87]), diabetes (HR=59.94, 95%CI[2.21, 1 627]) and hypertension (HR=47.72, 95%CI[1.37, 1 670]) were the major risk factors for the survival of patients after radical nephrectomy. The 1-year and 2-year survival rates of ccRCC patients in TNM stage I were significantly higher than those in TNM stage II-IV, respectively (100.0% vs 60.0%, P=0.004; 93.8% vs 8.3%,P=0.000). Conclusion: The expression of tumor metastasis-related gene CD99 may not be associated with the prognoses of ccRCC patients. Age, TNM stage, diabetes and hypertension are the major risk factors of prognosis after resection of ccRCC.

Design of ABC damage variable and positioning system for acetabular fractures and 1122 cases multi-center statistic analysis / 中国骨伤

<p><b>OBJECTIVE</b>To design ABC damage variable and positioning system for acetabular fracture and explore the feasibility and clinical practical value of the system through the multi-center analysis of 1122 acetabular fractures.</p><p><b>METHODS</b>According to acetabular three-column conception, and pelvic ring lesions damage direction caused by acetabular fracture domino effect and injury degree of proximal femur joint, it defined class A as any column acetabular fracture; class B as any two-column acetabular fracture; class C as front, dome and posterior mixture acetabular fracture. Lower case English letters a, m, p represented front, dome, posterior fracture, respectively. Acetabular damage variables: 1 was simple displaced fractures; 2 was comminuted fractures; 3 was compression fractures. Pelvic ring lesions damage variables: alpha was sacroiliac joints or sacroiliac fracture horizontal separation deflection; beta was sacroiliac joints or sacroiliac fracture vertical separation deflection; gamma was pubic symphysis separation/superior and inferior ramus of pubis fracture deflection; alpha beta gamma delta was compound floating damage. Proximal humerus joint damage variables: I was femoral head fracture; II was femoral neck fracture; II was intertrochanteric fractures of femur; IV was I to III compound fracture. The ABC damage variable positioning system for acetabular fracture was made up by the above-mentioned variables. The statistics from March 1997 to February 2010 showed 1122 cases acetabular fractures with 18 cases of double side acetabular fracture and 1140 cases of acetabular fractures. The pelvics anterior-posterior view, ilium and obturator oblique view, and 2/3D-CT materials were analyzed and researched.</p><p><b>RESULTS</b>Each damage variables distribution situation in 1140 cases of acetabular fracture involved A in 237 cases (20.8%), B in 605 cases (53.1%), C in 298 cases (26.1%);front column fracture in 808 cases(70.9%), dome fracture in 507 cases (44.5%), posterior fracture in 1026 cases (90%). Acetabular variables: variabe 1 in 203 cases of simple displaced fracture (17.8%); variabe 2 in 516 cases of comminuted fracture(45.3%); variabe 3 in 421 cases of compression fracture (36.9%); 249 cases of pelvic ring lesions damage (21.8%), 75 cases femoral head fracture (6.6%); 18 cases of double side acetabular fracture and relative pelvic ring and proximal humerus joint variables (1.58%). Key part and curative effect elements of 1140 cases acetabular fracture: 507 cases of dome or posterior acetabular fracture (44.5%); 421 cases of compression fracture (36.9%); 249 cases of pelvic ring variables (21.8%); 75 cases of proximal humerus joint variables (6.6%); 486 cases of simple Aa/pl/2,Bapl/2 acetabular fracture (42.6% ).</p><p><b>CONCLUSION</b>Compression fracture, especially defected compression fracture, takes important part in acetabular damage variables, and also presents that acetabular fracture with pelvic ring and proximal femoral damage variables are not rare at all. The relationship of the acetabular fracture damage variables, and its percentage shows the key points and elements in clinical treatment: weight-bearing to dome accounts for 44.5%; compression to defects account for 36.9%, pelvic ring to float accounts for 21.8%; dome fracture to double side fracture account for 6.6%. The system has significant guiding effects on clinic in terms of evaluation of injury severity, anatomic localization, difficulty index, alternative strategy, operative approach, effect of treatment,and prognosis. And the most important thing is that the system creates the comparison of damage variables in same type of fracture and the communication of homo-language and explores a new method.</p>

Closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children.</p><p><b>METHODS</b>From June 2007 to December 2008, 27 patients with Gartland III supracondylar fractures were treated with closed reduction and percutaneous Kirschner wire fixation combined with plaster support. Among the patients, 18 patients were male and 9 patients were female, ranging in age from 6 to 12 years,with an average of 8.1 years. Fifteen patients were extension type, 12 patients were buckling type; fourteen patients were ulnar deviation, 13 patients were radial deviation. The duration from injury to treatment ranged from 0.5 to 8 days, averaged 3.6 days.</p><p><b>RESULTS</b>Twenty-seven patients were followed up, and the duration ranged from 6 to 24 months, averaged 13.5 months. The healing time ranged from 4 to 6 weeks after surgery, with a mean of 4.5 weeks. Complications including implants loosening, fracture re-displacement, Volkmarm contraction, needle point or deep infection, ulnar nerve injury, myositis ossificans were found during follow-up. Two patients had postoperative elbow varus, but the varus angle was not more than 15 degree,which may be due to inappropriate functional exercise or early removal of external fixation. According to Flynn criteria, 19 patients got an excellent result, 5 good, 2 poor and 1 bad.</p><p><b>CONCLUSION</b>Closed reduction and percutaneous Kirschner wire fixation combined plaster support for the treatment of unstable supracondylar fractures in children has advantages including little trauma, reliable fixation, good elbow function and appearance.</p>

Prediction of B cell epitopes of tumor-associated protein EIF4G1 subtypes / 第二军医大学学报

Objective: To predict the B cell epitopes of tumor-associated protein EIF4G1 subtypes. Methods: The sequences of all the protein subtypes of EIF4G1 were retrieved from NCBI protein database. Based on single parameter evaluation, including hydrophilicity, flexility, antigenicity, the B cell epitopes of the EIF4G1 protein subtypes were predicted using NPS@ structure software and ABCpred software. Results: EIF4G1 protein had five subtypes. The variation of the five different EIF4G1 subtypes was limited within a 300aa region. We identified eight epitopes locating in or near 14-19, 21-27, 52-61, 106-112, 113-139, 183-189, 201-216, and 217-224, which can be used to identify specific B cell epitopes of different protein subtypes. Conclusion: B cell epitopes of EIF4G1 protein subtypes do exist, and they may be used for the protein subtypes evaluation and early diagnosis of tumor patients using artificially-produced matched peptides.

The application of external fixation for the treatment of supracondylar femoral fracture after total knee replacement / 中国骨伤

<p><b>OBJECTIVE</b>To explore the external fixation for treatment of supracondylar femoral fractures after total knee replacement.</p><p><b>METHODS</b>From June 2005 to July 2007, 7 cases of supracondylar femoral fracture after total knee replacement were treated with external fixation included 4 males and 3 females with an average age of 71 years ranging from 55 to 85 years. The fracture healing were observed and the knee function were evaluated by the HSS scoring.</p><p><b>RESULTS</b>All patients were followed-up for 6 to 23 months with an average of 12.5 months. The fracture healing time was from 6 to 12 weeks after operation (averaged 8.5 weeks). During the followed-up period, there were no infection and loosening, only one case occurred nail crossing delayed healing of skin. The HSS knee score was (60.6 +/- 16.0) before treatment and (77.6 +/- 11.6) after treatment according to HSS knee score criteria, the results were excellent in 2 cases, good in 4, and fair in 1.</p><p><b>CONCLUSION</b>Application of external fixation for treatment of supracondylar femoral fracture after total knee replacement, especially in poor physical condition, high age patients is a more appropriate treatment.</p>

Reconstruction of the collapse tibial plateau fracture by injectable artificial bone combined with supportive plate fixation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effective of the injectable artificial bone combined with plate fixation for reconstructing the collapse tibial plateau fracture.</p><p><b>METHODS</b>From June 2005 to January 2008,21 cases of collapse tibial plateau fracture of type Schatzker II, III were treated by injectable calcium sulfate bone substitute combined with supportive plate reconstruction including 16 males and 5 females with an average age of 35.3 years ranging from 27 to 62 years. The disease course was from 3 to 7 days (means 4 days). According to Schatzker classification, there were 17 cases of type II, 4 of type III. All patients preoperatively underwent radiography, CT scanning and three-dimensional reconstruction in order to accurately understand the extent of fracture and fracture collapse and the shattered fragments of the flip direction. All the fracture with collapse > 3 mm, without joint degeneration were selcected for surgical treatment. The knee joint function after fracture healing and recovery were evaluated by Lysholm scoring.</p><p><b>RESULTS</b>All patients were followed-up for from 6 months to 2.5 years (means 1.5 years). The X-ray films and features of all fractures showed anatomic reduction or near anatomic reduction, except one case of grade II severe comminuted fracture occurred a high degree of loss and platform reset ineffective after 6 months. The Lysholm scoring of knee function showed that the mean score was (88.3 +/- 5.2). The results were excellent in 12 cases,good in 7 cases, fair in 2 cases.</p><p><b>CONCLUSION</b>Minimally invasive injectable calcium sulfate bone combined with plate fixation for reconstructing the collapse tibial plateau fracture of type II, III can effectively prevent the further loss after reduction, to improve the long-term results. Minimally invasive injectable calcium sulfate as an artificial bone substitute materials has good prospects for clinical application.</p>

Evaluation of the clinical effect of knee osteoarthritis treated with moxibustion according to WHOQOL-BREF / 中国骨伤

<p><b>OBJECTIVE</b>To investigate and research WHOQOL-BREF evaluation of the clinical effect of application of moxibustion for treatment of knee osteoarthritis, to provide clinical according for the treatment.</p><p><b>METHODS</b>From January 2007 to June 2008, 90 cases of knee osteoarthritis were randomly divided into treatment group and control group. In treatment group there were 45 cases included 16 males and 29 females with an average age of (62.5 +/- 7.4) years; the average course was (26.5 +/- 14.6) months; Lysholm score of knee function before treatment was (65.5 +/- 3.5) hours on average. In control group, there were 45 cases included 11 males and 34 females with an average age of (62.5 +/- 9.3) years;the average course was (24.6 +/- 16.6) months; Lysholm score of knee function before treatment was (66.3 +/- 2.3) hours on average. Applied Quality of Life Scale WHOQOL-BREF in line with the inclusion criteria of the study evaluation. While applied Lysholm scoring of knee joint for supporting the evaluation criteria. All data were statistical analyzed by package SPSS 11.5.</p><p><b>RESULTS</b>Moxibustion was applied to treat the knee osteoarthritis and the quality of life was evaluated according to the WHOQOL-BREF scale score. The scores of the physical state, psychological state, as well as their own general health status of subjective feeling, and so on in treatment was significantly higher than that in control group (P < 0.05). According to Lysholm scoring, the score in treatment group was significantly higher than that of control group, too (t = 0.65, P < 0.05).</p><p><b>CONCLUSION</b>Application of moxibustion for treatment of knee osteoarthritis is a simple, economical and practical, and can avoid the further development of the disease, but also to improve the joint function and improve quality of life.</p>

Controlled clinical trials of initial observation on therapeutic effects of moxibustion for osteoarthritis of the knee: multi-center clinical effect / 中国骨伤

<p><b>OBJECTIVE</b>To compare therapeutic effects between moxibustion and infrared therapy for the treatment of knee osteoarthritis.</p><p><b>METHODS</b>From January 2007 to June 2008 period, 65 patients with knee osteoarthritis were divided into treatment and control groups randomly uniform random number table generated from SAS statistical software. Among 35 patients in the treatment group, 17 patients were male and 18 patients were female, ranging in age from 45 to 75 years, with an average of (61.2+/-6.4) years; the course of disease ranged from 9 to 43 months, with a mean of (23.6+/-13.8) months; the preoperative Lysholm score ranged from 19 to 28 scores, averaged (24.3+/-3.3) scores. In the control group, there were 30 patients, including 13 males and 17 females, ranging in age from 47 to 79 years, with an average of (62.5+/-9.3) years; the course of disease ranged from 8 to 45 months, with a mean of (24.6+/-16.6) months; the preoperative Lysholm score ranged from 20 to 29 scores, averaged (25.9+/-3.0) scores. The patients in the treatment group were treated with moxibustion, and the patients in control group were treated with infrared therapy. All the patients were followed up for 4 weeks. The Lysholm scores were compared between the two groups.</p><p><b>RESULTS</b>According to Lysholm score for clinical efficacy, treatment group got (87.5+/-5.6) scores and the control group were (85.9+/-3.5) scores, the Lysholm score of the treatment group was higher than that of the control group (P<0.05). Among pain score, joint flexion and extension score, joint stability score, and up and down stairs score, the pain and joint stability scores of patients in the treatment group were higher than those of control group (P<0.05).</p><p><b>CONCLUSION</b>Compared with infrared therapy, moxibustion treatment for knee osteoarthritis can get better joint function, which is effect to alleviate the patient's pain, improve joint stability, improve the efficacy, and is valued to be promoted.</p>

Effect of moxibustion in treating knee joint osteoarthritis and its relation with contents of hyaluronic acid in serum and synovial fluid / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the clinical effects of moxibustion (Mox) in treating knee joint osteoarthritis, and to detect the change of hyaluronic acid (HA) level in serum and synovial fluid (SF) for evaluating its significance.</p><p><b>METHODS</b>Thirty OA patients were treated with Mox applied on inner and outer hsiyens and Ashi point for 10 min once a day, 5 times a week for 3 months and the therapeutic efficacy was evaluated. Serum and SF levels of HA were measured by radio-immunoassay before and after the 3-month treatment, and compared with those from 30 non-OA persons for normal control.</p><p><b>RESULTS</b>After treatment, 19 patients (20 joints) out of the 30 patients were cured, the efficacy of Mox was evaluated as markedly effective in 8 patients on 10 joints, and as effective in 3 patients on 4 joints, the cure rate being 63.3%. Before treatment, HA level in serum (122.87 +/- 34.10 microg/L) was higher and in SF (0.98 +/- 0.17 g/L) was lower in OA patients than those in the normal controls (68.32 +/- 21.48 microg/L and 1.62 +/- 0.30 g/L, P<0.01), whereas after treatment, both the serum and SF levels of HA in patients changed toward normal range (70.29 +/- 27.30 microg/L and 1.58 +/- 0.26 g/L), showing insignificant difference as compared with those in the controls (P<0.01).</p><p><b>CONCLUSION</b>Mox is an effective approach for treatment of OA, and the levels of HA in serum and SF can be taken as the quantitative indicators for evaluating the pathogenetic condition of OA patients.</p>

Three-dimensional finite element analysis of lumbar vertebra loaded by static stress and its biomechanical significance / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To explore the mechanical behavior of lumbar spine loaded by stress and provide the mechanical basis for clinical analysis and judgement of lumbar spine fracture classification, mechanical distribution and static stress.</p><p><b>METHODS</b>By means of computer simulation method, the constructed lumbar spine three-dimensional model was introduced into three-dimensional finite element analysis by software Ansys 7.0. The lumbar spine mechanical behavior in different parts of the stress loading were calculated. Impact load is 0-8000 N. The peak value was 8000 N. The loading time is 0-40 minutes. The values of the main stress, stress distribution and the lumbar spine unit displacement in the direction of main stress were analyzed.</p><p><b>RESULTS</b>The lumbar spine model was divided into a total of 121 239 nodes, 112 491 units. It could objectively reflect the true anatomy of lumbar spine and its biomechanical behavior and obtain the end-plate images under different stress. The stress distribution on the lumbar intervertebral disc (L(3)-L(4)) under the axial, lateral flexion and extension stress, and the displacement trace of the corresponding processus articularis were analyzed.</p><p><b>CONCLUSION</b>It is helpful to analyze the stress distribution of lumbar spine and units displacement in static stress loading in the clinical research of lumbar spine injury and the distribution of internal stress.</p>

Analysis of traumatic conditions on casualties evacuated from Wenchuan earthquake area / 中国骨伤

<p><b>OBJECTIVE</b>To investigate and analyze the traumatic conditions on the casualties evacuated from Wenchuan earthquake area.</p><p><b>METHODS</b>Traumatic conditions of 34 patients evacuated to Changhai hospital were investigated. Meanwhile, classification of traumatic conditions and therapeutic methods was analyzed.</p><p><b>RESULTS</b>By organized emergency medical treatment,classification and transmission of casualties, selected application of external fixation,active repair of soft tissue injury, positive psychological assessment and intervention, healing rate was efficiently rasied and complications were decreased.</p><p><b>CONCLUSION</b>The summary of traumatic conditions and therapeutic experiences on wounded people of Wenchuan earthquake area can provide the primary basis and treatment methods for the wounded people with earthquake injury.</p>