目的 观察盐酸氨基葡萄糖治疗膝骨关节炎的临床效果。 方法 将2010年10月－2011年12月收治的70例膝骨关节炎患者随机分为观察组和对照组，每组各35例。对照组单纯口服对乙酰氨基酚；观察组在对照组基础上加用盐酸氨基葡萄糖。观察两组临床疗效和不良反应。 结果 观察组总有效率高于对照组，不良反应发生率低于对照组，两组比较差异均有统计学意义（P＜0.05）。 结论 盐酸氨基葡萄糖治疗膝骨关节炎安全有效。
目的 观察盐酸氨基葡萄糖治疗腰椎小关节骨关节炎的临床疗效。 方法 2010年9月－2012年5月门诊就诊的160例腰椎小关节骨关节炎患者随机分为两组进行治疗，对照组80例，口服非甾体抗炎药物尼美舒利；试验组80例，在服用尼美舒利的基础上加服盐酸氨基葡萄糖，治疗周期为2周。对两组患者治疗前及治疗后1、2周后日常生活能力、视觉疼痛模拟、心理测评（采用症状自评量表检测）3项指标进行检测，比较两组的临床疗效，并对患者进行3个月随访。 结果 两组患者各指标检测结果显示，治疗后较治疗前均明显改善，试验组明显优于对照组；总有效率试验组为97.3%，对照组为86.1%，试验组明显优于对照组，组间比较差异有统计学意义（P＜0.05）。 结论 盐酸氨基葡萄糖联合尼美舒利治疗腰椎小关节骨关节炎具有较好的临床疗效。
目的 观察噻托溴铵治疗慢性阻塞性肺疾病急性加重期（AECOPD）临床疗效与安全性。 方法 选取 2010 年 1 月－2011年12月入院的69例AECOPD 患者随机分为试验组（A组，n=36）和对照组（B组，n=33），A组在B组常规治疗的基础上吸入噻托溴铵。治疗起始及结束分别观察两组肺功能指标、慢性阻塞性肺疾病评估测试（CAT）评分、血气分析、6分钟步行距离、住院时间及药物不良反应。 结果 两组均显示出一定的临床效果，A组治疗后肺功能指标、CAT评分、血气分析、6分钟步行距离均优于B组，差异均具有统计学意义（P＜0.05）。A组住院时间短于B组（P＜0.05），且无严重不良反应。 结论 AECOPD患者在常规治疗同时吸入噻托溴铵，疗效显著且临床安全性较高。
Abstract： Surgical repair of functional tricuspid regurgitation (FTR) is often carried out concomitantly with other leftsided heart valve procedures. Though diseases of both left heart valve and tricuspid were treated during the surgery, postoperative residual or recurrent tricuspid regurgitation has been clearly associated with progressive heart failure and worsened longterm survival. To date, surgical interventions mainly address FTR at three anatomic levels: commissure, annulus and leaflets. However, a certain mid and longterm failure rate after operation still exists. High surgical mortality rates have been reported in patients with recurrent tricuspid regurgitation requiring complex reoperations. With a better understanding of tricuspid anatomical complex and valvuloplasty, significant improvements have been made in FTR surgical indications and techniques. This review article will focus on the development of surgical indications in tricuspid valve repair, while the repair techniques and their impact on longterm clinical outcome will also be compared.
Objective To compare the effectiveness between locking compression plate (LCP) and locked intramedullary nail (IMN) for humeral shaft fractures of types B and C. Methods Between January 2010 and January 2012, 46 patients with humeral shaft fractures of types B and C were treated, and the clinical data were retrospectively analyzed. LCP was used for internal fixation in 22 cases (LCP group), and IMN in 24 cases (IMN group). There was no significant difference in gender, age, injury causes, the side of fracture, the site of fracture, the type of fracture, associated injury, and time from injury to operation between 2 groups (P gt; 0.05). The regular clinical examination and evaluation of radiography were done. Shoulder function was evaluated by Neer grading system and elbow function was evaluated by Mayo elbow performance score after operation. Results The operation time and intraoperative blood loss in IMN group were significantly lower than those in LCP group (P lt; 0.05). There was no significant difference in hospitalization time between 2 groups (t=0.344, P=0.733). All patients were followed up 16.8 months on average (range, 12-24 months). At 6 months after operation, bone nonunion occurred in 1 patient of LCP group and in 2 patients of IMN group; the bone healing rate was 95.5% (21/22) in LCP group and 91.7% (22/24) in IMN group, showing no significant difference (χ2=0.000, P=1.000). Except for nonunion patients, the bone healing time was (11.77 ± 0.75) weeks in LCP group and (11.38 ± 0.82) weeks in IMN group, showing no significant difference (t=1.705, P=0.095). Between LCP and IMN groups, significant differences were found in radial nerve injury (4 cases vs. 0 case) and impingement of shoulder (0 case vs. 6 cases) (P lt; 0.05), but no significant difference in superficial infection (1 case vs. 0 case) and iatrogenic fracture (1 case vs. 2 cases) (P gt; 0.05). There was no significant difference in shoulder function and elbow function at 1 year after operation between 2 groups (P gt; 0.05). Conclusion LCP fixation and IMN fixation for humeral shaft fractures of types B and C can achieved satisfactory results. More attention should be paid to avoiding radial nerve injury by fixation of LCP; nail tail should be buried deeply into the cortex of the greater tuberosity and rotator cuff should be protected to decrease the rate of impingement of shoulder by fixation of IMN.
ObjectiveTo explorethe method and effectivenessofarthroscopically assisted treatmentof rotator cuff injury. MethodsBetween November 2009 and March 2011, 27 patients with rotator cuff injury were treated. There were 17 males and 10 females with a mean age of 43.6 years (range, 29-66 years). The disease duration was1 to 36 months (mean, 27months). The location was theleft shoulder in 11 cases and theright shoulder in 16 cases. Of them, 12 cases had a history of trauma and 15 caseshad no obvious predisposing causes. All patients had limitation of shoulder flexionandabduction. Anteroposterior and lateral X-ray films of the shoulder and the out-let X-ray films of the supraspinous muscle were taken. According to the acromion classification of Bigliani, there were 5 cases of type I, 13 cases of type II, and 9 cases of type III. MRI images showed all patients had rupture of the rotator cuff. The examination of shoulder arthroscope showed complete rupture of the supraspinatus muscle in 27 cases and acromion impingement in 23 cases. The patients without impingement underwent tear debridement, and the patients with impingement underwent acromioplasty and resection of subacromial bursa after tear debridement. The 3-4 cm incision was made with arthroscopically assisted positioning, and the metal suture anchorwas placed on the greater tubercle of humerus to repair rotator cuff. ResultsAll incisions healed primarily. All patients were followed up 13-27 months (mean, 19 months). No infection, loosening of internal fixation, and rotator cuffre-tearoccurred. Pain was relieved and the results was satisfactory after operation. The shoulder range of motion (ROM) at last follow-up was significantly improved when compared with preoperative ROM (P lt; 0.05). The visual analogue scale (VAS) score was significantly improved from 8.0 ± 1.8 at preoperation to 1.6 ± 0.7 at 2 weeks after operation and 0.8 ± 0.7 at last follow-up (Plt; 0.05); the University of California Los Angeles (UCLA) score of shoulder was significantly increased from 18.8 ± 6.6 at preoperation to 32.2 ± 3.3at 3months after operation and 33.6 ± 2.1 at last follow-up (P lt; 0.05). Conclusion The effectivenessofarthroscopically assisted treatmentof rotator cuff injury is satisfactory. However, long-termeffectiveness needs furtherfollow-up observation.
Objective To investigate the cl inical directive significance of three-dimensional reconstruction of CT in treating mandibular angle hypertrophy. Methods Between March 2009 and January 2011, 18 patients with mandibular angle hypertrophy were treated using the three-dimensional reconstruction technology of CT. All patients were female, aged20-36 years with an average of 25 years. Eighteen patients included: 14 single mandibular angle hypertrophy, 3 mandibular angle hypertrophy with masseter hypertrophy, and 1 mandibular angle hypertrophy with bilateral asymmetry; 6 cases of ptosis of mandibular angle, 9 cases of prominent mandibular angle, and 3 cases of introversive mandibular angle. According to the types of mandibular angle hypertrophy, the surgical methods could be correctly chosen. The procedure was planned and simulated; the osteotomy l ine was marked and the osteotomy was measured on the workstations of three-dimensional reconstruction. Results No fracture of mandible occurred in the operation. Facial nerve temporary attack occurred in 1 case and recovered at 3 months after operation. All patients were followed up 6-12 months (mean, 7.6 months). After 6 months of operation, the effectiveness was satisfactory in 15 cases, basically satisfactory in 2 cases, and unsatisfactory in 1 case (bilateral asymmetry). Conclusion Based on three-dimensional reconstruction technology of CT, surgical design performed on the model will promote the accuracy of operation. Basically symmetrical appearances can be achieved with satisfactory results.