目的 分析腰椎间盘突出症手术后复发的原因，探索有效的手术治疗方法。 方法 对2004年8月－2011年7月收治的32例腰椎间盘突出症术后复发再手术的患者，根据其病因采用3种不同手术方法治疗，其中椎间盘摘除术14例，椎间盘摘除联合腰椎后外侧融合内固定术7例，椎间盘摘除联合腰椎后路椎体间融合内固定术11例，术后应用改良Macnab疗效评定标准、Oswestry功能障碍指数（ODI）和影像学检查对手术治疗的临床疗效进行评价。 结果 3种手术治疗方法均取得了满意的优良率；术后3个月及末次随访ODI评分术后较术前明显降低，差异有统计学意义（P＜0.05）。 结论 腰椎间盘突出症术后复发与多种原因有关；根据复发患者的情况合理选择手术治疗方法均能取得较好的临床疗效。
Objective To explore the interventions for traumatic floating knee. Method We retrospectively analyzed the data of 32 patients with traumatic floating knee. The following-up time is 6 to 22 months with average time of 11 months. Result All the followed-up patients got bone union. One patient was with plate revealed, 2 patientss were infectious, 2 patients were with lock pin broken. According to Floating Knee Damage Limb Function Evaluation Scale produced by Karlstrom, 21 patients were excellent, 6 were good, 4 were fair and one was poor, and the excellent and good rate was 84.3%. Conclusion Operation for traumatic floating can recover the alignment and stability of lower limber, recover knee function and reduce complication.
Objective To investigate the operative effects of gluteal muscle contracture. Methods A total of 128 cases of gluteal muscle contracture treated with operative methods from February 2001 to May 2009 were reviewed. Results All the patients received operation. Most patients were satisfied with the treatment via function exercise in the early stage. No severe complication was found. The patients were followed up for 6 to 84 months, at the average of 36 months. According to Huang Yaotians criteria, 67.9% (87/128) of the patients were excellent; 27.3% (35/128) were good; 3.9% (5/128) were fair; and 0.8% (1/128) were poor in effectiveness. Conclusion Operation and function exercise after operation have advantages of minitrauma and good function recovery, and it is a satisfactory method to treat the gluteal muscle contracture.
Objective To investigate the effectiveness of autologous bone marrow mononuclear cells transplantation on lower l imb chronic venous ulcer. Methods Between May 2009 and September 2010, 17 patients with lower l imb chronic venous ulcer were treated with autologous bone marrow mononuclear cells transplantation (transplantation group) and 10patients treated without cells transplantation served as control group. In the transplantation group, there were 9 males and 8 females with age of (33.3 ± 6.1) years, including 11 cases of simple great saphenous vein varicosity and 6 cases of chronic venous insufficiency; the area of ulcer was (4.39 ± 2.46) cm2; and the duration of ulcer ranged from 3 months to 6 years. In the control group, there were 4 males and 6 females with age of (39.2 ± 10.3) years, including 7 cases of simple great saphenous vein varicosity and 3 cases of chronic venous insufficiency; and the area of ulcer was (5.51 ± 2.63) cm2; and the duration of ulcer ranged from 3 months to 2 years. All patients in both groups were classified as C6 according to Cl inical Etiology Anatomy Pathophysiology (CEAP) classification. No signficant difference was found in the general data between 2 groups (P gt; 0.05). The heal ing process of ulcer was observed. The granulation tissue was harvested for HE staining before operation and at 3 days after operation in the transplantation group. The microvessel density (MVD) and vascular endothel ial growth factor (VEGF) expression of ulcer granulation tissue were observed. Results In the transplantation group, ulcer heal ing was accelerated; complete heal ing was observed in 15 cases, partial heal ing in 1 case, and no heal ing in 1 case with the median heal ing time of 22 days. However, in the control group, the heal ing process was slower; complete heal ing of ulcer was observed in 7 cases and no heal ing in 3 cases with the median heal ing time of 57.5 days. There was significant difference in the heal ing time between 2 groups (Z=0.001 4, P=0.002 7). HE staining showed a great number of microvessels in the granulation tissue in the transplantation group. The immunohistochemical staining showed that MVD was significantly increased (t=3.120, P=0.008) after cell ransplantation (32.1 ± 12.8) when compared with that before transplantation (22.1 ± 6.7). The VEGF expressionafter transplantation (8.05% ± 5.10%) was increased sl ightly when compared with that before transplantation (6.13% ±4.20%), but the difference was not significant (t=1.150, P=0.268). Conclusion Autologous bone marrow mononuclear cellstransplantation can stimulate granulation tissue growth and improve ulcer heal ing.