ObjectiveTo observe the therapeutic effect of electro-acupuncture combined with oral glucosamine hydrochloride capsules in the treatment of knee osteoarthritis, and compare it with the curative effect of the two methods separately. MethodsA total of 168 patients with knee osteoarthritis treated from March 2006 to December 2012 were randomly divided into 3 groups. Electro-acupuncture combined with oral glucosamine hydrochloride capsules were given to the 58 patients in the treatment group, single acupuncture treatment was given to the 57 patients in control group A, and simple oral glucosamine hydrochloride capsules were given to the 53 patients in control group B. The treatment lasted for 6 weeks. Assessment of knee osteoarthritis by Lequesne international standard index number and the total efficiency was carried out before treatment and 3 weeks, 6 weeks and 6 months after treatment, respectively. ResultsThe total effective rate of the treatment group was 91.38%, of control group A was 68.42%, and of control group B was 79.25%. There was a significant difference between the treatment group and control group A, and between the treatment group and control group B (P<0.05). No blood, liver or kidney damage or gastrointestinal adverse reaction occurred among patients in all the three groups. ConclusionThe efficacy of electro-acupuncture plus oral glucosamine hydrochloride capsules is better than simple acupuncture and simple oral glucosamine hydrochloride capsules treatment.
ObjectiveTo investigate the significance of carbohydrate antigen 199 (CA199), alanine aminotransferase (ALT), gamma-glutamyl transferase (γ-GT) levels in the diagnosis of liver damage caused by hyperthyroidism. MethodA total of 106 patients confirmed to have hyperthyroid liver damage between February 2012 and February 2014 were selected to form the hyperthyroidism liver injury group (group A). Ninety-five hyperthyroidism patients without liver damage were regarded as the hyperthyroidism without liver injury group (group B). In the same period, 72 healthy subjects were designated to form the control group (group C). Automatic chemiluminescence detector was used to determine free triiodothyronine, free thyroid hormone and CA199, and automatic biochemical analyzer was adopted to measure the levels of γ-GT and ALT. Then we performed the statistical analysis. ResultsThe levels of serum CA199, γ-GT and ALT in group A were significantly higher than those in group B and group C, and the differences were statistically significant (P<0.05). CA199 and γ-GT levels in group B were significantly higher than those in group C (P<0.05). The area under the receiver operating characteristic curve for CA199, γ-GT, ALT was respectively 0.840, 0.895, and 0.818, the maximum Youden indexes were 0.593, 0.703, and 0.578, with the corresponding critical values 37.25 U/mL, 60.81 U/L, and 43.14 U/L, respectively. The parallel dectection of the three indexes improved Youden index to 0.763. ConclusionsCA199, γ-GT and ALT as diagnosis indexes of hyperthyroidism liver damage have good diagnostic value, and combined detection of the three indexes is more favorable for early diagnosis and prediction.
ObjectiveTo analyze the main causes and management of respiratory failure after surgery for esophageal cancer. MethodsWe retrospectively collected and analyzed the clinical data of 27 patients with respiratory failure after surgery for esophageal cancer in our hospital between January 2005 and December 2012. ResultsOf the 27 patients with respiratory failure after surgery for esophageal cancer, 23 were at advanced age, and 15 had moderately to severely impaired pulmonary function before surgery. After surgery, 19 suffered severe pulmonary infection, 8 yielded complications such as anastomotic leak, gastropleural fistula chylothorax, and postoperative bleeding. ConclusionPulmonary infections and surgical complications are the major and direct causes of respiratory failure after surgery for esophageal cancer. For high-risk patients at advanced age with impaired pulmonary function, enhancing perioperative airway management and improving surgical operation can decrease incidence of respiratory failure effectively.
ObjectiveTo compare clinical outcomes between video-assisted thoracoscopic surgery (VATS) and conventional surgery for the treatment of multiple rib fractures. MethodsA total of 173 consecutive patients with multiple rib fractures were admitted to Dujiangyan People's Hospital from January 2010 to December 2012. There were 122 males and 51 females with their age of 19-71 (41.3±7.1) years. According to different treatment strategies, all the patients were divided into 3 groups:conservative treatment group (83 patients with a mean of 4.9±1.3 fractured ribs, including 20 patients with flail chest), conventional surgery group (41 patients with a mean of 5.2±1.1 fractured ribs, including 11 patients with flail chest) and VATS group (49 patients with a mean of 5.3±1.5 fractured ribs, including 14 patients with flail chest). Length of hospital stay, duration of postoperative pain, incision length, operation time, chest drainage duration and morbidity were compared among the 3 groups. ResultsThe incision length (5.2±1.5 cm vs. 8.5±2.3 cm, P=0.031), operation time (1.1±0.3 hours vs. 1.8±0.2 hours, P=0.003), chest drainage duration (0.3±0.0 day vs. 3.2±1.1 days, P=0.007) and length of hospital stay (13.7±1.5 days vs. 17.3±2.3 days, P=0.017) of VATS group were significantly shorter than those of the conventional surgery group. A total of 159 patients were followed up, and chest x-ray was examined at 1, 3 and 6 months after discharge. After 3 months, bone callus formation was evident around the rib fractures in chest x-ray in patients undergoing surgery, while bone union with deformity was shown in some patients of the conservative group. ConclusionWith the development of various internal fixation materials, surgical internal fixation has become a trend for patients with multiple rib fractures, and VATS internal fixation is minimally invasive with satisfactory clinical outcomes.
ObjectiveTo investigate the application value of three-dimensional reconstruction and virtual pre-operative planning for Pilon fractures. MethodsBetween July 2010 and June 2014, 16 patients with closed Pilon fracture were treated, including 12 males and 4 females with an average age of 36.5 years (range, 22-53 years) and a mean disease duration of 10.2 days (range, 6-14 days). According to AO/Orthopaedic Trauma Association (AO/OTA) typing, 2 cases were rated as 43.B2 type, 3 cases as 43.B3 type, 3 cases as 43.C1 type, 2 cases as 43.C2 type, and 6 cases as 43.C3 type. The preoperative CT data from 16 patients were imported into Mimics10.01 software to establish the detailed fracture three-dimensional digital models. Virtual operation of fracture reduction and implanting internal fixation was performed on the models, and the optional surgical planning was made. Based on the virtual preoperative planning, operations were performed. ResultsEstablished detailed three-dimensional Pilon fracture digital models could perfectly reflect the fracture characteristics, could be observed at any direction, and aided for fracture classification accurately. Virtual fracture operations of reduction, internal fixation and other could be performed to simulate the clinical operation, which could assist the surgeon better preoperative planning in achieving visual presentation and improving the communication. The operation time was 70-130 minutes (mean, 87.8 minutes); intraoperative blood loss volume was 30-150 mL (mean, 71.9 mL). The wounds healed by first intension in all patients. The mean follow-up time was 11.6 months (range, 8-18 months). Postoperative radiological results at 3 groups showed good anatomic reduction according to the Burwell-Charnley criteria, and the fracture healing time was 3-6 months (mean, 3.7 months). There was no complication of internal fixation loosening or breakage during follow-up. The American Orthopedic Foot and Ankle Society (AOFAS) score was 71-100(mean, 92.3); the results were excellent in 10 cases, good in 5 cases, and fair in 1 case, with an excellent and good rate of 93.8% at last follow-up. No loss of fracture reduction was observed on the X-ray film. ConclusionThe clinical feasibility of virtual reconstruction preoperative planning is good in the treatment of Pilon fractures, which helps surgeons better understanding Pilon fracure and making the surgical planning.