Minimally invasive osteotomy and manual reduction for hallux valgus / 中国骨伤

OBJECTIVE@#To explore clinical effects of minimally invasive osteotomy and manual reduction in treating hallux valgus.@*METHODS@#From January 2018 to May 2019, 31 patients (42 feet) with hallux valgus were treated with minimally invasive osteotomy and manual reduction, including 3 males and 28 females aged from 18 to 76 years old with an average of (50.1± 4.9) years old. Preoperative and postoperative hallux valgus (HVA), intermetatarsal angles(IMA), length difference between 1 and 2 metatarsals were recorded and compared, and American Orthopedic Foot and Ankle Society (AOFAS)score were observed and measured.@*RESULTS@#Thirty-one patients (42 feet) were followed up from 14 to 18 months with an average of (15.1± 1.2) months. HVA, IM before operation were (38.5±5.4)°, (13.0± 1.1)°, and improved to (14.3±4.7)°and (9.1±1.5)°after operation respectively(@*CONCLUSION@#Minimally invasive osteotomy and manual reduction in treating hallux valgus have advantages of shorter operation time, less length of incision, and could correct hallux valgus deformity, improve front feet and receive good clinical effect in further.

Inner-heating acupuncture of lumbar degenerative lesions based on β-catenin signaling pathway / 中国骨伤

OBJECTIVE@#By observing the effect of inner-heating acupuncture on the expression of Wnt1, Axin and β-catenin in the intervertebral disc of rats with lumbar degenerative disease and to explore the regulatory mechanism of inner-heating acupuncture on the apoptosis of annulus fibrosus cells in rats with lumbar degenerative disease.@*METHODS@#Forty SD rats were randomly divided into normal group, model group, inner heating acupuncture group and acupuncture group with 10 rats in each group. Except for normal group, all rats were modeled. Bilateral were selected for inner-heating acupuncture and acupuncture treatment. Western-bolt assay was used to detect the expression of Wnt1, Axin and β-catenin in rat intervertebral discs.@*RESULTS@#Compared with the model group, Wnt1 and β-catenin expression in annulus fibrosus cells of rats in the inner heating acupuncture group and the acupuncture group were significantly decreased(0.05).@*CONCLUSION@#Inner heating acupuncture can down regulate the expression of Wnt1 and β-catenin and up regulate the expression of Axin in annulus fibrosus of rats with lumbar degenerative desease. It is suggested that the mechanism may be to regulate the expression of related factors in the β-catenin signaling pathway, so as to achieve the goal of treating lumbar degenerative diseases.

Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice / 中国中药杂志

Cheezheng Xiaotong Tiegao is a Tibetan traditional prescription,which has the functions of promoting blood circulation,relieving swelling and relieving pain. It has been widely used in various clinical departments such as orthopedics department,rheumatology department,pain management department,and rehabilitation department to treat all types of acute and chronic skeletal muscle pain. However,duet to the lack of detailed description of the specific use of various diseases in its manual,and in the published guidelines,monographs,and clinical reports,the introduction of the dominant clinical disease,usage,treatment,safety,etc. of Cheezheng Xiaotong Tiegao is not detailed. Therefore,this experts consensus statement has been prepared based on the research and analysis of clinicians and patients,evidence-based medical research and evaluation,combined with the experience of clinical experts. The experts consensus statement regulates usage,dosage,combination,safety,etc. in the treatment of acute and chronic contusion( soft tissue injury),osteoarthritis,low back pain,frozen shoulder,cervical spondylosis postoperative recovery pain and other pain relief and other skeletal muscle system diseases to provide evidence and reference for the rational and safety using of Cheezheng Xiaotong Tiegao.

Treatment of knee osteoarthritis with six-step manipulation combined with extracorporeal shock wave / 中国骨伤

OBJECTIVE@#To observe the clinical effect of six-step manipulation combined with extracorporeal shock wave in the treatment of knee osteoarthritis.@*METHODS@#Seventy-six patients with KOA from December 2016 to June 2018 were divided into control group and treatment group, 38 in each group. The patients in the control group were treated with oral medicine combined with extracorporeal shock wave therapy, while the patients in the treatment group were treated with six-step manipulation combined with shock wave therapy. The VAS score, WOMAC score and clinical efficacy of the two groups were compared before treatment, 1 day, 1 month and 6 months after treatment.@*RESULTS@#There was no significant difference in VAS score and WOMAC score between the two groups before treatment(>0.05). VAS score and WOMAC score in treatment group were significantly lower than those in control group at 1 day, 1 month and 6 months after treatment, and the difference was statistically significant(<0.05).@*CONCLUSIONS@#Six-step manipulation combined with extracorporeal shock wave therapy can significantly alleviate pain and improve knee function in patients with knee osteoarthritis, and the clinical effect is obvious.

Preparation instructions for Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice / 中国中药杂志

As a topical plaster developed by modern pharmaceutical technology based on traditional Tibetan medicine,Cheezheng Xiaotong Tiegao has functions of promoting blood circulation,relieving swelling and relieving pain. Since its introduction in 1993,it has been widely used in the treatment of various types of acute and chronic musculoskeletal pain and various types of spinal,joint and soft tissue diseases. In order to better standardize the clinical application and improve the clinical efficacy of Cheezheng Xiaotong Tiegao,the research and development work of the Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice was officially launched on October 19,2017,upon approval from China Association of Chinese Medicine. In this paper,main R&D process and related technical links for the experts consensus on Cheezheng Xiaotong Tiegao would be summarized,which will help the various medical workers understand,master and apply more accurately,and also provide reference for the development of experts consensus on clinical application of other topical Chinese medicines.

Study on the correlative factors of the pain under the second metatarsal in patients with hallux valgus / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the correlation between the hallux valgus angle and arch X-ray parameters change, plantar pressure by measuring the X-ray indexes and foot-pressure indexes in patients with hallux valgus, as well as to study the main cause factors for the pain under the second metatarsal head.</p><p><b>METHODS</b>A retrospective study of 254 patients(477 feet) treated in Wangjing Hospital from January 2012 to June 2013 was performed. The pain under the second metatarsal head and age distribution were recorded. All the patients were divided into two groups according to the second plantar bone pain: pain group and no pain group. The following indexes were measured and compared: HAVA(hallux abductor valgus angle), IMA1-2(the inter-metatarsal angle between the first and second metatarsals), IMA1-5(the inter-metatarsal angle between the first and fifth metatarsals), TAOTMLA (top angle of the medial longitudinal arch), AAOTMLA (anterior angle of the medial longitudinal arch), SMRL (the second metatarsal relative length than the first), and the plantar pressure indicators including TPUM (touch the ground time percentage under the second metatarsal head), PPUM (peak pressure under the second metatarsal head), and IUM(impulse under the second metatarsal head). All the factors were evaluated by Logistic regression analysis.</p><p><b>RESULTS</b>Spearman rank correlation test showed that there were statistical significance in correlation between HAVA and IMA1-2, IMA1-5, TAOTMLA, AAOTMLA, TPUM(<0.05, r=0.647, 0.553, 0.127, -0.165, 0.158). Factors including the HAVA, SMRL and the TPUM were the risks for the pain under the second metatarsal head in patients with hallux valgus(<0.05, ORj=1.030, 1.069, 1.060).</p><p><b>CONCLUSIONS</b>Increase of the hallux valgus angle causes the collapse of hallux valgus arch, extending the weight bearing time of the second metatarsal and increasing the possibility of the pain under the second metatarsal.</p>

Analysis of stability and healing on minimally invasive osteotomy for the treatment of hallux valgus / 中国骨伤

To treat hallux valgus, minimally invasive osteotomy on 1st metatarsal neck,immobilization with "8-shape" bandagev was performed, and the effect was definited. The principles of osteotomy stability were analyzed from the osteotomy position, methods, direction and angle. The grinding drill was used to increase friction coefficient between the ends of osteotomy. Correct direction of osteotomy and suitable angle were the key point of stability. The immobilization with "8-shape" bandage complied with the principle of elastic fixation created the conditions for the slight movement of the osteotomy ends. Compared with internal fixation ,it was better on osteotomy healing,and the osteotomy ends were stable and healed with cartilage

Extracellular splitting pattern of mitochondria and the depressant effects of CsA on the process / 中国骨伤

<p><b>OBJECTIVE</b>To investigate extracellular splitting pattern of mitochondria and the depressant effects of CsA on the process and explore the mechanism of post-traumatic SIRS and its therapeutic strategy.</p><p><b>METHODS</b>Ten male SD rats with 60 to 70 days age and 240 to 280 g weight were used for mitochondrial isolation. Freshly isolated mitochondria were randomly divided into two groups, which were cultured in blood plasma with or without CsA respectively for 8 h. COX and MDH were assayed by ELISA every 30 min. Meanwhile, Rat macrophage cell line NR8383 were treated as follows, control (group A): cultivation with normal medium; NR8383+CsA co-culture group (group B): culture medium was supplemented with CsA of 10 mmol/L; NR8383+intact mitochondria co-culture group (group C): culture medium was supplemented with intact mitochondria (mtDNA=5 g/ml); NR8383+intact mitochondria+CsA co-culture group (group D): culture medium was supplemented with intact mitochondria (mtDNA=5 μg/ml)and CsA of 10 mmol/L; NR8383+disrupted mitochondria co-culture group (group E): culture medium was supplemented with disrupted mitochondria (mtDNA=5 μg/ml); NR8383+disrupted mitochondria+CsA co-culture group (group F): culture medium was supplemented with disrupted mitochondria (mtDNA=5 μg/ml)and CsA of 10 mmol/L. TNF-α and IL-6 concentrations in supernatant were assessed at 1, 3, 5 h after culture.</p><p><b>RESULTS</b>In the mitochondria plasma cultures, MDH and COX levels were increased with the time and peaked at about 3 h and 3.5 h; CsA can delay the appearance of peak to 4.5 h. Among different treated groups,there was no significant difference in TNF-α and IL-6 between group A and group B; there was significant difference in TNF-α and IL-6 other groups. After 1 h culture, compared with group C, no significant difference of TNF-α and IL-6 was observed in group D, while TNF-α and IL-6 were significant higher in group E; after 3 h culture, compared with group C, TNF-α and IL-6 were significantly lower in group D, while TNF-α and IL-6 were significantly higher in group E; after 5 h culture, compared with group C, TNF-α and IL-6 were significantly lower in group D, while no significant difference of TNF-α and IL-6 were observed in group E. At each time point, there was no significant difference in TNF-α and IL-6 between group F and group E.</p><p><b>CONCLUSION</b>Mitochondria can split in serum with time, which will further activate macrophages. CsA has depressant effect to mitochondrial splitting on the process and will therefore inhibit the activation of macrophages.</p>

Case-control study on bone-setting manipulation for the treatment of isolated systolic hypertension combined with cervical spondylosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effect and safety of bone-setting manipulation in treating isolated systolic hypertension combined with cervical spondylosis.</p><p><b>METHODS</b>From January 2012 to January 2015, 320 patients suffered from isolated systolic hypertension combined with cervical spondylosis were randomly divided into treatment group and control group. In treatment group, there were 160 patients including 84 males and 76 females with an average age of (39.82 ± 10.33) years old, average blood pressure was (149.61 ± 10.75)/(81.01± 8.25) mmHg, NPQ score was 24.61 ± 8.14; treated with flexion top spin and lock bone-setting manipulation of cervical spine, once every two days for 20 days. While in control group, there were 160 patients including 90 males and 70 females with an average age of(41.37 ± 9.42) years old, average blood pressure was (151.48 ± 11.32)/ (79.65 ± 9.32) mmHg, NPQ score was 25.78 ± 9.53; treated with manipulation of reposition cervical spine by rotation, once every two days for 20 days. Blood pressure and NPQ score were tested and compared for evaluating clinical effects.</p><p><b>RESULTS</b>Before and after a period treatment, systolic pressure in treatment group was (149.61 ± 10.75) mmHg and (129.67 ± 12.26) mmHg; (151.48 ± 11.32) mmHg and (132.02 ± 11.73) mmHg in control group. After treatment, systolic pressure in both two groups was obviously decreased, and treatment group was better than control group. Before and after a period treatment, diastolic pressure in treatment group was (80.01 ± 8.25) mmHg and (78.15 ± 10.34) mmHg, (79.65 ± 9.32) mmHg and (76.89 ± 9.79) mmHg in control group, and there was no significant difference between two groups. NPQ score in treatment group was 24.61 ± 8.14 before treatment, 12.46 ± 7.94 after treatment, while in control group was 25.78 ± 9.53, 14.17 ± 8.86; NPQ score of the two groups after treatment was better than before treatment, while there was no obviously significance between two groups after treatment. The whole clinical effect in treatment group was better than control group.</p><p><b>CONCLUSION</b>Bone-setting manipulation for isolated systolic hypertension combined with cervical spondylosis at early stage could receive good clinical result, and flexion top spin and lock bone-setting manipulation of cervical spine was better and safety than manipulation of reposition cervical spine by rotation.</p>

Correlative analysis on metatarsalgia and the X-ray measurement indexes under weight-bearing and non-weight-bearing of hallux valgus / 中国骨伤

<p><b>OBJECTIVE</b>To study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of hallux valgus and the pain under the metatarsal head.</p><p><b>METHODS</b>From May 2012 to October 2012, 240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the pian under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle (HVA), the inter-metatarsal angle between the first and second metatarsals (IM1-2), the inter-metatarsal angle between the first and fifth metatarsals (IM1-5), top angle of the medial longitudinal arch (TAOTMLA),and anterior angle of the medial longitudinal arch (AAOTMLA) were measured on the X-ray films. The differences of HVA, IM1-2, IM1-5, TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM1-2, IM 1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed.</p><p><b>RESULTS</b>One hundred and forty-eight feet had the pain under the metatarsal head. The IM1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM 1-2,IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM1-5 and the degree of the pian under the metatarsal head.</p><p><b>CONCLUSION</b>The degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM 1-2,IM 1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has important significance in evaluating the degree of the collapse of the arch of foot with hallux valgus,preventing and curing the the pain under the metatarsal head.</p>

Finite element modeling and mechanical analysis on supination-external rotation ankle injury / 医用生物力学

Objective To simulate the supination-external rotation ankle injury and establish a 3D finite element model of the ankle. Methods Based on CT images of the normal human ankle joint, the 3D model of the ankle with ligaments was established. The supination-external rotation ankle injuries with four different degrees of Lauge-Hanson were analyzed by finite element method. Distributions of the ankle joint stress and tibial articular surface pressure were obtained. Results The maximum stress was at the anterior tibiofibular ligament attachment point of the tibial under supination-external rotation loading. When the anterior tibiofibular ligament was ruptured, the maximum stress was at the interosseous membrane. After the interosseous membrane was ruptured, the high stress was at the posterior ligament of the ankle. When the posterior tibiofibular ligament was ruptured, the high stress was at the deltoid ligament. The high pressure was at the distal fibula or the rear of tibial articular surface. Conclusions The established ankle-foot 3D numerical model can be used for the mechanical analysis of supination-externalrotation ankle injury. The calculated distributions of the ankle stress and the tibial articular surface pressure were in agreement with the description of Lauge-Hanson classification.

Reconstruction of oral soft tissue defects with free anterolateral thigh flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To assess the clinical features and therapeutic efficacy of anterolateral thigh (ALT) flaps for the intraoral defects reconstruction.</p><p><b>METHODS</b>The clinicopathologic data of 67 cases with oral tumors were obtained from School of Stomatology, Nanjing University Medical Center from Dec. 2008 to Dec. 2010. All the patients underwent the simultaneous tumor resection and intraoral defects reconstruction with free anterolateral thigh flaps. The defects included the tongue, buccal, gingival, mouth floor, and so on. The descending branch of lateral femoral circumflex artery was anastomosed to the external maxillary artery or superior thyroid artery; the vein was anastomosed to the common facial vein or external jugular vein. The flaps were divided into three types: musculocutaneous ALT flap, fasciocutaneous ALT flap and thinned ALT flap.</p><p><b>RESULTS</b>There were 38 male patients and 29 female. The anterolateral thigh flaps included 35 musculocutaneous flaps, 17 fasciocutaneous flaps and 15 thinned flaps. The success rate was 98.5% (66/67). Partial necrosis happened in one case with diabetes, which healed after debridement and dressing. 1 flap was totally necrosis. Double venous anastomosis was performed in 41 flaps, and one venous anastomosis was performed in 26 flaps. 8 patients required operative exploration in the perioperative period including 6 flaps with thrombotic events (5 flaps were complete survival after the salvages, and 1 flap was failure) , 1 flap with hematoma, and 1 flap with twisting of perforator. The follow-up period ranged from 2 to 24 months( mean, 8.7 months). The result was satisfied. The donor sites were closed directly in all patients, and the wounds healed uneventfully.</p><p><b>CONCLUSIONS</b>The free anterolateral thigh flap is an ideal soft tissue flap for the intraoral defects reconstruction with good functional result at recipient area and less morbidity at the donor site.</p>

Effects on VEGF and VEGF mRNA expression of the tissues of periosteum in three-period treatment of TCM for the fractures in rabbit / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of the three-period treatment theory of bone fracture in TCM (Traditional Chinese Medicine) on VEGF and VEGF mRNA expression in the issues of outer periosteum, endosteum and bone marrow of rabbits, and to explore the rationality of phasing method in TCM in treating fracture.</p><p><b>METHODS</b>3 mm bone defection were made at lower one third part of both radius in 140 male healthy rabbits. The rabbits were randomly divided into four groups, including three-period treatment group (TTG), one-period treatment group(OTG), positive medicine treatment group(PTG) and model control group (MCG). The rabbits in TG were treated with three-period treatment, rabbits in OTG were treated with one-period treatment, rabbits in PTG were fed by Guzhe-Cuoshangsan (a Chinese patent medicine which was used to treat bone fracture), rabbits in model control group were given no prescription or drug but distilled water as same dose as that of other groups. At day 3, 6, 9, 14, 28, 42 and 56, five rabbits from every group were randomly selected and were killed by aeroembolism. The left radiuses were taken out as the research object. Immunohistochemistry stain and in situ hybridization stain were performed to examinate the VEGF and VEGF mRNA expression in the outer periosteum, endosteum and bone marrow.</p><p><b>RESULTS</b>The VEGF and VEGF mRNA expression of all TCM treatment groups were enhanced in the outer periosteum, endosteum and bone marrow at different time points in fracture healing. The VEGF and VEGF mRNA expression in the three tissues of TTG had the tendency of higher than that of the other groups at the most time points after operation.</p><p><b>CONCLUSION</b>Treating fracture in stages has more predominant effect on the expression of VEGF and VEGF mRNA in the outer periosteum, endosteum and bone marrow than that of treating fracture with single prescription or drug.</p>

Observation of long-term efficacy of visco-supplementation with sodium hyaluronate in treating knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To retrospectively analyze the long-term efficacy of intra-articular injection with sodium hyaluronate for the treatment of knee osteoarthritis.</p><p><b>METHODS</b>From January 2006 to August 2007,120 patients (181 knees) with knee osteoarthritis, (mild 61 knees, moderate 72 knees, severe 48 knees), were treated by intra-articular injection with sodium hyaluronate, 2 ml every week for 5 weeks. The clinical effects were analyzed according to VAS, JOA scoring before treatment, at the 1 month, 1, 2 years after treatment.</p><p><b>RESULTS</b>(1) VAS scores were respectively (7.26 +/- 1.83), (1.85 +/- 1.21), (2.54 +/- 1.40), (3.07 +/- 1.51) scores before treatment, at the 1 month, 1 and 2 years after treatment. There was significant difference between every post-treatment and pre-treatment. (2) JOA scoring of knee function was respectively (18.7 +/- 6.6), (84.3 +/- 15.5), (75.4 +/- 22.4), (64.8 +/- 25.6) scores before treatment, at the 1 month, 1 and 2 years after treatment. There was significant difference between every post-treatment and pre-treatment. (3) Assessment of long-term efficacy among 181 knees who were followed up 1 year, 70 cases got excellent results, 54 good, 34 fair and 23 poor. Those who were followed up 2 years,40 cases got excellent results, 54 good, 53 fair and 34 poor. Knee function became poor along with time-lapse. The efficiency was respectively 86.89% (53/61), 79.17% (57/72), 54.17% (26/48) in mild knees, moderate knees, severe knees at the 2 years after treatment.</p><p><b>CONCLUSION</b>The long-term efficacy of intra-articular injection with sodium hyaluronate is satisfactory in treating knee osteoarthritis. The efficacy is better for mild and moderate osteoarthritis than for the severe osteoarthritis. The short-term efficacy is acceptable and the long-term one is worse for the severe knees.</p>

Case control study of hook needle knife for the treatment of stenosing tenovaginitis of flexor digitorum / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect and safety of the hook needle knife for the treatment of stenosing tenovaginitis of flexor digitorum.</p><p><b>METHODS</b>From September 2007 to September 2008, 60 outpatients with stenosing tenovaginitis of flexor digitorum were randomized divided into the treatment group and the control group, 30 cases in each group. Among the patients, 44 patients were female and 16 patients were male, aged from 34 to 69 years, averaged 56 years, the duration of disease ranged from 1 month to 1 year, averaged 3 months. All the patients were treated with hook needle knife and local-blocking respectively. The patients were followed up for 6 months, and the relief of moving-pain, tender-pain, stretching-pain and resist-ing--pain were observed respectively. All the patients were evaluated by the symptoms with numerical rating scale.</p><p><b>RESULTS</b>The relief of moving-pain, tender-pain, stretching-pain and resisting-pain in the treatment group were significantly better than those of the control group; and the therapeutic effects of treatment group were better than those of the control group.</p><p><b>CONCLUSION</b>The method for treating stenosing tenovaginitis of flexor digitorum with hook needle knife has advantages of definite effects, micro-invasion and safety.</p>

Swanson double-stem silicone implant arthroplasty in the treatment of Freiberg disease / 中国骨伤

<p><b>OBJECTIVE</b>To observe the short-term results of Swanson double-stem silicone implant arthroplasty in the treatment of late stage Freiberg disease.</p><p><b>METHODS</b>From July 2006 to December 2007, Swanson double-stem silicone implant arthroplasty was performed on 13 patients, 11 male (1 foot) and 12 females (17 feet), suffering from late stage Freiberg diseases. All the cases were the second metatarsophalangeal joints. According to the Smillie classification, 11 feet present with grade 4 osteonecrosis, 7 feet with grade 5. The AOFAS scoring system was used for clinical assessment. All the patients were followed up for an average of 11.3 months (3 to 17 months).</p><p><b>RESULTS</b>The mean preoperative and postoperative AOFAS scores were (50.06 +/- 9.59) and (77.50 +/- 4.99), respectively (P<0.05). The complaint of pain with joint motion was decreased in all patients. The postoperative passive range of motion of joints improved significantly.</p><p><b>CONCLUSION</b>Swanson double-stem silicone implant arthroplasty yields satisfied short-term results in late stage Freiberg disease, which is effective to improve range of motion and relieve pain of joint.</p>

Comparison study on polymerase chain reaction (PCR) and standard culture technique in detecting mycobacterium tuberculosis to diagnose of joint tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To study the role of PCR technique in detection of mycobacterium tuberculosis in the samples from joint tuberculosis, and to evaluate the clinical value of PCR in diagnosis of joint tuberculosis.</p><p><b>METHODS</b>From June 1993 to August 2001, PCR was used to detect DNA of mycobacterium tuberculosis, and the standard culture was applied to detect mycobacterium tuberculosis. Mycobacterium tuberculosis were respectively blindly by the two techniques in the samples obtained from 95 patients with joint tuberculosis (55 males and 40 females, the age ranging from 2 to 75 years, with an average of 34 years). The positive rate of mycobacterium tuberculosis detection was calculated.</p><p><b>RESULTS</b>In the detection of mycobacterium tuberculosis, positive rate was 82% (78/95) in PCR technique, and 16% (15/95) in standard culture technique. There were statistical differences between the two groups (chi2=67, P<0.001). The whole process of PCR amplification was automatic and could be finished within several hours, and the detecting time was considerably shorter.</p><p><b>CONCLUSION</b>PCR technique is a rapid, simple, sensitive and specific method for detection of mycobacterium tuberculosis in the samples of joint tuberculosis, showing more marked advantages than the standard culture technique. It is valuable in the early rapid diagnosis and differential diagnosis of joint tuberculosis.</p>

Application of titanium mesh and free forearm flap for reconstruction of maxillary defect resulted from tumor resection / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of titanium mesh and free forearm flap for reconstruction of maxillary defect resulted from tumor resection.</p><p><b>METHODS</b>From 2004 to 2008, 19 cases with maxillary tumor underwent tumor resection. The defects were reconstructed immediately with titanium mesh for bony defects and free forearm flap for oral mucosa defects.</p><p><b>RESULTS</b>16 cases achieved satisfactory functional and cosmetic results. The speech assessment was good without oronasal reflux. The titanium mesh was exposed and infected in 3 cases. Then the meshes were taken out and the defects were covered with the forearm flap to close the oronasal fistula. The midface was slightly depressed with no functional morbidity.</p><p><b>CONCLUSIONS</b>It is simple and practical to reconstruct maxillary defect with titanium mesh and free forearm flap. Both the functional and cosmetic results are satisfactory.</p>

Treatment of capsulitis of little toe with minimal incisional osteotomy and manipulations / 中国骨伤

<p><b>OBJECTIVE</b>To study therapeutic effects of capsulitis of little toe treated with minimal incisional osteotomy and manipulations procedures.</p><p><b>METHODS</b>From 2003.7 to 2008.6, 90 patients (160 feet) with capsulitis of little toe including 3 male (5 foot) and 87 female (155 foot) ranging in age from 17 to 76 years(average of 49.2 years).The average medical history was 10.1 years ranging from 1 to 32 years. All patients with capsulitis of little toe were treated with minimal incisional osteotomy and manipulations procedures adopting the modified Coughlin standard to evaluation.</p><p><b>RESULTS</b>All patients were followed up, the duration of follow-up raunged from 3 to 36 months with averagement of 15.7 months. According to the modified Coughlin standard, 80 cases obtained an excellent result, 8 good, 2 fair and 0 poor, the effective rate was 97.8%. However,two patients were found delayed union after operation, the distal fragments healed following the time of fixation were delayed.</p><p><b>CONCLUSION</b>The treatment of capsulitis of little toe with minimal incisional osteotomy and manipulations procedures is easy to operate and its therapeutic effect is convincing.</p>

Observation on pathological changes of the medial aspect of the first metatarsal head of hallux valgus / 中国骨伤

<p><b>OBJECTIVE</b>To observe pathological characteristic of bone and soft tissue of the medial aspect of the first metatarsal head in order to investigate the pathogenesis of hallux valgus.</p><p><b>METHODS</b>One hundred and twenty-three patients with hallux valgus (235 feet) were obtained from August 2003 to December 2004 in our department. The bone and soft tissue of the medial aspect of the first metatarsal head were taken out from the incision. The pathological conditions of specimen were observed by HE stain.</p><p><b>RESULTS</b>The pathological changes included: degeneration and desmoplasia around the attachment point of tendon and joint capsule, reactive hyperplasia of periost, decreasing of bone trabecula, cartilaginification of periost, cortical bone and tendon insertion, bone formation and osteoclasts response.</p><p><b>CONCLUSION</b>The pathological changes of the medial aspect of the first metatarsal head of hallux valgus presented extensive chronic inflammation.</p>