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Objective To investigate the clinical efficacy of dynamic anterior plate-screw system(DAPSQ)assisted by preoperative digital design in the treatment of acetabular bi-column fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 34 patients with acetabular bi-column fractures admitted to the General Hospital of Central Theater Command from January 2012 to January 2018.There were 24 males and 10 females,aged 21-65 years [(43.0±14.2)years].According to the treatment method,the patients were divided into Group A treated with DAPSQ assisted by preoperative digital design and Group B treated with conventional DAPSQ.Group A was consisted of 17 patients,including 11 males and six females aged 22-64 years [(42.7±12.4)years].Group B consisted of 17 patients,including 13 males and four females aged 21-65 years [(43.2±14.6)years].The operation time,intraoperative blood loss,hospitalization time,fracture healing time,Matta radiological standard score of fracture reduction,Merle d' Aubignre-Postel score and complications were recorded and compared between the two groups.Results All patients were followed up for 12-62 months [(32.8±9.1)months].The operation time [(160.8±38.5)minutes] and intraoperative bleeding [(455.6±190.4)ml] in Group A were significantly less than those in Group B [(216.9±59.5)minutes] and [(780.2±211.6)ml](P＜0.05).There were no significant differences in hospitalization time,fracture healing time,Matta radiological standard score,modified Merle d' Aubignre-Postel score at the last follow-up between the two groups(P＞0.05).In Group A,four patients had traumatic arthritis,with one patient receiving total hip replacement.In Group B,three patients were found with traumatic arthritis,and one with avascular necrosis of femoral head who underwent total hip replacement.None of the two groups had complications such as screws' entry into articular cavity,failure of internal fixation,and incision infection.Conclusions For acetabular bi-column fractures,DAPSQ can effectively maintain the stability of the fracture,without the risk of screws entering the joint cavity,and obtain satisfactory clinical effect.Compared with conventional DAPSQ,preoperative digital design can significantly shorten the operation time and reduce intraoperative bleeding.
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Objective@#To investigate the clinical efficacy of dynamic anterior plate-screw system (DAPSQ) assisted by preoperative digital design in the treatment of acetabular bi-column fractures.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 34 patients with acetabular bi-column fractures admitted to the General Hospital of Central Theater Command from January 2012 to January 2018. There were 24 males and 10 females, aged 21-65 years[(43.0±14.2)years]. According to the treatment method, the patients were divided into Group A treated with DAPSQ assisted by preoperative digital design and Group B treated with conventional DAPSQ.Group A was consisted of 17 patients, including 11 males and six females aged 22-64 years [(42.7±12.4)years]. Group B consisted of 17 patients, including 13 males and four females aged 21-65 years[(43.2±14.6)years]. The operation time, intraoperative blood loss, hospitalization time, fracture healing time, Matta radiological standard score of fracture reduction, Merle d'Aubignre-Postel score and complications were recorded and compared between the two groups.@*Results@#All patients were followed up for 12-62 months [(32.8±9.1)months]. The operation time [(160.8±38.5)minutes] and intraoperative bleeding [(455.6±190.4)ml] in Group A were significantly less than those in Group B [(216.9±59.5)minutes] and [(780.2±211.6)ml] (P<0.05). There were no significant differences in hospitalization time, fracture healing time, Matta radiological standard score, modified Merle d'Aubignre-Postel score at the last follow-up between the two groups (P>0.05). In Group A, four patients had traumatic arthritis, with one patient receiving total hip replacement. In Group B, three patients were found with traumatic arthritis, and one with avascular necrosis of femoral head who underwent total hip replacement. None of the two groups had complications such as screws' entry into articular cavity, failure of internal fixation, and incision infection.@*Conclusions@#For acetabular bi-column fractures, DAPSQ can effectively maintain the stability of the fracture, without the risk of screws entering the joint cavity, and obtain satisfactory clinical effect. Compared with conventional DAPSQ, preoperative digital design can significantly shorten the operation time and reduce intraoperative bleeding.
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Objective To explore the clinical efficacy of internal fixation with dynamic anterior plate-screw system for quadrilateral area(DAPSQ) in the treatment of complex acetabular fractures involving the quadrilateral surface.Methods Between January 2005 and January 2017,a series of 143 patients with complex quadrilateral surface fracture of the acetabulum were treated at Department of Orthopaedics,General Hospital of Central Theater Command.They were 86 males 57 females,with a mean age 46.6 years (range,from 19 to 77 years).By the Letournel-Judet classification,there were 38 anterior column plus posterior hemitransverse fractures,26 T-shaped fractures and 79 double column fractures.They were all closed.The delay from injury to surgery averaged 9.6 days(range,from 3 to 21 days).All the cases were treated with DAPSQ internal fixation via the ilioinguinal approach.Their operation time,intraoperative bleeding volume,quality of fracture reduction,hip function and complications were recorded.Results The operation time for this series ranged from 2.5 to 5.0 hours,averaging 3.8 hours.The intraoperative blood bleeding ranged from 400 to 2,500 mL,with an average of 680 mL.By the Matta criteria for fracture reduction,76 cases were rated as excellent,51 as good and 16 as poor,giving an excellent and good rate of 88.8％.The 143 patients were followed up from 4 months to 10 years (mean,4.1 years).The clinical fracture union was achieved after 2 to 4 months (mean,3 months).By the modified Merle d'Aubigné & Postel criteria,the affected hips scored 9 to 18 points (mean,16.3 points) at the final follow-ups,with 64 excellent,52 good,19 fair and 8 poor cases,giving an excellent and good rate of 81.1％.The postoperative complications included lesion of lateral femoral cutaneous nerve in 7 cases,urinary tract infection in 15 ones,traumatic osteoarthritis in 20 ones 5 of whom had to receive total hip arthroplasty,and heterotopic ossification (Brooker Grade Ⅰ) in 5 ones.Conclusion Internal fixation with DAPSQ is safe and effective for the treatment of complex acetabular fractures involving the quadrilateral surface.
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Objective To investigate the significance of lactate dehydrogenase(LDH) in the diagnosis and treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods This was a study of children with Mycoplasma pneumoniae pneumonia(MPP) admitted to hospital from June 2013 to June 2016.All patients were treated with erythromycin.Based on the definition of RMPP,subjects were divided into usual MPP group and RMPP group.The children in RMPP group were treated with erythromycin combined with methylprednisolone.The indicators including LDH,WBC counts,C-reactive protein,erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),aspartate amino ransferase(AST) and creatine kinase were analyzed between RMPP group and usual MPP group.The differences of the above indicators between the effective and ineffective group before and after methylprednisolone treatment were also compared.Results In total,253 subjects were enrolled,including 161 in the usual MPP group and 92 in the RMPP group.The average age in RMPP group was older than that in the usual MPP group.The indicators(including LDH,AST,ALT,and ESR) of RMPP group were higher than those in the usual MPP group.Logistic regression showed that LDH and ESR were the significant factors in predicting RMPP.The odds ratio(OR) of LDH was 1.029 with 95%CI 1.020-1.037,and the OR of ESR was 1.063 with 95%CI 1.009-1.120.Receiver operating characteristic curve analysis showed that the area under the curve of LDH(400.50U/L) was the largest(0.959,95%CI 0.936-0.983).The administration of methylprednisolone to patients in the RMPP group resulted in the rapid improvement of symptoms and decrease in serum LDH and ESR levels in effective group(P＜0.05).Conclusion Serum LDH may be used as a biomarker to predict RMPP at the early stage,also may be an important marker for the evaluation of therapeutic efficacy in RMPP.
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<p><b>OBJECTIVE</b>To evaluate the effects of an exercise-based treatment programme (dyslexia, dyspraxia and attention-deficit treatment, DDAT) on various subtypes of attention-deficit/hyperactivity disorder (ADHD).</p><p><b>METHOD</b>Ninety-one ADHD children with standing balance dysfunction (ADHD-I 43, ADHD-HI 15 and ADHD-C 33) were given DDAT for 6 months, the efficacy of DDAT was evaluated before DDAT, three, six months after the treatment and three month after end of the treatment according to SNAP-IV, before and after the treatment by balancing function test and Conners Parents Rating Scale.</p><p><b>RESULT</b>Inattention subscale scores of ADHD-I, ADHD-HI and ADHD-C before and after the interventions were 1.99 ± 0.34, 0.96 ± 0.31, 2.17 ± 0.31and 1.19 ± 0.45, 0.81 ± 0.28, 1.32 ± 0.37, differences of ADHD-I and ADHD-C were significant (P < 0.05), hyperactivity subscale scores of three subtypes of ADHD were 0.81 ± 0.35, 2.01 ± 0.35, 1.96 ± 0.33 vs.0.45 ± 0.33, 0.79 ± 0.41, 1.10 ± 0.35, there were significant differences as well (P < 0.05). The score of hyperactivity symptom was reduced more compared to that of inattention symptom by the SNAP-IV scale parent forms. There were significant difference before and after the treatment based on Conners parent scale for conduct problem (1.11 ± 0.48 vs. 0.76 ± 0.44) , learning problem (1.97 ± 0.58 vs.1.60 ± 0.67), psychosomatic problems (0.61 ± 0.49 vs. 0.29 ± 0.35) , activity/ hyperactivity (1.46 ± 0.69 vs.1.09 ± 0.55) and anxiousness (1.05 ± 0.63 vs.0.62 ± 0.47) as well (P < 0.05); the standing balance dysfunction improved for most of the children, total effective rate was 87.9%, no significant difference was found among the three subtypes (P > 0.05).</p><p><b>CONCLUSION</b>DDAT is a safe and efficient intervention for the ADHD children with standing balance dysfunction, the improvement on hyperactivity symptom was better than that on inattention symptom. This study shows that an exercise-based treatment programme for cerebellum function improves symptoms of ADHD and balance function.</p>