[Clinical research of modified taohe chengqi granule combined mannitol for treating complicated edema in affected limbs of patients after tibiofibulas double fracture operation].

OBJECTIVE: To observe the therapeutic efficacy of Modified Taohe Chengqi Granule (MTCG) combined mannitol for treating complicated edema in affected limbs of patients after tibiofibulas double fracture operation (TDFO). METHODS: Totally 64 TDFO patients complicated edema were randomly assigned to the treated group and the control group, 32 in each group. Those in the treated group took MTCG combined intravenous dripping of mannitol, while those in the control group received intravenous dripping of mannitol alone. The treatment course was 1 week. The clinical efficacy, the onset time, the swelling degree, and the pain index were observed and compared between the two groups. RESULTS: One week after operation, the effective rate was 98.0% and the markedly effective rate was 87.5% in the treated group, while they were 78.0% and 56.9% respectively in the control group. Better results were obtained in the treated group, showing statistical difference when compared with the control group (P < 0.05). As for the onset time for swelling subsiding, it was (2.4 +/- 1.3) days in the treated group and (3.8 +/- 2.9) days in the control group. There was statistical difference between the two groups (P < 0.05). Better effects on the swelling subsiding degree and the pain index were obtained in the treated group, showing statistical difference when compared with the control group (P < 0.05). CONCLUSIONS: MTCG combined mannitol could obviously abate the edema in affected limbs of patients after TDFO. It was a better treatment method for managing edema in the peri-operative period of orthopedics.

Clinical significance of microRNA-93 downregulation in human colon cancer.

AIM: MicroRNA-93 (miR-93) has been shown to suppress proliferation and colony formation of colon cancer stem cells. The aim of this study was to examine the expression pattern and prognostic value of miR-93 in patients with colon cancer. MATERIALS AND METHODS: A quantitative real-time PCR analysis was carried out to detect the expression levels of miR-93 in 138 paired samples of tumoral and nontumoral colon tissues diagnosed with colon cancer. Associations of miR-93 expression with clinicopathological parameters and survival were also examined. RESULTS: miR-93 expression was significantly decreased in tumoral compared with nontumoral colon tissues (P<0.001). Low miR-93 expression was significantly correlated with advanced tumor stage (P=0.02), positive nodal metastasis (P=0.006), and positive distant metastases (P=0.01). In addition, Kaplan-Meier survival analysis by Cox regression showed that low miR-93 expression [hazard ratio (HR), 10.2; 95% confidence interval (CI), 1.9-42.8, P=0.003] was associated closely with poor overall survival in patients with colon cancer. Moreover, multivariate analysis showed that miR-93 decreased expression (HR, 4.3; 95% CI, 0.8-17.2, P=0.02), advanced tumor stage (HR, 3.1; 95% CI, 0.2-13.9, P=0.04), positive nodal metastasis (HR, 4.1; 95% CI, 0.7-16.8, P=0.02), and positive distant metastases (HR, 3.7; 95% CI, 0.5-14.1, P=0.03) were independent risk factors for overall survival in patients with colon cancer. CONCLUSION: Our data show for the first time that the downregulation of miR-93 was significantly correlated with unfavorable clinicopathologic features and short overall survival in patients with colon cancer, suggesting that decreased expression of miR-93 be used as a novel prognostic factor for this disease.

Tumor associated glycoprotein-72 is a novel marker for poor survival in hepatocellular carcinoma.

To investigate the relationship of tumor associated glycoprotein-72 (TAG-72) expression with clinicopathological features in hepatocellular carcinoma (HCC) patients. Sixty pairs of HCC and paracarcinomatous (PCLT) tissues, and 10 normal liver (NL) tissues were collected for Western blot analysis, and 244 pairs of HCC and PCLT tissues were collected for immunohistochemistry analysis. TAG-72 protein expression was elevated significantly in HCC tissues compared with PCLT and NL tissues. Its increased expression was correlated with TNM stage, Edmondson-Steiner grade, vein invasion and multiple tumor nodes. It is noteworthy that the HCC patients with high TAG-72 expression had shorter overall survival and disease-free survival than the patients with low expression. Multivariate Cox regression analysis revealed that TAG-72 expression was an independent prognostic factor for HCC patients. The current study demonstrated for the first time that the increased expression of TAG-72 was correlated with poor survival in patients with HCC, indicating that TAG-72 is a novel prognostic marker for HCC.

[Outcomes of surgeries for acute cervical spinal cord injury without cervical spine fracture or dislocation in young and middle-aged patients].

OBJECTIVE: To study the outcomes of surgeries for acute central cervical spinal cord injury without cervical spine fracture or dislocation in young and middle-aged patients. METHODS: The clinical data of 58 young and middle-aged patients with acute central cervical spinal cord injury treated in our hospital between August 2005 and August 2009 were analyzed retrospectively. Of these patients, 33 (24 males and 9 females) received surgical treatment and 25 (17 males and 8 females) had conservative therapy. The ASIA grade and ASIA motor and sensory score were used for evaluation at admission and at 14 days and 1 year after the treatment. The neurological symptoms and treatment outcomes in the two groups were evaluated. RESULTS: The proportion of patients with ASIA grade D-E and the ASIA motor and sensory scores were all significantly higher in the surgical group than in the non-surgical treatment group (P<0.05). CONCLUSION: For young and middle-aged patients with central cervical spinal cord injury, immediate surgery can relieve the pressure on the injured spinal cord and improve the micro-circulation to promote functional recovery of the spinal cord.

[Infection of intervertebral space and the interventional therapy].

OBJECTIVE: To investigate the effect of interventional therapy in the treatment of intervertebral space infection. METHODS: The needle was punctured into the infected intervertebral space from the post-lateral side of the spine monitored by X-rays. The pus was drained, the degenerative disc tissues and necrosis tissues were excised and taken out, and at the end a drainaging catheter was put into the space through the needle. The patient should lie in bed absolutely. The antibiotics was injected into the space through the silicon catheter every day. Three to four weeks later, the catheter was removed. RESULTS: All the 8 patients got good results after the therapy. The low back pain was dramatically alleviated instantly at the day of operation. Erythrocyte sedimental rate gradually descended. After 3 approximately 4 weeks of treatment,the catheter was removed. CONCLUSION: Interventional therapy of the intervertebral space infection has notable advantage over the open operation.

One-stage surgical management for multilevel tuberculous spondylitis of the upper thoracic region by anterior decompression, strut autografting, posterior instrumentation, and fusion.

STUDY DESIGN: A retrospective clinical study of 1-stage surgical management for multilevel tuberculous spondylitis of the upper thoracic region (MTSUTR). OBJECTIVE: MTSUTR has rarely been documented in the literature. We present a retrospective clinical study of 23 patients with MTSUTR treated by anterior decompression, strut autografting, posterior instrumentation, and fusion. The purpose was to determine the clinical efficacy of such surgical treatment for MTSUTR. SUMMARY OF BACKGROUND DATA: It is considered safe and effective to treat surgically tuberculous spondylitis with local spinal cord compression. Many reports have documented a good clinical efficacy of surgical management for spinal tuberculosis. However, how to deal with MTSUTR is rarely reported in the literature. METHODS: There were 14 men and 9 women, with average age of 35 years. All patients underwent 1 stage anterior debridement, strut autografting, and posterior instrumentation and received combined medication antituberculosis chemotherapy for 12 to 24 months (average 18 mo). The following data were followed up for an average period of 42 months (24 to 60 mo) in these patients: deformity angle, neurologic function, and spinal bony fusion. RESULTS: The average preoperative deformity angle was 44 degrees, correcting to 20-degree postoperatively and 24 degrees at final follow up. In the series, 19 patients with preoperative neurologic deficit restored by 1.3 grades according to Frankel. All patients got bony spinal fusion within 6 months postoperatively. There was no recurrent tuberculous infection. CONCLUSIONS: Single-stage anterior debridement, strut autografting, posterior instrumentation, and fusion proved safe and effective for MTSUTR, which can achieve goals of complete spinal cord decompression and good deformity correction.

[Preliminary study on treating patellar instability guided by arthroscopy].

OBJECTIVE: To explore the operation method in treating patellar instability guided by arthroscopy and to evaluate its therapeutic effects. METHODS: Thirty-two patients (34 knees) with patellar instability including 2 patellar tilt (2 knees), 26 (27 knees) patellar subluxation, and 4 (5 knees) patellar dislocation, diagnosed by clinical and arthroscopical standard, were treated with anterior transfer of the gracilis or medial transfer of the tibial tuberosity based on the lateral retinacular release and medial tightening. RESULTS: Twenty-eight patients were followed up for 5-87 (mean 36.6) months. The excellence rates was 92.8%. CONCLUSION: The patellofemoral alignment can be seen directly and dynamically under the arthroscopy. The combinational treatment including anterior transfer of the gracilis in repairing patellar instability can avoid the recurrence effectively and get satisfactory results.

[Clinic and pathology of the knee menisci injury with sclerosis denaturalization].

OBJECTIVE: To summarize the characteristics of clinic and pathology of the knee menisci injury with sclerosis denaturalization and to discuss the mechanism of the sclerosis and its clinic significance. METHODS: We retrospectively analyzed the diagnosis and treatment and healing of the knee menisci with the sclerosis denatured injury from 1989 to 2003. The changes of the partial meniscus with sclerosis denaturalization were observed in tissue section. RESULTS: Menisci with sclerosis denaturalization occupied 24.1%, and 77.6% of them subordinated to simple sclerosis denaturalization without tear. Their characteristics were that the manifestations were not except typical knee pain, tenderness at joint line,integrity shape with dull or less lubricity and tiny grand on the super face of menisci under the arthroscopy,and trembles could be touched by a probe. Pathology showed the formation of local sclerosis with the histological changes of fibro-hyperplasia, hyaline degeneration and mucous degeneration in the menisci. No operation obtained curative effects. Symptoms can be eliminated by the excision of the menisci with sclerosis denaturalization. CONCLUSION: The clinic of simple meniscus injury with sclerosis denaturalization are non-typical and arthroscopic check-up is valuable for the diagnosis. The menisci can be removed from the patients suffered from heavy symptoms for a long time.