Outcomes of Radiotherapy for Osseous Echinococcosis of Meriones meridianus.

BACKGROUND: Osseous cyst echinococcosis (CE) is an infectious disease that causes disability and deformity in patients, yet there is still no satisfactory treatment. Focusing on the feasibility and prognosis of radiotherapy as an adjuvant or palliative treatment for osseous CE, this study investigated the outcome of Meriones meridianus with osseous CE after radiotherapy. METHODS: The study utilized a comparison control group design with three groups of gerbils, and 240 osseous CE gerbils were randomly divided into control, 40Gy/5times, and 50Gy/5times groups. Different doses of radiotherapy were given to the gerbils, and then, the effects of radiotherapy on gerbils and lesions were observed at 3 and 6 months after radiotherapy. Statistical analysis was done using χ 2 test, unpaired t-test, and one-way ANOVA. RESULTS: Significant changes (P < 0.05) were achieved between the three groups in terms of seven parameters at 3 and 6 months, including the number of dead gerbils and lesion sites with ulceration and infection, number of dead scolices, protein content, Ca2+ concentration, the maximum diameter of lesion site, and wet weight of cysts. Except for the number of dead gerbils and lesion sites with ulceration and infection, all other parameters were observed a big difference between 3 months and 6 months in the 50Gy/5times group. CONCLUSION: Radiotherapy at a dose of 50 Gy has inhibitory and therapeutic effects on osseous CE in gerbils, and radiotherapy could probably be a treatment option for persistent or recurrent osseous CE.

Treatment of femoral intertrochanteric fractures by reduction without a traction table in a special position and fixation with proximal femoral nail antirotation (PFNA) / 中华创伤骨科杂志

Objective To study the treatment of femoral intertrochanteric fractures by reduction without a traction table in a special position and fixation with proximal femoral nail antirotation (PFNA).Methods From May 2016 to May 2017,34 patients with femoral intertrochanteric fracture were treated with PFNA.They were 20 men and 14 women,from 36 to 89 years of age (average,69.9 years).The left side was affected in 15 cases and the right side in 19.By AO classification,there were 10 cases of type AO 31-A1,13 ones of type 31-A2,and 11 ones of type 3 l-A3.Two cases were complicated with other fractures,and 5 with internal system disease,3 of whom had more than 2 concomitant diseases.Preoperative deep venous thrombosis was found in 2 cases.Surgery was performed for them between 2 and 8 days after injury (average,3.7 days).Reduction was performed in a special position without a traction table.The duration of anesthesia,operation time,intraoperative hemorrhage,postoperative complications and hip function by Harris scores were recorded.Results For the 34 patients,the anesthesia time ranged from 57 to 85 min (average,67.5 min),the operation time ranged from 28 to 65 min (average,40.9 min),and the intraoperative hemorrhage from 80 to 150 mL (average,110.6 mL).They received effective follow-up for 6 to 12 months (average,8.4 months).All the fractures healed after 6 to 12 months(average,7.2 months).No failure of internal fixation was observed during follow-ups.By the Harris scores at the final follow-up,the function of the affected hip was rated as excellent in 9 cases,as good in 21 and as fair in 4,giving an excellent to good rate of 88.2％.Conclusion In the treatment of femoral intertrochanteric fractures,reduction without a traction table in a special position and PFNA fixation may reduce anesthesia time,leading to satisfactory clinical outcomes.

Interlocking intramedullary nail versus plate for distal femoral fractures in adults:a meta-analysis / 医学研究生学报

Objective Along with the development of science and technology , increase in the number of species gradually distal femoral fractures internal fixation materials , the choice of performer operation method is put forward to the test .To provide theo-retical basis for surgery of adult distal femoral fractures by systematically compare the distal femoral fractures in adults treated by intr -amedullary nail and plate . Methods We searched for articles comparing intramedullary nail and plate for distal femoral fractures in adults in Cochrane library, HighWire, CNKI, PubMed, super star MedaLink, Wanfang database.Manual retrieval related magazines, the retrieve date from June 2003 to June 2013.The RevMan5.1 provided for the extraction of available data after evaluate the quality of eligible literature . Results A total of 1200 patients were included ( 545 in the intramedullary nailing group and 655 in the plate group).Compared with the plate, intramedullary nail significantly reduced the risk of total complications (RR=0.48,95%CI[0.35, 0.67],P<0.01).Shorten the hospital stay (WMD =-3.55,95%CI[ -4.89, -2.24], P <0.01),full weight-bearing time (WMD=-0.80,95%CI[-1.49,-0.10],P=0.02), healing time(WMD=-3.32,95%CI[ -3.72,-2.92],P<0.01), all the above differences are statistically significant .In addition, this study found that intramedullary nail group is better in operation time and blood loss than steel group , but the conclusion by contrast in some literature . Conclusion Intramedullary nailing treatment of distal femoral fractures in adults can decrease the occurrence of postoperative complications .And in the operation time , hospitalization time, healing time, load time and blood loss, etc is superior to the steel group .Influenced by quality into literature , the above conclu-sion needs high quality case-control study further confirmed .