[Single mini-incision combined with honeycomb titanium plate in treatment of acute acromioclavicular joint dislocation].

OBJECTIVE: To explore clinical effect of single small incision with honeycomb titanium plate in treating acute acromioclavicular dislocation. METHODS: The clinical data of 40 patients with acute acromioclavicular dislocation admitted from December 2019 to December 2021 were retrospectively analyzed and divided into two groups according to different surgical methods. Among them, 20 patients were fixed with single small incision with honeycomb titanium plate (titanium plate group), including 11 males and 9 females, aged from 23 to 65 years old with an average of (47.40±12.58) years old;12 patients on the left side, 8 patients on the right side;11 patients with type Ⅲ, 3 patients with type Ⅳ, and 6 patients with type Ⅴ according to Rockwood classification. Twenty patients were fixed with clavicular hook plate (clavicular hook group), including 8 males and 12 females, aged from 24 to 65 years old with an average of (48.40±12.08) years old;12 patients on the left side, 8 patients on the right side;10 patients with type Ⅲ, 2 patients with type Ⅳ, and 8 patients with type Ⅴ according to Rockwood classification. Operative time, incision length, intraoperative blood loss, hospital stay, visual analogue scale (VAS) and Constant-Murley score of shoulder joint function were compared between two groups. Anteroposterior radiographs of the affected shoulder joint were recorded before, immediately and 6 months after surgery, and the coracoclavicular distance was measured and compared. RESULTS: Both groups of patients were successfully completed operation without serious complications. All patients were followed up for 6 to 15 months with an average of (11.9±4.8) months. There were no incisional infection, internal plant fracture or failure, bone tunnel fracture and other complications occurred. The incision length of titanium plate group (35.90±3.14) mm was significantly shorter than that of clavicular hook group (49.30±3.79) mm (P<0.05). There were no significant difference in operative time, intraoperative blood loss and hospital stay between two groups (P>0.05). At 1 and 3 months after operation, VAS of titanium plate group was lower than that of clavicular hook group (P<0.05). Connstant-Murley scores in titanium plate group at 1, 3 and 6 months after operation were (86.80±1.36), (91.60±2.32) and (94.90±2.22), respectively;and in clavicular hook group were (78.45±5.47), (85.55±2.01) and (90.25±1.92), which were higher than that of clavicular hook group (P<0.05). There was no significant difference in coracoclavicular distance between two groups immediately and 6 months after operation(P>0.05). CONCLUSION: For the treatment of acute acromioclavicular joint dislocation, single small incision combined with honeycomb titanium plate have advantages of shorter incision, fast recovery of shoulder joint function without the second operation, and has good satisfaction of patient.

[Radiological features of AIDS complicated by pulmonary tuberculosis and the association with CD4+ T lymphocytes].

OBJECTIVE: To explore the imaging features in cases with AIDS complicated by pulmonary tuberculosis and the association with CD(4)(+) T lymphocytes. METHODS: A retrospective analysis was carried out of the manifestations of chest X-rays in patients with late stage AIDS complicate by pulmonary tuberculosis (n = 26 cases) and patients with pulmonary tuberculosis only (n = 60 cases). The results of measurements of CD(4)(+) T lymphocytes were compared. RESULTS: (1) The chest X-ray features in patients with AIDS complicated by pulmonary tuberculosis showed more patchy and blurring shadows (53.8% vs 8.3%; P < 0.01), more military changes (23.1% vs 5.0%; P < 0.05), more enlarged intrathoracic lymph nodes (34.6% vs 8.3%; P < 0.01) as well as more extra-pulmonary tuberculous processes (23.1% vs 3.3%; P < 0.05) as compared to patients with pulmonary tuberculosis alone. Fewer upper lung or apical lesions (23.1% vs 76.7%; P < 0.01), as well as less consolidation (11.5% vs 71.7%; P < 0.01) and cavity formation (7.7% vs 30.0%; P < 0.05) were found in AIDS patients. No significant difference was found in the occurrence of hydrothorax (11.5% vs 20.0%; P > 0.05). (2) The relative numbers of CD(4)(+) T lymphocytes in patients with AIDS complicated by pulmonary tuberculosis and in patients with pulmonary tuberculosis alone were (5.0 +/- 6.4)% and (65.3 +/- 1.5)% respectively. Atypical manifestations of tuberculosis were found in 15 out of the 26 cases of AIDS patients showing a CD(4)(+) T lymphocytic count < 50/microl, in 3 of the 4 cases with the count between 50/microl - 100/microl, while in cases with CD(4)(+)T lymphocytic count between 100/microl -200/microl (n = 4) and > 200/microl (n = 2), numbers of atypical tuberculosis were 2 and 0 respectively. CONCLUSIONS: The chest X-ray changes of tuberculosis in cases with late stage AIDS were mostly of the atypical pattern, and were related to a significant decrease in CD(4)(+)T lymphocyte count.

Correlation between imaging features of Pneumocystis Jiroveci Pneumonitis (PCP), CD(4) (+) T lymphocyte count, and plasma HIV viral load: A study in 50 consecutive AIDS patients.

PURPOSE: To investigate the imaging manifestations of Pneumocystis Jiroveci Pneumonitis (PCP) in AIDS patients, and the correlation between imaging features, CD(4) (+) lymphocyte count, and plasma HIV viral load. MATERIALS AND METHODS: A total of consecutive 50 AIDS patients with PCP were reviewed retrospectively. Chest CT manifestations, CD(4) (+) lymphocyte count, and plasma HIV viral load were analyzed to investigate their correlation. RESULTS: PCP chest CT manifestations included ground-glass opacities dominated in 28 cases (28/50, 56%), lung cysts dominated in 10 cases (10/50, 20%), consolidation dominated in 6 cases (6/50, 12%), interstitial lesion dominated in 3 cases (3/50, 6%), and mixed lesions in 3 cases (3/50, 6%). In these 50 patients, CD(4) (+) lymphocyte count ranged from 2 to 373 cells/µL. Plasma HIV viral load ranged from 500 to 5.28×10(7) copies/mL. CD(4) (+) lymphocyte count in ground-glass opacities dominated patients was higher than that of lung cyst dominated patients (P<0.05). Plasma virus load of lung cysts dominated PCP patients was higher than that of consolidation dominated patients (P<0.05). CONCLUSIONS: The typical chest imaging features of PCP in AIDS patients included lung ground-glass opacities and lung cysts. The chest imaging features were correlated with CD(4) (+) T lymphocyte count and plasma HIV viral load.