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Chen B.-Z.,Sichuan Provincial Hospital for Women and Children | Tan L.,University of Sichuan | Zhang L.,Sichuan Orthopaedic Hospital | Shang Y.-C.,University of Sichuan
Journal of Clinical Anesthesia | Year: 2013

Study Objective: To test the hypothesis that muscle relaxant is not necessary in patients who are undergoing laparoscopic gynecological surgery with a ProSeal Laryngeal Mask Airway (ProSeal LMA™). Design: Prospective, randomized study. Setting: Operating room of Sichuan Provincial Hospital for Women and Children. Patients: 120 adult, ASA physical status 1 and 2 women, aged 18 to 55 years. Interventions and Measurements: Patients were randomly assigned to two groups (n=60) to receive a muscle relaxant (Group MR) or not (Group NMR). General anesthesia was used in patients of both groups for airway management with the ProSeal LMA. Peak airway inflation pressures, airway sealing pressure, minimum flow rate, and recovery time were assessed. Surgical conditions were assessed by the operating gynecologist. The frequency of sore throats was recorded. Main Results: ProSeal LMA insertion was 100% successful. Patients' lungs were ventilated with a maximum sealing pressure of 32 ± 5.1 cm H2O (Group MR) or 31 ± 4.9 cm H2O (Group NMR) (P = 0.341). The seal quality in both groups permitted the use of low flows: 485 ± 291 mL/min in Group MR and 539 ± 344 mL/min in Group NMR (P = 0.2). Surgical conditions were comparable between the two groups. There was no difference in the frequency of sore throats (20% vs 21.7%; P = 0.28). In Group NMR, there was a statistically significant reduction in recovery time versus Group MR (4.5 ± 2.6 min vs 10.3 ± 4.2 min; P < 0.01). Conclusion: Muscle relaxant is not necessary in general anesthesia with a ProSeal LMA. © 2013 Elsevier Inc. All Rights Reserved.

Hu X.,Sichuan Orthopaedic Hospital
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery | Year: 2012

To investigate the method and effectiveness of operative treatment of anterior olecranon fracture-dislocation. Between January 2007 and December 2010, 10 cases of anterior olecranon fracture-dislocation were treated. There were 6 males and 4 females with an average age of 46.1 years (range, 27-68 years). The injury was caused by traffic accident in 7 cases, falling from height in 2 cases, and falling in 1 case. Nine cases were fresh fracture and 1 case was old fracture. There were 9 cases of ulnar olecranon comminuted fracture and 1 case of simple oblique fracture. Associated fractures were Regan-Morrey type III coronoid process fractures in 5 cases, Mason type II radial head fracture in 1 case, and Mason type III radial head fracture in 1 case. Open reduction and internal fixation were performed in all cases: reconstruction plates were used in 4 cases, tension band and reconstruction plates in 5 cases, and tension band and one-third tubular plate in 1 case; bone graft was performed in 2 cases. All incisions healed by first intention. The patients were followed up 12-26 months (mean, 19.8 months). The X-ray films showed that fractures healing was achieved at 12-24 weeks (mean, 16.4 weeks). No failure of internal fixation, ulnohumeral joint instability, or traumatic arthritis occurred. At last follow-up, the elbow function score was 69-100 (mean, 89.1) according to the Broberg-Morrey evaluation criteria; the results were excellent in 4 cases, good in 4 cases, and fair in 2 cases with an excellent and good rate of 80%. The Disability of Arm-Shoulder-Hand (DASH) score was 0-22 (mean, 9). The visual analogue score (VAS) was 0-3 (mean, 0.5). For anterior olecranon fracture-dislocation, an early and stable anatomic reconstruction of the trochlear notch of the ulna with plates and early active mobilization are given, the good functional results can be obtained.

Chen K.-Y.,Sichuan Orthopaedic Hospital | Cao W.-J.,Sichuan Orthopaedic Hospital | Zhang M.-Y.,Xinjiang Medical University
Chinese Journal of Tissue Engineering Research | Year: 2015

BACKGROUND: There is always a controversy about nonsurgical and surgical repair of acute Achilles tendon rupture. Except retrospective analysis, there is a lack of high-level evidence-based medicine data. OBJECTIVE: To systemically evaluate the clinical effectiveness of the nonsurgical versus surgical treatment for acute closed rupture of the Achilles tendon. METHODS: The randomized controlled trials about the nonsurgical versus surgical treatment for acute Achilles tendon rupture were searched in PubMed, EMbase, CBM, CNKI, Ovid, and WanFang Data by computer as well as in relevant journals by hand, which were reported before February 2014. The Cochrane Library (Issue 1, 2014) was also retrieved. Two reviewers independently screened studies, extracted data, and evaluated the methodological quality according to the inclusion and exclusion criteria. Then Meta-analysis was conducted using RevMan 5.2 Software. RESULTS AND CONCLUSION: Nine randomized controlled trials were included, and totally 874 patients were involved, 441 cases in the nonsurgical group and 433 in the surgical group. The results of Meta-analysis showed that compared with the surgical group, the incidence of complications was lower [OR=0.41, 95%CI(0.26, 0.63), P < 0.000 1], but the rate of tendon re-rupture [OR=2.86, 95%CI(1.62, 5.02), P=0.000 2] and incidence of cicatricial adhesion [OR=0.07, 95%CI(0.03, 0.19), P < 0.000 1] were higher in the nonsurgical group. However, there were no significant differences between the two groups in patient satisfaction, superficial infection, motionrecovery, and deep infection. Compared with the surgical treatment, the nonsurgical treatment can reduce the incidence of complications, but has a higher incidence of re-rupture. Because of sample-size and methodological quality restrictions, this conclusion needs further verification of large-sample, multicenter, and high-quality randomized controlled trials. © 2015, Chinese Journal of Tissue Engineering Research.All rights reserved.

Liu J.,Sichuan Orthopaedic Hospital | Tang J.,Sichuan Orthopaedic Hospital | Liu H.,Sichuan Orthopaedic Hospital
Orthopaedic surgery | Year: 2014

OBJECTIVE: To systematically compare the fusion rate and safety of lumbar interbody fusion using one cage versus two cages for the treatment of degenerative lumbar spinal diseases.METHODS: All randomized controlled trials (RCTs) and comparative observational studies written in English comparing the outcome of lumbar interbody fusion using one or two cages in patients with degenerative lumbar spinal diseases were identified by a comprehensive search of PubMed Central, MEDLINE, EMBASE, BIOSIS and the Cochrane Central Registry of Controlled Trials. An exhaustive electronic search up to July 2013. The quality of the methodology was assessed and relevant data retrieved independently by two reviewers, after which the resultant data were subjected to meta-analysis. All meta-analyses were performed using Review Manager 5.0, which is recommended and provided by the Cochrane Collaboration.RESULTS: Our systematic search yielded 745 studies from the selected databases. After duplicate studies had been identified and the titles and abstracts screened, 736 studies were excluded because they were irrelevant to our topic. The full texts of the remaining nine potentially relevant references were comprehensively evaluated and four excluded for the following reasons: two studies involved co-interventions and the other two lacked control groups. Two relevant RCTs and three comparative observational studies involving 384 patients and 501 spinal segments with at least one year follow-up were identified. Analysis of the pooled data demonstrated no significant difference in fusion rate between the one-cage and two-cage groups. However, intraoperative blood loss and operating time were less and the complications rate lower in the one-cage group.CONCLUSION: In patients with degenerative lumbar spinal diseases, lumbar interbody fusion using one cage has an equal fusion rate and is safer compared with using two cages. However, because this meta-analysis had some limitations, more high quality RCTs are needed to strengthen the evidence. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Chen H.,Sichuan Orthopaedic Hospital | Hu X.,Sichuan Orthopaedic Hospital | Yang G.,Sichuan Orthopaedic Hospital | Xiang M.,Sichuan Orthopaedic Hospital
European Journal of Trauma and Emergency Surgery | Year: 2015

Abstract: Introduction: Minimal invasive plate osteosynthesis (MIPO) is one of the most important techniques in the treatment for humeral shaft fractures. This study was performed to evaluate the efficacy of MIPO technique for the treatment for humeral shaft fractures. Abstract: Materials and methods: We retrospectively evaluated 128 cases with humeral shaft fractures that were treated with MIPO technique from March 2005 to August 2008. All the patients were followed up by routine radiological imaging and clinical examinations. Constant–Murley score and HSS elbow joint score were used to evaluate the treatment outcome. Abstract: Results: The average duration of the surgery was 60 min (range 40–95 min) without blood transfusion. All fractures healed without infection. All cases recovered carrying angle except four cases with 10°–15° cubitus varus. After the average follow-up of 23 (13–38) months, satisfactory function was achieved according to Constant–Murley score and HSS elbow joint score. Constant–Murley score was 80 on average (range 68–91). According to HSS elbow joint score, there were 123 cases of excellent clinical outcome and five cases of effective outcome. Abstract: Conclusion: It seems to be a safe and effective method for managing humeral shaft fractures with MIPO technique. © 2015 Springer-Verlag Berlin Heidelberg

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