ObjectiveTo compare the effectiveness of anterior cruciate ligament (ACL) reconstruction between the ligament advanced reinforcement system (LARS) and bone-patellar tendon-bone (BPTB) autograft. MethodsBetween July 2007 and July 2011, 50 cases (50 knees) of ACL injury were treated with LARS in 24 cases (LARS group) and with BPTB in 26 cases (BPTB group), respectively. There was no significant difference in age, gender, time from injury to surgery, and injury reason between BPTB group and LARS group (P gt; 0.05). The postoperative rehabilitation protocol was performed in 2 groups. ResultsAll incisions healed at the first stage. All patients were followed up 2-3 years. The results of Lachman test, anterior drawer test, and pivot shift test were negative. Screw loosening in femur and tibia occurred in 1 case of each group respectively, anterior knee pain in 2 cases of BPTB group and in 1 case of LARS group. The Lysholm and Tegner scores were significantly higher in LARS group than in BPTB group at 2 and 6 months after operation (P lt; 0.05); but no significant difference was found between 2 groups at 12 and 24 months (P gt; 0.05). The IKDC scores showed no significant difference between 2 groups at different time points after operation (P gt; 0.05). During follow up, KT-1000 arthrometer and knee stability showed significant differences in antedisplacements of the tibia between 2 groups at all time points after operation (P lt; 0.05). ConclusionLARS has less trauma and earlier functional recovery than BPTB autograft for ACL reconstruction, but the long-term effectiveness is similar.
ObjectiveTo summarize the clinical experience and investigate the safety and reliability of uniportal procedure for the correction of pectus excavatum (PE). MethodsFrom November 2010 to November 2015, 203 PE patients (164 males, 39 femalzs average age of 5.7±3.0 years, ranging from 2 to 19 years) underwent the correction operation with only single 2 cm incision on right lateral chest. There were 188 patients under 12 years of age and 15 patients above 12 years. According to Park classification, 176 patients were symmetric and 27 were asymmetric. ResultsAll operations were performed successfully. The average operating time was 16.1±5.2 min with a range of 4-65 min and the average postoperative hospital stay was 6.4±1.3 d, ranging from 4-14 d. A single incision was made on the right chest and only one bar was inserted in the patients. Postoperative follow-up was 1-56 months (mean, 27.6 months). There was no complication occurred such as bar turnover, displacement and redepressed sternum. Totally, 84 patients received bar removal procedure. ConclusionIn terms of operation time and surgical trauma, uniportal procedure for PE is superior to Nuss procedure. And there is no significant difference in the safety and effectiveness between two procedures. Uniportal procedure is especially suitable for the treatment of PE children under 12 years of age.
Objective To explore the effect of antihypertensive therapy for hypertension patients from plateau area. Method A retrospective analysis of medical records for Tibetan patients with hypertension from October to December 2013 in Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region. Results The study recruited 165 patients. The rate of treatment, control, and compliance of hypertension patients were 86.7% (143/165), 23.8% (34/143), 43.4% (62/143), respectively. The main characteristics of hypertension treatment were higher proportions of single-drug therapy (81.1%, 116/143); among those the Tibetan drug (24.1%), calcium channel blockers (21.6%), diuretics (19.0%), and traditional compound preparation (18.1%) were most commonly used in the antihypertensive therapy. Conclusions The rate of treatment was high, but the rate of control and compliance were low in Tibetan patients with hypertension. It was necessary to carry out hypertension education to patients and strengthen the training of doctors at the plateau.
ObjectiveTo define the patient characteristics and perioperative management, and to define the mortality and its risk factors after arterial switch operation (ASO).MethodsWe conducted a bidirectional cohort study with 571 consecutive patients undergoing ASO from 1997 to 2016 in our hospital. We enrolled patients who underwent ASO before 2012 retrospectively and after 2012 prospectively and followed up all the patients prospectively. Demographic characteristics, clinical information and mortality of these patients were summarized. Joinpoint regression analysis was used to identify the time trend of the overall mortality. Kaplan-Meier survival analysis was used to evaluate the mid- and long-term survival rate after ASO. Cox proportional hazards regression models were used to explore the potential factors associated with mortality. The cumulative incidence of complications after ASO was predicted using competing risk models.ResultsSeveral aspects of patients’ characteristics and perioperative management in our center differed from those in the developed countries. The overall mortality and in-hospital mortality after ASO was 16.3% and 15.1%, respectively. The overall cumulative survival rate at 5, 10 and 15 years after ASO was 83.3%, 82.8% and 82.8%, respectively. A significant decrease of overall mortality from 1997 to 2016 was observed. Independent risk factors of mortality included earlier ASO (1997-2006), single or intramural coronary anatomy and longer cardiopulmonary bypass time. Ten years after ASO, re-intervention, arrhythmia, pulmonary and anastomotic stenosis were the most common complications with a cumulative incidence over 10%.ConclusionSignificant improvements in the results of the ASO were observed and the postoperative mortality rate is close to reports from developed countries. Nonetheless, we have identified the need for further improvement in the early and late postoperative periods after ASO. Pulmonary stenosis, anastomotic stenosis and arrhythmia should be paid attention to during the long-term follow-up after ASO.