Search

Objective: To investigate the pathogenesis and clinical efficacy of arthroscopic treatment for hallux ganglion cyst deriving from ankle joint. Methods: The clinical data of 21 patients with ankle arthroscopic in the Department of Hand and Foot Surgery,Affiliated Hospital of Jining Medical College from January 2019 to March 2021 were analyzed retrospectively.There were 15 male and 6 female cases,aged (52.6±8.2) years (range:42 to 70 years).There were 9 cases of primary operation and 12 cases of recurrence after operation in other hospital.All the patients were examined by ankle arthrography and MRI before operation.The synovial membrane of the ankle was debrided and the tendon sheath of flexor longus was removed at the ankle canal.One year after operation,MRI was performed,and the American Orthopedic Foot and Ankle Society(AOFAS) score of forefoot function and visual analogue scale (VAS) before and after operation were compared by the paired t test or Mann-Whitney U test.The postoperative complications and recurrence were recorded. Results: All patients were operated successfully.The joint capsule at the back of the ankle joint of the patients were ruptured and communicated with the tendon sheath of the flexor longus tendon at the ankle canal.No wound infection,vascular and nerve injury occurred.The follow-up period was (15.0±2.2) months (range:12 to 18 months).During the follow-up period,there was no recurrence of toe appearance and MRI.At the last follow-up,the AOFAS score (90.8±4.3) was significantly higher than that (72.8±6.3) before operation ( t =-10.810, P <0.01),and the VAS score( M (IQR)) was significantly lower than that before operation,the difference was significant (1.0(1.0) vs. 3.0(0.5), Z =-4.081, P <0.01). Conclusions: The possible mechanism of hallux ganglion cyst deriving from ankle joint is that the joint capsule at the back of the ankle joint ruptures and communicates with the tendon sheath of the flexor longus tendon at the ankle canal,and the intra-articular synovial fluid through the cylinder effect generated by sliding with the flexor tendon of the flexor longus tendon in the tendon sheath sac leads to the heel valange cyst.Ankle-synovial cleansing of the ankle joint under ankle arthroscopy and resection of the flexor tendon sheath of the flexor longus tendon at the ankle canal are effective and less invasive.

Objective: To evaluate the value of high-resolution ultrasound the diagnosis and prognosis of cubital tunnel syndrome., Methods: From January 2018 to June 2019, 47 patients with cubital tunnel syndrome were treated with ulnar nerve release and anterior subcutaneous transposition. There were 41 males and 6 females, aged from 27 to 73 years old. There were 31 cases on the right, 15 cases on the left, and 1 case on both sides. The diameter of ulnar nerve was measured by high-resolution ultrasound pre-and post-operatively, and measured directly during the operation. The recovery status of the patients was evaluated by the trial standard of ulnar nerve function assessment, and the satisfaction of the patients was assessed., Results: All the 47 cases were followed up for an average of 12 months and the incisions healed well. The diameter of ulnar nerve at the compression level was (0.16±0.04) cm pre-operatively, and the diameter of ulnar nerve was (0.23±0.04) cm post-operatively. The evaluation of ulnar nerve function:excellent in 16 cases, good in 18 cases and fair in 13 cases. Twelve months post-operatively, 28 patients were satisfied, 10 patients were general and 9 patients were dissatisfied., Conclusion: The preoperative examination of ulnar nerve by high-resolution ultrasound is consistent with the intuitive measurement during operation, and the result of postoperative examination of ulnar nerve by high-resolution ultrasound is consistent with follow-up results. High-resolution ultrasound is an effective auxiliary method for the diagnosis and treatment of cubital tunnel syndrome.

Objective: To analyze the effect of insufficient intake of vitamin D (VD) on sperm quality and male fertility and to discuss the mechanism of the effect. Methods: VD deficiency mice were fed with VD-deficient diet and light-sheltered. The sperm motility, morphology, ultrastructure, testicular pathology, sex hormones and fertility of normal and VD-deficient mice were analyzed to investigate the effects of VD deficiency on male reproduction. Results: Compared with the normal group, the mice with VD deficiency had lower sperm concentration[(128±53) ×10(6)/ml vs( 58±15) ×10(6)/ml, P <0.05], less sperm in the epididymis, slightly less mature spermatozoa.The serum testosterone[(328±65 )nmol/L vs(255±58 )nmol/L]and estradiol levels[(60±115) pmol/L vs(384±104) pmol/L]were significantly lower ( P <0.05), and the FSH[(296±177)ng/L vs(219±105 )ng/L]and LH[(393±129) ng/L vs(364±108) ng/L]levels were significantly higher ( P <0.05). The other tests did not show any significant difference ( P >0.05). Conclusion: The impact of insufficient intake of VD on sperm quality is not prominent, the specific impact of VD on male reproductive needs to be further studied.

Objective: To investigate the prevalence of Ureaplasma urealyticum (UU) infection in infertile men, its influence on routine semen parameters and the distribution of antisperm antibody (AsAb) and its types in infertile patients with UU infection., Methods: We detected the positive rate of UU infection, semen parameters, and the distribution of AsAb and its types in 662 infertile men and 25 normal fertile male controls followed by comparison of the obtained data between the two groups of subjects., Results: The positive rate of UU infection was significantly higher in the infertile men than in the normal controls (52.87% ［350/662］ vs 16.00% ［4/25］, χ2 = 11.68, P <0.05). The semen volume, sperm count, sperm concentration and percentage of progressively motile sperm were remarkably lower in the UU-positive infertile males than in the control group (P <0.05). No statistically significant difference was observed between the UU-positive and UU-negative groups in the positive rates of total AsAb (43.4% vs 36.5%, χ2 = 3.25, P >0.05) and AsAb IgA, IgM and IgG in the seminal plasma, or in the percentages of serum AsAb IgM (16.9% vs 20.5%, χ2 = 1.22, P >0.05) and IgG (32.7% vs 28.9%, χ2 = 0.99, P >0.05) except in that of serum AsAb IgA (23.6% vs 17.0%, χ2 = 4.03, P <0.05)., Conclusions: The UU infection rate is high in infertile males, which decreases the semen volume, total sperm count, motile sperm concentration and percentage of progressively motile sperm and increases the positive rate of serum AsAb IgA.

Objective: Sperm DNA fragmentation (SDF) is widely used to predict male infertility and the methods of detecting SDF are varied. This study aimed to compare two methods of SDF detection and investigate the correlation between SDF and sperm quality., Methods: Using sperm chromatin structure assay (SCSA) and sperm chromatin dispersion test (SCD), we detected SDF in 108 semen samples collected in the Center of Reproduction and Genetics of Suzhou Municipal Hospital. We compared the results of the two methods and analyzed the correlations of SDF routine semen parameters, sperm morphology and the age of the patients., Results: A significant consistency was found in the SDF index (DFI) between the two methods (P<0.01). The DFI was correlated negatively with sperm motility, the percentage of progressively motile sperm, and that of morphologically normal sperm (P <0.01), but positively with the teratozoospermia index (P <0.01 in SCSA and P <0.05 in SCD). The DFI measured by SCSA showed a significantly positive correlation with the patients' age (P <0.01), but not that obtained by SCD., Conclusions: The results of both SCSA and SCD play an important role in predicting sperm quality. As a clinical index, the DFI has a predictive value for male infertility. However, the results of different detecting methods vary widely, which calls for further studies on their standardization.

Objective: To compare the therapeutic effect of impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial osteoarthritis of knee joint in aged patients., Methods: From July 2003 to July 2006, 30 patients with flexional medial knee osteoarthritis were treated with impacted high tibial osteotomy or conventional high tibial osteotomy randomly. All patients,aged from 60 to 82 years,were suffered from 7 degrees to 19 degrees knee flexion deformities and 3 to 20 years medical histories. The bone healing periods, the recover of flexion and inversion deformities, and the recover of the knee joint function were observed postoperatively. The patients were followed up at 4, 6, 8, 9, 10, 12 and 16 weeks, and 5, 7, 9 and 12 months postoperatively. The bone healing periods and the recover of flexional and inversion deformities were evaluated and compared. Twelve months postoperatively,the knee joint function were assessed with the Lysholm scoring criteria, and the therapeutic effects were compared between the two groups., Results: There was a significant difference in the average bone healing period between the impacted high tibial osteotomy group (9.26 +/- 2.23) weeks and the conventional high tibial osteotomy group (11.53 +/- 3.15) weeks. The knee joint function were evaluated according to the Lysholm clinical rating scales. One year postoperatively,the average Lysholm score were (88.5 +/- 4.4) points in the impacted high tibial osteotomy group,and the results showed excellent in 14 cases, good in 1. The average Lysholm score were (78.1 +/- 5.7) points in the conventional high tibial osteotomy group. The results showed 8 cases excellent, 5 good, 2 fair, accordingly. Postoperatively, the flexion deformities of the knee in the impacted high tibial osteotomy group were -1.1 degrees to 0 degrees and was corrected averagely (130 +/- 3.30) after surgery, and that in conventional high tibial osteotomy group (140 +/- 3.30) (the same as preoperation). The average postoperative femorotibial angle (FTA) were 170.2 degrees (ranged from 169.1 degrees to 172.3 degrees) and was corrected 12.3 degrees to 12.5 degrees after surgery in both groups., Conclusion: Compared with conventional high tibial osteotomy, impacted high tibial osteotomy can significantly shorten the bone healing period, improve the knee flexion, varus deformity, and the knee function.

A child, 2 years old, male suffering from severe jaundice, melena, severe anemia and right upper abdominal mass was admitted into our hospital. Diagnosis of obstructive jaundice was made before operation. On exploration, a tumor mass was found in the pancreatic head, which involved the duodenum and distal common bile duct. Pancreaticoduodenectomy with one stage pancreaticojejunostomy, choledochojejunostomy and gastrojejunostomy was carried out. Postoperative pathology showed adenocarcinoma of the distal common bile duct invading the periampullary tissues of the duodenum and infiltrating, to a lesser extent, into the pancreatic head. Carcinoma arising from the distal common bile duct is rare in infancy and childhood. Radical resection should be attempted if possible. In general, the prognosis is poor in this tumor. No complication after operation occurred on this patient but close follow-up is necessary. Pathology related to this tumor is discussed with a review of literature.