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1. Posterior interosseous nerve entrapment after Monteggia fracture-dislocation in children | |||
Li Hai | |||
Clinical Medicine 22 January 2013 | |||
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Abstract:Object Although most of nerve injuries associated with Monteggia fracture-dislocation in children are neurapraxias and will recover spontaneously after conservative treatment, surgical exploration of the involved nerve is always required in the cases with the entrapment of posterior interosseous nerve (PIN). However, the necessity and time frame for surgical intervention for specific patterns of nerve dysfunction remains controversial. Methods Eight cases, six boys and two girls, with Monteggia fracture-dislocation complicated by PIN injury, managed operatively at the authors' hospital from 2007 to 2008 were retrospectively reviewed. All the patients underwent the attempted closed reduction, before they received exploration of PIN, with open reduction and internal fixation or successful closed reduction. Results The PIN was found to be trapped acutely posterior to the radiocapitellar joint in 4 out of 5 Type III Bado's Monteggia fractures. In the remaining cases, since there were longer time intervals from injury to operation, chronic compressive changes and epineural fibrosis of radial nerve were visualized. After a microsurgical neurolysis performed, the complete recovery in the nerve function was obtained in all the cases during the follow-up.Conclusion The findings from this study suggest that every case of type III Monteggia fracture-dislocation with decreased or absent function of muscles innervated by the PIN and an irreducible radial head in child should be viewed as an indication for immediate surgical exploration of the involved nerve to exclude a potential PIN entrapment. | |||
TO cite this article:Li Hai. Posterior interosseous nerve entrapment after Monteggia fracture-dislocation in children[OL].[22 January 2013] http://en.paper.edu.cn/en_releasepaper/content/4516904 |
2. Treatment of HBV and HCV seropositive patients after renal transplantation | |||
liuhua,Xue Wujun,Tian Puxun,Ding Xiaoming,Feng Xinshun | |||
Clinical Medicine 10 February 2009 | |||
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Abstract:Backgroud/Purpose. There are higher incidence of hepatitis virus infection in renal transplant patients. In present study, we evaluated the risk and investigate the effect of integrative treatment on renal transplant patients with hepatitis B surface antigen (HBsAg) and/or seropositivity for anti-hepatitis C virus (HCV) antibody. Methods. A total of 79 HBsAg-positive and/or anti-HCV-positive patients underwent transplantation (78 kidney, one kidney and liver) between 2000 and 2007. After renal transplantation, patients with liver dysfunction received integrative therapy, including adjustment of dosage and/or type of immunosuppressants, and hepatic protection depending on the extent of the liver dysfunction. Hepatitis B virus (HBV)-DNA-positive patients were treated with lamivudine to inhibit viral replication. Results. On review of the total programme, 40 patients (50.63%) experienced liver dysfunction in the first 2 months post-operation, and five (6.33%) of these patients were HBV-DNA or HCV-RNA positive. The liver dysfunction rate was 26.09% in patients treated with tacrolimus/ mycophenolate mofetil (MMF)/prednisone (Pred), and was 60.71% in those treated with cyclosporine/MMF/Pred (P<0.05). After integrative therapy, the liver function of 36 (90%) patients was restored to normal. At the last follow-up, the survival rate of the patients and grafts was 98.48/98.48%, 92.31/92.31% and 89.26/85.71% at 1, 3 and 5 years, respective1y. Conclusion. These data suggest that timely hepatic protection and anti-viral treatment and appropriate adjustment of immunosuppressant dosage and/or type may improve the survival rate of renal transplant patients who are positive for hepatitis virus. | |||
TO cite this article:liuhua,Xue Wujun,Tian Puxun, et al. Treatment of HBV and HCV seropositive patients after renal transplantation[OL].[10 February 2009] http://en.paper.edu.cn/en_releasepaper/content/28744 |
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