Background Limited research has evaluated imaging results following a combination of operations for recurrent patella dislocation (RPD) based on medial patellofemoral ligament (MPFL) reconstruction. Therefore, this study aimed to retrospectively compare the imaging and clinical results of RPD following 2 types of combined surgical techniques. Methods Patients who underwent combined surgery for RPD from January 2008 to December 2019 were enrolled in the study and allocated into 2 groups. MPFL reconstruction combined with lateral retinacular release (LRR) was performed in groups A and B, and an additional tibial tuberosity transfer (TTT) was performed in group B only. Patients in group A with a tibial tuberosity trochlear groove (TT-TG) distance greater than 15 mm were included in subgroup A*. Congruence angle (CA), patellar tilt angle (PTA), lateral patellofemoral angle (LPA), lateral patellar displacement (LPD), TT-TG, Insall-Salvati Index (ISI), the Dejour type of trochlear dysplasia, and knee function were assessed. All groups were followed up in the short-term (1–2 years), and group B was also followed up in the mid-term (over 5 years). Results A total of 40 knees (36 patients) were included in group A, 26 knees (24 patients) in subgroup A*, and 27 knees (26 patients) in group B. In group A, CA, PTA, and LPD had increased at the short-term follow-up, yet LPA had decreased compared to the results 3 days after surgery. In group B, at the mid-term follow-up, PTA (12.54±6.88 vs. 15.23±6.10; P=0.002) increased while LPD (7.08±6.48 vs. 4.69±6.28; P=0.049) decreased compared with the short-term outcomes. The more severe the femoral trochlear dysplasia, the lower the mid-term Kujala scores in group B (P=0.007). The short-term TT-TG (17.32±4.288 vs. 12.84±3.758; P<0.001) and ISI [1.25 (1.1075, 1.300) vs. 1.06 (1.00, 1.16); P<0.001] in group B were lower than those in group A, who had a higher Kujala score (P<0.001). The CA, LPD, ISI, TT-TG, and Kujala score in subgroup A* were higher than those in group B at the short-term follow-up (P<0.05). Conclusions Both types of combination treatments were successful in altering the patellofemoral joint in a satisfactory manner, and the knee function improved in both groups. A TTT might not be necessary for patients with a TT-TG distance greater than 15 mm.
Carbon monoxide(CO)poisoning is one of the common accidental poisonings in clinic.Due to high metabolism and energy demand,the central nervous system is the most vulnerable structure in acute carbon monoxide poisoning(ACMP)patients.The direct symptoms caused by ACMP-induced brain injury occur immediately after exposure.It can persist,or it may develop delayed encephalopathy after acute carbon monoxide poisoning after recovery with a lucid interval,which involves complex pathophysiological mechanisms and seriously affects the quality of life of patients.With the development of magnetic resonance technology,the pathogenesis,pathophysiological changes,and neuroimaging patterns of ACMP-induced brain injury have been further studied.In this article,the application status of new magnetic resonance technology in ACMP-induced brain injury was reviewed,and the future research direction was prospected.
Purpose:To investigate the application of digital subtraction angiography(DSA)image overlay technology assisted by hepatic artery mark in guiding transjugular intrahepatic portal systemic shunt(TIPS)puncture.Methods:A retrospective analysis was conducted in patients undergoing TIPS in our hospital.The patients were divided into ultrasound guided group(ultrasound guided TIPS puncture)and new procedure group(DSA image overlay technology assisted by hepatic artery mark guided TIPS puncture).The subjects were compared in terms of portosystemic shun puncture time,puncture times,surgical time,and surgery related clinical indicators.Results:Forty-eight patients were included in the study.Compared with the ultrasound guided group,the puncture time(P＜0.001)and surgical time(P=0.018)in the new technology group were significantly reduced.In both groups,postoperative aspartate aminotransferase,B-type natriuretic peptide,and portal vein pressure were significantly decreased.In the new technology group,total bilirubin(P=0.004),alanine aminotransferase(P=0.022)were significantly reduced.Conclusion:DSA image overlay technology assisted by hepatic artery mark can be used to guide TIPS puncture effectively by shortening surgical time and puncture time.
Purpose:To explore the correlation among type 2 diabetes mellitus(T2DM),fasting blood glucose(FPG),glycosylated hemoglobin(HbAlc),blood glucose control,different glucose control methods and the progression of white matter hyperintensity(WMH)in elderly patients.Methods:This retrospective cohort study included patients with or without T2DM who visited the affiliated hospital of Xuzhou medical university and underwent two times brain MRI scans from May 2013 to March 2022.Conventional structural MR1 and clinical data were collected.Multiple linear regressions were used for evaluating the effects of FPG,HbAlc,glycemic control and different glucose-control treatments on WMH progression.Results:Three hundreds and ninety-four subjects were included,with 175 and 219 patients in the diabetic and non-diabetic groups,respectively.The baseline WMH volume and annual change in WMH volume(△WMH/y)in the non-diabetic group were lower than those in the diabetic group(all P＜0.05).HbAlc was significantly related to WMH burden and △WMH/y after adjustment for different models.In diabetic individuals,WMH progression was mainly affected by glycemic control(P＜0.05),but not by the way of glycemic control(P＞0.05).The poor glycemic control group was with significantly higher △WMH/y than both the well glycemic control and non-diabetic groups(all P＜0.05),whereas there was no significant difference between the well glycemic control and non-diabetic groups(P＞0.05).Conclusion:T2DM is associated with WMH progression,and HbAlc is a marker for that progression.Well glycemic control is very important,no matter how to control,as it may postpone the progression of WMH.
Purpose:To investigate the clinical symptoms and imaging characteristics of hereditary diffuse leukoencephalopathy with spheroids(HDLS).Methods:The clinical and imaging data of 14 patients with HDLS treated in Ruijin Hospital were retrospectively analyzed.Results:The mean age of onset was(38.43±6.80)years in 14 patients with HDLS,and the most common clinical symptom was progressive cognitive hypoacusis.The main abnormal MRI findings were white matter lesions around the lateral ventricles,atrophy of the corpus callosum and diffusion restriction on DWI.Conclusion:HDLS has a diverse clinical presentation and is easily misdiagnosed.High intensity DWI signal in the white matter of the diseased brain,atrophy of the corpus callosum,and degeneration of the white matter around the lateral ventricle suggests the possibility of HDLS and might be helpful for the early diagnosis of HDLS.
