[Objective]To study the correction of deformity with major bone defect by lengthening with different external fixators and to evaluate the results.[Method]From August 2000 to March 2004,7 patients suffering from deformity with major bone defect were treated by external fixators including Ilizarov, Orthofix LRS,and Hybrid external fixators combined with Orthofix LRS.Linar or wedged osteostomy was carried out at the deformity site.Wedged osteotomy and callus distraction were used for the cases of deformity with limb shortening,and compression of dock site combined with bone transport was used for those of deformity with bone defect and shortening.[Result]The cases corrected were: 1 femur with anterior angular deformity and 7cm shortening,and 6 tibiae including 2 varus deformities,2 posterior angular deformities,and 2 complex deformities.The average length was 5.3cm(4.5～7 cm),with an average distraction time of 3.5 months and followed by an average time of external fixation of 7 months.There were no obvious complications,such as vascular and nerve injuries.The function of the adjacent knee and ankle was not affected.[Conclusion]External fixators including Ilizarov,Orthofix LRS and Hybrid external fixators may provide one of good alternatives for correction of deformity with major bone defect.Compared with Ilizarov,Orthofix LRS and Hybrid external fixators are more conventional,more advantaged,and preferred,especially for its distinct clamp which can provide multi-plane fixation and correct the deformity simultaneously with limb lengthening.

Objective To explore the clinical result of fixation on the distal femur and/or proximal tibia with LISS(Less Invasive Stabilization System), and to analyze the related factors during the operation. Methods From July 2003 to March 2005, 16 patients(17 fractures) were treated with LISS (Mathys, Swiss). There were 11 males and 5 females, with an average age of 39 years (mean, 19-58 years), including 9 distal femoral fractures and 8 proximal tibial fractures, while 1 patient sustaining distal femoral and proximal tibial fracture on the ipsilateral side. The LISS plates were inserted beneath the periosteum through a small incision after closed reduction(except the intraarticular fractures). The locking screws were inserted through stab incisions, and by monocortical fixation. Only 1 patient underwent the bone graft who accepted the open reduction 21 days after injury. Results All the patients achieved bone union during the follow up from 5 to 25 months ( mean, 15 months ). 3 patients had their implants removed. The function of the knee was evaluated according to Karlstr?觟m score system based on both the subjective feeling and objective PE, and there were 10 excellent and 3 good, and 3 fair, the good-excellent rate was 81%. Secondary reduction loss occurred in one patient, but bone union and the function of the knee were not compromised. There was also neither infection nor implant pull-out and breakage. Conclusion The unique designed LISS has the advantages of protecting the blood supply of bone fragments and the periosteum, optimizing bone union and function recovery. LISS provides an alternative for treatment of distal femoral or proximal tibial fractures. However, as a new designed system, not only conception but the procedure as well should be demanded strictly.

Objective To evaluate the clinical results of femoral, tibial and humeral fractures treated with locked intramedullary nailing. Methods 546 fractures of femur, tibia, and humerus in 526 patients treated with locked intramedullary nailing from April 1994 to September 2004 were retrospectively reviewed. There were 430 fractures in 412 males, 116 fractures in 114 females, with an average age of 36.4 years. 432 were close fractures, 76 old fractures, and 38 open fractures. With image intensifier, 196 fractures were reduced closely, while 350 fractures failed to be reduced by close manipulation and required open reduction. Bone grafting were undertaken in 161 fractures of the latter group. 485 fractures were reamed, and 61 unreamed. 539 fractures were stabilized statically, and 7 dynamically. The nails were inserted antegradely in 519 fractures, and retrogradely in 27. Dynamization was undertaken in 10 statically locked fractures due to delayed union. The early postoperative weight-bearing was directed. The patients were followed up with an average of 31.6 months (9~123 months). Results Among the 546 fractures, 543 fractures(99.5%) were eventurally healed, with an average union time of 4.4 months. 530 fractures(97.1%)primarily healed, and 13 fractures(2.4%) healed after secondary operation. The complications were 11 delayed unions(2.0%), 4 nonunions(0.7%), 3 malunions(0.5%), 5 bone infections(0.9%), 2 traumatic fractures(0.4%), 9 hip heterotopic ossifications(1.6%), 6 implant failures(1.0%), with 3 nail breakages(0.5%), 3 interlocking screw breakages or back-outs, 1 radial nerve palsy, and 1 fatal pulmonary embolism. The ROM of the hips and the knees were excellent in patients with femoral or tibial fractures. Flexion restriction(90?~125?) of the knee were found in 10 patients. There were 5 and 10 anterior knee pains in femoral and tibial fracture patients respectively. The ratio of excellent and good function of the shoulder was high in the humeral shaft fracture patients, with the abduction less than 90? in 2 patients, extension loss of 15? in 2 elbows, and shoulder pain in 6 patients. Conclusion Interlocking intramedullary nailing is one of the good alternatives in treating long bone fractures, with a higher union rate and a lower complication rate. Close reduction for fresh fracture, open reduction for old fracture, static locking, reaming or unreaming in regard to the site and severity of the fracture, and individualized rehabilitation protocols all contribute to the excellence of the results.

This paper systematically stated the sexual moral problems of the repairment of ruptured hymen resulted form different reasons and the moral principles and requirements for the operator.

AIM: To study ba cteriostasis activities of ligand (2-(carboxymethoxyl) benzaldehyde benzoyl hyd razone (H 2L)) and their complexes. METHODS: Ligand H 2L and t heir complexes were synthesized. The bacteriostasis activities of H 2L and thei r complexes in vitro were tested with K-B method. RESUL TS: 2-(carboxymethoxyl) benzaldehyde benzoyl hydrazone only showed bact eriostasis activities on Staphyloccus aureus and their complexes had dramatic bacteriostasis activity on Staphylococcus aureus, Escherichia coli, and Bacillus subtilis. Bacteri ostasis ring diameter of Cu-complex was largest. CONCLUSION: L igand H 2L complexes have bacteriostasis activities in vitro. B acteriostasis activities of Cu-complex are strongest among the complexes.

Objective: To investigate the targeting and anti-tumor ability of the tumor vessel-specific antibody ScFvH1 selected from phage-ScFv library, and to discuss the application of the antibody in clinical diagnosis and therapy of cancer. Methods: The ScFvH1 gene was inserted into pET-28a(+)/EGFP vector containing green fluorescent protein(GFP) gene and pTIG-Trx vector containing thioredoxin gene; the products were then expressed in E.coli and purified by using Ni-NTA. Tumor-bearing mice model was established by subcutanuous injection of cervical cancer cell line HeLa. The mice were injected with purified ScFv-EGFP fusion protein through vena caudalis and the GFP signals were observed by fluorescent microscope to evaluate the targeting ability of the antibody. Meanwhile, the mice model also received intratumoral injection of purified ScFv-EGFP fusion protein to evaluate the anti-tumor effect of the antibody. Results: Soluble ScFvH1 gene and ScFvH1-EGFP protein were successfully expressed in E.coli; a single band was showed in SDS-PAGE after the purification by Ni-NTA. We found that ScFvH1-EGFP fusion protein was enriched to tumor tissues, but there was only weak fluorescent signal when EGFP protein was injected. No EGFP signal was observed in the lung of tumor-bearing mice. Tumor inhibition experiment showed that the tumor growth in the antibody treatment group was similar to that of the PBS control group. Conclusion: The tumor vessel-specific antibody ScFvH1 selected from phage-ScFv library can specifically target tumor vessels, but it has no obvious inhibitory effect on tumor growth. Our findings pave a way for antibody in cancer diagnosis and treatment.

Objective To investigate the feasibility of a noval anterior cubital approach for the coronoid via flexor?prona?tor teres interval and assess the clinical result. Methods Five formalin?fixed adult cadaver elbows were used. Through a single universal anteromedial longitudinal skin incision, the coronoid tip was exposed via pronator and flexor carpiradialis interval, and coronoid anteromedial facet and base via palm longus and flexor carpi ulnaris interval. The distances from the entry point to the muscles or branching point of the nerves to the line passing through medial and lateral epicondyles, as well as the length were mea?sured with regard to the motor nerve branches arising from median nerve to pronator teres, flexor carpiradialis, palm longus and flexor digiti superficialis, as well as the most proximal two motor branches to flexor carpi ulnaris arising from ulnar nerve. From September 2013 to August 2014, 4 male patients with ulnar coronoid fracture were treated operatively through the above anterior cubital approach in our hospital. They were all left side involved, with an average age of 32 years (range, 16-42 years). According to O’Driscoll classification, there were two cases of type Ib and two cases IIb respectively. They were all treated by open reduction and internal fixation through flexor?pronator teres interval. Results At cubital fossa, there were 2-3 branches to the pronator teres mostly, 1 branch to flexor carpiradialis and palm longus arising from median nerve. The branch to the flexor digiti superficia?lis usually was long and thick, and divided into 2-5 short twigs near muscle. The branch to palm longus had the same trunk with that to flexor digiti superficialis. The branch to flexor digiti superficialis was the most proximal among those passed through the in?terval of pronator teres and flexor carpiradialis, and its entry point to the muscle had an averaged distance of 37.22 mm to the line passing through medial and lateral humeral epicondyles. It was optimal to expose coronoid tip through the interval of pronator teres and flexor carpiradialis. It was safe to expose coronoid proximal to the branch to flexor digiti superficialis. While, it was better to expose the anteromedial facet and base of corocoid through the interval of palm longus and flexor carpiulnaris via median and ul?nar nerve interface. All of the four patients were followed up for an average period of 9 months. They all achieved bone union from 6 weeks to 3months (mean, 9 weeks). All the patients obtained excellent result according to the modified An&Morrey elbow per?formance index with scores from 94 to 100. Conclusion The novel anteromedial cubital approach via flexor?pronator teres is opti?mal for exposure of coronoid.

Objective To evaluate the clinical results of operative treatments for the complex posterior tibial plateau fractures via posterior approach. Methods Eleven cases with complex posterior tibial plateau fracture from June 2008 through June 2010 were reviewed retrospectively. There were 7 males and 4females, with age from 33 years to 60 years (average, 47.8 years). According to AO classification, there were 41-B2.2.4 type in 2 cases, 41-B3.1.2 type in 3, 41-B3.3.2 type in 3, 41-B3.1.2 type combined 41-B3.3.2 type in 2, 41-C3.3 type in 1. Carlson posterior lateral approach were used in 5 cases, posterior medial approach were used in 3 cases, and posterior medial and/or lateral approach combined with anterior approach were used in 3 cases. All fractures were fixed with plates. Autogenous ilium grafts were used if necessary.Results All cases were followed up. The average follow-up time was 1.6 years (range, 3-24 months). At the final follow-up visit, bone union was obtained in all cases. The mean Rasmussen score was 16.7 (range, 15-18), and the mean HSS was 86.2 (range, 75-96). The postoperative knee range of motion were 0°-135°, 0°-130° and -10°-125° in 5 cases with posterior lateral plateau fractures, 3 cases with posterior medial plateau fractures and 3 cases with anterior and posterior plateau and intercondylar fractures respectively. There was no vascular and nerve injuries. Loosing or breaking of hardware's was not found. Conclusion The Carlson posterior lateral and/or medial approach is preferred for the complex posterior plateau fractures, with the advantages of direct reduction and stabilization.

Objective: To establish a method for determining the molecular weight and molecular weight distribution of Poly(Lactide-co-Glycolide Acid) (PLGA) using Size Exclusion Chromatography-Refractive Index-Multiangle Laser Light Scattering (SEC-RI-MALLS) and Size Exclusion Chromatography-Refractive Index (SEC-RID), and to compare the results obtained from these two methods.
Methods: For SEC-RI-MALLS, tetrahydrofuran was used as the mobile phase, Shodex GPC KF-803L was employed as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, and an injection volume of 100 μL. For SEC-RID, tetrahydrofuran was also used as the mobile phase, Agilent PLgel 5 μm MIXD-D was used as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, differential detector temperature at 35 ℃, and an injection volume of 20 μL. The molecular weight and molecular weight distribution were calculated using Agilent’s GPC software. The newly established methods were validated methodologically, and the molecular weight and molecular weight distribution of 13 batches of samples were determined.
Results: The precision, accuracy, stability, and repeatability tests for SEC-RI-MALLS showed RSD values of 1.35%, 1.58%, 1.53%, and 1.26%, respectively. The SEC-RID method exhibited good linearity (r=0.999 9), with RSD values for precision, accuracy, stability, and repeatability tests (n=6) of 2.05%, 1.62%, 1.30%, and 2.97%, respectively. The results obtained from SEC-RI-MALLS were lower than those from SEC-RID, and the molecular weight distribution coefficient was smaller, but the results from the paired T-test performed with the value measured by SEC-RID method and the value measured by SEC-RI-MALLS method multiplied a conversion coefficient of 1.5 showed no significant difference between the two methods.
Conclusion: Both methods are stable and reliable, and can be used for the determination of PLGA molecular weight and molecular weight distribution based on the specific situations.

Objective To explore the feasibility of the extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach.Methods Eight patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary sinus lesions.The indications,surgical management and outcomes of the surgery were presented.Results There were 2 cases of maxillary dentigerous cyst with oroantral fistula,2 cases of antrochoanal polyp,2 cases of maxillary sinus inverted papillomas,1 case of odontogenic maxillary sinusitis with oroantral fistula,and 1 case of maxillary sinus mucocele.All patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach without intraoperative complication,with good access to the lesions.Complete resection could be achieved through this approach,no postoperative complications occurred except one patient had a delayed wound healing of inferior turbinate,all patients were free of recurrence with the average postoperative follow-up of 7.8 months (range 4-12 months).Conclusion The extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach is recommended for some maxillary pathology owing to its good access to the lesions and complete resection.