[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.

Most pelvic fractures were commonly seen in polytrauma caused by violent forces,and often complicated with hemorrhagic shock,with mortality being 25%～39%.Anti-shock and control of bleeding are th e philosophy of treatment of this critical condition.Since 1985,hundred s of pelvic fracture victims have bee n sal-vaged in my hospital by VIP procedure which means ventilation(V),infusion(I),and pulsation(P).First,V was to establish an airway,then I was to manage hypovolumic shock,and fin ally,P was to improve the impaired heart function to maintain normal hemodynamics and tissue perfusion.It was necessary for antishock therapy to infuse rapidly and sufficiently in o rder to gain diluted blood.Pneumatic antishock garment,angiography an d em-bolism,and retroperitoneal tampon aded bleeding could control most hem orrhage associated with pelvic fractures.[

Objective To investigate the mechanism of cytokines in brain pathologic changes caused by lipopolysaccharide(LPS).Methods A rat model of LPS was established by injection with a dose of 5mg/kg LPS into thigh vein.60 SD rats were randomly divided into three groups:control group,LPS group,naloxone+LPS group,each group included 20 rats and was subdivided into 4 subgroups(1h,2h,4h,6h respectively).In each subgroup,cerebral pathological changes and concentrations of TNF-α,IL-1β,IL-6 in brain homogenate were investigated.Results Brain homogenate concentration of TNF-α in subgroup LPS 2h was higher than control group[(9 30±0.57) ng/g vs(8.00±0 79)ng/g,P＜0.01],other subgroups have no significant difference from control group. Naloxone group had lower TNF-α level than LPS group.Brain homogenare concentration of IL-1β in subgroup LPS 1h increased apparently[(0.56±0.08)ng/g,P＜0.01],subgroup LPS 2h had no significant change;other subgroups have no significant difference from control group.Natoxone group had lower IL-1β level than LPS group(P＜0.01).but no difference from control group.Brain homogenate concentration of IL-6 in subgroup LPS 2h and 4h were respectively(459.68±79.15)ng/g,(816.07±111.31)ng/g,significantly higher than control group[(377.22±63.73)ng/g,(369.98±34.35)ng/g,respectively].Control group had no significant cerebral pathologic changes,while LPS group showed apparent changes:edema,interstitial substance and mening vessels expanding and hyperaemia,neurosome minification,Nissl's body lost,karyopycnosm,and nucleoli abolition.Naloxone group had lighter neurocyre injuries and brain edema,especially at 2h and 4h.Conclusions After LPS injection,the level of cytokines changed as time goes by,and this fits the brain pathologic changes.Naloxone has protecnve effect on brain tissue in LPS treated rats.Inflammatory cytokines play an important role in the mechanism of cerebral damage in LPS rats.

Objective To investigate the possibility of human umbilical cord blood mesenchymal stem cells' migrating to the gastric carcinoma xenografts. Methods Gastric cancer cells SGC-7901 were injected subcutaneously into one side of the inguinal groove in the hairless mice to establish the animal model.Gastric cancer-bearing mice were divided randomly into two groups and five in each group (n =5). Then mesenchymal stem cells and the fibroblast HFL-Ⅰ labeled with fluorescent dye SP-DiI were injected at the opposite side. Ten days later, the mice were put to death, and the gastric carcinoma xenografts, liver, spleen,lung and the tissue of injected point were obtained. Cryosections from frozen tissues were processed for fluorescent microscopy and the distribution of MSC and fibroblasts in different organs were observed. Adjacent sections were stained with HE. Results Human umbilical cord blood mesenchymal stem cells were mainly distributed in gastric carcinoma xenografts (0.0150±0.0079), but were found only a little in liver (0.0010±0.0005), spleen (0.0015±0.0012), lung (0.0014±0.0008) and injected point (0.0043±0.0039). Fibroblasts were mainly observed in the tissue of injected point, but none in other tissues (P ＜0.01). Conclusion Human umbilical cord blood mesenchymal stem cells have the tendency of migrating to tumor sites, suggesting that it can be hopefully used in the diagnosis and treatment of gastric cancer.

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.

The changes of immunoreactive neurotensin (ir-NT) contents in the brain areas, pituitary gland and plasma in the trautized rats were observed by radioimmunoassay. The results showed the significant changes of the ir-NT contents in the hypothalamus, pituitary gland, plasma, injured tissue, hippocampus, central gray and spinal cord in the posttraumatic rats at different intervals. A predominant characterization of the change of ir-NT levels in the brain areas, pituitary gland and plasma, was the dramatical decrease at various times except for the hypothalamus, central gray, and hippocampus with biphasic alterations. The ir-NT contents in the frontal cortex, pons and medulla also displayed changes to different extent under the acute craniocerebral trauma condition These results suggest that NT may play a role in the pathophysiology of traumatic injury.

Objective:To investigate the inhibitory effect of cytokine-induced killer cells (CIK) against implanted gastric cancer cells. Methods:Gastric cancer SGC-7901 cells were subcutaneously injected into the inguina of nude mice to establish gastric cancer model. The tumor bearing mice were randomly divided into CIK group and fibroblasts group,in which mice were subcutaneously injected with fluorescence dye SP-DiI labeled CIK and fibroblasts HFL-I cells,respectively. Distribution of CIK and HFL-I cells in different tissues of gastric cancer bearing mice were observed. Meanwhile,tumor volume was measured after different treatments and tumor inhibitory rate was calculated. Tumor necrosis areas in different groups were observed. Results:SP-DiI labeled CIK was mainly located in the gastric cancer tissues 10 d after injection,and was hardly detected at the injection sites,liver,spleen and lung tissues (P

The contents of ir-oxytocin (it-OT), ir-Arg-yasopressin (ir-AVP) and ir-?-endorphin (ir-?-EP) in hypothalamus, pituitary and plasma were measured by. radioimmunoassay (RIA) when the rats were swimming. It was showed that the ir-OT contents in hypothalamus, pituitary and plasma were significantly increased in the animals having swum 1, 5, 15 and 20min (P

Objective To assess the factors which affect the activity of isolated islets,and to construct a steady and effective isolation method of rat pancreatic islets.Methods Pancreatic islets were isolated by collagenase method.The glucose-stimulation of insulin secretion(GSIS) in different conditions was performed by batch incubation method and measured by RIA.Results GSIS was improved by BSA;There was a evident decrease of insulin secretion in cultured islets of 7 days,however,no difference was observed between the freshly isolated islets group and the 1～5days cultured islets groups.Compared to the groups of(5.5 mmol/L) and(25 mmol/L) glucose in the culture medium,(11.1 mmol/L) glucose group stimulated higher insulin release.Conclusion BSA,glucose concentration of RPMI1640 medium and the culture period are related to the activity of isolated islets.