Objective To investigate the effects of surgical operations on different femoral condylar fractures. Methods A retrospective study was carried out on surgical operations of 84 patients with different femoral condylar fractures. The healing of fracture, functional recovery of knee joint and complications were analyzed. Results All the fractures healed in 6 to 12 months. According to Karlstrom's knee function score system, 48 knees were rated as excellent, 20 good, 13 fair, and 3 poor. The total good and excellent rate was 80.9%. Conclusions Anatomical reduction, secure fixation, timely treatment of complicated damage, and early rehabilitation exercise are important in treatment of femoral condylar fracture. The sustain blade plate is recommendable, because its design suits the anatomical structure of femoral condylar, and it not only provides convenient and stable fixation but also allows early postoperative functional training.

Objective To obtain the optimal extraction process of Prunella vulgaris L.Methods With the dependent variables of ethanol concentration,reflux time and solvent fold,and dependent variable of the amount of baicalin,Central Composite Design/Response Surface Method was applied to optimize the reflux extraction process.Predictions were carried out by comparing the observed and predicted values.Results The optimum conditions of extraction process were 45% ethanol,2 hours for reflux,4 fold sovent.Regression coefficients of binomial fitting complex model was 0.9759.Bias between observed values and predicted values was-3.86%.Conclusion The optimum model is simple,precise and highly predictive.

Abnormalities, Multiple ; genetics ; metabolism ; pathology ; surgery ; Actins ; metabolism ; Adolescent ; Chromosome Inversion ; Chromosomes, Human, Y ; Diagnosis, Differential ; Disorders of Sex Development ; genetics ; pathology ; Humans ; Hypospadias ; pathology ; surgery ; Male ; Mullerian Ducts ; abnormalities ; metabolism ; pathology ; surgery ; Neprilysin ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Syndrome

Objective To systematically review the existing evidence about the effect of medial and lateral (crossed) entry pins versus only lateral entry pin fixation on the supracondylar fractures of the humerus in children.Methods Eligible studies were identified in Cochrane library,the Cochrane Bone,Joint and Muscle Trauma Group (till March 2011 ),Medline (from 1966 to March 2011 ),EMbase (from 1966 to 2011 ),CBM (from January 1979 to March 2011 ),PubMed,Wanfang Data (from 2000 to March 2011 ) and CNKI and the references of the included studies and several Chinese orthopedic journals were manually searched.Then,the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) about two entries (crossed and only lateral pinning) for supracondylar fractures of humerus in children were collected.After evaluation of methodology with the enrolled studies,available data was extracted and systematic review was conducted via the method recommended by the Cochrane Collaboration.Results In total,five RCTs involving 311 patients were involved.Compared with the preoperative data,the meta-analysis results showed no significant difference in reduction stability in terms of change in Baumann angle and Carrying angle between the two groups.For the postoperative function outcome including complete reduction,Flynn grade and full return to function,no significant difference was found between the two groups.For the postoperative complications,there was no difference in the infection of pin tract,though lateral entry resulted in a significant lower incidence of the iatrogenic nerve injury compared with the medial and lateral entry.Conclusions With the Kirschner wire fixation for supracondylar fractures of humerus in children,current existing evidences indicate that the lateral entry of pinning has similar results in reduction stability,function outcome and incidence of pin tract infection compared with medial and lateral entry.Nevertheless,lateral entry,as a safe pinning technique,may effectively decrease the risk of iatrogenic nerve injury

OBJECTIVE:To study the feasibility of purifying the effective blood-fat dropping parts from radix puerariae and fructus crataegi and to optimize the technical conditions and parameters.METHODS:Absorption capacities of four different macroporous resins on pueraria total isoflavones,crataegi total flavonoids and crataegi total triterpenic acid were compared.With adsorption quantity as index,optimization of the technics of purifying the effective blood-fat dropping parts from radix puerariae and fructus crataegi with macroporous resins were performed.RESULTS:AB-8resin showed a best adsorbability on the effective blood-fat dropping parts from radix puerariae and fructus crataegi,its optimum purification condition was the following,the concentration of the stock solution was0.13g crude drug/ml with a flow rate at0.5ml/min,and its pH value at about3.5(the same as the stock solution);80%ethanol solution was taken as the eluting solvent at an eluting flow rate of2ml/min.The purity coefficient of the purified effective portions was above85%.CONCLUSIONS:AB-8macroporous resin could be used for the purification of the effective blood-fat dropping parts from radix puerariae and fructus crataegi,the process is feasible and the reproduction of resin is easy.

Objective To test intraoperative radiotherapy with mobile photon beam using the INTRABEAM system ( Germany) , and to analyze the dosimetric characteristics of low?energy photon beam using X?ray source and spherical applicators and explore its potential limitations in clinical application. Methods A special water phantom, a parallel?plate ionization chamber, and an electrometer were used to measure the depth dose rates and isotropy of dose distribution in x/y plane of X?ray source and different spherical applicators in the INTRABEAM system. Those data were then compared with the system data. Results For the X?ray source, the deviation of observed depth dose rate and isotropy in the x/y plane from the system data were-2.16%± 1. 36% and-1.9%~ 2. 1%, respectively. For applicators with different diameters, the deviation of observed depth dose rate, transfer coefficient, and isotropy in x/y plane from the system data were-10.0%~2. 3%,-8.9%~4. 2%, and-1.6%~2. 6%, respectively. Surface dose rate and dose gradient became larger with the decrease in the diameter of the spherical applicator. The measurement of depth dose rate and isotropy of X?ray source and spherical applicators showed good repeatability. The influencing factors for measurement accuracy included the positioning error of ionization chamber, energy response, noise current, and correction factor f ’ ( R ) . Conclusions This study reveals the dosimetric characteristics of the INTRABEAM system, verifies the accuracy of the system data, and obtains the data for clinical application and routine quality assurance. However, large dose gradient and small therapeutic range may limit its wide clinical application.

[Objective] To investigate the incidence and risk factors for posttransplantation anemia (PTA) following kidney transplantation. [Methods] A retrospective cohort study reviewing the medical records of the patients who received a renal transplant at our center from January 2004 to June 2008 was performed. All possible risk factors for PTA were recorded. Outcomes among the patients with PTA were compared with those without PTA using t-test and chi-square analysis methods. Logistic regression analysis was done to rank the relative risk of potential variables and calculate the 95% CI. [Results] Prevalence of PTA in our center was 31.0% (hemoglobin <120 g/L or Hct< 0.38 for males, < 110 g/L or Hct < 0.35 for males). Univariate and Logistic regression analysis revealed that the risk factors for PTA after kidney transplantation were female (RR=8.738; 95%CI 2.558～29.853; P= 0.001), creatinine level (RR=1.035; 95%CI 1.018～1.052; P<0.001) and acute rejection (RR=19.827; 95%CI 2.056～191.19; P=0.01); [Conclusions] PTA is a frequent complication after kidney transplantation. Great attention should be paid to this complication considering its negative effect on graft function. Female, impaired renal function and acute rejection are risk factors of anemia in kidney transplantation recipients.

Objective To investigate whether the change of cardiac output (CO) with bed head raising (BHR) combined with passive leg raising (PLR) can be used to assess volume overload in critical patients.Methods A prospective observational diagnostic trial was designed. The patients who underwent fluid resuscitation 6 hours or more, and admitted to intensive care unit (ICU) of Meizhou People's Hospital in Guangdong Province from January to December in 2016 were enrolled. Volume overload were identified with the criteria including the increasing of pulmonary rales, the higher levels of N-terminal brain natriuretic peptide (NT-proBNP) and new pulmonary exudates in chest radiograph. CO and heart rate (HR) were monitored with impedance cardiography at supine position and BHR by 30°(BHR30), 60° (BHR60), and PLR in all patients. The changes of CO (?CO30,?CO60,?COPLR) and HR (?HR30,?HR60,?HRPLR) were calculated at different positions. The receiver operating characteristic curve (ROC) was used to evaluate the predictive values of?CO30,?CO60 and combination of?CO60 and?COPLR on volume overload.Results A total of 62 patients were enrolled in this study, with 44 males and 18 females, age of (58.9±15.9) years, a body mass index of (22.7±2.4) kg/m2, and an acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of 18.7±4.4. The CO of 32 patients with volume overload was significantly increased at BHR30 or BHR60 compared with supine position [?CO30 was (14.5±11.5)%,?CO60 was (26.9±17.5)%, bothP< 0.01], and the?CO60 was increased more than the?CO30 (P < 0.01);while CO was slightly decreased after PLR,?COPLR was (-8.4±11.3)% (P > 0.05). There was no consistent change of CO at BHR30 or BHR60 compared with supine position in 30 patients without volume overload,?CO30 was (-3.4±9.1)% (P < 0.05),?CO60 was (-2.4±14.0)% (P > 0.05), while CO was significantly increased after PLR,?COPLR was (12.4±11.3)% (P < 0.01). There was no significant change of HR after BHR and PLR in patients with volume overload and non volume overload. ROC curve showed that when the cut-off value of ΔCO30≥3.3%, the area under ROC curve (AUC) was 0.903±0.039, the sensitivity was 90.6%, the specificity was 80.0%, and the accuracy was 85.5% for predicting volume overload; when the cut-off value of ΔCO60≥5.6%, the AUC was 0.911±0.036, the sensitivity was 96.9%, the specificity was 73.3%, and the accuracy was 85.5% for predicting volume overload. If volume overload was assessed by the increase of ΔCO60 combining with the decrease of ΔCOPLR, the AUC was 0.928±0.034, the optimal cut-off value for the new combined predictive indicator in predicting volume overload was -0.008, and the sensitivity, specificity, accuracy was 96.9%, 83.3%, 90.3%, respectively, and its evaluation effect is better than the use of ΔCO30 or ΔCO60 alone.Conclusion The change of CO with BHR combined with PLR can be used to accurately evaluate volume overload in patient with critically illness.

Objective To investigate the effect and mechanisms of recipient-derived immature dendritic cells(imDC) transfected with IKK2dn and loaded with donor antigen on renal allografts survival in the rats.Methods DC were cultured from recipient rats'(Lewis) bone marrow,transfected with IKK2dn and loaded with donor antigen.The expression of CD86 and MHC Ⅱ was detected,and the ability of DC stimulating lymphocyte proliferation in vitro was measured.Male Brown Norwav rats and Lewis rats were used as donors and recipients respectively.Four groups were set up(DC group,empty transfection group,transfection group and control group),receiving 1×10~7 DC,Adv-0-DC,Adv-IKK2dn-DC loaded with BN antigen,and equal volume of normal saline,respectivelv 7 davs before transplantation.In the third party donor-group,Wistar rats as donors were treated the same as DC;group before transplantation.After transplantation,the T lymphocyte proliferation in reciPients was measured and the expression of serum IL-2 and IFN-γ was detected.The survival time of recipients and the acute reiection were observed.Pathological changes were examined tO identify the grade of rejection.Results DC assessment in vivo revealed that the transfected DC could still express CD86 and MHC Ⅱ in a low level as compared with those not transfected with IKK2dn. After DC were loaded with donor's antigen,the expression of CD86 and MHC Ⅱ was up-regulated.After DC were transfected with IKK2dn before loaded with donor's antigen, the expression of CD86 and MHC Ⅱ had no significant change. When DC were loaded with donor's antigen, its allostimulatory activity of T lymphocyte proliferation was enhanced (P<0. 05). When DC were transfected with IKK2dn before loaded with donor's antigen, its allostimulatory activity of T lymphocyte proliferation was not enhanced. Compared with control groups, IKK2dn-transfected DC pulsed with BN splenocyte lysate markedly prolonged the survival of renal allografts (26. 8±1.76d, P<0.01), and elicited markedly lower proliferative responses and reduced IL-2 and IFN-γ production. The pathological grade of rejection was low in the transfection group. Conclusion Recipient-derived imDC transfected with IKK2dn and loaded with donor splenocyte lysate could prolong the renal allograft survival in rats probably by down-regulating the expression of DC costimulatory molecules and inhibiting the T_H 1 cytokine production.

Objectives To explore ventilation induced cytokine production and the role of oxidant stress in lung stretch. Methods Both in vitro and in vivo models of ventilator-induced lung injury (VILI) were used. Alveolar epithelial cells were stretched in vitro to mimic the lung injury in VILI. Rats were ventilated at large tidal volume to produce ventilator-induced lung injury in vivo. A total of 23 inflammatory cytokines were screened with micro gene array in stretched alveolar epithelial cells. Cytokines found to have up-regulated in cells were measured in serum and lung tissue of rats exposed to large tidal volume ventilation. For investigating the intracellular pathway of cytokine up-regulation in VILI, exogenous TNF-α or H2O2 was added to culture media of alveolar epithelial cells. Cytokines were then measured. To explore the role of oxidant stress in VILI, N-acetylcysteine (NAC), as an anti-oxidant, was used in vitro and in vivo. Results We found that transforming growth factor-β1 (TGF-β1 and transforming growth factor-β2 (TGF β2) were up-regulated in stretched alveolar epithelial cells and also in serum of rats with large tidal volume ventilation. Tumor necrosis factor-α (TNF-α) had no effects on TGF-β production in alveolar epithelial cells. Exogenous H2O2, as an oxidant, increased TGF-β production in alveolar epithelial cells. NAC, an anti-oxidant, decreased stretch induced TGF-β production, along with a down-regulation of oxidant injury. NAC also blocked the up-regulation of TGF-β in in vivo model of VILI. Conclusion TGF-β1 and TGF-β2 were up-regulated in VILI. Oxidant injury mediated up-regulation of TGF-β in VILI. NAC, which attenuated oxidant injury and blocked TGF-β up-regulation in VILI, could be a future therapeutic strategy in VILI.