Objective To explore efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of distal tibia comminuted fracture by using normal anatomical plate. Methods Between January 2007 and July 2008,18 cases of distal tibia facture were treated by MIPPO using anatomical plate. The clinical data of the patients were reviewed. Results A mean of 6.5 cm incision (5.0-8.5 cm) was made in the patients; the intraoperative blood loss ranged from 60 to 300 ml (mean,145 ml);and the operation time ranged from 30 to 120 min with a mean of 63 min. After the surgery,2 patients developed mild skin necrosis,and was then cured by conventional therapy; no patient had nonunion of the fracture,failure of internal fixation,or delayed wound healing. The 18 cases were followed up for a mean of 8 months (range,4 to 10 months); all of them were healed clinically and could walk without crutch in 4 months postoperatively. According to Johner-Wruhs score system,11 were excellent and 7 were good; the excellent-good rate was 100%. Conclusions MIPPO with anatomical plate is an optimal treatment for distal tibia comminuted fracture with advantages in protecting the soft issues and bony blood supply,promoting the wound-healing process,and reducing the rate of complications.

CD4 Antigens ; immunology ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; T-Lymphocyte Subsets ; immunology ; physiology ; T-Lymphocytes, Regulatory ; physiology

OBJECTIVE:To put forward the tentative idea of the application of the access and benefit-sharing regime in the field of Chinese medicine.METHODS:The existing problems of protecting biological diversity in the field of Chinese medicine and what problems the access and benefit-sharing regime could solve were analyzed.RESULTS & CONCLUSION:Our preliminary idea for applying access and benefit-sharing regime in the field of Chinese medicine is to set up a special department for negotiation,identify the rights and subject,construct registration system and informed consent procedure,improve the source disclosure system and add the benefit-sharing regulation.

Objective: To observe the clinical efficacy of acupoint injection with salmon calcitonin for back pain in elderly patients with primary osteoporosis. Methods: A total of 76 patients were selected and randomly divided into two groups by the random number table method, with 39 cases in the treatment group and 37 cases in the control group, respectively. Patients in both groups received routine anti-osteoporosis treatment. Patients in the treatment group received additional acupoint injection with salmon calcitonin at bilateral Pishu (BL 20) and Shenshu (BL 23), while patients in the control group received additional intramuscular injection with salmon calcitonin. The treatments for both groups were given once a day and lasted for 4 weeks. Visual analog scale (VAS) and Chinese Oswestry disability index (CODI) scores were observed before treatment, after 2 weeks and 4 weeks of treatment, and the use of analgesics during the treatment were recorded. Results: After treatment, the clinical efficacy in the treatment group was more significant than that in the control group (P<0.05). After 2 weeks and 4 weeks of treatment, the VAS scores in both groups showed significant intra-group and between-group differences (all P<0.05), and the CODI scores in both groups showed significant intra-group differences (all P<0.05). After 2 weeks of treatment, the CODI score showed no significant between-group difference (P>0.05). After 4 weeks of treatment, the improvement of CODI score in the treatment group was more significant than that in the control group (P<0.05). During the treatment, 2 cases in the treatment group took analgesics versus 8 cases in the control group, and the result showed a significant between-group difference (P<0.05). Conclusion: For back pain in elderly patients with primary osteoporosis, based on the routine treatment of oral medication, the clinical efficacy of acupoint injection with salmon calcitonin at bilateral Pishu (BL 20) and Shenshu (BL 23) is more significant than that of intramuscular injection. Acupoint injection treatment can improve patients' conditions and reduce the use of analgesics.

Adult ; Electromyography ; Gasoline ; poisoning ; Humans ; Male ; Poisoning ; physiopathology ; psychology ; Young Adult

BACKGROUND:Three-dimensional (3D) printing technology exhibits a broad future in the orthopedics,especially exhibiting good guidance and auxiliary in the treatment of tibial plateau fractures.However,the related researches are few,and there is a lack of evidence-based medicine to confirm its application values.OBJECTIVE:To compare the efficacy of 3D printing-assisted surgery and traditional surgery in the treatment of tibial plateau fractures through a meta-analysis.ME=THODS:MEDLINE,Cochrane library,Embase,CBM,CNKI and WanFang databases were searched by computer and the relevant literatures were retrieved manually,to collect the controlled trials concerning the efficacy of 3D printing-assisted surgery versus traditional surgery for tibial plateau fractures.Methodology quality of the trials was assessed critically and relative data were extracted,followed by analysis on Stata 11.0 (Stata Corporation,College Station,TX) software.RESULTS AND CONCLUSION:(1) Seven controlled trials involving 362 patients were included.(2) Meta-analysis results showed that the 3D printing-assisted surgery had shorter operation time (SMD=-2.411,95％C/=-2.718-2.104,P=-0.00) and less intraoperative blood loss (SMD=-1.579,95％C/=-1.842--1.316,P=-0.00) than those in the traditional surgery.The excellent and good rate in Rasmussen and Hospital for Special Surgery knee scores showed no significant differences between two growps (P ＞ 0.05).(3) To conclude,compared with the traditional surgery,the 3D printing-assisted surgery can significantly shorten the operation time and reduce the intraoperative blood loss in the treatment of tibial plateau fractures.

Acute paraplegia is a rare presentation for a spinal cord ependymoma. Subarachnoid hemorrhage (SAH) due to spinal ependymoma is also very rare. We report a 32-year-old woman who presented with acute paraplegia and typical clinical signs of SAH with normal cerebral angiography, and further diagnostic work-up revealed an spinal cord ependymoma as the source of the hemorrhage. There is evidence that some spinal cord ependymomas have intratumoral hemorrhage, but most of these bleedings occur without symptoms. We discuss the clinical and neuroradiological findings of this rare case and review the literature related to this unusual presentation.431

To develop a safe and efficient recombinant subunit vaccine to foot-and-mouth disease virus(FMDV)type Asia 1 in sheep,a tandem repeated multiple-epitope gene consisting of residues 137-160 and 197-211 of the VP1 gene of FMDV was designed and artificially synthesized.The biologically functional molecule,the ovine IgG heavy constant region(oIgG)as a protein carrier was introduced for design of the multiple-epitope recombinant vaccine and recombinant expression plasmids pET-30a-RE and pET-30a-RE-oIgG were successfully constructed.The recombinant proteins,RE and RE-oIgG,were expressed as a formation of inclusion bodies in E.coli.The immune potential of this vaccine regime in guinea pigs and sheep was evaluated.The results showed that IgG could significantly enhance the immune potential of antigenic epitopes.The recombinant protein RE-oIgG could not only elicit the high levels of neutralizing antibodies and lymphocytes proliferation responses in the vaccinated guinea pigs,but confer complete protection in guinea pigs against virus challenge.Although the recombinant protein RE could not confer protection in the vaccinated animals,it could delay the appearance of the clinical signs and reduce the severity of disease.Inspiringly,the titers of anti-FMDV neutralizing antibodies elicited in sheep vaccinated with RE-oIgG was significantly higher than that for the RE vaccination.Therefore,we speculated that this vaccine formulation may be a promising strategy for designing a novel vaccine against FMDV in the future.

Objective To observe the changing characteristics of plasma lysophosphatidic acid (LPA) or acidia phospholipid (AP) levels in patients with obstructive sleep apnea syndrome-associated(OSAS)acute cerebral infarction and to explore the pathophysiological mechanisms of OSAS-related stroke so as to provide basis for clinical antithrombotic therapy. Methods Thirty-six patients of OSAS, 32 patients of OSAS-related acute stoke and 36 patients of acute stoke without OSAS diagnosed by clinical and accessory examinations were enrolled in the current study. Thirty-eight age-matched healthy subjects were recruited as controls. The changes of the plasma LPA and AP levels were measured. Results Within 24 hours after symptom onset, the plasma LPA and AP levels in the OSAS-related acute cerebral infarction group (LPA(3. 78 ±0. 56) μmol/L; AP(7. 63 ± 1. 38) μmol/L) were significantly higher than those in the OSAS group(LPA(3. 17 ±0. 65) μmol/L; AP(6. 60 ± 1. 20) μmol/L) ,the not OSAS-related acute cerebral infarction group (LPA (3. 40 ± 0. 59)μmol/L; AP (6. 41 ± 1. 37)μmol/L) and the control group (LPA(2.76±0.45)μmol/L;AP(4.52±0. 83) μmol/L (P < 0. 01)) . The levels of LPA and AP in the OSAS group and the not OSAS-related acute cerebral infarction group were significantly higher than those in the control group(P<0. 01). Seven days after symptom onset, the plasma LPA and AP levels in the OSAS-associated acute cerebral infarction group (LPA(3.08 ± 0. 58) μmol/L; AP(6. 15 ±1. 14)μmol/L) were still higher(P < 0. 01) . The plasma LPA levels were not significantly different among the OSAS-related acute cerebral infarction group, the not OSAS-related acute cerebral infarction group and the control group 21 days after symptom onset, whereas the plasma AP levels in the OSAS-related acute cerebral infarction group (5. 04 ± 0. 83) μmol/L were still significantly higher than those in the not OSAS-related acute cerebral infarction group (4. 57 ± 0. 94) μmol/L and the control group (P < 0.05). Conclusions The significantly elevated plasma LPA and AP levels in patients with OSAS suggested that platelets in vivo are in an activated state and in cerebral ischemia and hypoxia state, especially for the OSAS-related acute cerebral infarction patients. The activated state of platelet may persist for a long time, thus the time window for antithrombotic therapy may be longer.

Cardiomyopathy, Dilated ; pathology ; Humans ; Infant, Newborn ; Male