The characteristics and purpose of treatment of tibiofibular comminuted fracture is reviewed in this paper.The present points of view is that tibiofibular comminuted fracture is a kind of smash fracture,that is valuable for restoring its tubular structures.The appearance of a series of new type plates and external fixations represents the trend of researching.The combination of internal/external-fixation and sequential treatment is waited for more research.

Objective:To explore the solutions to enhance the professional skills and humanistic quality of neurosurgery in theprimary hospitals, and to improve the neurosurgery medical care level.Methods: a comprehensive analysis of the literature retrieval as well as information collected in practice the first hospital of Zhangjiakou in, extract the problems of neurosurgeon training in primary hospital, to carry out grading treatment requirements, explore the basic path to improve the clinical ability of primary hospital neurosurgeon, and through the establishment of standard clinical operating procedures and systems to ensure the quality of medical service.Results: from Wanfang database retrieved from 2006 to 2015 research journals in Chinese on improving grassroots doctors ability of 819 papers, bibliometric analysis shows that the trend is increasing year by year, in 2015 issued a number is 5.21 times in 2006. There are 28 papers including neurosurgery area, accounting for 3.42% of the total number of papers; the hot topics focus in the mode of training neurosurgery doctors in primary hospitals,transfer the technology of minimally invasive neurosurgery and spreadmodern neurosurgery theory and knowledge.Conclusion: to improve the ability of doctorsof primary hospitals should be combined with the characteristics of local diseasesand primary hospital neurosurgeon status, from making training plan, appropriate to establish the corresponding clinical standard, promote the essential neurosurgery technology, in order to ensure implementation of the tiered diagnosis and treatment .

Objective To study and evaluate the diagnostic and differencial diagnostic value of detection of human telomerase reverse transcriptase(hTERT) mRNA and telomerase activity in pancreatic juice of (pancreatic) cancer(PC) .Methods hTERT mRNA expression and telomerase activity in pancreatic juice in 24 cases of (pancreatic) cancer and 14 cases of chronic pancreatitis(CP) were detected and compared.Results Expression of hTERT mRNA was detected in 87 .5% (21/24) of PC cases and 21.4%(3/14) of CP cases(P

Objective To discuss external fixation method for the complex diaphyses fracture involving condyles of femur and evaluate its clinical efficacy.Methods A retrospective study was done on 42 patietns with comminuted femur diaphyses fracture combined with distal intra-articular fractures treated surgically from January 2001 to Janurary 2007.There were 24 males and 18 females at mean age of 33 years (20-66 years).According to AO/ASIF classification,there were 18 patients with type C2 fractures and 24 with type C3 ones.Simple internal fixation plus external fixation was performed on patitents with C3 fractures but only external fixation on those with C2 fractures.Four patients were treated with intramedular fixation.Results All patients were followed up for 1-12 months.According to Kotmert's assessment standard on function of proximal femur,the knee function was satisfactory in 35 patients (83% ) ,good in six (14% ) and unsatisfactory in one (2% ).Conclusions Minimally invasive external fixation can utmostly restore relative length of the femur and regulate between articular face of the femur and longitudinal axis of femur shaft to reach a symmetrical relation with middle and inferior part of opposite femur.Postoperative exercise is important for maximal recovery of the knee function.Attention should be paid to reconstruction of tubiform structure of the femur.

Objective To analyze, treatment of ipsilateral Pilon and calcaneal fractures (IPCF). Methods Injury causes included fallings in seven patients, traffic injury in two and impact injury in one, with ISS score of 5-22 points. There were seven patients with open injuries and 3 with close ones. Nine pa-tients had Ⅱ-Ⅲ degree of Pilon fractures according to the AO/OTA classification and six comminuted com-pression calcaneal fractures according to the Essex-Loprest classification. The Pilon fractures were fixed by cannulated nail, screw or Kirschner wire through open reduction in six patients including four fixed with ex-ternal fixators (the calcaneal fractures were fixed with percutaneous eannulated nail or Kirschner wire by poking reduction). The calcaneal fractures were fixed with only Kirschner wire through poking reduction in two patients and double fractures treated conservatively in two. Results The reduction of Pilon and cal-caneal fractures treated by operation were markedly improved in six patients, while there occurred angular deformity and joint surface introeession in the patients treated conservatively. The wound healing of soft tis-sue was sound in seven patients but unsatisfactory in the other three. The ankle-hind foot score was 82-94 points in four patients who were followed up. Conclusions IPCF is caused by the high energy force and characterized by severe injures of the soft tissues and the bone tissues at the distal tibia and calcaneua, for which limited internal fixation plus external fixation are suitable treatment choice.

The experience in diagnosis and treatment of bleeding complications in severe acute pancreatitis (SAP) by transcatheter arterial embolization was summarized. The clinical data of 19 SAP patients complicated with intra-abdominal bleeding in our hospital from Jan. 2000 to Jan. 2003 were analyzed retrospectively and the therapeutic outcome of TAE was evaluated statistically. The results showed that the short-term successful rate of hemostasis by TAE was 89.5% (17/19), the incidence of re-bleeding after TAE was 36.8% (7/19) and the successful rate of hemostatis by second TAE was 71.4% (5/7). It was concluded that the intra-abdominal bleeding in SAP was mainly caused by the rupture of erosive/infected pseudoaneurysm. Mostly, the broken vessels were splenic artery and gastroduodenal artery; In terms of emergence hemostatis, TAE is the most effective method. Surgical hemostasis is necessary if hemostasis by TAE is failed or re-bleeding occurs after TAE.
Aneurysm, False/diagnosis ; Aneurysm, False/etiology ; Aneurysm, False/therapy ; *Embolization, Therapeutic/methods ; Hemoperitoneum/diagnosis ; Hemoperitoneum/etiology ; Hemoperitoneum/*therapy ; Pancreatic Pseudocyst/diagnosis ; Pancreatic Pseudocyst/etiology ; Pancreatic Pseudocyst/therapy ; Pancreatitis, Acute Necrotizing/*complications ; Pancreatitis, Acute Necrotizing/therapy ; Retrospective Studies

The proliferation and differentiation of pancreatic duct epithelial cells in remnant pancreas during regeneration after partial pancreatectomy in rats were studied, and the source of pancreatic stem cells was characterized. Partial (90 %) pancreatectomy was performed on 4- to 5-week-old Sprague-Dawley rats, and different duct epithelial cells and acinar cells were detected by immunohistrochemical stain method and scored using 5-bromo-2'-deoxyuridine (BrdU) labeling index (LI) at various time points after partial pancreatectomy. It was found that at 24 h after partial pancreatectomy proliferation started in the main, large and small duct cells, and persisted in small duct cells to day 5. There was significant difference between the experimental group and the control group (P<0.001). Acinar cells positive for BrdU were greatly increased and reached the peak LI on day 5. The destroyed lobular architecture almost totally recovered on day 7, and the newly islet cells appeared around the pancreatic ducts. These results suggest that regeneration after partial pancreatectomy is involved in proliferation and differentiation of pancreatic stem cells, and pancreatic stem cells may locate in the pancreatic ductules.

In order to investigate the expression of Notch-1 in rats with acute pancreatitis (AP) and its relation with apoptosis of pancreatic cells, mild AP (MAP) and severe AP (SAP) models were established by retrograde injection of different concentrations of sodium taurocholae into pancreatic duct. The apoptosis index and the expression of Notch-1 protein and mRNA were detected by using TUNEL, Western blot and real-time PCR in MAP and SAP at different time intervals. The results showed that in MAP group the apoptosis index was significantly elevated during 4 to 24 h after induction of pancreatitis, but there was no significant difference among different time intervals. In SAP group, the apoptosis index reached the peak at 4th h after induction of pancreatitis, then gradually declined. There was significant difference in apoptosis index between MAP and SAP groups. Starting from 4th after induction of pancreatitis, the expression of Notch-1 in both MAP and SAP group was increased at different time intervals, but that in SAP group was significantly higher than in MAP group (P<0.05). The expression of Notch in MAP and SAP groups reached the peak at 12th and 8th h respectively after induction of pancreatitis. It was concluded that there was significant difference in apoptosis index and the Notch-1 expression in different types of AP. The overexpression of Notch-1 could aggravate AP by inhibiting the apoptosis of pancreatic cells.

The effects of oxygen partial pressure on cryopreservation of the cells with organ preservation solution were explored. Hypoxic UW solution was made by purging the UW solution with argon. The pig proximal tubule epithelial cells (LLC-PK1 cells) were cryopreserved in hypoxic UW solution (Ar-UW group) or standard UW solution (UW group) at 4 degrees C for 48 h. Trypan blue staining and LDH detection were performed to evaluate the injury of the cells. The results showed that the oxygen partial pressure in Ar-UW group was significantly declined from 242+/-6 mmHg to 83+/-10 mmHg. After cryopreservation at 4 degrees C for 48 h, LDH leakage rate and Trypan blue-stained rate in Ar-UW group were (11.3+/-3.4)% and (10.5+/-4.7)%, respectively, which were significantly lower than in UW group [(49.5+/-6.9)% and (47.6+/-9.3)% respectively, both P<0.01]. It was concluded that lower oxygen partial pressure of UW solution was more beneficial to the cryopreservation of LLC.
Adenosine ; Allopurinol ; Cell Hypoxia ; Cell Line ; Cryopreservation ; Cryoprotective Agents ; Epithelial Cells/*cytology ; Glutathione ; Insulin ; Kidney Tubules, Proximal/cytology ; Organ Preservation Solutions ; Oxygen/pharmacology ; Raffinose ; Swine ; Tissue Preservation/methods

In order to explore the method to prepare hypoxia UW solution and the stability and preservation of hypoxia UW solution, UW solution was purged by argon or air for 15 min or 60 at a flow rate of 0.8 or 2 L/min, and the oxygen partial pressure of UW solution was detected. The hypoxia UW solution was exposed to the air or sealed up to preserve by using different methods, and the changes of oxygen partial pressure was tested. The results showed that oxygen partial presure of 50 mL UW solution, purged by argon for 15 min at a flow rate of 2 L/min, was declined from 242+/-6 mmHg to 83+/-10 mmHg. After exposure to the air, oxygen partial pressure of hypoxia UW solution was gradually increased to 160+/-7 mmHg at 48 h. After sealed up by the centrifuge tube and plastic bad filled with argon, oxygen partial pressure of hypoxia UW solution was stable, about 88+/-13 mmHg at 72 h. It was concluded that oxygen of UW solution could be purged by argon efficiently. Sealed up by the centrifuge tube and plastic bag filled with argon, oxygen partial pressure of UW solution could be stabilized.
Adenosine/chemical synthesis ; Allopurinol/chemical synthesis ; Anoxia ; Glutathione/chemical synthesis ; Insulin/chemical synthesis ; Organ Preservation/*methods ; Organ Preservation Solutions/*chemical synthesis ; Oxygen/*analysis ; Partial Pressure ; Raffinose/chemical synthesis