The distal humeral fractures are difficult to treat because of the nature of the injury. Although numerous operative approaches have been describe d for them,satisfactory results are difficult to achieve because of the postoper ative complications.We have reviewed relative literature to discuss the incidenc e,cause,prophylaxis and treatment of different complications to deepen the knowl edge of distal humeral fractures.

Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.

Objective To develop a biosensor method with strong specificity and high‐throughput by combining with the surface plasmon resonance (SPR) and gene chip technique and aiming at 9 kinds of common respiratory tract viruses including influenza A and influenza B ,(Influ A ,B) ,H1N1 ,respiratory syncytial virus (RSV) ,parainfluenza virus 1 -3 (PIV1 -3) ,adenovirus (ADV) and coronavirus (SARS) leading to severe acute respiratory syndrome .Methods Firstly the software primer 5 was used to design the specific primer and probe of related viruses in the conserved sequence ;the designed nine kinds of corresponding respiratory virus probes were immobilized in the specific region of SPR chip after chemical modification .The SPR technique was applied to conduct the real time monitoring the hybridization process of the probe with the PCR products .Finally the signal amplification was realized by the biotin and streptavidin system .Results The designed gene chip could detect 9 kinds of respiratory tract viruses by high‐throughput with better detection specificity ;the chip surface could be reutilized after certain regeneration condition ,which avoided the influence of intra‐batch difference on the results ;the detection sensitivity reached the nanomole level .Conclusion The prelimi‐nary study results demonstrate that using the SPR biosensor technique to establish a high‐‐throughput detection of respiratory tract viruses has some practicability and feasibility ,and is expected to become a rapid ,large scale and high‐ throughput measure for screening respiratory tract viruses with good application prospect .

Objective To summarize the clinical experience of laparoscopic repair of esophageal hiatal hernia.Methods A total of 15 cases of esophageal hiatal hernia underwent laparoscopic hernia repair and fundoplication from May 2004 to April 2005 in this division.There were 4 cases of type Ⅰ hernia(all of which presented severe gastroesophageal reflux disease),10 cases of type Ⅱ hernia,and 1 case of type Ⅲ.Surgical procedures included laparoscopic Nissen total fundoplication in 9 cases,Toupet partial fundoplicatin in 4 cases,and Dor partial fundoplication in 2.Symptoms of gastroesophageal reflux disease,including heart burn,dysphagia,regurgitation,chest pain,and belching,were evaluated by using the Visual Analogue Scales(VAS) at preoperative period,1 postoperative month,and 6 postoperative months,respectively.Results No conversion to open surgery was required in this study.The operative time ranged 100~187 min(mean,125 min).The postoperative hospital stay was 2~5 days(mean,2.8 days).All the patients were followed for 1~12 months(mean,8.5 months).No hernia recurrence was found.The VAS scores decreased from 5.0?3.9 preoperatively to 0.9?1.3 at 1 month postoperatively(t=3.823,P

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

The major surgical managements for tibial plateau fractures are anatomical reduction, firm fixation and bone grafting. There have appeared many new techniques in recent years, such as less invasive stability system (LISS) and arthroscopy assisted treatment. But such complications as loss of reduction, infection, soft tissue lesion around the knee, nonunion, posttraumatic arthritis, and knee stiffness seem to be inevitable. This article introduces the mechanism, treatment and prevention of the complications of the tibial plateau fracture.

Objective To study application of surface plasmon resonance(SIR)system in detection of clinical pathogen with a gene chip.Methods 27 clinical samples were detected by SPR-based gene chip system.These samples were composed by 8 positive blood samples,3 positive pyoid samples,9 positive leucorrhea samples and positive reproductive tract pyoid samples,1 positive biopsy sample and 6 negative biopsy samples.Specific primers and probes for target pathogens were designed by bioinformatics methods and validated by PCR and enzyme-labelled chemiluminescence,respectively.SPR-based gene chip was prepared and utilized to detect clinical samples by SPR system.Results The primers and probes showed good specificity and accuracy,which can be applied to perform PCR and application of the gene chip.Compared with the clinical analysis,gene chip analysis of 26 clinical samples showed the consistent results.Conclusions SPR detection system proved to be accurate and reliable.The chip will have a promising prospect in application.

Objective To study the platelet antibody screening and crossing match by surface plasmon resonance(SPR) ,and to find a new way for platelet compatibility testing .Methods The corresponding universal platelet antigen was fixed on the SPR chip surface by the amino coupling method .Platelet antibody positive and negative control serum were analysed by SPR micro-ar-ray ,the stability ,sensitivity and specificity of this technique were discussed ,and compared with MAIPA assay .Finally we used the SPR technology to cross match for ten cases of the platelet antibody positive patients before infusion ,and to evaluate the effect of platelet infusion .Results For the SPR technology ,the stability ,sensitivity and specificity of platelet antibody detection were all better ,106 cases of the repeated platelet transfusion samples were tested by SPR assay and MAIPA method ,there was no signifi-cant difference between them(chi-square=0 .333 ,P>0 .05) ,the total consistency was 97 .2% .The 10 cases of platelet antibody positive patients were crossed match before platelet transfusion by SPR technology ,the good results of 8 cases of them were found by the clinical tracking evaluation ,1 h CCI>7 .5 ,24 h CCI>4 .5 .Conclusion SPR technology for screening platelet antibody mat-ches with MAIPA method in basic quality ,but SPR assay is simple ,rapid ,reliable and intuitive ,label free ,which can satisfy the re-quirements for clinical rapid detection of platelet antibody screening and crossing match .

OBJECTIVE A practical gene chip which aimed to detect and identify pathogens rapidly and exactly is developed on the basis of patent technology of nano-enlargement-detection. METHODS Oligonucleotide probes for the specific gene fragments of target pathogens were designed and immobilized on gene chip.Target sequences were labeled by nanogold as reporter materials.After hybridization,its results were recorded by the interaction between nanogold and silver which amplified the hybridization signal to form brown particles,which could be detected by naked eyes. RESULTS The probes designed were all of strong specificity and great reliability possessing identity of hybridization conditions.The reaction time for marking could be decreased by properly raising the ratio of nanogold and nucleic acid and the speed of labeling reaction could be fastened significantly by gentle agitation.A better hybridization results could be obtained when the samples were hybridized for 8 hours at 45℃ with 0.8 mol/L ionic strength,and then strictly rinsed.Furthermore,the hybridization efficiency could be increased remarkably by slight circumgyratation.A better chromatic effect resulted from the reaction way in 3min?3 at 37℃.The sensitivity of gene chip assays in this test could reach to 100 fmol/L.Compared with traditional detection approach,detection by the chip displayed such advantages as speediness and simplicity and the detection results could be easily recognized by naked eyes. CONCLUSIONS The chip detection technology has met the demand of design exhibiting high sensitivity,strong specificity,and easy operation without special device and showing a promising prospect.

Objective For realizing the simultaneous detection of multiple pathogens,by looking for a method with a combination of the new gene chip detection system based on nano-gold with the technology of restriction endonuclease without PCR.Methods Helicobacter pylori,Mycoplasma pneumoniae,Chlamydia trachomatis,Candida albicans,Ureaplasma urealyticum,and EB virus were selected as the experimental targets.Endonuclease Hha Ⅰ was selected as tool enzyme.After bering digested by Hha Ⅰ,the digested fragments of samples were tailed with poly-A.The samples were then detected by the gene chip detection system based on nano-gold.Both specific and common probes were used in the hybridization.The coincidence rate of the detection results between the new constructed chip test and the fluorescence quantitative PCR test in 168 clinical samples was examined.The stability and sensitivity of chips detection were also checked.Results The new constructed nano-gold-baesd gene chip combined with restrictive enzyme digestion without PCR could be used to detect the target pathogens.The coincidence rate of the chip detection test and fluorescence quantitative PCR test in 168 clinical samples was 89.2%.Chip detection results showed that the stability of chips detection was 100% and the sensitivity was 50pmol/L.Conclusion The newly constructed nano-gold-baesd gene chip combined with restrictive enzyme digestion without PCR can be widely applied in the simultaneous detection of Mycoplasma,Chlamydia,fungus,virus and bacteria.It shows a bright prospect in increasing the throughput of identifieation of pathogene.