Treatment of sacral fractures,unstable ones in particular,has attracted more and more attention.Despite numerous classification systems for sacral fractures,the commonly used ones are Denis and Tile classifications.Stable sacral fractures deserve conservative treatment,but unstable ones should be treated surgically,by operative reduction,internal fixation to reconstruct stability of the pelvis,and prevention or relief of nerve compression.There are many methods of internal fixation for unstable sacral fractures,and each has its own advantages and disadvantages.This review summarizes the progress in surgical treatment of unstable sacral fractures and makes comments on the latest surgical strategies.

Objective To explore the relationship between N-acetyltransferase-2(NAT2)alleles polymorphism and type 2 diabetes mellitus(T2DM).Methods Polymerase chain reaction and sequence determination technique were used to identify NAT2 alleles in 174 patients with T2DM(T2DM group)and 174 unrelated healthy individuals(control group).Results Compared with control group,the allelic frequency of NAT2 mutation was no significant difference in T21DM group(x2=7.38,P＞0.05).The frequencies of the NAT2 genotypes(Wt/Wt,Wt/M1,Wt/M2,Wt/M3,M1/M1,M1/M2,M1/M3,M2/M2,M2/M3,M3/M3)were 39.08％(68/174),3.45％(6/174),22.99％(40/174),14.94％(26/174),0.57％(1/174),2.30％(4/174),1.15％(2/174),4.60％(8/174),9.20％(16/174),1.72％(3/174)and 44.83％(78/174),2.60％(8/174),27.59％(48/174),17.24％(30/174),0.57％(1/174),0.57％(1/174),0.57％(1/174),1.15％(21174),2.30％(4/174),0.57％(1/174)respectively,and significant differences showed between T2DM group and control group(x2=13.92,P＜0.01).The proportion of fast acetylate in T2DM group was significantly higher than that in control group[94.25％(164/174)vs.80.46％(140/174)],and the propoaion of slow acetylate in T2DM group was significantly lower than that in control group[5.75％(10/174)vs.19.54％(34/174)](P＜0.05),The risk of T2DM in people who were fast acetylate had 3.98 times(95％ CI:1.90-8.35)more than that in people who were slow acetylate.Conclusion It shows that the fast acetylate may be one of the genetic factors that influencing the susceptibility to T2DM,and slow acetylate may be one of the protecting factors.

AIM: To explore the effect of acute and chronic hypoxia on the chemotaxis of polymorphonuclear leukocytes(PMNs) of rats.METHODS: Serum and PMNs were separated from rats under normoxia, acute hypoxia and chronic hypoxia condition,and cell aspiration technology system was used to determine the chemotactic migration of pseudopod of PMNs induced by serum as chemotactic factor.RESULTS: Induced by autoserum,the length of pseudopod of PMNs migrated into micropipette [(1.200?0.178)?m,(1.094?0.164)?m ]under acute hypoxic and chronic hypoxic condition was significantly longer than the corresponding value for control[(0.914?0.156)?m,P

Adolescent ; Child ; Child, Preschool ; Female ; Homeodomain Proteins ; genetics ; Humans ; Infant ; Male ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics

Objective To evaluate the protective effects of ulinastatin on renal function in rabbits with traumatic hemorrhagic shock. Methods Thirty rabbits were randomly allocated to three groups: control group, traumatic hemorrhagic shock group and ulinastatin treatment group. Blood was sampled at two time points: pre-shock and 4h after blood volume replenishment, and the plasma levels of NE, BUN and Cr were measured. 4h after blood volume replenishment, the rabbits were sacrificed, and the activity of MPO in renal tissue and urine NAG were measured. Results In all the three groups, the plasma concentrations of BUN and Cr were somewhat elevated but showed no statistical significance in comparison with each other. The activity of NE in blood, MPO in renal tissue and NAG in urine were increased significantly in the traumatic hemorrhagic shock group compared with those of ulinastatin-treated group (P

Objective To summarize the technique and evaluate the effect of anesthesia for off-pump coronary artery bypass surgery (OPCAB). Methods From 1997 through March of 2005, five hundred and forty-three consecutive patients undergoing OPCAB were retrospectively studied. Anesthesia was induced with midazolam 0.05～0.12mg/kg, ketamine 0～0.5mg/kg and fentanyl 5～15?g/?kg. Anesthesia was maintained with isoflurane 0.3%～1.5% and oxygen, combined with propofol 1～3mg/(kg?h). Intraoperative hypotension resulting from either surgical procedure or anesthetics should be dealt with inotropes immediately. Results Intraoperative hemodynamics deviation was tolerated with the support of inotropics. The mean extubation time was 5.8?1.6h. The ICU stay was 0.5 to 2.0 day. The patients were discharged in 8.0?1.2 days. Two patients met sudden death in the second postoperative day. Conclusion Rational use of anesthetics and inotropics to stabilize hemodynamics during operation plays a key role in successful OPCAB.

Objective To analyse the clinical manifestation of thoracostomach-airway fistula in order to improve the recognition.Methods The clinical information in 20 cases with thoracostomach-airway fistulas was analyzed retrospectively.Results The main clinical manifestations were choke after drinking or eating,inhalation pneumonia,fever,becoming thin ness,aridity,turbulence of water and electrolyte,et al.The stomach radiography showed thoracostomach-tracheal fistulas in six cases,thoracostomach-carina fistula in fwo cases,thoracostomach-left main bronchial fistulas in 10 cases and thoracostomach-right main bronchial fistula in two cases,vespectively.Conclusions Thoracostomach-airway fistula could be diagnosed according to the specific clinical significances and stomach radiography.

Objective To study the effects of deep hypothermia and L-arginine(NO precursor) pretreatment on cerebral protection after circulatory arrest and resuscitation in a canine model. Methods Ten healthy adult dogs of both sexes, weighing 14.45?2.3kg, were randomly divided into two groups(n=5): sham treatment group and L-arginine pretreatment group. Extracorporeal circulation was established routinely,circulatory arrest was induced when the nasopharyngeal temperature was reduced to 18℃, then the animals were resuscitated 90min later with extracorporeal circulation. SjvO2 was measured at 30min before circulatory arrest, 0min, 45min, 90min after circulatory arrest and at 60minutes after resuscitation. The ultrastructure changes in cerabral cortex were observed with transmission electron microscope (HITACHI 7500). The brain water content was also determined after the dogs were sacrificed. Results SjvO2 had decreased obviously after circulatory arrest, attaining the lowest level in CA 90min.After resuscitation it increased again in both groups. The levels of SjvO2 in dogs of L-arginine pretreatment group were markedly higher than that of control group at 45min and 90min after circulatory arrest (P

Objective To investigate the effects of hypoxia on the rheologic properties of leukocytes in microcirculation of rats, and its relationship with the expressive changes of CD18 of neutrophils. Methods Hypobaric chamber was used to simulate the plateau condition for the establishment of animal hypoxic model. Adult Wistar rats were randomized in three groups: control group, short-term hypoxia group (Hypobaric chamber simulated 5000m altitude for 3days) and long-term hypoxia group (Hypobaric chamber simulated 5000m altitude for 30 days). Intravital microscopy and computer image analysis system were used to evaluate the rheologic properties of leuckcytes in mesentery microcirculation. Neutrophils of the three experimental groups were purified and the expression of CD18 was determined by flow cytometer. Results Compared with control group, the rheologic properties of leukocytes were changed obviously at both short-term hypoxia and long-term hypoxia groups, including the number of leukocytes rolling and adherenced on endothelium increased, TLECT (total leukocyte-endothelium contact time) obviously extended (P

Objective To explore the effects of acute or chronic hypoxia on the viscoelastic properties of polymorphonuclear leukocyte (PMN) of rats. Methods Hypobaric chamber was used to simulate high altitude condition. Fifteen adult Wistar rats were randomized into 3 groups: control, acute hypoxia (5 000 m for 3 d) and chronic hypoxia (5 000 m for 30 d). Micropipette aspiration technique was used to evaluate the biomechanical properties of PMNs of rats and the experimental results were fitted with a three-element standard linear solid model. Results The viscoelastic coefficients of PMNs in acute hypoxic condition [K1=(86.66?26.84) Pa, K2=(399.89?22.03)Pa, ?=(4.23?1.82) Pa?s] or those values in chronic hypoxic condition [K1=(179.61?26.31) Pa, K2=(472.12?30.36) Pa, ?=(9.21?2.65) Pa?s] were significantly higher than the corresponding value of PMNs in control(P