BACKGROUND:High-energy patelar comminuted fracture significantly increased. Single fixation cannot meet the requirement of anatomical repositioning of the patela, multiple-point strong fixation, and early functional exercise. OBJECTIVE:To compare the clinical effect of adjustable patela claws + absorbable suture and Kirschner wire tension band in the repair of comminuted patelar fractures. METHODS: A total of 57 patients with comminuted patela fracture were randomly selected and randomly assigned to two groups. 29 cases received open reduction and adjustable patela claws + absorbable suture fixation. 28 cases received open reduction and Kirschner wire tension band fixation. Operative time, incision length, fracture healing time, postoperative complications and Hospital for Special Surgery knee function scores were compared between the two groups, and then statistical analysis was conducted. RESULTS AND CONCLUSION:No significant difference in incision length and operative time was detected between the adjustable patela claws + absorbable suture group and Kirschner wire tension band group. Significant differences in healing time, incidence of complications and knee function after treatment were observed between the two groups, and above indications were better in the adjustable patela claws + absorbable suture group than in the Kirschner wire tension band group (P < 0.05). These results confirm that compared with the Kirschner wire tension band, adjustable patela claws + absorbable suture in repair of patelar comminuted fracture has some advantages such as short healing time, less postoperative complications, as wel as good functional recovery of knee joint. The fixation is accorded with biomechanical principle of internal fixation, simple to operate, firmly fixed, and has good prospects.

It has been over two decades from the discovery of extracorporeal shock wave(ESW).The therapy of ESW has been proved effective in improving fracture healing,and has been developed quickly both in the choice of indications and in the medical equipments research.The status quo of ESW research,application in orthpedic trauma and treatment mechanism are summarized in this paper.Successful cases are reviewd in treating post-traumatic nonunion,renovation of artificial joints,and traumatic osteonecrosis of the femoral head.Common complications and its preventive measures are given.Detailed description of ESW operating principles and selection of working parameters are also described,with the expectation of wider range of clinical applications of ESW.

Objective To investigate the different effects of 2 species of Fructus aurantii immaturus on cardiovascular and respiratory system.Methods The extract of 2 species of Fructus aurantii immaturus were administered to anesthetized rats by duodenum and the dosages were 4.2,2.1 g crude drug/kg respectively.After administration,a continuous observation of blood pressure,respiration and ECG effects for 4 hours were performed.Results Compared with the control group,both of Citrus aurantium and Citrus sinesis exerted a transient increase to respiration rate after 20 min administration.No significant impact was observed during the experiment period on the ECG.The influence of Citrus aurantium on blood pressure was more significant.Compared with the control group,the effects of SBP,DBP and MBP reduced was observed in high-dose group of Citrus aurantium after 40,60,80 min administration,and so in low-dose group of Citrus aurantium after 60 min.The impact duration was up to 2 hours or more.However,the antihypertensive effect of Citrus sinesis was not obvious.And the blood pressure lowering effect of Citrus aurantium was superior to Citrus sinesis.Conclusion The 2 species of Fructus aurantii immaturus exert a transient excitatory effect on respiratory system.And the direct effect of them on heart is not obvious.The blood pressure lowering effect of Citrus aurantium is superior to Citrus sinesis.The attention should be given in the clinical usage of Fructus aurantii immaturus.

Objective To investigate the influence of Tanyu-Tongzhi (TYTZ)recipe on Rho/Rho kinase signal transduction pathway of myocardial ischemia-reperfusion injury in high fat-fed rats.Methods 60 SD rats were divided into 5 groups randomly,a sham-operated group,a model group,a western medicine control group,a high-dose group and a low-dose group of TYTZ recipe.The model of ischemia reperfusion of the myocardium was reproduced by ligation of left descending artery for 30 min followed by releasing the ligation for 2 hours in rats.The downstream substrates of ROCK myosin light chain (MLC) phosphorylation expression of myocardial tissues in rats were detected by Western blotting method.The levels of RhoA,ROCK Ⅱ mRNA were determined with RT-PCR.Results Compared with the model group,the expression of p-MLC and RhoA,ROCK Ⅱ mRNA were lower in low-dose group of TYTZ,there were significant differences between the two groups(P=0.004、0.003、0.018、0.004,P＜0.01).Conclusion The TYTZ Recipe can protect myocardium from MI/RI.The mechanism of action was related to its inhibiting the protein expression of RhoA,ROCK Ⅱ and p-MLC,restraining the activation of Rho/Rho kinase signal transduction pathway.

Objective To evaluate the clinical value of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage?Methods The clinical data of 217 cases of old patients with hypertensive cerebral hemorrhage, including 105 patients underwent continuous monitoring of intracranial pressure(monitoring group) and 112 patients without monitoring of intracranial pressure(control group),were retrospectively analyzed?The times and the total dosage of mannitol, the complications and prognosis of two groups were compared?Results The times and the total dosage of mannitol of monitoring group was respectively (42?1±5?4) times and ( 820?1±114?8) g,significantly less than that of control group((59?5±8?2) times, (1187?7±241?5) g;P=0?032,0?011)?The rate of pulmonary infection and stress ulcer showed no significant difference between two groups ( P = 0?608, 0?471 )?The rate of acute renal insufficiency and electrolyte disturbances was significantly lower in the monitoring group than that in the control group ( 11?4%( 12/104 ) vs?29?6%( 33/112 ) , 28?6%( 30/105 ) vs?41?9%( 47/112 );P = 0?004, 0?036 )?The prognosis of the monitoring group was better than that of the control group(72% vs?48%;χ2=13?02,P<0?01)?Conclusion Intracranial pressure monitoring has an important value for the treatment of old patients with hypertensive cerebral hemorrhage.

objective To analyze the causes of defective nonunion of femoral shaft and to evaluate interlocking intramedullary nails in treatment of shortened limb deformity following nonunion of femoral shaft. Methods 12 patients with shortened limb deformity following nonunion of femoral shaft were treated with autograft of ilium to fill up the defects and fixation by interlocking intramedullary nails. The patients were followed up for an average of 20 months. Results All the 12 patients healed by first intention after an average of 22 months. The limbs were lengthened averagely by 3.2cm. No failure occurred due to bent or broken major nails or intramedullary nails. Conclusions The main cause of shortened limb deformity following femoral shaft nonunion is bone resorption due to unreliable fixation. Interlocking intramedullary nails are an ideal device for shortened limb deformity following femoral shaft nonunion, though the union process is slow. In bone graft, care should be taken to avoid the complication of bone defect and weight bearing should be carried out some time later.

Objective:To investigate the effects of Xiaoyu-Jiangzhi capsules on blood lipid, carotid artery atherosclerosis (CAA) and plaque in apolipoprotein E knockout (ApoE -/-) mice. Methods:The ApoE -/- mice were fed with high-fat food to establish carotid atherosclerosis model. The ApoE -/- mice were randomly by weight divided into model group, Atorvastatin group, low- and high-dose Xiaoyu-Jiangzhi capsules group. The C57BL/6cnc mice were used as control group and fed with normal diet. The Atorvastatin group was given atorvastatin suspension 1.3 mg/kg, low and high dose groups were given Xiaoyu-Jiangzhi capsule suspension 325 and 975 mg/kg, and the control group and model group were given equal volume of distilled water. The mice were gavaged with 0.1 ml/10 g body weight, once a day, and the weight of mice was recorded weekly. After 12 weeks of continuous intragastric administration, the blood lipid and liver /body weight index of the mice were measured. Carotid arteries were sliced to conduct oil red O staining and VG staining for the pathological analysis. Results:After 12 weeks of drug administration, the weight of mice in the high-dose group was significantly lower than the model group. The level of TC (25.92 ± 4.21 mmol/L vs. 30.39 ± 4.67 mmol/L) and LDL-C (7.97 ± 2.14 mmol/L vs. 10.26 ± 1.97 mmol/L) in the high-dose group significantly decreased ( P<0.05), the level of HDL-C in the low and high-dose group significantly increased ( P<0.05). The pathological results showed that after 12 weeks of administration, the carotid artery lipid deposition blockage rate in the Atorvastatin group and the high dose group were significantly smaller than the model group( P<0.05), and no vascular plaque has been formed. Conclusion:The Xiaoyu-Jiangzhi capsules could reduce LDL-C, increase HDL-C levels, reduce the constriction of arterial stenosis and slow down the formation process of carotid plaque.

Objective To compare the analgesic effect ofHuamoyan Keli(HMYKL) between Kunming mice and BALB/c mice.Methods Eighty Kunming mice and eighty BALB/c mice were randomly divided into five groups, respectively: a control group, a ibuprofen group, a HMYKL high-dose group(13.98 g crude dru g/kg), HMYKL middle-dose group(6.99 g crude drug/kg)and a HMYKL low-dose group(3.50 g crude dru g/kg). There were 16 mice in each group with 8 male mice and 8 female mice. Drugs were administered intragastrically daily for 5 days. After 1 h of drug treatment on day 4, the latency of tail-flick response was evaluated using illuminated pain measurement instrument. After the last drug treatment, pain model was established by i.p. acetic acid, writhing latency and writhing times were recorded to evaluate the analgesic effect of HMYKL.Results In tail-flick test, there was no statistical difference among male and female Kunming mice in the HMYKL groups. Among male BALB/c mice, the latency in HMYKL middle-dose group was significantly longer than that in the control group(4.84±1.16 minvs. 3.93±0.76 min,P<0.05). In writhing test, compared with control group(19.06±6.34), the writhing times among BALB/c mice were decreased in HMYKL high-dose group(8.56±6.19), HMYKL middle-dose group(5.73±3.17), HMYKL low-dose group(6.88±4.59)(allP<0.01).Conclusion All dose groups of HMYKL showed good analgesic effect on the pain induced by chemical stimulation and there was no sex difference. Kunming mice were not suitable for the evaluation of the analgesic pharmacodynamics because of their large individual difference. On contrast, BALB/c mice which had less individual difference could be used to produce the model of pain.

We tested the mechanical properties of fiber layers in adult anulus fibrosus of lumbar interverbral disc 4,5. Aulus fibrosus of lumbar interverbral disc was delaminated by using microsurgical technique. 8 testing points were taken in each layer according to the fibers going and 5 testing specimens were taken from each testing point. The length was 15-20mm, the width 1-2mm, and the thickness 0. 1-0. 5mm. By using tension test,the relationship curves of stress and strain were tested, the fitting curves and equations were obtained, and then the elastic modulus, damage strain and damage stress were obtained. Therefore we knew the parameters and equations of mechanical properties of each testing point. We got the result that the elastic modulus of each testing point, along the radius from outside to inside, decreased with the increase of layers. The damage stress decreased linearly from outside to inside. The damage strains of the outside 9 layers increased slightly with the increase of layers, and the others were almost constants, i. e. 0.34 +/- 0.14. We get the conclusion that analus fibrosus of intervertebral disc has special mechanical properties corresponding with its functions, which is in a close relationship with lumbar vertebral diseases.
Adult ; Biomechanical Phenomena ; Elasticity ; Humans ; Intervertebral Disc ; physiology ; Lumbar Vertebrae ; physiology ; Male ; Stress, Mechanical ; Tensile Strength ; physiology

Objective The purpose of this study was to investigate the anti-inflammatory effects on acute and chronic inflammation ofHuamoyan Granules(HMYG).Methods KM mice and SD rats were randomly divided into model group, ibuprofen group and HMYG high, middle and low three dosages groups. The Ibuprofen group was administrated drug by gavage, mice 0.13 g/kg and rats 0.093 g/kg. The HMYG groups were administrated orally, mice 12, 6 and 3g/kg, rats 4, 4.2 and 2.1 g/kg. The model group was given the same volume distilled water, once a day, 3 or 10 continuous days. The increased permeability of mice abdominal capillary was induced by acetic acid, edema of rat hind paw was induced by albumen and carrageenin, which both were adopted to observe the acute anti-inflammatory effects; and cotton pellet granuloma was to observe the chronic anti- inflammation effects of HMYG.Results Compared with the model group, the ibuprofen group, the HMYG high and middle group showed anti-inflammatory actions of mice induced by acetic acid (0.185 ± 0.046, 0.177 ± 0.055, 0.190 ± 0.052vs. 0.246 ± 0.050,P<0.05 orP<0.01); after 0.5, 1, 2, 4 and 6 hrs inflammation, HMYG high dosage group had significant inhibition for the edema of rats hind paw induced byalbumen model, the inhibitory rate was 22.46%, 19.20% and 24.32%, 33.75%, 24.19%; 4 and 6 hrs after inflammation, HMYG high dosage group could reduce rats paw edema induced by carrageenin, the inhibitory rate was 32.05%, 30.56% and 19.23%, 20.83%.Conclusion HMYG has evident anti-inflammatory effects on acute inflammation.