Objective To evaluate the technique and clinical effect of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with suture bridge fixation technique. Methods From May 2013 to July 2015, 18 patients with anterior cruciate ligament tibial eminence avulsion fracture were treated with arthroscopic re﹣duction and fixation by suture bridge technique. There were 12 males and 6 females with an average age of 29.8 years old (range, 9~45 years). The right knees were involved in 10 cases and left knees in 8 cases. The injury caus﹣es included traffic accident injury in 10 cases, sports injury in 5 cases and other reasons in 3 cases. 2 patients had old fracture, the others had fresh fracture. The results of Lachman and anterior drawer test were both positive. The International Knee Documentation Committee (IKDC) subject score was (53.8 ± 4.2). Based on Meyers-Mckeaver classification, there were 5 cases in typeⅡ, 10 cases in type Ⅲ and 3 cases in type Ⅳ. Results The operation time was 50~80 minutes (mean, 60.5 minutes), X-ray showed satisfactory fracture reduction after surgery. Primary healing of incision were obtained with no infection, all 18 patients were followed up for 6 ~ 31 months (mean, 18.6 months). The results of Lachman and anterior drawer test were both negative in 17 cases, the result was negative for anterior drawer test and was weakly positive for Lachamn test in 1 case. The IKDC subject score were significantly improved to (95.2 ± 3.8) at last follow-up (P< 0.05). Conclusion It could achieve early restoration of knee joint function to treat the anterior cruciate ligament tibial eminence avulsion fracture with suture bridge fixation technique because of satisfactory reduction, reliable fixation, minor trauma, and quick recovery.

Objective To compare the outcomes of in-vitro maturation (IVM) and in-vitro fertilization (IVF) after early follicular phase gonadotropin-releasing hormone agonist (GnRH-a)down-regulation in infertile patients with polycystic ovary syndrome (PCOS).Methods From July 2010 to December 2012,72 infertile patients with PCOS undergoing assisted reproductive technology treatment in the Affiliated First Hospital of Wenzhou Medical University were enrolled in this study.The patients were divided into 2 groups,which were patients with early follieular phase down-regulation IVM (36 cases) at IVM group and early follicular phase down-regulation long protocol IVF (36 cases) at IVF group.The laboratory parameters and clinical outcomes were compared between two groups.Results (1) Lab parameters:a total of 442 oocytes were retrieved in group IVM,and 560 were in group IVF.The rate of mature oocytes of 83.8％ (469/560) and high-quality embryos of 70.9％ (212/299) at group IVF were significantly higher than that of group IVM [54.1％ (239/442) and 50.7％ (73/144),retrospectively,P ＜0.01].In group IVM,the average duration of gonadotropin (Gn) was (2.8 ± 1.5) days and the average dosage of Gn was (285 ± 169) U,which were significantly lower than (11.0 ± 1.0) days and (1499 ±165) U in group IVF (P ＜0.01).The mean number of oocytes retrieved 12.8 ± 2.5,fertilization rate of 64.8％ (155/239),and implantation rate of 31％ (23/74) in group IVM and 15.6 ±3.1,65.5％ (307/469),31％ (23/74) in group IVF,which did not reach statistical difference (P ＞0.05).(2) Clinical outcomes:the clinical pregnancy rate (17/31,55％) of IVF group was not significantly higher than that 44％ (14/32) at IVM group (P ＞ 0.05).The abortion rate was 1/17 at Group IVF and 1/14 in group IVM,which did not show statistical difference.Women at IVM group has no ovarian hyper-stimulation syndrome (OHSS) cycle,group IVF has 31％ (11/36) cycles presented moderate and severe OHSS.Conclusions Infertile patients with PCOS undergoing IVM and IVF treatment after early follicular phase GnRH-a down-regulation can get satisfactory laboratory and clinical outcome.In addition to short treatment cycle,IVM can also avoid the occurrence of OHSS completely,but it has a rising trend in the abortion rate.IVF has a high incidence of OHSS,meanwhile,it increases the dosage of gonadotropins.

Objective To study the renal damage of patients with juvenile primary Sjgren's syndrome (pSS)and its clinical manifestations,pathologic characteristics with biopsy,treatment and prognosis.Methods Ten patients with juvenile pSS complicated with renal impairments were retrospectively analyzed.Data of these 10 patients were compared with those without renal impairments.Results Ten patients complicated with renal impairments in 24 patients with juvenile pSS,9 of them presented with type I renal tubular acidosis(RTA), 5 with hypokalemia paralysis,3 with calcification of the renal tissue,3 with positive urine protein.1 with dia- betes insipidus.There was no significant difference between patients with renal impairments and those without. Three patients underwent kidney biopsy that showed chronic interstitial nephritis(CIN)with extensive lymp- hoplasmie cell infiltration.Two patients had glomerular lesions and one of them was diagnosed as pSS over- laped with systemic lupus erythematosus(SLE).Steroid and immunosuppressive agents had significantly alle- viated symptoms and the hypergammaglobulinemia was significantly improved.Conclusion Renal impairment may be the major complication in juvenile pSS.The major clinical manifestations are RTA and the glomeruli are involved occasionally.Treatment with steroid anti immunnsuppressive agents should be given to those who have evidence of systemic involvement.

Objective To detect attenuated plaque by using intravascular ultrasound (IVUS) in patients with acute myocardial infarction (AMI) and to investigate the influence of attenuated plaque on perioperative period of percutaneous coronary intervention (PCI). Methods Coronary angiography and IVUS were performed in 85 hospitalized patients with AMI, additional implantation of stent was employed when necessary. According to the presence or absence of attenuated plaque determined by IVUS, the patients were divided into attenuated plaque group(n=35) and non-attenuated plaque group(n=50). The perioperative IVUS findings, the blood flow classification after myocardial infarction thrombolysis (TIMI) and the postoperative peak value of creatine kinase MB (CK-MB) determined were compared between the two groups. Results Among the 85 AMI patients, attenuated plaque was detected in 35 (41.2%) and no attenuated plaque was found in 50(58.8%). No statistically significant differences in the age, sex and risk factors existed between the two groups (P>0.05). The proportion of having attenuated plaque in patients with ST segment elevation myocardial infarction (STEMI) was obviously higher than that in patients with non-STEMI (P<0.01). In performing coronary angiography, the difference in TIMI blood flow classification between the two groups was not statistically significant (P>0.05), but after balloon dilatation the TIMI grade 0-2 in theattenuated plaque group was strikingly higher than that in the non-attenuated plaque group (P=0.003). After PCI, the proportion of patients with elevated CK-MB value and higher peak value in the attenuated plaque group was remarkably higher than those in the non-attenuated plaque group (P<0.01). Conclusion The results of this study indicate that attenuated plaque can increase the incidence of no-reflow and slow reflow after PCI, which is more often seen in STEMI patients. The attenuated plaque carries significantly high risk, and the presence of attenuated plaque is helpful in predicting, the elevated extent of CK-MB value after PCI.

Objective To explore the clinical manifestations,imaging findings,pathological classification and treatment of congenital cystic adenomatoid malformation (CCAM)of the lung.Methods The clinical features,imaging findings,pathology information,diagnosis,treatment method and its prognosis of children with CCAMconfirmed by ope-ration and pathology were retrospectively analyzed in Yuying Children′s Hospital Affiliated to Wenzhou Medical Univer-sity from August 2006 to August 201 4.Results Eleven patients were boys and 4 patients were girls.One case had a-symptomatic clinical features,1 2 cases had pulmonary infection,1 case had recurrent chest pain,and 1 case had de-pressed deformity in sternum inferior segment.Chest CT scanning indicated that 9 cases had multiple gas cysts at unila-teral side of lung,among which 1 case was of funnel chest and pulmonary sequestration,1 case of huge cyst containing air and fluid at inferior lobe of left lung,and 4 cases of high density lung shadow;CT examination indicated that 1 case had recurrent chest pain and eventration of diaphragm of the right side combined with pulmonary sequestration.All ca-ses were treated by surgical resection,of whom 1 case was given cystectomy and sequestrectomy,diaphragmatic plication respectively,1 case complicated with funnel chest disease underwent lesion pulmonary lobectomy,sequestrectomy and minimally invasive corrective surgery in pectus excavatum (Nuss surgery),and the remaining 1 2 cases received lesion pulmonary lobectomy.All of 1 5 cases recovered well without complications.Pathological classification type of CCAMin-cluded 1 1 cases of type Ⅰ,3 cases of type Ⅱ and 1 case of type Ⅲ,among which 2 cases had pulmonary sequestration. Conclusions CCAMis a rare disease which can be discovered along with pulmonary infection.Multiple gas cysts are the most common imaging findings and the preoperative diagnosis of CCAM is mostly based on chest CT examination. Type Ⅰ and type Ⅱ are the most common pathological classification.The surgical resection should be given early surgi-cal resection and the prognosis is usually good.

Objective To observe the distribution and possible mechanism of P2X7R in periaq-ueductal gray matter (PAG)in a rat model with chronic neuropathic pain in vivo.Methods The in-trathecal catheterization and sciatic nerve injury (SNI)were performed.All animals were randomly assigned into 3 groups with 26 rats in each,which was group Sham,control group (group C)and brilliant blue G (BBG)group (group BBG),respectively.Normal saline or BBG 10 μl were intrathe-cally injected after SNI and repeated for seven days.Paw-withdrawal mechanical thresholds (PWT) were measured on day 0,day 7,day 14,and day 21 after SNI.The rats were sacrificed and PAG tis-sues were collected on day 14 and day 21,separately.The distributions of P2X7R were observed by immunofluorescence.The protein contents of P2X7R and GFAP were assessed by Western blot assays.Results The P2X7R was expressed in PAG in rats.The PWTs of the control group showed a significant decrease during the 21-day period compared with the sham group.The P2X7R signals were predominantly expressed in astrocytes in PAG after SNI.Both P2X7R and GFAP expression remark-ably increased.Administration of BBG increased the PWTs,and inhibited the P2X7R and GFAP ex-pressions compared with those atthe same point of time of the control group.Conclusion These results indicated that P2X7R in PAG might participate in nociception modulation in the midbrain in chronic neuropathic pain.

Objective To explore the inhibitory effect of Oldenlandia diffusa extract on colorectal cancer angiogenesis in BALB/c mice. Methods Thirty-two BALB/c mice with subcutaneous CT26 colon cancer animal model were randomly equally divided into four groups,including the control group (groupⅠ,saline 0.1 mL/(10. d), O. diffusa ethanol extract of 90 mg/(kg.d) (groupⅡ), O. diffusa ethanol extract of 180 mg/(kg.d) (groupⅢ) and O. diffusa ethanol extract of 360 mg/(kg.d) (group Ⅳ) . Each group of mice were treated with intragastric administration of law administration 12 days after vaccination, then stopped and continue fed to 32 days, and the mice were killed. Micro-vascular dense ( MVD) was observed and countered under the microscopy by immunohistory chemistry. Results The murine colon tumor volumes of GroupⅡ,ⅢandⅣwere significantly less than that of groupⅠ,with significant difference ( <0.05) . The tumor microvessel density values of four groups was (7.83±2.87), (5.32±1.27), (1.77±0.70) and (1.87±0.68),respectively. The number of tumor blood vessels in GroupⅡ,Ⅲ and Ⅳ were significantly less than that of Ⅰ group, with significant difference ( <0.05) . Conclusion Within a certain dose range, the ethanol extract of O. diffusa can significantly inhibit the mouse colon cancer and the mechanism may be realated to inhibiting tumor angiogenesis.

Objective To explore the inhibitory effect of the ethanol extract of Oldenlandia diffusa on the proliferation of CT-26 colon cancer cells which come from BALB/c mice. Method We determined the inhibitory effect of different concentrations of ethanol extract of Oldenlandia diffusa on CT-26 cells' proliferation by using methyl thiazolyl tetrazolium (MTT), and calculated the 50% inhibiting concentration (IC50) . Results As to the same concentration, the inhibitory effect of the ethanol extract of Oldenlandia diffusa on CT-26 cells was increased with time, for exsample:after treated with 0.08 mg/mL of ethanol extract of Oldenlandia diffusa for 24 h, 48 h and 72 h, the inhibitory rates of CT-26 cells were (16.67 ±9.35)%, (34.66 ±9.23)%and (40.07 ±9.16)%, respectively. After treating CT-26 cancer cells for 24 h, 48 h and 72 h, the IC50 values of the ethanol extract of Oldenlandia diffusa were 0.315,0.155 and 0.115 mg/mL, respectively. In the same treatment time, the inhibitory effect of the ethanol extract of Oldenlandia diffusa on CT-26 cells was increased with the increase of concentration:after treatment for 72 h with different concentrations (0.06 mg/mL,0.08 mg/mL,0.10 mg/mL,0.12 mg/mL, 0.14 mg/mL,0.16 mg/mL,0.18 mg/mL and 0.20 mg/mL) of the ethanol extract of Oldenlandia diffusa,the inhibitory rates of CT-26 cells were (35.46 ±3.59)%, (40.07 ±9.16)%, (40.77 ±6.92)%, (52.81 ±1.87)%, (54.22±2.35)%, (68.72±3.71)%, (70.04±8.03)%and (71.84±3.12)%, respectively. Conclusion The ethanol extract of olenlandia diffusa can inhibit the proliferation of CT-26 colon cancer cells from BALB/c mice in a time and dose dependent manner.