Objective To explore the clinical features and operative treatment of floating shoulder injuries. Methods The clinical data of 36 patients with floating shoulder injuries that had been admitted to our hospital from June 1999 to June 2005 were retrospectively analyzed. The scapular neck fractures associated with clavicle fractures were in 31 cases and acromioclavicular joint dislocation in 5 cases. All cases were accompanied by associated injuries, in which rib fractures combined hemopneumothorax and/or lung contusion was 88.9%. The mean time from primary injury to the fracture operation was 9.6 days (range, 3 to 43 days). The clavicle fractures or acromioclavicular joint dislocation were dealt with firstly, then scapular neck fractures treated through modified Judet posterior approach. Thirty-three cases received internal fixation with both injuries of scapular neck and clavicle or acromioclavicular joint and 3 cases received internal fixation only in clavicle shaft. Results All fractures had been restored anatomical reduction in the target site. The mean followed up time was 19.7 months (range, 6 to 69 months). According to Constant and Murley's evaluation, the median score of functional results was 93% (mean 81.3%, range from 9% to 100%). Based on Herscovici's evaluation, 25 (69.4%) cases showed excellent results, 6 (16.7) good, 4 (11.1%) fair, and 1 (2.8%) poor. The recurrence of primary hemopneumothorax was found in 1 case, shoulder joint abduction weakness and subacromial space pain in 3 cases, delayed lesion of suprascapular nerve in 1 case, and posttraumatic shoulder joint instability secondary to arthritis in 1 case postoperation. Conclusion The double injuries with scapular neck and their suspensory device of clavicular shaft or acromioclavicular joint in floating shoulder injuries can hardly be corrected and reduced in three dimensional displacement of distal fracture unit without operation. It is an effective way for such unstable injuries to get good results after open reduction and internal fixation in early stage.

Objective To explore the clinical features and outcomes of defo rm ities correction of old bucket handle and tilt fractures of pelvis. Methods From October 1998 to October 2002, six patients treated with open reduction, osteoto my and internal fixation for old bucket handle and tilt fractures of pelvis were analyzed. There were 3 males and 3 females aging from 18 to 51 years (mean, 27. 5 years). According to Tile’s classification, all fractures were diagnosed as t ype B2 with longitudinal stability and rotational instability, which were caused by traumatic violence of lateral compression, and associated with anterior ring injuries of ipsilateral inferior and superior rami of pubis combined symphysis separation as well as contralateral posterior ring injury of innominate fracture , dislocation of sacraoiliac joint, or sacral fracture. The incidence of associa ted injury was 100% in the patients as injured. The mean interval from the prima ry injury to the operation was an average of 6.5 months ranging from 2 to 15 mon ths. The limb shortening of buckle handle side of pelvis ranged from 2 to 3.5 cm (mean, 2.5 cm), and the rotational deformity of pelvis was more than 30? in al l patients. The tilting proximal fragment of the superior ramus and disrupted sy mphysis projected inferiorly and posteriorly into the perineum. The surgical pro cedures consisted of: 1) osteotomy through the superior pubic ramus malunion in 6 cases to correct anterior ring deformity, and through innominate osteotomy in 3 cases, direct osteotomy of sacral malunion in 1 case , and sacraoiliac fusion in 2 cases to correct the posterior ring deformity; 2) reduction by manipulati on or assisted with instrumentation; 3) fixation with reconstruction plate in 3 , reconstruction plate combined with anterior pelvic frame in 2, and reconstruct ion plate combined with lag screws in 1. Results All the patients were followed up on an average of 15.6 months (range, 3 to 45 months). The limb discrepancy ha d been completely corrected following satisfactory fracture reduction and union. According to Mears’s evaluation, the anatomical reduction of the pelvis was fo und in 5 cases and satisfactory in 1 patient. According to Majeed’s radiography evaluation, 5 patients were classified as excellent, and 1 good. One patient wi th delayed sacral nerve injury recovered without any treatment after operation. Conclusion The combination of osteotomy through anterior and posterior pelvic ri ng to correct the entire deformities in one stage is an useful technique for imp rovement of the affected limb shortening and prevention of the related complicat ions.

With the wide use of nanomaterials in biomedicine,materials,chemicals and other fields,their environmental exposure and cellular toxicity have come to the attention of researchers as a new research area in the field of nanotoxicology and nanomedicine. Researches on the toxic effects of nanomaterials have not only provided of a theoretical basis for safety evaluation of nanomaterials ,but also promoted the have applications of nanotechnology. Numerous studies have revealed cell death is closely associated with the toxicity of nanomaterials. In this paper,we elaborated on the roles of three key cell death modes in nanotoxicity,including autophagy,apoptosis,and necrosis. Furthermore,the pos?sible mechanisms involved in these three modes were explored. All this will provide reference for safety evaluation of nanomaterials.

Objective To study the effect of auricular-plaster and meridian-pressing instrument on the prevention of gallstones recurrence after stone removeol.Methods 120 cases which were after endoscopic minimally cholecystolithotomy were selected and randomly divided into the control group and treatment group.All cases were observed for 3 years.Results This research altogether fell off 6 cases,including 2 cases in the control group and 4 cases in the treatment group.The treatment group's gallbladder wall (2.13 ± 0.36)mm was more thinner than the control group's(3.21 ± 0.40)mm,the treatment contract function was more strenghen than the control group,and the gallstone recurrence after stone removeol of the treatment was more smaller.Conclusion Aricular-plaster and meridian-pressing instrument can reduce inflammation of the gallbladder wall,enhance the gallbladder contraction function,and prevent the recurrence of gallstone.

To observe the effect of Astragali Radix polysaccharides (APS) on the learning and memory functions of aged rats, in order to explore its mechanism for improving the learning and memory functions. Natural aging female SD rats were selected in the animal model and randomly divided into the control group, the APS low-dose group (50 mg x kg(-1)), the APS high-dose group (150 mg x kg(-1)) and the piracetam-treated group (560 mg x kg(-1)). They were orally administered with the corresponding drugs for consecutively 60 days. Besides, a young control group was set. The learning and memory functions of the rats were tested by the open-field test and the Morris water maze task. The Western-blot method was used to observe the levels of relevant neural plasticity protein N-methyl-D-aspartate receptor (NMDA receptor) in hippocampus, calcium/calmodulin dependent protein kinase II (CaMK II), protein kinase (PKA), the phosphorylation level of CAMP response element binding protein (CREB) and the protein expression of brain derived neurotrophic factor(BDNF). In this study, the authors found that the learning and memory functions and the hippocampus neural plasticity protein expression of the aged rat group were much lower than that of the young control group (P < 0.01). Compared with the aged rat group, the APS group showed the significant improvement in the impaired learning and memory functions of aged rats and the up-regulation in the hippocampus neural plasticity protein expression. The results showed that APS may improve the learning and memory functions of aged rats by increasing the expressions of relevant neural plasticity proteins.
Aging ; drug effects ; metabolism ; psychology ; Animals ; Astragalus Plant ; chemistry ; Brain-Derived Neurotrophic Factor ; metabolism ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Female ; Hippocampus ; drug effects ; metabolism ; Humans ; Learning ; drug effects ; Memory ; drug effects ; Polysaccharides ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism

Objective To collect the families with generalized epilepsy with febrile seizures plus(GEFS+) and analyze the clinical status and heredity features of Chinese GEFS+.Voltaged-gated sodium channel ?1 subunit(SCN1B) gene of 2 families were detected,and expect to find new mutation sites.Methods All participant in the study of 2 families members were informed of voluntary participate in this investigation,health examination and blood sampling.All 6 gene exons of proband,patients and healthy control group were sequenced.The sequencing result was compared and analyzed with the normal sequence of genomic exon fragment and exon fragment sequencing result of control group through internet(BLAST).Results 1.A new G/A heterozygous polymorphism (G181A)was found in the 181th basyl of SCN1B gene exon 3,and codon was changed from TCG to TCA,both encoding serine (Ser,S).It was synonymous mutation.2.A new G/A heterozygous polymophism(G15A)was found in the 15th basyl of SCN1B gene exon 3,and codon was changed from GAG to GAA,both encoding glutamic acid(Glu,E).It belonged to synonymous mutation.3.A new T/C heterozygous polymorphism (T37C)was found in the 37th basyl of SCN1B gene exon 6.The patients genetype were:5 cases with T/C heterozygote,3 cases with T/T homozygote,2 cases with C/C homozygote.Healthy control group were all T/T homozygote.Allele frequency distribution for T was 55.0%,and 45.0% for C.4.A new A/C heterozygous polymorphism (A81C)was found in the 81th basyl of SCN1B gene exon 6.The patients genetype were:5 cases with A/C heterozygote,3 cases with A/A homozygote,2 cases with C/C homozygote.Healthy control group were all A/A homozygote.Allele frequency distribution for A was 55.0%,and 45.0% for C.Conclusions Two new heterozygous polymorphism (G181A),(G15A) were found in SCN1B gene exon 3.Two new heterozygous polymorphism (T37C),(A81C) were found in SCN1B gene exon 6.These 4 polymorphism enriched single nucleotide polymorphism(SPN) database and provided candidate sites for the research of epilepsy susceptbility polymorphisms.

Generalized epilepsy with febrile seizures plus(GEFS+) is a new epilepsy syndrome proposed by International League Against Epilepsy.At present,the progress of genetic studies of GEFS+ focus on gene mapping based on family analysis,many researches indicate that GEFS+ is associated with voltaged-gated sodium channel(SCN) gene mutation.This paper intends to discuss the relationship beween GEFS+ and SCN1B,SCN2B,SCN1A,SCN2A genes,mutations in order to improve the cognition about GEFS+.

Objective:To understand the recognition status of cancer pain in basic medical staff from small towns to provide the basis for the improvement of cancer pain management in these areas. Methods:The medical staff of Hengjiang Town and subordinate villages was selected. The study area is situated in southwest China. Centralized questionnaires regarding cancer pain were collected and analyzed. A program and education of cancer pain were provided for these medical workers. Results: The medical staff from Hengjiang asserted that only 17%of cancer pain patients receive treatments. Approximately 70%of the medical staff did not consider the popularization and explanation of cancer pain treatment in their patients. Approximately 64%of the medical staff was not familiar with standardized cancer pain control, 87%did not believe that narcotics could suffice the need of patients, and 44%did not participate in the training for cancer pain control. Conclusion: The medical staff in Hengjiang possesses less knowledge on the importance of cancer pain. Hence, further training is necessary. The specific management of cancer pain as a part of community chronic diseases is mandatory.

25 mmHg) had no response to conservative management, and,therefore,had to be decompressed by invasive procedure,including 6 patients performed by decompression laparotomy,2 patients by laparoscopic decompression and 5 patients by ultrasound/computed tomography location and needle paracentesis drainage.These 13 ACS patients had obvious amelioration in physiological variables (hemodynamic,respiratory and tissue perfusion) after 24 hour post-decompression (P