Objective To describe the operative procedures.fracture patterns and clinical outcomes of treatment of posterior column tibial plateau fractures.Methods From February 2005 to August 2006,36 patients with posterior column tibial plateau fracture were operated on.Twenty patients were treated with open reduction and buttress plate fixation via a posterior approach.They were 13 males and 7 females,with a mean age of 38.5(ranging from 29 to 52)years.The other 16 patients were operated on via anterior plus posterior approaches.They were 11 males and 5 females,with a mean age of 37.3(ranging from 27 to 49) yeam. Results All were followed up for an average of 14.5(ranging from 12 to 15)months.All frac- tures got united with an average radiographic bone union time of 15.7(ranging from 11 to 16)weeks and an average full weight-bearing time of 17.6(range from 13 to 21)weeks.The mean HSS(The Hospital for special surgery)score of all these patients at 12 months postoperatively were 83.4(ranging from 68 to 92). There were 1 case of inferior medial genicular vessel injury during the operation,1 wound dehiscence and 1 partial incision necrosis postoperatively which were all eventually healed with conservative treatments.Three cases of numbness within the posterior lower part of the calf occurred postoperatively.No screw toggle,slide, dislodging or fixation failure was found during follow-up.There were no significant differences both between TPA and PA on radiographies and between immediately after operation and 12 months psstoperatively. Conclusion Open reduction and internal fixation with buttress plates via a posterior or anterior plus posterior approaches is appropriate for treatment of posterior column tibial plateau fractures.

ve To understand the levels of trace elements in hair of patients with hypertension disease and coronary heart disease. Methods The contents of zinc, copper, manganese and iron in hair were determined among 45 patients with hypertension disease, 36 patients with coronary heart disease and 40 healthy controls by flame-atomic absorption spectrophotometry respectively. Results The contents of zinc and the ratio of the contents of zinc vs the contents of copper in hair of patient with hypertension disease and coronary heart disease showed significantly higher levels compared with those of healthy controls (P

Objective:To explore the relationships between perfectionism and coping strategies among graduate students.Methods:396 college graduate students completed the COPE (the Coping Inventory),FMPS (Frost's Multidimentional Perfectionism Scale) and General Self-efficacy Scale.Results:①Significant positive correlations were found between adaptive perfectionism and self-efficacy,while negative correlations between doubt about actions in maladaptive perfectionism and self-efficacy;② Regression analysis indicated predictability of perfectionism and self efficacy to coping strategies.Self-efficacy still had significant predictability after perfectionism and its sub-dimension were controlled.Conclusion:Self-efficacy plays an important mediation role between perfectionism and coping strategy.

Objective To compare the esophageal acid and alkaline exposure characteristics of patients with cardia carcinoma after proximal gastrectomy or total gastrectomy.Method A total of 77 patients of cardia carcinoma who underwent radical resection from Sep 2007 to Sep 2011 in our hospital were retrospectively reviewed.24 hour esophageal pH monitoring were performed in all patients.Result Patients were divided into three groups:group TG had total gastrectomy (n =25),group PP had proximal gastrectomy with pyloroplasty (n =33),group NP had proximal gastrectomy (n =19).It revealed that indicators of acid reflux including the overall time length of acid episodes,＞ 5 min times of acid episodes,duration of longest acid episodes,time length of pH ＜ 4.00 and the DeMeester Scores in group NP were significantly higher than in group PP(U =32,P ＜ 0.01 ; U =35,P ＜ 0.01 ; U =23,P ＜ 0.01 ; U =39,P ＜0.01 ;U =49,P ＜0.01 respectively).Only alkline reflux was observed in group TG.The total times of alkaline episodes in PP group was significantly lower than in group TG(U =52,P ＜0.01) and group NP (U =182,P ＜0.01).＞5 min times of alkaline episodes in group TG was larger than in group PP,and that in group PP was larger than in group NP(P ＜0.01).Duration of longest alkaline episodes and total period of pH ＞7.00 in group PP was significantly higher than in group TG(U =125,P ＜ 0.01 ; U =143.5,P ＜ 0.01),and that in group TG was higher than in group NP(U =23.5,P ＜ 0.01 ; U =14,P ＜ 0.01).Conclusions Alkaline reflux deserves more attention in evaluating esophageal reflux in patients with cardia carcinoma after resection.Pyloroplasty is not helpful to relieving esophageal acid episodes while causing severe alkaline reflux.

Objective To investigate the predictive value of breast cancer susceptibility gene 1 (BRCA1) and class Ⅲβ-tubulin protein expression in tumor tissue for the efficacy of taxol and cisplatin combined chemotherapy (TP) in stage Ⅲβ/Ⅳ non-small cell lung cancer(NSCLC) patients. Methods A total of 92 stage Ⅲβ/Ⅳ NSCLC patients were recruited with 87 patients evaluated. Bronchoscopy or lung puncture tumor biopsy samples were obtained with BRCA1 and class Ⅲβ-tubulin protein expression examined immunohistochemically before chemotherapy. The patients were randomly assigned to be received 4 to 6 cycles of TP chemotherapy regiments and followed up until death or lost. Response rate (RR) , overall survival (OS) and time to tumor progression (TTP) were assessed. Results Among the 87 evaluated patients, the positive expression rates of BRCA1 and class Ⅲβ-tubulin were 57. 5% (50/87) and 48. 3%(42/87) respectively. There was no significant difference in clinical characteristics among patients with different positive expression rate. According to different expression of BRCA1 and class Ⅲβ-tubulin, the patients were divided into four groups: group A (low expression of both BRCA1 and class 1 p-tubulin) ,group B (high expression of both BRCA1 and class Ⅲβ-tubulin) , group C (high expression of only BRCA1) and group D (high expression of only class Ⅲβ-tubulin). The RR was higher in group A than other three groups (60. 7% , 34. 8% , 9/19 and 6/17 respectively). The OS and TTP were longer in group A than other three groups [OS: (539. 4 ± 17. 6) days, (267. 2 ± 20. 5) days, (325. 6 ± 24. 1) days and (283.7±26.2) days respectively ; TTP: (256. 9 ± 28. 4) days, (143.8±17.6) days, (179. 3 ± 19. 8)days and (152. 6 ±23. 5) days respectively]. There were no significant differences among the other three groups. Conclusions The expression level of BRCA1 and class Ⅲβ-tubulin in tumor tissue is probably a predictor for the efficacy of TP chemotherapy in NSCLC patients. TP chemotherapy is more suitable for the NSCLC patients with lower expression of both BRCA1 and class Ⅲβ-tubulin. Our study may provide a new sight for tailored chemotherapy in NSCLC patients.

Adolescent ; Adult ; Dust ; Female ; Humans ; Male ; Mental Health ; statistics & numerical data ; Middle Aged ; Occupational Exposure ; Steel ; Surveys and Questionnaires

Objective To evaluate the effect and clinical value of open surgery combined ultrasound-guided Mammotome in the treatment of multiple breast lumps. Methods Four hundred and forty-four patients in our hospital from Jan. 2006 to Jun. 2008 were divided into 3 groups, who underwent classical open surgery, ultrasound-guided Mammotome operation, or combined therapy respectively and followed by post-operation visits reguarly. The operation effects were compared between the 3 groups. Results Compared with the classical open surgery, combined therapy had no difference in time of procedure and procedural bleeding, but had lower incidence of local skin, better incision condition and higher satisfaction of patients. Compared with ultrasound-guided Mammotome operation, combined therapy took less time in procedure, and in the same time had less procedural bleeding, lower post-operation complication and higher patients satisfaction. Conclusions Combined therapy has high complete removal rate, low post-operation complication as well as cosmetic effect. It has special advantages over the other two kinds of surgery, so it has wide clinical application.

OBJECTIVETo summarize the clinical features, diagnostic and therapeutic experiences of colorectal Non-Hodgkin's lymphoma (NHL).

METHODSClinical data of 32 patients with colorectal NHL admitted to our hospital from January 1988 to December 2006 was retrospectively analyzed.

RESULTSThis study included 22 B-cell NHL and 10 T-cell NHL cases. In the B-cell NHL group, the male: female ratio was 14:8 and the median age was 60.5 years. In the T-cell NHL group, the male: female ratio was 5:5 and the median age was 31.0 years. The ileocecal region was most frequently involved in both groups, which accounted for 77.3% and 60.0% of the B and T group respectively. The common clinical manifestations included abdominal pain, weight loss, and abdominal mass. Of the 14 cases of B-cell NHL with definite subtype classifications, 64.3% were of the Diffuse Large B-cell Lymphoma (DLBCL) type. Among the 22 B-cell NHL, 40.9% were with localized diseases (stage I-II1), while all 10 patients in T-cell NHL group were in stage IV with 3 patients complicated with massive GI bleeding and 4 with perforation. All patients of B-cell type received chemotherapy utilizing mainly CHOP after surgical resection. After a median follow-up of 55 months, the disease-free survival was rate 88.2%. Among the T-cell NHL group, 8 out of 10 patients underwent surgery and chemotherapy was given to all those who could tolerate it. Five patients died within 2 months after surgery. It's known that 3 patients were still alive after 23 months.

CONCLUSIONSThe ileocecal region is the most frequently involved site of the colorectal NHL. The histology is usually B-cell type with a majority being DLBCL. Currently R-CHOP chemotherapy after the surgical resection is the principal treatment modality. Patients of B-cell type have a better prognosis while the prognosis of T-cell NHL is poor. Therefore more aggressive diagnostic and therapeutic approaches are recommended for T-cell NHL patients. The prospective of organ preservation treatment for colorectal NHL is still in need of further investigations.

Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; therapy ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; therapy ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo investigate the change of JNK and c-Jun in lung injury associated with paraquat poisoning of rats.

METHODS46 Rats were randomly divided into four groups: PQ group (n = 12), control group (n = 10), PQ + ZnPP group (n = 12) and PQ + Hm group (n = 12). The rats were injected with 2% PQ (25 mg/kg, ip) in PQ group. ZnPP and Hemin (10 mg/kg, 10 mg/ml) were injected through inguinal vein before intraperitoneal administration of 2% paraquat in PQ + ZnPP group and PQ + Hm group respectively. The rats were injected NS (1 ml/kg, ip) in control group. HE dyeing of lung tissue and MDA content of plasma were used for estimating the injury of lung tissue. The content of CO in the lung tissue was determined. The expression of HO-1 mRNA of the lung tissue was detected by the reverse transcription-polymerase chain reaction. The phosphorylation of JNK and c-Jun was evaluated by Western blot analysis.

RESULTSThe degree of lung injury in PQ group and PQ + ZnPP group was higher than that in control group and PQ + Hm group. But in PQ + Hm group the degree of lung injury was lower. The content of MDA in PQ group and PQ + ZnPP group was higher than that in control group and PQ + Hm group (P < 0.01). The content of MDA in PQ + Hm group was higher than that in control group (P < 0.05). The content of CO in lung tissue in PQ group, PQ + ZnPP group and PQ + Hm group was and (1.08 +/- 0.15 mg/L) respectively, and higher than that in control group (P < 0.01). The content of CO in lung tissue in PQ + Hm group was significantly higher than that in PQ + ZnPP group (P < 0.01). The expression of HO-1 and the phosphorylation of JNK (55.24 +/- 9.34, 38.15 +/- 10.71, 128.55 +/- 19.43) and c-Jun (23.16 +/- 4.85, 15.49 +/- 3.13, 44.89 +/- 10.37) were increased remarkably in PQ group, PQ + ZnPP group and PQ + Hm group. Those in PQ + Hm group were higher significantly than PQ group and PQ + ZnPP group (P < 0.01). Those in PQ + ZnPP group were lower than PQ group (P < 0.05).

CONCLUSIONThe increase of CO of lung tissue in rats at the lung injury associated with paraquat poisoning reduces the acute lung injury of rats. The level of JNK and c-Jun phosphorylation increases obviously, especially after Hemin is utilized.

Acute Lung Injury ; chemically induced ; metabolism ; Animals ; Disease Models, Animal ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Lung ; metabolism ; Male ; Paraquat ; poisoning ; Proto-Oncogene Proteins c-jun ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To study the dosimetric impact of different angle fields in intensitymodulated radiotherapy (IMRT) and the feasibility of beam angle optimization (BAO) for multiple intracranial metastases.Methods In total,11 patients with multiple intracranial metastases were included in these analyses.Two treatment techniques were designed for each patient:the 7 equal spaced fields (BAF group) IMRT,and 7 fields by beam angle optimization (BAO group) IMRT.The dose distribution in the target,the dose to the organs at risk and normal brain tissues,and total MU in two groups were compared to explore the dosimetric differences.Results In comparison to the BAF group,the BAO group reduced the maximum dose to left and right lenses by an average of 45％,37％ (t =-5.707,-4.438,P ＜ 0.05);the mean dose to the left and right eyes were reduced by an average of 42.6％,44.5％ (t =-4.380,-5.638,P ＜0.05);the maximum dose to the right eyes were reduced by an average of 32.5％ (t =-2.518,P ＜ 0.05).The maximum dose of the right optic nerve and the mean dose of normal brain tissue were reduced by an average of 23％ and 3％ (t =-3.105,-3.437,P ＜0.05),respectively.For the target dose,conformity and homogeneity in PTV,no statistical differences were observed between the two groups (P ＞ 0.05).The BAO group reduced the maximum dose of the brainstem and the optic chiasm,as well as the number of MU,however,the differences were not statistically significant (P ＞ 0.05).Conclusions In comparison to the BAF group,the BAO group shows a similar target dose and reduces the dose for the organs at risk.For multiple intracranial metastases,IMRT protocols with BAO are feasible and beneficial.