Objective The population structure and ecological distribution of endophytic fungi in Changium smyrnioides from the different habitats and growing phases,and the effects of fungal elicitor on the cell biomass and polysaccharide accumulation were studied in this paper.Methods The isolation,culture,and identification of microorganism,and plant cell suspension culture technology were adopted;And relative data were analyzed by the statistical methods.Results In four producing areas,116 strains were isolated and classified into eight genera.The dominant populations were Fusarium LK.ex FR.,Geotrichum LK.,and Alternaria Nees.The population structure of endophytic fungi obviously changed at the different growing phases.Species and quantity of endophytic fungi were plentiful at the seedling stage and bud stage,and especially at the bud stage the isolation rate and isolation frequency were more than 30% and 19%,respectively.Some endophytic fungi had the obvious area and tissue specificity.Compared with the control by adding the elicitor of Fusarium sp.3,the yields of cell biomass and polysaccharide were increased to 31.86% and 38.01%,respectively.Conclusion Endophytic fungi in C.smyrnioides have abundant biodiversity.And there is close relationship between the population structure and distribution of endophytic fungi with ecological conditions.And fungal elicitors could obviously enhance the yields of cell biomass and polysaccharide of C.smyrnioides.

Objective To compare the clinical results of percutaneous compression plating (PCCP)and Trigen short reconstruction intramedullary nail for intertrochanteric hip fractures. Methods During 2005 and 2008, the patients suffered with AO/OTA Al and A2 intertrochanteric hip fractures were divided into two groups; 36 fractures were treated with PCCP and 48 fractures with Trigen short reconstruction nail.During an average of (16.3±3.2) months follow-up, clinical evaluation involved visual analogue scale(VAS)score for pain in the 1st week, the 1st month, the 3rd month, the 6th month and the 12th month, and a Harris hip score one year post operation. Radiographs were examined for fracture healing-time, displacement scale of the neck screws and fracture impaction scale. All the complication in both groups was recorded. Results There were no difference in blood loss and operation time in both groups. The postoperative pain was significantly lower in the PCCP group in the initial three months after the surgery. Larger scale of fracture impaction and screw telescoping were seen in PCCP group. Also shorter healing time, higher Harris score results were achieved in PCCP group than those of Trigen short reconstruction nail group. Four peri-implant fractures occurred in Trigen short reconstruction nail group, which included one in the greater trochanter and three in the femoral shaft, but only one case need revision for bone displacement. In PCCP group, it was found that the superior neck screw was slightly displaced for tendency to cut-out in one patient. Conclusion Both PCCP and Trigen short reconstruction intramedullary nail can be successfully used to treat Al and A2 intertrochanteric hip fractures with minimal invasive technique. And the PCCP showed more rapid pain relief and bone healing, easily bony reduction and fewer complications.

Objective To explore the surgical treatment strategy for tibial pilon fractures.Methods Forty-seven patients with tibial pilon fractures surgically treated in our hospital from May 2005 to March 2008 were retrospectively studied. There were 37 males and ten females, at mean age of 42 years (range 23-46 years). There were 51 sides of tibial pilon fractures, for four patients were with bilateral tibial pilon fractures. Injury causes included traffic accidents in 34 patients, fall from height in 12 and bruise by heavy objects in five. Open fractures were determined in seven patients and close fractures in 44 patients. According to Ruedi-Allgower classification, there were six sides of type Ⅰ fractures, 28 type Ⅱ fractures and 17 type Ⅲ fractures. According to Tscherna-Grotzen tissue injuries classification,open fractures were determined as 1° in two patients, 2° in three and 3° in two; close injuries were defined as 0° in two patients, 1° in 27 and 2° in 15. Distal tibia was partitioned as anterolateral column,anteromedial column and posterior column in order to select reasonable internal fixation. Eighteen fractures were treated with DePuy T plate, 10 with AO cloverleaf pattern plate, two with AO small T plate,two with locking plate, four with Link anterolateral anatomic plates and 15 with Orthofix overtake-anklejoint outside-fixed frame combined with limited internal fixation. Results The patients were followed up for a mean time of 23 months (range 12-44 months). According to Mazur ankle evaluation grading system, 29 patients were graded as excellent, 13 good, seven fair and two poor, with an excellence rate of 82.4%. Conclusions Correct operation time and treatment plans on the basis of Ruedi-Allgower classification and Tscherne-Gotzen classifications of soft tissues and reasonable internal fixation according to the condition of the involved three column in distal tibia can decrease postoperative complications and achieve good and satisfactory clinical effect.

Objective To investigate the effect of treating tibial plateau fractures involving the posterior column via anterolateral approach.To discuss its merit and demerit,indications and contraindications.Methods From Jan 2012 to Jan 2015,37 patients with closed tibial plateau fractures involving the posterior column were treated by 3.5mm proximal tibial plate with narrow plate head through standard anterolateral approach.The group included 25 males and 12 females,aged from 23 to 65 years old (average 44.6 years old).During the treatment and follow-up period,the curative effect was evaluated by using Rasmussen's radiological grading for early radiological outcomes and HSS grading,Lysholm grading,Lachman test and Pivot-shift testfor clinical examination at the 1 year follow-up.Results The average time for the operation was 98 min (range,55-170 min).1 year follow-up was completed in 37 patients.The average fracture union time and full weight bearing were 10.6 weeks (range,8-16 weeks) and 11.2 weeks (range,8-20 weeks) respectively without reduction loss.No statistical difference was found in either the tibial plateau angle (TPA) or posterior slope angle (PA) when comparing the results at instant,3rd month,6th month and 12 month.The mean score of the Rasmussen' s radiological grading was 15.6(range,12-18) and the mean score of the HSS grading was 88.6 (range,80-100).The average range of motion of the knee joint was 128.6°(range,110°-150°).The mean score of the Lysholm grading was 91.6±3.9. The Lachman test and the Pivot-shift test were negtive.Conclusion Treating tibial plateau fractures involving the posterior column by 3.5 mm proximal tibial plate with narrow plate head through standard anterolateral approach is an effective method.The protocol is simple and safe,the approach is familiar by most clinicians.Good reduction and fixation,earlier functional exercise can be achieved easily.The knee function recovered well and earlier curative effect was satisfied.

Objective To investigate the value of external fixator in the treatment of posttraumatic elbow stiffness.Methods From January 2007 to December 2009,25 patients with posttraumatic elbow stiffness received surgical arthrolysis with assistance of external fixator.There were 10 patients with grade 1 stiffness,12 patients with grade 2 stiffness and three patients with grade 3 stiffness.The range of motion (ROM) was 0°-75° ( average 33.4°) preoperative,with ＜ 30° in 12 patients.For the patients with grade 1 stiffness,intraoperative distraction with an external fixator rather than open arthrolysis was performed ; for the patients with grade 2 stiffness,the heterotopic ossification was removed through a limited approach before the external fixator was applied; for the patients with grade 3 stiffness,additional osteotomy and internal fixation before arthrolysis were performed.After operation,there was a rehabilitation phase,followed by mobilization of the elbow joint under protection of the external fixator for a mean period of six weeks.Results The intraoperative mean ROM was 105.6°,which was significantly improved than that before operation (P ＜0.05).The maximal flexion degree was above 110°in all patients.No instability occurred.Two patients were excluded from the follow-up:one had ulna fracture two weeks after operation due to an incorrect placement of the pin,and additional internal fixation was then carried out;another patient had numbness in the ulna side when flexed the elbow after arthrolysis,and the ulna nerve transposition was performed through another operation.Other patients were followed up for a mean period of six months.At the latest follow-up,the mean ROM was 97.4°( range,70°-130°),significantly improved than that before operation (P ＜ 0.05 ),and lest 8.2°on average (0°-15 °) compared with the intraoperative ROM (P ＞ O.05).The maximal flexion in all patients was above 100° Conclusion With the advantages of minimal invasive or noninvasive,indirect capsular traction,stability maintenance during the movement,and prevention of the motion loss during the rehabilitation,arthrolysis of the elbow joint with the use of external fixation frame can be a good alternative in the treatment of posttraumatic elbow stiffness.

Objective To investigate the morphological properties of posterior Monteggia lesion with associated elbow dislocation,to propose its injury mechanism,and to present its surgical methods and its outcomes.Methods The injury mechanism,radiographs and surgical records of patients with posterior Monteggia fractures and associated elbow dislocation were retrospectively reviewed from January 2011 to December 2013.11 patients were included,with 43.3 years old on average.10 were resulted from high-energy injuries.According to the Jupiter classification,Ⅱ A fracture-dislocation 9 cases,Ⅱ B fracture-dislocation 1 case and Ⅱ C fracture-dislocation 1 case.The general medical data,morphological properties,and the surgical methods.Functional outcomes were followed up.Results These cases had several intrinsic morphologic features:fractures of the coronoid tip and its anteromedial aspect;dislocation of the olecranon from the trochlear notch;fracture of the radial head and disruption of the lateral collateral ligament;a normal proximal radioulnar joint.Operation was carried out with emphasis on elbow stability restoration.All patients underwent the primary operations in the supine position and a routine posterior approach was used.An additional anterior approach was used in 1 case (Ⅱ B).The coronoid tip was first fixed,followed by the anteromedial coronoid fragment,the radial head,the olecranon,and then the LCL.An anatomic olecranon plate was used as the fundamental fixation device.Anteromedial coronoid fractures were mostly fixed with a T-shaped metacarpal plate.The coronoid tip fractures were fixed with screw,Kwire or suture,and the injured LCL was repaired with suture anchors.Ten of the 11 patients were followed up with a mean period of 22.7 months.The extension-flexion motion ranged from 45°-140° (104° average),and the pronation-supination motion ranged from 45° 180° (128° average).According to the Broberg and Morrey functional index,the excellent to good ratio was 70％.Conclusion Patients with posterior Monteggia fracture and associated ulnohumeral dislocation have small and comminuted coronoid fractures,and mostly have a normal PRUJ relationship.It might experience a different mechanism to those of the posterior Monteggia fracture without elbow dislocation.Emphases should be address to restore the rotation stability of the elbow when operation.

Objective To evaluate the frequency and morphological characteristics of the posterolateral articular fracture in tibial plateau fractures.Methods A retrospective analysis of CT images and clinical data was taken among 309 cases of tibial plateau fractures from 2008 May to 2013 January.There are total 264 patients were recorded excluding 45 cases with which the CT image is missing or not compatible with the medical Picture Archiving and Communication Systems (PACS).To determine the occurrence rate of the posterolateral articular fracture in tibial plateau fractures and measure morphological parameters such as the axial angle of fracture line,articular surface area,sagittal fracture angle,fracture height,and amount of displacement.Results 39 cases of posterolateral articular fragments were found in 264 cases of tibial plateau fractures with the 14.8％ incidence (39/264).There were 18 males and 21 females,aged from 31-70 years (mean,52 years).17 left cases and 22 right cases.The mechanism of injury were traffic accident in 22 patients,blow by a heavy object in 2 patients,a fall in 11 patients,and other causes (unknown) in 4 patients.The posterolateral plateau articular fracture fragment has morphological characteristics of a conical shape fragment and the major articular fragment angle was 22° (range,-43°-62°),and an average accounted for 14.1％ of the articular surface of the total tibial plateau (range,8％-32％).The posterolateral fragment exhibits a vertical fracture pattern and an average sagittal fracture angle was 76° (range,58°-97°),suggestive of shear instability and vertical displacement.Maximum posterior cortical height was 28 mm (range,18-42 mm),and average size of the displacement was 10.48 mm (range,2-19 mm).Conclusion The posterolateral plateau articular fracture fragment has morphological characteristics of a conical shape fragment,relative small articular surface area and sagittal fracture angle.

Objective To Evaluate the performance of serum adenosine deaminase assays of different manufacturers and explore the approach for harmonization of test results.Methods It was evaluated the indice including the limit of blank ,precision,linearity range and reference interval of 10 test systems.It was as the reference system by Mindray test system to evaluate the comparability and the difference of ADA results among 10 different systems.The evaluation was performed before and after calibration by a selected fresh serum assigned by the reference system.A commercial calibrator of the minimum matrix effect was selected from 8 different calibrators as the long-term calibrator to harmonize the ADA results of 10 systems.Results The results of LoB were 0.1-6.3 U/L,respectively.The within-run CVs and total CVs of 10 systems were all less than 5%and actual linearity ranges were conformed to claims of manufacturers.After calibration with fresh serum calibrator ,the averaged difference of 10 test systems was reduced from 14% to 3.0%, and the average difference was 1.8% after calibration with long-term calibrator.The common reference interval of all test systems was 5-24 U/L identically.Conclusions The comparability of ADA measurements can be improved by using a common human serum calibrator and the commutable commercial calibrator.And it is necessary and feasible to develop the standardzation of ADA.

Objective To study the import way of schistosomiasis and the vector snail in Three Gorges Reservoir areas (TGR), so as to provide the reference for the surveillance, early warning of schistosomiasis.Methods A total of 256 movement population in Badong County and Zigui County and 1584 immigrants from TGR to the endemic area of Hubei Province were investigated by questionnaire, and screened by means of IHA and COPT. The farm cattle were surveyed in Badong County and Zigui County. Production of paper mills, the source of papermaking raw material, flowers and trees in gardens were investigated for snail survey. At the same time, current situation of immigrants in TGR was investigated. Social data (statistic yearbook, etc) and policy data of development of TGR were collected. Results No farm cattle from endemic area of schistosomiasis was found. In Hubei reach of TGR, the movenment population were mainly from the endemic area of schistosomiasis in Hubei Province. The positive rate of both IHA and COPY was 0 57%(1/175); the positive rate of both IHA in emigrants from TGR was 1 01%(12/1186). No Oncomelania snail was found in the introduced flowers and trees in garden. In paper mills, no reed from the endemic area of schistosomiasis was found. Migrants′ living and sanitary condition were improved after moving,but the production was not well arranged. Orange industry, travel industry, animal husbandry and fishery should be developed preferentially in the future. Conclusion Migrants from TGR to the endemic area of schistosomiasis and the movement population will be the mainly infection source. The problem on cattle as the infection source should be paid attention. It can't be excluded that snail will enter TGR together with the raw material for paper mills or flowers and trees. To develop orange industry will be good for the control of schistosomiasis; but the development of animal husbandry, fishery and travel industry will increase the risk of import of the infection source and snails to TGR.

Objective To analyze clinical outcomes of the spouse donor kidney transplantation for evaluating the security.Methods Sixty-three cases of living-renal transplantation were divided into two groups, spouse donor group (12 cases) and the other related donor group (53 cases). Twelve cases of spouse-donor(SD)renal transplantation were summarized, that were compared with the nospouse transplantation cases of the other living-related renal transplantation in the same period, which were similar in basic conditions and in immunosuppressant scheme. The observational parameters included average hospitalization time, rate of acute renal necrosis, acute rejection incidence within 1 year, serum creatinine at 7 d, 30 d and 1 year after transplantation.Results The recipient age of the 2 groups was (39±3)years and (37±3)years(P=0.05), dialysis time was (4.7±3.2)months and (4.4±2.9)months(P=0.78), the average hospitalization time was (20.9±8.3)d and (23.0±7.8)d(P=0.41). There was no significant difference between the spouse donor group and the no spouse related donor group. The acute rejection incidence within 1 year was 33.3%(4/12) in spouse group and 3. 9%(2/51) in the other related group, there was significant difference between the 2 groups(P＜0.05). The rate of acute renal necrosis was 16.7%(2/12) in spouse group and 3.9%(2/15)in no spouse related group, there was no significant different between the 2 groups(P＞0.05).SCr was (206.47±47.22)μmol/L and (163. 75±25.91)μmol/L in spouse group at post-operation 7 d and 30 d, and was (142.79±89.42)μmol/L and (119. 99±15.03)μmol/L in no spouse group. There was significant difference between the groups(P=0.02, P=0.00). One year after operation, SCr was (133. 40±6. 11)μmol/L in spouse group and (121. 00±34.12)μmol/L in no spouse group,there was no significant difference between the 2 groups (P=0.25).Conclusions Preoperative comprehensive assessment of the spouse donors and recipients renal transplantation is the guarantee for the success.Short-term outcomes of spouse donor renal transplantation is ideal, but rate of acute rejection within 1 year is higher than that of the other living-relative donor kidney transplantation, which dose not influence the long-time survival of spouse recipients.