Objective To investigate the treatment of pronation external rotation ankle injuries and to evaluate its outcomes. Methods 58 cases of severe ankle injuries of pronation external rotation type who had been hospitalized between October, 2001 and October, 2003 were retrospectively analyzed. They were 42 males and 16 females, with an average age of 32.4 years old (16 to 61 years old). According to Lauge Hansen classification, 39 cases were grouped as grade Ⅲ, while other 19 cases as grade Ⅳ. Most cases were surgically managed, and routine examinations were done. Results The average follow up period was 16.4 months (from 10 to 36 months). The satisfactory outcome was 89.7%. 2 cases of osteoarthritis were observed. Conclusions In treatment of pronation external rotation ankle injuries, the key points are to correct the fibular shortening and external rotation and to take great care of technical details.

The efferent projections of the rostral ventrolateral medulla(RVL) to the hypothalamic paraventricular nucleus(Pa) and the thoracic cord were studied in the adult cat by using WGA-HRP or fluorescent retrograde tract-tracing method. After injection of WGA-HRP or fluorescent tracer Fast blue(FB) into one side of the Pa, retrogradely labelled cells were found in bilateral RVL, with an ipsilateral predominance. The labelled cells decreased in number from the caudal to the rostral level. After injection of FB into one side of the thoracic cord at T_2-T_3 segments, retrogradely labelled cells in the RVL were observed which increased in number from the caudal to the rostral level and reached the peak at 1.0-1.5mm caudal to the trapezoid body. Most of these cells were distributed in the ipsilateral RVL, and clustered in the region 0.0-1.0mm from the ventral surface of the medulla. After Diamino yellow 2HC1 and FB were injected into the Pa and the thoracic cord respectively, only single labelled cells were detected in the RVL, no double labelled cells were found. The above results suggest that the Pa and the thoracic cord receive separate fiber projections from different cells of the RVL.

The distribution of serotonin(5-HT), phenylethanolamine-N-methyltransferase (PNMT), substance P(SP) and leu-enkephalin(L-ENK) immunoreactive neurons in the rostral ventrolateral medulla (RVL) of the cat was studied with the immunohistochemical ABC technique, and the projection of 5-HT, SP and L-ENK positive neurons of the RVL into the thoracic cord was preliminarily investigated by a combined fluorescent retrograde transport and immunofluorescence method. The results indicate that 5-HT, PNMT, SP and L-ENK immunoreactive neurons mentioned above were localized primarily in the caudal part of nucleus paragigantocellularis lateralis and the rostral part of nucleus lateralis reticularis. SP positive cell bodies in the reticular formation close ventrolateral to nucleus ambiguus were also found. Some 5-HT, SP and L-ENK positive cells were situated in the area near the pia mater. In the most area of the RVL, 5-HT, PNMT, SP and L-ENK immunoreactive cell bodies had an overlapping distribution. 5-HT or PNMT or L-ENK positive neurons crowded, intertwined each other with their processes in the region at the levels 1.0-3.5mm caudal to trapezoid body, about 3.3mm lateral to the midline and about 0.8mm from the ventral surface of the medulla, and formed a longer or shorter continuous cell column which ran in the rostrocaudal direction. These three columns nearly coincided with each other at the level 1.5-2.5mm caudal to trapezoid body. Part of 5-HT, SP and L-ENK positive neurons in the RVL projected into the thoracic cord. The functional significance of these substances in the RVL was also discussed.

[Objective]To use urodynamic method to evaluate "free sacro-capsule"pre-operation and post-operation effect,also evaluate bladder and urethral function.[Method]Twenty children were included in this study.[Result]All children had none damage after operation.The PVR and DLPP of post-operative group are significantly decreased.The BC and MCC of post-operation group was significantly higher than pre-operation group(P

BACKGROUND: During the hip replacement, selection of prosthesis often depends on patients' bone condition. There has been no gold standard for selection of prosthesis. It will be of scientific significance to select femoral prostheses implanted under different bone densities through three-dimensional finite element analysis and simulated contrast mechanical tests.OBJECTIVE: Three-dimensional finite element analysis was employed to select femoral prostheses according to different bone densities, and simultaneously simulated contrast mechanical tests were performed to determine the age criteria regarding the selection of femoral prosthesis during the hip replacement.DESIGN, TIME AND SETTING: An open experiment was performed at the Second Department of Orthopedics, First Clinical Hospital of Jilin University and Institute of Biomechanics, Jilin University between September 2006 and May 2007.MATERIALS: Freshly adult femoral specimens were harvested from cadavers.METHODS: Three-dimensional finite element models of femur were established using Solidworks software. Following the known formula, the bone density and elastic modulus at different age brackets were calculated and input into the computer. The human one-foot standing condition was simulated and pressure was loaded on the reconstructed femoral models.MAIN OUTCOME MEASURES: Some biomechanical characteristics of uncemented and cemented femoral prostheses, such as the distress distribution and initial micromovement at different bone densities, were measured.RESULTS: Relatively well-distributed whole distress and slight initial micromovement of uncemented femoral prostheses were found in male patients at 30-60 years old and in female patients at 40-55 years old. Symptoms of cemented femoral prostheses the same as the uncemented femoral prostheses were present in male patients at 60-70 years and in female patients older than 55 years old.CONCLUSION: Results of three-dimensional finite element analysis and simulated contrast mechanical tests suggest that uncemented femoral prostheses provide better therapeutic effects in male patients younger than 60 years and in female patients younger than 55 years than cemented femoral prosthesis.

BACKGROUND:Standard artificial prosthesis does not well match to patients' skeleton due to absolute individuation,while the difference between them does not keep the stabilization of artificial joint for a long term.OBJECTIVE:To construct three-dimensional models of custom-made femoral prosthesis by using computer-aided design and to verify whether custom-made femoral prosthesis is superior to popular femoral prosthesis via simulating and contrasting mechanical study.DESIGN,TIME AND SETTING:Opening study was performed in the Orthopaedics Institute of the First Clinical Hospital and the Biomechanics Institute,Jilin University between September 2006 and May 2007.MATERIALS:One fresh femur was derived from adult corps.METHODS:Two-dimensional images of the fresh femur was obtained by using total-length CT scanning and processed with computer edge recognition and three-dimensional contour extraction software to identify outer and inner contour of bone cavity,extract contour data of bone cavity and prosthesis,and construct three-dimensional models of femur and custom-rhade femoral prosthesis.SolidWorks software was used to establish three-dimensional prosthetic models in common biological and bone cement types; moreover,bone-cement,biological,and custom-made femoral prosthesis were replaced via simulating clinical surgery.MAIN OUTCOME MEASURES:Standing on single or double feet was simulated to measure stress distribution,interface stress,and primary micromotion of femoral prosthesis in the three types.RESULTS:Edge extracting was replaced by Canny calculator,characterizing by stable running,credible outcome,and consistent with the primary request.Stress,femoral stress,interface stress,and primary micromotion of custom-made femoral prosthesis were significantly lower than biological and'bone-cement femoral prosthesis (P ＜ 0.01).CONCLUSION:The computer-aided design is reliable to perform the assistant design of prosthesis; furthermore,biomechanical properties of the custom-made femoral prosthesis are superior to those of popular femoral prosthesis.

Objective To discuss the reasons and the best treatment of the encephalocele during severe head injury. Method Retrospective analysis 26 cases of the clinical data of patients with acute encephalo-cele during severe head injury used bilateral craniotomy method. Result Good recovery in 4 patients, mod-erate disability in 5 patients, severe disability in 2 patients, vegetative state in 3 patients, death in 12 pa-tients. Conclusion Delayed intracranial hematoma and acute diffuse brain swelling are the main reasons of craniotomy brain injury in acute encephalocele, and using bilateral craniotomy can significantly increase the survival rate and quality of life.

Objective To investigate the antitumor effect of specific cytotoxic T lymphocytes induced by renal cell carcinoma multiple antigen peptide dendritic cell (DC) vaccine in vitro. Methods Dendritic cells were induced by hGM-CSF,hIL-4 from blood.Peptide of renal cell carcinoma cell line (RCC786-0)was got by citrate-phosphate buffer elution.Peripheral blood mononuclear cell was cultured.Multiple antigen peptide DC cell vaccine was obtained by acid-eluted peptide pulsed DC.The tumor antigen specific CTL was generated from activated T cell by vaccine.Killing activity of the tumor antigen specific CTL was activated by vaccine. Results Antigen peptide DC cell vaccine could show a strong cytotoxic activity of CTLs(31.93±5.05%),which was much higher than control groups(5.88±2.26%,8.03±6.70%,9.70±2.09%,9.35±3.58%). Conclusion Renal cell carcinoma antigen peptide DC vaccine could show a high antitumor effect in vitro.

Objective To evaluate the clinical,neuroimaging and electrophysiology features of 62 patients with multiple system atrophy(MSA).Methods Sixty-two cases with diagnosis of probable MSA were recruited in a retrospective studied.Clinical,neuroimage and external anal sphincter electromyography (EAS-EMG)data was retrospectively analyzed.Results In 62 cases(44 male and 18 female),the onset age was between 37 and 76.Among them,29 cases(46.8 % )were MSA-A,with orthostatie hypotension as the main clinical manifestation;24 cases(38.7 % )were MSA-C,with cerebellar ataxia ag the main chnical manifestation;9 cases(14.5 % )were MSA-P,with extrapyramidal symptoms as the main clinical manifestation.MRI showed that main lesion of MSA-A was in the cerebellum:that of MSA-C was in the cerebellum,pons and medulla;and that of MSA-P was in the putamen.Fifty-one cases did EAS-EMG and 46 cases showed neurogenie impairments.Nineteen cases were initially misdiagnosed with other diseases.Conclusions MSA is easy to be omitted or misdiagnosed at early stage.The diagnostie rate of MSA can be increased by the combination of clinical expressions,neuroimage,EAS-EMG and other necessary examinations.

BACKGROUND:Acetabular cup orientation is critical for preserving the range of motion and preventing dislocation of the prosthesis. Cup malpositioning may result in an increased polyethylene wear rate,pelvic osteolysis and acetabular migration (aseptic loosening).There are no definite criterion for the orientation of the acetabular cup.OBJECTIVE:To explore the relationship between acetabular cup Position and the load distribution within the acetabulum and to confirm an optimal range of cup position.thereby providing a theoretical criterion from a biomechanical aspect for proper cup implantation in clinical work.DESIGN:Repeated measurements.SETTING:Second Department of Orthopaedics in the First Clinical Hospital of Jilin University.MATERIALS: One healthy male adult fresh Cadaveric pelvis was offered by the Department of Anatomy in Jilin University.METHODS:This experiment was carried out at the Institute of Orthopaedics in the First Clinical Hospital of Jilin University,and the Institute of Biomechanics in Jilin University from September 2005 to May 2006.Cadaveric pelvic was scanned with spiral CT,and then the two-dimensional images were evaluated using GE medical systems software and the outline of the pelvis was identified by the edge detective estimation.Pelvic coordinate data were put into the computer to build up a three-dimensional (3D) finite element model of the pelvic using Solidworks software.A P48 non-cemented cup from Tianjin Huabei Medical Instrument Factory was used,and the 3D measurement of the cup was carried out by CLY single-arm 3D measurement apparatus,which was made in Testing Technology Institute of China.The measurement data were transferred into computer.Through the CAD SliodWorks2003 software,the 3D model of the cup was automatically reconstructed. Afterwards, one-foot standing position was simulated to conduct the loading and constraint of the model,the Mises and shear force distributing of the cup were analyzed,forecasting the mechanical risk of prosthetic failure.MAIN OUTCOME MEASURES:The evaluation of Mises stress and shear force distributions under different cup positions.RESULTS:In the 3D finite element modeI of human pelvis.the number of total nodes was 103043 and the number of total elements was 69271.Abduction angle did not affect the Mises and shear force distributions between the range of 40°-50°(P>0.05).However,significant affects appeared in Mises and shear force once the abduction angle was<35°or>50°.The change of the cup anteversion within 5°-30°would not affect the Mises and shear forces in the acetabulum(P>0.05).CONCLUSION:A uniform load distribution on the cup-bone interface can be obtained when the cup abduction angle is from 40°to 50°.The change of the cup anteversion angle can not affect the load distribution in the acetabulum,therefore the cup abduction range of 40°-50°can be confirmed as the safe range for cup implantation.