Objective To analyze prognostic relative factors in treatment by evaluating the surgical results of tibial pilon fracture retrospectively. Methods 32 cases with unilateral tibial pilon fracture were treated operatively between January 1997 and December 1999. Among them, 16 cases were found with unsatisfied results due to incisional complications, degenerative changes and stiffness of the ankle joint. Of 16 cases, there were 13 males and 3 females. The average age was 36.5 years (range, 25 to 55 years). The mechanisms of injury were fall in 7 cases, traffic accident in 5 cases, crash in 3 cases and other cause in 1 case. 6 cases with open fracture were treated in emergency. However, 10 cases with closed fracture were operated with an average interval of 8.1 days from injury to surgery(range, 2 to 25 days). According to the Ruedi-Allgower classification, there were type Ⅱ fracture in 7 cases and type Ⅲ fracture in 9 cases. Furthermore, there were 14 cases associated with fibular fracture. During operation, 7 cases were treated with open reduction and internal fixation with plates and screws, and 9 cases were treated with open reduced minimally and external fixation with a cast. Results The average period of follow-up was 24 months (range, 12 to 36 months). According to Mazurs criterion, the result of the treatment was evaluated as fair in 6 cases, 4 cases of which were type Ⅱ fracture, and 2 cases type Ⅲ fracture; poor in 10 cases, 3 cases of which were type Ⅱ fracture, and 7 cases type Ⅲ fracture. Complications included wound dehiscence in 1 case; infection in 4 cases, 2 of which with open fracture were superficial infection, and 2 cases with closed fracture were deep infection; posttraumatic arthritis of the ankle joint in 9 cases; and severe varus deformity in 2 cases.11 cases suffered from ankle stiffness. Conclusion Discouraged results of pilon fractures are significantly related to fracture type, reduction status and time of operation, reduction and fixation of fibular fracture, and bone grafting.

Objective To review and summerize effectiveness and method of the Boston's balloon dilation in cardiac achalasia. Methods The intensified guide wire was inserted into stomach through mouth cavity under TV controll. The Boston's balloon was inserted to the cardiac stricture through the guide wire and dilatated with 15% contrast medium with to a maximum diameter for five minutes and then the balloon was dilatated again for 3～5 minutes, all together for 3～4 times. The severe stricture must be pre dilatated with 20～25mm diameter balloon. Results The balloon insertion was technically successful in all 26 patients. The once succese of ballon dilation was achieved in 24 patients and twice in other 2. Follow up time was from 2 weeks to 31 months(mean 10.6 months). Recurrent stenosis had not occurred in all patients. Remission rate of dysphagia was 100%. Esophageal reflux occurred in 3 patients. Conclusions The Boston's balloon dilatation is simple and effective for treatment of cardiac achalasia. The method sometimes may replace surgical procedure.

Total laparoscopic splenectomy combined with pericardial devascularization has become an important surgical treatment for portal hypertension patients. Compared with the traditional open surgery, laparoscopic surgery has multiple advantages including precise operation, small trauma and quick recovery. Accurate preoperative evaluation, precise surgical operation and delicate perioperative management are still important parts in perioperative management of laparoscopic surgery. Preoperative reasonable and accurate individualized assessment, strict control surgical indications and contraindications are the important basis to ensure the perioperative surgery to be safe and rational; standardized and individualized surgical operation is the key for accurate vascular disconnection, reducing intraoperative bleeding and perioperative complications; the concept of fast-track surgery is conducive to the rapid recovery of patients with portal hypertension and reduce the operation related complications. Anticoagulant therapy is a safe and effective treatment to reduce portal vein thrombosis. It is an important task to strengthen the cooperation among different disciplines for the treatment of portal hypertension in the future.

Objective To explore effects of apoAI on MCP?1 levels in the plasma and the Ly6Chi monocyte proportion in the blood and spleen of atherosclerotic mice,as well as on CCR2 expression in vitro. Methods Sixteen male apoE?/?mice were fed with high cholesterol diet for 12 weeks. Mice were randomly divided into control and apoAI groups and were administered with PBS or apoAI(40 mg/kg),respectively,via tail vein on the 1st and 3rd day before sacrifice. Mice in both groups were administered LPS(25μg/mouse)via intraperitoneal injection 12 h before sacrifice. Plas?ma levels of MCP?1 were determined using ELISA,and the Ly6Chi monocyte proportion was analyzed using flow cytometry. In addition,human monocytic THP?1 cells were randomly divided into control and apoAI(10 mg/L)?treated groups,pretreated with corresponding intervention,and incubated with LPS(10μg/L). CCR2 expression levels were measured by Western blotting. Results Compared with the control treatment, apoAI treatment remarkably reduced MCP?1 levels in plasma and Ly6Chi monocyte proportion in the blood and spleen(P<0.01). Furthermore, apoAI treatment inhibited CCR2 expression in monocytes in vitro(P<0.05). Conclusion apoAI can reduce MCP?1 levels in plasma and the Ly6Chi monocyte proportion in the blood and spleen and can inhibit CCR2 expression in monocytes in vitro.

Objective To study the effect of pulmonary artery perfusion with the modified low-potassium dextran(LPD) solution on cardiopulmonary bypass(CPB)-induced systemic inflammatory response. Methods 30 patients undergoing mitral valve replacement were randomly divided into control group (n=15) and lung perfusion group (n=15). The patients in the lung perfusion group were perfused with the modified LPD solution by pulmonary artery during CPB. The patients in the control group underwent the routine procedure of mitral valve replacement. The plasma concentrations of TNF-? and IL-8 were measured before and 0 h, 6 h after surgery by ABC-ELISA. Results The plasma levels of TNF-? and IL-8 significantly increased after surgery in both groups. The plasma levels of TNF-? and IL-8 were significantly lower(P

Objective To study the effect of epigallocatechin-3 gallate (EGCG) on cholesterol efflux in foam cells and its mechanism.Methods THP-1 cells were induced to differentiate into macrophages which were then transformed to foam cells.Foam cells were divided into 0 μmol/L EGCG group,10 μmol/L EGCG group,30 μmol/L EGCG group,and 100 μmol/L EGCG group (1.5 × 106 in each group).Their cholesterol content was measured with a cholesterol test kit,apoA-I-mediated cholesterol efflux was assayed with a liquid scintillation counter,expression of ATP-binding cassette A1 (ABCA1) was detected by RT-PCR and Western blot respectively.Results The ABCA1 mRNA and protein expression levels and cholesterol efflux were significantly higher while the cholesterol content was significantly lower in 10 μmol/L EGCG group,30 μmol/L EGCG group,and 100 μmol/L EGCG group than in 0 μmol/L EGCG group (7.04％ ±0.21％,7.75％±0.17％ and 8.53％±0.18％ vs 3.37％±0.16％,P＜0.01;419.33±19.75 mg/g,352.58± 14.23 mg/g and 312.62±17.45 mg/g vs 520.51 ±20.62 mg/g,P＜0.01),and in 30 μmol/L EGCG group,100μmol/L EGCG group than in 10μmol/L EGCG group (P＜0.05).Conclusion EGCG increases cholesterol efflux and decreases cholesterol content in foam cells by upregulating the transcription and expression of ABCA1.

Objective To establish viral inactivation/removal techniques for blood products , and apply them to inacti-vation/removal process validation of blood products .Methods Enveloped and non-enveloped model viruses were propaga-ted.Viral inactivation/removal techniques for blood products ,including solvent/detergent (S/D) treatment, low pH incuba-tion, dry heat method, pasteurization,and nanofiltration, were established.The virus titer was evaluated using cytopathic effects ( CPE) and Spearman and Karber method .The viral inactivation/removal techniques were believed to be effective when LRV≥4.These techniques were used in viral inactivation /removal validation of blood products .Results Enveloped model viruses were inactivated through S/D treatment and the low pH incubation method .Enveloped and non-enveloped model viruses were inactivated through dry heat and pasteurization .Within a certain range of filtration capacity , PPV was removed through nanofiltration .Conclusion The established viral inactivation/removal techniques can be used in viral inactivation/removal process validation of blood products , which can improve viral safety of blood products .

3.0 cm in diameters.Contrast-enhancement CT showed tumors with abundant blood vessel,1 case appeared as uniform enhancement and was difficult to distinguish between tumor body and internal carotid and external carotid because of the iso-density of them.On MRI,the flow void blood vessels inside the tumors could be identified and internal carotid and external carotid separated.MRA displayed all the relation between the tumors and carotid and its branches.DSA could demonstrate the supply arteries of the tumors.Conclusion Ultrasonics,CT,MRI and DSA have own definitely characteristic value in diagnosing carotid body tumor.

Objective To review and summarize the effects of interventional treatment of hand arteriovenous malformation in 5 cases.Methods Through catheterization of brachial artery ipsilaterally the blood-supply artery of arteriovenous malformation was embolized,using high-temperaure managed gelatin sponge,silk thread,pingyangmycine and spring coil.Results Total 13 blood-supply arteries in 5 cases were embolized with successful rate of 100%,including 1 case of complex malformation under effectively controlled,3 cases cured clinically and 1 case still awaiting observation.Conclusions Transcatheter arterial embolization for the treatment of hand arteriovenous malformation is safe,effective and high successful.(J Intervent Radiol,2007,16:277-279)