BACKGROUND: Magnetic navigation META nailing for tibial fractures via the supra-patellar approach is a novel surgical method, exhibiting overt advantages.OBJECTIVE: To retrospectively analyze the clinical characters of magnetic navigation META nailing via the supra-patellar approach for tibial fractures.METHODS: Clinical data of 58 cases of tibial shaft fracture were collected and analyzed retrospectively, and all patients were treated with navigation META-NAIL via the supra-patellar approach. The patients received the postoperative prophylactic antibacterial therapy; non-weight bearing functional training was performed at 3 days postoperatively, and full weight-bearing functional exercise was conducted at an average of 12 weeks postoperatively.RESULTS AND CONCLUSION: (1) The Lysholm scores ranged from 83 to 95 (average, 90) at 24 weeks postoperatively. (2) The excellent and good rate evaluated by Johner-Wruh scoring reached up to 95％. (3) The average operation time was 65 minutes, and the blood loss was 30 mL. (4) There was no complaint of knee pain during the follow-up. (5) No postoperative complications, such as non-healing wounds, infection, bone nonunion, osteomyelitis or deformity recovery, occurred.(6) These results manifest that the magnetic navigation META-NAIL for tibial shaft fractures via the supra-patellar approach exerts a lot of advantages, including short operation time, accurate reduction and stable fixation. Most importantly, it can avoid cut patellar tendon tissue, and reduce the rate of knee pain, further promoting early functional exercise, which obtains satisfactory treatment outcomes.

Objective: To analyze the relationship between meteorological factors and the number of daily heart failure (HF) patients for emergency room (ER) visit at Fengxian district of Shanghai in order to provide the experience for prevention and control of HF morbidity. Methods: Daily number of HF patients treated in ER of our hospital from 2012-01 to 2014-12 with corresponding meteorological, air pollution data at the same period were collected and analyzed by Spearman correlation study and multiple stepwise regression analysis. Results:①The differences of temperature, humidity, air pressure at 24-, 48-hour before and 48-hour after ER visit were positively related to the number of HF patients; the number of HF patients was signiifcantly related to the differences of temperature and air pressure at 48-hour before ER visit,P<0.001.②Multiple stepwise regression analysis showed that the most affecting meteorological factor for ER visit of HF patients was the daily lowest temperature,P<0.05, the second factor was the daily average relative humidity,P<0.05. Conclusion: Radical changes of temperature, relative humidity and air pressure elevated the number of HF patients for ER visit; daily lowest temperature and decreased relative humidity were the important factors for elevating the number of HF patients for ER visit.

BACKGROUND:In senile osteoporosis patients, capacity of pedicle screw fixation is relatively poor due to fragile bone substance. Currently, augmentation of pedicle screw fixation with bone cement can improve the ability of screw fixation, but bone cement leakage and difficulties in screw removal become the problem to be solved. OBJECTIVE:To develop a novel pourable pedicle bone cement and to investigate its biomechanical properties, safety and practicality, thus providing the basis for clinical treatment of osteoporosis and spinal diseases.
METHODS:Six cases of complete wetting spines were colected at the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from December 2013 to January 2015, including 42 vertebrae. Pedicle screw fixation with X-ray assisted bone cement injection (2 mL) was performed unilateraly as experimental group, and conventional pedicle screw fixation was done contralateraly as control group. Bone cement dispersion was observed in the two groups. RESULTS AND CONCLUSION:It was 3-4 minutes for bone cement to agglomerate. Injection of bone cement paste into the infusion cylinder using a syringe was more convenient. The cylinder was connected tightly with the tail-end of the screw with no leakage. The push bar could provide sufficient perfusion force. Bone cement dispersion was found in the holow part and side holes of the screw. Side holes arranged regularly, and the hole pitch was equal. Compared with the control group, the yield load and yield displacement were significantly higher in the experimental group (P < 0.05), but the ultimate strength and ultimate displacement were significantly lower in the experimental group (P < 0.05). Bone cement around the pourable cement screw dispersed regularly, which was diffused into the surround cancelous bone and integrated with adjacent bone cement mass. The axial withdrawal force was increased by 114% in the experimental group compared with the control group (P < 0.05). The maximum rotary torque was significantly higher in the experimental group than the control group (P< 0.05). These finding suggest that the new pourable cement screw combined with bone cement putter and infusion cylinder is applied more convenient, can effectively control the leakage of bone cement, and can improve the stability of the pedicle in osteoporosis patients, which has been widely used.

Objective To observe the solo-allied expression of Survivin, Smad4/dpc4 and APC gene, and study the relationship between the three genes and biological behavior of colorectal cancer. Methods The expressions of Survivin, Smad4/dpc4 and APC gene were detected by SP immunohistochem-istry among the cases from 40 eu-intestine ,80 large intestinal adenoma and 80 CRC. Results The positive rate of survivin protein in the eu-intestine, the large intestinal adenoma and CRC was 0,35.0% ,75.0% , respectively. The positive rate of Smad4/dpc4 protein was 100% , 95. 0% , 78. 8% , and the positive rate of APC protein was 100% ,80.0% ,45.0% , respectively. In the eu-intestine, APC + Smad4/dpc4 Z- expressed in 40 cases, with the incidence of 100%. In the large intestinal adenoma, APC + Smad4 expressed in 38 patients, with the incidence of 47. 5% , and the three genes expressed in 29 patients with the incidence of 23. 8%. In the CRC, two genes expressed in 57 patients, with the incidence of 71. 3% , and three genes expressed in 28 patients, with the incidence of 35.0%. Conclusion The detection of survivin was a new indicator in early diagnosis of CRC. It was significant in the diagnosis of CRC that energetic search for the positive rate level realm of survivin. The catastrophe or absence of Smad4/dpc4 gene not only induced the genesis of CRC but also encouraged its growth. Smad4/dpc4 was ant- carcinomatous gene intimately correlated to the CRC. Detection of APC gene had very important significance, it could be helpful to conduct the research of tumorous aetiology, nosogenesis and early diagnosis. The allied detection of Survivin, Smad4/dpc4, APC gene played a very important role in early diagnosing and healing the CRC.

Objective To analyze the early risk factors of overweight and obesity in preschool children.Methods Using stratified cluster sampling,the data of 1 335 preschool children's physical examination in High-tech Zone,Urumqi,Xinjiang were collected,and the case group had 153 overweight and obese children,the control group had 1 182 non-overweight and obese children;a case-control study was conducted.The basic data of mothers and the basic data of neonatal birth were analyzed retrospectively.The univariate and unconditional multivariate logistic regression analysis was performed.Results The prevalence of overweight and obesity in preschool children in High-tech Zone in Urumqi was 11.5％.Non-conditional multivariate logistic regression analysis showed that children's age (OR=1.31,95％ CI:1.07-1.61),mother's pre-pregnancy BMI (OR=1.11 95 ％,CI:1.06-1.17) and whether mothers had gestational hypertension (OR=1.99 95％,CI:1.03-3.85) were the risk factors for overweight and obesity in preschool children (P＜0.05).Conclusion In Urumqi high school district preschool children's overweight and obesity rate was high;mothers with high BMI before pregnancy,and those with high blood pressure during pregnancy can increase the risk of overweight and obesity in children,preschool children's increased age may increase the risk of overweight and obesity in children.

Objective To Discuss the impacts of different dosage of atorvastatirs on serum hsCRP,IL-10 and MCP-1 levels on post-intervention patients with coronary stenting. Methods 93 post-intervention patients with coronary stenting were selected and randomly divided into 3 groups.Each group took different dosage of oral atorvastatins after the operation for more than one week.The dosage for each group was 10 mg,20 mg and 40 mg,respectively.Each patient was phlebotomized for three times,which are 24 hours before the operation,24 hours after the operation and one week after the operation.Serum MCP-1,IL-10 and hs-CRP levels were measured by enzyme linked immunosorbent assay(ELISA)and immunoturbidimetry(ITM). Results Serum hs-CRP and MCP-1 levels of post-intervention patients were significantly higher than those of pre-intervention.This illustrated that the serum hsCRP and MCP-1 levels were closely related to PCI.Serum hs-CRP and MCP-1 levels decreased in those patients one week after operation which proves they are negatively correlated with the dosage of atorvastatins.There was no statistic evidence to prove the correlation between different dosage of atorvastatins and the level of serum IL-10.The ratio of MCP-1/IL-10 at 24h post-intervention patient was significantly higher than pre-intervention,which proves the ratio was negatively correlated with the dosage of atorvastatins. Conclusion Atorvastatins decreases serum MCP-1 and hs-CRP levels after PCI.Serum MCP-1 and hs-CRP levels were negatively correlated with the dosage of atorvastatins.

BACKGROUND: Anterior cervical decompression and bone graft fusion is always the standard operation type for the treatment of cervical spondylotic radiculopathy and myelopathy. However, secondary degeneration and new symptoms caused by the stress increase of adjacent segments following anterior cervical spinal fusion have been paid more and more attention. Artificial cervical disc replacement provides a new choice for the treatment of cervical syndrome.OBJECTIVE: To observe the therapeutic effect of BRYAN& artificial cervical disc displacement for the treatment of cervical spondylotic radiculopathy and myelopathy.DESIGN: Self-control experiment.SETTING: Department of Orthopaedics, Sixth Hospital of Ningbo.PARTICIPANTS: Seventeen patients with cervical spondylotic radiculopathy and/or myelopathy admitted to the Department of Orthopaedics, Sixth Hospital of Ningbo were involved between December 2003 and February 2005 were involved in the study. Informed consents were obtained, and all participates were approved by Medical Ethics Committee.There were 9 patients with cervical spondylotic myelopathy, and 8 patients with cervical spondylotic radiculopathy.BRYAN& artificial cervical disc system is an artificial cervical intervertebral disc with composite structure. It is constructed by two titanium alloy end plates and polymer core, which can bear loading and took polyisocyanate as matrix.METHODS: BRYAN& artificial cervical disc system was used in the treatment. All the patients underwent single-segment displacement. Two patients underwent the displacement at C3-4, five at C4-5, 8 at C5-6 and 2 at C6-7. At postoperative 1, 3and 6 months, X-ray lateral position, anteflexion position, posterior extension position, the left and right side dynamic position plains were taken to investigate prosthetic stability. Neurologic function was evaluated according to Japanese Orthopaedic Association (JOA) scoring system.MAIN OUTCOME MEASURES: ① Investigating whether or not prosthesis displaced by means of dynamic position plains.② Investigating the recovery of neurologic function by JOA scoring system.RESULTS: ①JOA average scores were elevated to 15 from preoperative 8.5. Nervous system symptoms had improved to different extents, and the mean improvement rate was 75%. At postoperative 1,3 and 6 months, all the patients were followed up and their X-ray plains of cervical lateral position and flexion-extension position showed good stability,indicating that motor function was not lost obviously. No heterotopic ossification was found around the prothesis. ②Wound infection was not found in any patient. At postoperative 3 months, less than 2 mm slight displacement appeared in the prothesis in one patient, and there were no obvious symptoms. Prothesis abrasion, subsidence, bone bridge formation and other rejections were not found in the other prothesis. Prothesis had good biocompatibility, and could be examined by routine CT and MRI.CONCLUSION: Artificial cervical disc replacement can obviously improve the symptoms of patients, and has good therapeutic effects in the treatment of cervical syndrome.

BACKGROUND:In the treatment of tibial plateau fractures, because of the variety of fracture, the complexity of anatomical changes, X-ray films or three-dimensional CT scan limited by two-dimensional plane, increases the difficulty in preoperative plan and surgical treatment. The application of three-dimensional (3D) printing technology has attracted attention in the department of orthopedics. OBJECTIVE:To explore the auxiliary role of 3D printing technique in preoperative plan and treatment for tibial plateau fractures. METHODS:Thirty patients with tibial plateau comminuted fractures were enroled in this study and divided into two groups: experimental and control groups, with 15 patients in each group. In the experimental group, patients underwent 3D CT scan, which was stored in DICOM format, and processed by Mimics software. Data were converted into STL format, entered 3D printer, and a 1:1 entity size of the fracture model was made, in accordance with repair plan of 3D fracture model. Operation time and intraoperative blood loss were compared between the two groups. At 12 months after treatment, their outcomes were assessed using Rasmussen evaluation criteria. RESULTS AND CONCLUSION: The 3D printing fracture models of 1:1 ratio identified fracture type and made a repair program before surgery in the experimental group. Operation time and intraoperative blood loss were significantly less in the experimental group than in the control group (P < 0.05). After surgery, patients were folowed up for 12 to 18 months. The healing time was 3-5 months, averagely 4.3 months. At 12 months after treatment, the Rasmussen evaluation criteria results showed that the excelent and good rate was significantly higher in the experimental group than in the control group (P < 0.05). These results suggest that the fracture model of 3D can help to make the operation plan. The treatment of tibial plateau fractures is more precise, personalized and visual.

Objective:To explore the relationship between pulmonary function and coronary artery disease (CAD) with the severity of coronary artery lesions in relevant patients.
Methods:A total of 200 patients received coronary angiography (CAG) in our hospital were studied. The patients were divided into 2 groups: Non-CAD group, n=88 and CAD group, n=112. The degree of coronary stenosis was assessed by GENSINI score;the pulmonary function, echocardiography and fasting blood level of brain natriuretic peptide(BNP) were examined in all patients.
Results:Forced expiratory volume in 1 second (FEV1) in CAD group (2.33±0.54) L/1s was lower than Non-CAD group (2.63±0.39) L/1s, P=0.04. Multivariate logistic regression analysis indicated that decreased FEV1 was the independent risk factor for CAD (OR=2.9, 95%CI 1.89-4.23, P<0.01). Spearman correlation analysis showed that FEV1 was negatively related to blood level of BNP (r=-0.54, P<0.01), positively related to the ratio of E/A (r=0.27, P=0.03). GENSINI score was positively related to smoking (r=0.31, P=0.01), diabetes (r=0.19, P=0.03) and negatively related to FEV1 (r=-0.40, P<0.01). With adjusted variables, partial correlation analysis presented that FEV1 was negatively related to GENSINI score (r=-0.21, P=0.01).
Conclusion:Decreased FEV1 is not only related to CAD occurrence, but also related to the degree of coronary stenosis in relevant patients.

Objective To develop an HPLC-MS/ MS method for quantitative determination of PA-824 in rat plasma and to study the pharmacokinetics of PA-824 in rat after oral administration. Methods An HPLC-MS/ MS method was developed and validated for determination of PA-824 in rat plasma using metronidazole as internal standard.The proteins in plasma samples were precipitated with methanol,and PA-824 was enriched for analysis by HPLC-MS/ MS.An Inertsil? ODS3 C18 column (150 mm×4.6 mm,5 μm) was applied with mobile phase composed of methanol- 0.03% triethylamine (TEA) in water (90:10) ,at a flow rate of 0. 5 mL ? min-1 and column temperature of 30 ℃ . Quantitation was performed on a triple quadrupole mass spectrometer applying electrospray ionization technique and operating in multiple reaction monitoring (MRM) and positive ion mode with transitions at 360.1/ 175.0 for PA-824 and 172.0/ 128.0 for metronidazole.The concentration of PA-824 in plasma was tested after oral administration at various time points and the data were processed with software DAS.2.0. Results The standard calibration curve for spiked rat plasma containing PA-824 was linear over the range of 0. 1 - 10. 0 μg?mL-1 . The recoveries obtained for PA-824 were greater than 92.13%.Intra-day and inter-day coefficient of variation were less than 6.6%.After oral administration,the main pharmacokinetic parameters were AUC(0-t) : ( 3 297. 503 ± 320. 958) mg ? L-1 ? min-1 , AUC(0-∞ ) :(3 558.315±338.860)mg?L-1?min-1 ,tmax:(360.000±64.143)min,Cmax:(3.5±0.3)μg?mL-1 . Conclusion The method is rapid,accurate,simple,and successfully applied in a pharmacokinetic study of fixed dose oral administration of PA-824 in rats.