BACKGROUND:Superior tibiofibular joint dislocation is not common, and often combined with other injuries in the clinic, so it is easy to be neglected or missed. Thus, some side outcomes appeared, such as chronic knee joint pain, dysesthesia and limitation of motion.
OBJECTIVE:To reconstruct normal superior tibiofibular joint by using autologous tendon graft to bone tunnel.
METHODS:Three patients with superior tibiofibular joint dislocation, who were missed and treated with improper method, were enrol ed in Workers General Hospital, Xishan Coal Electricity Group since 2009. One was a male soldier aged 26 years old;one was a male miner aged 36 years old;one was a female athlete aged 36 years old. The clinical symptoms were different in these three patients, but their capitulum fibulae had the feeling of tenderness and flotation. Accessory examinations (X-ray/MRI) presented negative. Ipsilateral autologous semitendinosus muscles and gracilis tendon were used to repair superior tibiofibular joint dislocation in the three patients so as to reconstruct superior tibiofibular joint.
RESULTS AND CONCLUSION:The effects of postoperative functional exercise were satisfactory in three patients with superior tibiofibular joint dislocation. Lateral knee joint was swol en. Fibular head presented obvious tenderness and floating feeling. When ankle joint was moving, pain and limitation of motion completely disappeared. The sense of ankle and foot and the strength of muscle recovered to normal. These results indicated that to avoid missed diagnosis, physicians should check whether the capitulum fibulae was moving or not before autologous tendon graft was utilized to reconstruct superior tibiofibular joint dislocation.

Objective To investigate the chemical constituents of Myrica nana collected in Yunnan Province,China.Methods Column chromatography techniques were used for separation and purification of the compounds and extensive spectral analyses including 2D NMR spectrum were employed for structural elucidation.Results Eleven compounds were isolated from the roots of M.nana.Structures of these compounds were identified by ~(13)C-NMR,~1H-NMR,and MS as following:2?,3?-dihydroxyl-lup-20(29)- en-28(19)-lactone(Ⅰ),2?,3?-isopropylidene-lup-20(29)-en-28(19)-lactone(Ⅱ),longispinogenin(Ⅲ), masilinic acid(Ⅳ),oleanolic acid(Ⅴ),myricadiol(Ⅵ),arjunolic acid(Ⅶ)、arjunglucosideⅡ(Ⅷ), dihydroxyligustilide(Ⅸ),hydropiperoside(Ⅹ),6'-O-acylclionastero-3-O-glucoside(Ⅺ).Conclusion CompoundⅠis a new compound named lupeolenolide;CompoundⅡis a new artifact ofⅠproduced during isolation procedure,named isopropyl-lupeolenolide and compoundsⅢ,Ⅷ—Ⅺare isolated from the roots of M.nana for the first time.

Frontal recess locates at the anterosuperior part of the ethmoidal labyrinth,the anatomical structure of which is most complicated. The acknowledgement of this area is fundamental for the endoscopic frontal sinus surgery. With the development of technology,images of the computed tomography can display more delicate micro structure of the anatomy. So we can study the frontal recess anatomy in detail with the technique. This study reviewed the current research on the image anatomy of the frontal recess.

Hedgehog(Hh) pathway plays a key role in a variety of processes, such as embryogenesis, maintenance of tissue homeostasis, tissue repair and carcinogenesis. Recent studies indicate that the aberrant activation of Hh pathway has been linked to multiple types of human cancer. Here, we present an overview of the processing and secretion of Hh pathway and the role of Hh pathway in gastric cancer.

Objective To investigate the effects of low dose testosterone on heart function,and ventricular remodeling in male rats with postinfarction congestive heart failure(CHF).Methods Sixty SD rats were undergone surgery,of which,45 rats were performed coronary artery ligation and other 15 were sham group (PS group).Six weeks later,left ventricular function of survived rats was examined by echocardiography,and LVEF≤45％ was defined as the standard of successful CHF model.All survived model rats were randomly divided into 2 groups:TU group(n =16) treated with TU 5 mg/kg per 2 weeks intramuscular injection;placebo (PL) group (n =16) treated with PL.Mter treatment for 12 weeks,left ventricular ejection fraction(LVEF) was assessed by echocardiography again.Serum testosterone level was determined by radioimmunoassay.The expression of tumor necrosis factor-or (TNF-α) mRNA and matrix metalloproteinase (MMP)-9mRNA in myocardial tissue was measured by RT-PCR.Results In male post-myocardial infarction rats,serum testosterone level and LVEF were decreased significantly than PS group(P ＜ 0.05),and the expression of TNF-α mRNA and MMP-9 mRNA in myocardial tissue was increased significantly than PS group (P ＜ 0.05).Mter low dose TU therapy,LVEF of rats in TU group improved significantly(P ＜0.05),and the expression of TNF-α mRNA and MMP-9 mRNA in myocardial tissue was reduced significantly (P ＜ 0.05).Meanwhile,the mortality was decreased (P ＜ 0.05).Conclusion Low dose testosterone therapy can restore the inflammatory imbalance and suppress the ventricular remodeling in male post-myocardial infarction rats and improve left ventricular function,as well as reduce mortality.

Thermoablation is a local treatment effectively used to prevent metastasis of colon cancer in the liver and can retain peripheral normal liver tissues. Ablation therapy is less invasive, easier to use, and more repeatable than surgery. This form of therapy also allows the local control of unresectable diseases. Furthermore, thermoablation can be applied as an alternative therapy for small re-sectable lesions in patients who manifest insufficient hepatic function after surgery or those with severe complications. Ablation therapy can artificially increase the surgical margin, thereby increasing the resection rate in patients. Multiple lesions in the liver and surgically inaccessible or unresectable diseases can also be removed. However, several limitations, including the local recurrence of the disease and treatment-related complications in patients, are also observed. The treatment outcome of thermoablation therapy can be further im-proved because this technique is used as a part of multimodality treatment.

Objective: To observe the therapeutic efficacy of acupuncture combined with hyperbaric oxygenation for cervical spondylosis of nerve root type in acute phase.
Methods: One hundred cases with cervical spondylosis of nerve root type in acute phase were randomly divided into two groups, with 50 patients in each group. The patients in the treatment group were treated by acupuncture combined with hyperbaric oxygenation, and those in the control group only received the same acupuncture therapy as the treatment group. The therapeutic efficacy was evaluated after 2 courses of treatment.
Results: In the treatment group, 27cases were cured, 9 cases showed markedly effective, and 4 cases were invalid, and the recovery rate was 67.5%, the total effective rate was 90.0%; in the control group, 18 cases were cured, 17 cases showed markedly effective, 15 cases were invalid, and the recovery rate was 36.0%, the total effective rate was 70.0%. There were statistically significant differences between two groupsin the recovery rate and the total effective rate (bothP<0.05). The average cure time of the treatment group was (15.56±7.13) d, and that of the control group was (22.13±7.78) d, which also had significant difference between the two groups (P<0.05).
Conclusion: Acupuncture combined with hyperbaric oxygenationhas rapid and reliable effects for cervical spondylosis of nerve root type in acute phase.

Objective To evaluate the clinical applica ti ons of endoscopic thyroid surgery by way of breast areola. Methods We retrospectively analyzed clinical data of 15 cases of endoscopic thyroid surgery through the breast areola approach form August 2002 to June 2004. Proble ms on the selection of surgical methods, indications, contraindications and the safety of the procedures were discussed. Results The operation was completed smoothly in 14 cases, with an operation time of 60~120 min (mean, 100 min), whereas a conversion to open surgery was required in 1 case because o f hemorrhage. No complications were seen. The patients were fully freed of the d isease and discharged from the hospital 7 days after the operation. One patient was diagnosed as having thyroid cancer and was cured with a total thyroidectomy. Follow-up for 3~6 months (mean, 4.5 months) in 13 cases found no recurrence. Conclusions Endoscopic thyroid surgery through breast areola appro ach is safe and applicable, with good cosmetic effects.

Objective Endoscopy, 24-hour esophageal pH monitoring were used to objectively estimate the extent of gastroesophageal reflux and affecting factor after esophagectomy for cancer. Methods Endoscopy, 24 hour pH monitoring were performed in thirty-nine patients, including 21 undergoing esophagogastrostomy above the aortic arch (group A) and 18 below the aortic arch (group B). Results (1) DeMeeter score of gastroesophageal reflux in group A was significantly higher than that in group B in different postoperative period (P0.05). Conclusion Thoracic anastomosis in the lower thorax is more likely to be followed by gastroesophageal reflux and esophagitis. There is no significant change in extent of gastroesophageal reflux over time.

To investigate the changes of inducible nitric oxide synthase mRNA (iNOSmRNA) in pulmonary tissues of tail suspended rats during simulated weightlessness, experiments on 40 Spragno Dawley male rats were conducted. The rats were divided into 4 groups:suspended for 7d, and its control, suspended for 21d, and its control tail suspension(-30 ) was used as weightlessness simulation.The condition of iNOSmRNA in pulmonary tissues was examined by hybridization in situ.The results showed that the level of iNOSmRNA in pulmonary tissues of 7d tail suspended rats increased significantly( P