Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of complex intraarticular calcaneal fractures.Methods A retrospective comparative study was performed on the 50 patients with intraarticular calcaneal fracture (Sanders types Ⅲ and Ⅳ) who had been treated by uniaxial locking plates (n =26) or polyaxial locking plates (n =24) between January 2013 and June 2015.Operation time,intraoperative bleeding,union time,radiological and functional outcomes and functions by the Maryland foot score were compared between the 2 groups.Results All the patients were followed up for 12 to 44 months(average,20.8 months).There were no significant differences between the 2 groups in average operation time (105.2 ± 18.2 min versus 95.5 ± 17.7 min),average intraoperative bleeding (125.2 ±23.4 mL versus 120.3 ±21.5 mL),or union time (12.1 ± 3.7 weeks versus 11.8 ± 3.7 weeks) (P ＞ 0.05).All patients obtained bony union.The polyaxial locking plates group displayed significantly better B(o)hler and Gissane angles at 3 and 12 months after operation than the uniaxial locking plates group (P ＜ 0.05).Evaluated by the Maryland foot score,the excellent and good rate for the polyaxial locking plates group [91.7％ (22/24)] was insignificantly higher than that for the uniaxial locking plates group [84.6％ (22/26)] (P =0.267).Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for complex intraarticular calcaneal fractures,but polyaxial locking plates may be superior in stability and functional recovery.

Gastric cancer is the fourth malignancies and the second cancer -related mortality rate in the world.Although the incidence of gastric cancer has declined in the past few decades ,it is still a serious health problem.Tumor microenvironment plays an important role in tumorigenesis and progression .The main components of gastric cancer include tumor associated macrophages、lymphocytes、cancer-associated fibroblasts、angiogenesis factors,cytokines,gastric microenvironment and the mechanism of action of chemokines .In this review,the corre-lation between tumor microenvironment and GC is discussed .

Objective To explore the method of oleic acid two strike to build a better clinical pathophysiology of acute lung injury animal model state.Methods The 60 male and healthy Sprague-Dawley rats, weighing 180 ～ 220g.According to the time of purchase.No.1, 2, 3 The order No.60, Each number, were randomly divided into 3 groups: normal control group(20 rats) : intravenous injection of normal saline 0.07ml/kg, an hour after intravenous injection of saline 0.03 ml/kg.The traditional group(20 rats) : intravenous injection of oleic acid 0.l ml/kg.The model group(20 rats) : intravenous injection of oleic acid 0.07 ml/kg, one hour after intravenous injection of oleic acid 0.03 ml/kg.Close observation of vital signs of breathing and Hemodynamicsin rats.Stable operation of 30 min, Each operation is stable after 30 minutes of measuring arterial blood gas, lung water content, the change degree evaluation of early lung injury of lung tissue pathology.Through the analysis of arterial blood gas, lung water content, HE stained pathological changes of lung tissue in Smith scoring method to determine the degree of lung injury in rats, to evaluate whether the model was successfully established.Results There are 5 rats died after a sharp drop in blood pressure of oleic acid used in traditional group rats, the changes of hemodynamics of traditional group compared with model group were severe, especially in the 5 ～ 30min after injection of oleic acid.The model group was no death, intravenous injection of oleic acid(0.1 ml/kg) from 7 to 8 min after respiratory frequency rats increased gradually, difficulty in breathing, endotracheal see pink frothy sputum.After 1 h pumping and arterial blood gas results showed that pH (7.17 ± 0.15) PaO2, (41.85 ± 8.16) mmHg was significantly lower than that of normal group(P ＜ 0.01) , oxygenation index (PaO2/FiO2) ≤ 300 mmHg, met the diagnostic criteria of acute lung injury, the moisture content(P ＜ 0.05), according to the Smith score, pathological model group compared with normal group significantly increased(P ＜ 0.01).Conclusion Two hit the body can produce severe inflammatory reaction of lung and lasting, build a close clinical pathophysiology of acute lung injury animal model successfully state.Meet the pathophysiological clinical change of acute lung injury, and can be used for basic and clinical research of acute lung injury in infants.

BACKGROUND:Whether lumbar spondylolisthesis needs to be treated with reduction remains controversial.OBJECTIVE:To investigate the clinical effectiveness of pedicle screw fixation combined with posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis in the patients aged more than 70 years old.METHODS:The clinical data of 30 patients with degenerative spondylolisthesis aged over 70 years old undergoing pedicle screw fixation combined with posterior lumbar interbody fusion were analyzed retrospectively.The Visual Analogue Scale,Oswestry Dysfunction Index and the Japan Orthopedics Association scores were compared and analyzed before and after surgery.RESULTS AND CONCLUSION:(1) Among 30 patients,12 were male and 18 female,the average age was (75.1±6.7) years old,and all were followed up for more than 12 months.(2) The postoperative Visual Analogue Scale,Oswestry Dysfunction Index and the Japan Orthopedics Association scores were significantly improved compared with baseline (P ＜ 0.05).According to the Japan Orthopedics Association scores,3 cases were cured,24 were significantly effective,and 3 effective.(3) Graft fusion was achieved at all patients,the average fusion time was (5.13±0.65) months.(4) The average operation time was (225.6±23.4) minutes,the average intraoperative blood loss was (470±45.5) mL,and the average follow-up time was (25.8±3.5) months.(5) Six patients presented complications (20％),including one case of dural tear,two cases of paralytic intestinal obstruction,and three transient lower extremity nerve symptoms.(6) These results indicate that if the associated disorders are strictly controlled,pedicle screw fixation combined with posterior lumbar interbody fusion can achieve good surgical results in the treatment of degenerative spondylolisthesis in the elderly.

Objective Artificial atrial septum defect combining pulmonary artery banding to create a model of congenital heart defect with decreased pulmonary blood flow to explore the morphological changes of immature pulmonary vascular. Methods Choose twenty piglets with about one to two-month-old, which are exclusively for experiment used. The piglets were randomly divided into three groups: normal control group (group C, n = 6), Small incisions on the right chest, produced a transient reduction in pulmonary blood; low-medium pulmonary artery stenosis groups ( group T1, n = 7 ) : Did artificial room septostomy creation by self-dilators which were delivered into the surface of the right atrium and controlled Systolic trans pulmonary artery banding pressure (Trans-PABP) at pressure of 20 - 30 mmHg; severe pulmonary artery stenosis groups ( group T2, n = 7): T2 were the same surgical procedures with group T1 ,and controlled Trans-PABP ≥ 30 -50 mmHg. Monitored ultrasound after operation , carried out 64-slice computed tomography scanning after one month, to measure the proximal vessel diameter and TransPABP , after two month surgical exploration on the left chest. When the animals were sacrificed, the heart and lung tissue was cut to measure atrial septal defect, pulmonary artery and the banding diameter. By weihgt elastic fiber and van Cieson staining to observe the morphological pathological changes, three groups took lung tissue with right middle lobe lateral segment about 1.0 cm × 0.8 cm × 0.8cm at the end of surgery and 2-months after operation respectively. Results The models were all successfully in the survival animal of the two test groups. One pig died from tracheal intubation accident in the C group, there was one case died due to bowel obstruction in the T1 group, And there were two cases died result from acute right heart failure and chronic heart failure respectively in T2 group. 64-slice CT angiography showed that BD was significantly lower than the AOD in the two test groups, the proximal pulmonary vascular expansion result from stenosis, distal pulmonary vascular scarce. Histopathology showed that the pulmonary artery inside diameter of T1 and T2 was significantly higher than group C(P ＜0. 05,P ＜ 0.01), and the NAPSC of two experimental groups were significantly lower than group C 2-month after operation( P ＜0.01).Conclusion This type of Piglet model is closer to clinical pathological and physiological ,64-slice spiral CT combined with lung histopathology observed for the evaluation of pulmonary vascular hypoplasia is a reliable method. Tunica media of pulmonary arterioles hypoplasia with the number reducing, with pulmonary artery banding increased,the degree of pulmonary arterioles hypoplasia gradually increased.

ObjectiveTo study the mechanism of myocardial dielectric property changes in radio frequency during hypothermic preservation and explore myocardial viability evaluative method. Methods Hybrid young pigs (20-30 kg) were used in the experiment. Heart arrest was induced with GIK solution. According to preservative temperature, the animals were divided into three groups: group A (4 ℃),group B (15 ℃) and group C (25 C). The heart was preserved in saline for 12,6 and 4 h respectively. Myocardial dielectric properties and ATP content were tested every 5 and 30 min during hypothermic preservation respectively. The relationship between tanoδm and ATP content was analyzed. ResultsTanδm of three groups was decreased significantly at the beginning, most slightly in group A and most obviously in group C. There was no significant difference in Tanδm between group B and group C with group A at 1 h,but there was obvious difference at 2,3 and 4 h (P＜0. 05,P＜0. 05,P＜0. 01 ). There was correlation between tanδm and ATP in the three groups. ConclusionTanδm in three groups is dropped with preservation time and temperature, and tanδm had a correlation with ATP content. Detection of myocardial dielectric property in radio frequency is a kind of quick, accurate and noninvasive method.