Objective To evaluate the results of patients with intercondylar fracture treated with open reduction and internal fixation. Methods Forty- one patients with complete clinical data treated operatively during 1989－ 1998 were followed up for an average of 40 months. They were evaluated with modified Cassebaum rating system. The relationship between final result and the period from injury to operation, fracture pattern, operative approach, the time of initiation of exercise after operation were analyzed respectively. Results One nonunion occurred. 13 rated as excellent, 15 as good, 10 as fair,and 3 as poor. Conclusion The degree of comminution and displacement of fracture hinders the final result. Early operation, with osteotomy of the olecranon, anatomical reduction, rigid fixation and early exercise are the key factors that can improve the final result.

Objective To evaluate the choice of operative method, timing of surgery and the outcome of tibia Pilon fracture. Methods Thirty one patients with unilateral tibia Pilon fracture operatively treated between 1993 and 1998 were followed up. The average age was 39.4 years(range from 15 to 64 years). The average period between injury and surgery was 7.2 days. According to the R?edi Allgwer classification, there were 3 cases of type Ⅰfracture, 14 cases type Ⅱfracture and 14 cases type Ⅲfracture. During operation, 13 patients had the fractures reduced and internal fixation was done with the cloverleaf plate, 15 patients had limited open reduction and internal fixation coupled with external fixation, which included 5 patients with the external fixation apparatus and 10 patients with plaster splint, in the remaining 3 cases, the fibular fractures were fixed with plate and tibia fractures were immobilizated with external fixation apparatus. The average period of follow up of these 31 patients was 30.2 months. Results According to Mazurs criterion, the result of the treatment was evaluated as excellent in 25 patients, good in 5 patients and fair in 1 patient. No poor result was found. Complications included wound dehiscence in 3 cases, infection in 2 cases, delayed union of fracture 1 cases and late degenerative changes of the ankle joint in 8 cases. Conclusion In order to get a satisfactory result it is important to have the right choice and timing of surgery and correct method of fixation in tibia Pilon fractures.

Objective To review our experience of surgical treatment for postinfarction ventricular septal defect. Methods From 1990 to 2004, 22 patients with postinfarction ventricular septal defect underwent surgical treatment. There were 15 males and 7 females with a mean age of (62.2?7.3) years (from 52 years to 72 years),19 had anterior ventricular septal defect and 3 had posterior VSD, and there were 18 cases with left ventricular aneurysm.10 patients also had introaortic balloon pumping in the early experience. In all the patients cardiac function were in NYHA class III～IV. Results There were 8 operative deaths (35%). There were 7 operative deaths before 1999 and 1 case after 1999. The other patients are clinically asymptomatic after surgery, and the cardiac function is in NYHA class I～II. Conclusion Postinfarction ventricular septal defect is an infrequent but serious complication of myocardial infarction. Surgery is the best way to treat this condition. A coronary angiography should be performed in all patients who can be stabilized hemodynamically and myocardial revascularization should be performed in patients with significant coronary artery stenosis.

ObjectiveTo evaluate and compare long-term clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with remnant preservation versus remnant resection.MethodsFrom October 1999 to May 2005,standard ACL reconstruction with autogenous quadrupled hamstring tendons under arthroscopy using remnant resection with transtibial techniques was conducted in 87 patients.From June 2005 to May 2010,ACL reconstruction with autogenous quadrupled hamstring tendons using outside-in bone tunnel establishment and remnant preservation was performed in 221 patients.Only the patients who underwent simple ACL reconstruction together with more than three years follow-up records were enrolled in the study,including 66 patients in remnant preservation group and 39in remnant resection group.ResultsPatients of both groups were all followed up for 36-60 months,which showed insignificant difference between groups ( P ＞ 0.05).Compared with the preoperative data,the latest follow up data demonstrated satisfactory outcomes in both groups.The two groups showed no significant differences regarding the preoperative data including age and gender distribution,average time from injury to surgery,joint instability extent and functional score of the affected knee ( P ＞ 0.05 ).There was no statistical difference in regards of the thigh muscle atrophy and Lachman test between groups ( P ＞0.05).However,the remnant preservation group was superior to the remnant resection group in aspects of the range of motion of the affected knee,Lysholm score,stability in anterior drawer test,stability in pivot shift test and international knee documentation committee (IKDC) grade ( all P ＜ 0.05 ). ConclusionCompared with standard ACL reconstruction using remnant resection with transtibial techniques,the ACL reconstruction using outside-in bone tunnel establishment and remnant preservation has better longterm clinical outcomes including stability and function of the affected knee.

The paper analyzes different expressions of indirectly associated strong-weak connection in the process of biomedical literature knowledge discovery,defines the effect and function of strong-weak connection on literature knowledge discovery,and indicates that the accuracy rate of the discovery of potential connection through strong connection is obviously higher than the accuracy rate obtained through weak connection,and strong connection can serve as an important factor for improving the application effect of literature knowledge discovery.

Objective To investigate the expression and significance of TGF‐β receptor Ⅰ /TGF‐β receptor Ⅱ (TGF‐β Ⅰ /TGF‐β Ⅱ) in human skin malignant melanoma A375 cell line .Methods The reverse transcription‐real time polymerase chain reac‐tion (RT‐PCR) and Western blot were utilized to assess the expressions of TGF‐βR Ⅰ /TGF‐‐βR Ⅱ in A375 cell line and human normal melanocytes .Results The expressions of TGF‐βR Ⅰ /TGF‐‐βR Ⅱ mRNA and protein of A375 cells line were significantly lower than those of human normal melanocytes .Conclusion The down‐regulated expression of TGF‐βR in the TGF‐β/Smad signal pathway of human skin malignant melanoma may be one of the pathogenesis of skin malignant melanoma .

Objective To construct the RNA interference (RNAi) eukaryotic expression vectors of galectin-1, and establish the LST-R1 cell lines stably transfected by RNAi vectors. Methods Two pairs of small interfering RNAs (siRNA) targeting to galectin-1 mRNA (GenBank: NM002305) were designed. The corresponding single-strand short hairpin interfering RNAs (shRNA), containing BamH Ⅰ, Hind Ⅲ sites and a 9nt hairpin structure, was synthesized and annealed. The annealed product and the linear eukaryotic expression plasmid pSuperior-puro, which were digested with Bgl Ⅱ and Hind Ⅲ, were ligated by T4 ligase to set up the interfering system. The recombined plasmid was identified with EcoR Ⅰand Hind Ⅲ enzyme digestion and sequencing, and co-transfected to LST-R1 cells with pcDNA6/TR with Lipofectamine2000. Positive clones were selected with 0.8?g/ml puromycin. After incubated with 4?g/ml tetracyclin for 48 hours, RT-PCR, Western blotting and immunochemistry were employed to determine galectin-1 mRNA and protein levels. Results Sequencing results suggested that the nucleotide sequence and read frame of RNAi eukaryotic exprssion vector of galectin-1, p-shRNA1 and p-shRNA2 were perfect. Stably transfected LST-R1 cell lines of p-shRNA1-LST and p-shRNA2-LST were established. The relative values of galectin-1 expression in LST-R1 cells, p-shRNA1-LST cells, p-shRNA2-LST cells and p-LST cells by RT-PCR were 0.616, 0.298, 0.373 and 0.641, respectively, and 1.00, 0.07, 0.38 and 0.97 by Western blotting. The p-shRNA1 gave the best interfering effect, which was in conformity with the results of immunochemistry measurement. Conclusions RNAi eukaryotic expression vector of galectin-1 mRNA has been successfully constructed. Establishment of the stably transfected LST-R1 cell lines may lay a foundation to explore the roles of galectin-1 in laterally spreading tumor.

Objective:To examine the validity and reliability of the Padua Inventory-Washington State University Revi-sion(PI-WSUR) used in Chinese college students.Methods:The translated version of the PI-WSUR,was used in 673 col-lege students to examine its reliability and factorial structure by principal component analysis,internal consistency and test-retest.153 college students were administered the PI-WSUR twice for test-retest study to further investigate its dif-ferentiation validity and its relationship with the obsessive-compulsive subscale of the Symptom Checklist-90-Revised(SCL-90-R OC).Results:Five factors were extracted from the Inventory and all of them had significant differentiation va-lidity(P

Successful pain management of perioperative shoulder arthroscopy may allow patients to go home earlier, improve the quality of life in perioperative period, and facilitate rehabilitation. A comprehensive method to perioperative pain control has three stages including preoperative, intraoperative and postoperative phase. Successful pain reduction should begin preoperatively because of an excellent communication between patient and physician, moreover, preoperative analgesia also should be administered. Intraoperative efforts should include local wound infiltration and the administration of anesthetic medication intra-articularly. Postoperative management should include oral analgesics, constant infusion devices, Patient Controlled Analgesia (PCA), sedative-hypnotic drug, continuous cryotherapy and vicarious treatment.
Acupuncture Analgesia ; Analgesia ; methods ; Analgesia, Patient-Controlled ; Arthroscopy ; Humans ; Pain, Postoperative ; therapy ; Perioperative Period ; Shoulder Joint ; surgery ; Transcutaneous Electric Nerve Stimulation

Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.