Objective To investigate the influence of different head and neck positions on airway sealing pressure (OLP) with i-gel laryngeal mask airway (LMA) in patients undergoing elective surgery under general anesthesia with mechanical ventilation.Methods Thirty ASA Ⅰ or Ⅱ patients of both sexes aged 32-64 yr with a body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were studied.Size 4 i-gel LMA was placed blindly after induction of anesthesia and connected to anesthetic circuit.The criteria for successful placement were easy inflation with small leak,peak inspiratory pressure (PPeak) within normal range and normal PETCO2 wave form.Fiberoptic bronchoscopy was performed to check the position of LMA.OLP,expiratory tidal volume ( VTE ),PPeak and efficiency of mechanical ventilation were measured in different head and neck positions.OLP was measured by gradually increasing airway pressure until PPeak was reached.The measurement was stopped when there was large leak or OLP ＞ 35 cm H2 O.The efficacy of ventilation was evaluated by manually inflating the lungs (perfect:easy inflation,no audible leak; satisfactory:easy inflation,small leak; poor:difficult inflation,large leak).Results Flexion of the head significantly increased OLP and PPeak and decreased VTE,while hyperextension significantly decreased OLP and PPeak and increased VTE as compared with middle position of the head.Lung ventilation was less satisfactory when the head was flexed.Turning the head to either side did not affect ventilation.Conclusion Flexion of the head should be avoided when i-gel LMA is used during anesthesia.

Tibial plateau fracture,one of the most common fractures,includes simple and complicated fractures.Inappropriate treatment could result in pain and deformity,which has a bad effect on patient life.With the development of the surgical technique,a lot of methods could be selected when an orthopedist deals with these fractures.X-ray,one of the most common assistant examination,is the preferred method for tibial plateau fracture and could diagnose most of these fractures.Due to high resolution,CT scan could find these micro-fractures which X-ray cannot find and it could supplement the Schatzker type.MRI could find ligament,meniscus and arthrodial cartilage injury.Surgical approach includes anterolateral approach,medial approach,posteromedial approach,post approach,anterior approach.Anterolateral approach could be used for most of tibial plateau fractures.Posteromedial approach is used for medial plateau fracture involving post plateau fracture or post plateau fracture alone.Common plate,locking plate,dual plate and external fixation are commonly used fixation method.Dual plate is often used for complicated tibial plateau fracture.However,how to make accurate diagnosis and choose appropriate fixation is crucial for patients.We will summarize the application of X-ray,CT scan and MRI in diagnosis of tibial plateau fracture.Commonly used approaches to the proximal tibia,which together allow for the treatment of any proximal tibia fracture,will be described in this article.

Objective To investigate effects of radiofrequency vaporization in arthroscopic treatment of knee disorders.Methods Arthroscopic surgery was conducted in 126 consecutive cases of various knee disorders by using the Arthrocare 2000 System,includng 72 cases of meniscus injury,20 cases of synovitis,15 cases of osteoarthritis,8 cases of patella subluxation,6 cases of synovial syndrome,and 5 cases of anterior cruciate ligament rupture.Results All the patients were followed postoperatively.Knee function evaluation with the Neer Scores showed excellent outcomes in 82 cases,good in 35 cases,and fair in 9 cases,the rate of excellent-or-good outcomes being 92.9%.Conclusions Application of radiofrequency vaporization under arthroscopy for knee joint disorders has advantages of simple and accurate performance,effective hemostasis,minimal invasion,and quick recovery of joint functions.

To investigate the feasibility of using limited flap to repair different wounds by using fractionated transfer of one flap to repair different wounds in 8 cases. Among them, 2 cases were pedicle iliolumbar skin flaps, 2 cases were pedicle iliolumbar and hypogastric combined skin flaps, 2 cases were free latissimus dorsal myocutaneous flaps, 1 case was gastrocnemius myocutaneous flaps, and 1 case was deltopectoral skin flap. The flap in donor area was isolated normally, and then transferred to repair the main wound or the wound following scar excision. The other remnant wounds were treated by using thorough debridement. Blood supply training was performed from two weeks after operation. When the flap had reliable blood supply, a second-stage operation was performed. The remnant wounds were repaired by anterograde or reversed transfer. According to the ways of the second-stage operation, blood supply training and dissection of the pedicles were performed at 2 weeks after operation in some of the patients. All these flaps survived, and the wounds were repaired with satisfactory. The appearances and functions were improved after a six months follow-up. Results suggested that it was safe and feasible to use the same pedicle repaired different parts, which can solve the problem of using limited flap to repair different wounds.

Objective:To investigate the effects of TJU103 on T lymphocytes proliferation and cytokine production in vitro.Methods:MTT and ELISA assays were used respectively to detect the proliferation and the cytokine production of donor T lymphocytes blocked by TJU103.Results:There are significant difference in the inhibition of T-cell proliferation and the cytokine production between groups of with TJU103 or without.Conclusion:TJU103 could significantly inhibit the T-cell proliferation and the cytokine production.

[Objective]To investigate the clinical results and significance and mechanism of early dislocation rate after total hip arthroplasty following the posterolateral approach with posterior capsulotendinous repaired.[Method]The incidence of early dislocation and the prosthetic range of rotation motion among 212 consecutive primary THAs with the posterior capsule and the short external rotators which had been sutured to the medius tendon was reviewed retrospectively,and was compared to the results of 486 consecutive unilateral primary THAs with a complete posterior capsulectomy.[Result]During a 6 months to 5 years(3.7 years in average)following-up,there were significant differences between two groups.In patients with posterior capsulotendinous repair,two of 224 primary total hip arthroplasty(0.9%) had an early posterior dislocation.In patients with a complete posterior capsulectomy,27 of 486 primary total hip arthroplasty(5.6%) had an early dislocation.The difference was statistically significant(x~2=8.51,P

Advances in surgical techniques and internal fixation materials have been continuously improving treatment of intertrochanteric fractures, but postoperative failure of internal fixation is inevitable and its causes are still controversial. An advanced age, female and severe osteoporosis are believed to lead to an unstable fracture and a fall more likely, increasing the risk for failure of internal fixation. Unstable intertrochanteric fractures such as comminuted fracture of medial femur, basicervical fracture, reverse intertrochanteric fracture and lateral wall fracture are more likely to lead to internal fixation failure. Non-anatomical reduction, improper insertion point and poor position of a lag screw are also prone to internal fixation failure. Extramedullary fixation for unstable fractures may increase the risk of failure. Long waiting time for surgery, late weight-bearing and infection may also increase the risk of failure. Therefore, it is still crucial for a successful treatment to clarify the specific risk factors for internal fixation failure and make corresponding countermeasures to enhance the success rate of a primary operation. This paper summarizes the risk factors for postoperative failure of internal fixation for intertrochanteric fracture so as to provide guidance for clinical treatment.

Objective To improve the surgical treatment of square mandible deformity. Methods Based on cephalometric and facial feature, an integrated therapeutic project was designed. Through an oral approach the bilateral prominent mandibular angles were reseeted. Meanwhile, genioplasty was applied to correct chin deformity. Results From March 2000 to December 2006, 18 cases of square mandible with chin deformity were corrected with this procedure. The postoperative appearance was improved greatly after 3～6 months. Beautiful chin outline was reconstructed in esthetical standard. Mentolabial sulcus became natural and harmonious. Conclusion Mandible angle osteotomy combined with genioplasty is an ideal methods to recontour square mandible with chin deformity. It is beneficial to whole facial con-tour improvement.

Objective To evaluate the role of histone methylation in the spinal cord in maintenance of neuropathic pain (NP) in rats.Methods Sixty healthy male Wistar rats, weighing 200-250 g, aged 6-8 weeks, were randomly divided into 5 groups (n =12 each) using a random number table: control group (C group), sham operation group (S group), NP group, chaetocin group (CH group), and dimethyl sulfoxide (DMSO) group.NP was induced by chronic constriction injury (CCI) to the sciatic nerve in NP, CH and DMSO groups.The sciatic nerve was only exposed in group S.H3K9 methylation methyltransferase inhibitor chaetocin 50 μg was injected intrathecally in group CH, and the equal volume of DMSO was given instead in group DMSO for 4 consecutive days, starting from 2nd day after CCI.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before CCI (T0),before administration on 2nd day after CCI (T1), and at 5, 7, 9 and 14 days after CCI (T2-5).Six rats in each group were sacrificed after measurement of pain threshold at T3 and T5, and the lumbar segment of the spinal cord was removed for detection of the methylated H3K9 expression by immunohistochemistry.Results Compared with C group, no significant change was found in the MWT, TWL and methylated H3K9 expressionat each time point in S group (P＞0.05) , the MWT was significantly decreased, and the TWL was shortened at T1-5, and the methylated H3K9 expression was up-regulated at T3 and T5 in NP and DMSO groups, and the MWT was significantly decreased, and the TWL was shortened at T1 in CH group (P＜ 0.05).Compared with NP group, the MWT was significantly increased, and the TWL was prolonged at T2-5, and the methylated H3K9 expression was down-regulated at T3 and T5 in CH group (P＜0.05) , and no significant change was found in the MWT, TWL and methylated H3K9 expression at each time point in DMSO group (P＞0.05).Conclusion Histone methylation in the spinal cord is involved in the maintenance of NP in rats.

Objective To investigate the effect of recombinant human interferon α-2b on influenza virus in vitro.Methods Influenza A virus subtype H1N1 and influenza B/Y virus were inoculated into Vero cells and different concentrations of interferon α-2b and oseltamivir were added.Numbers of virus plaques were observed and calculated,and quantitative RT-PCR were used to assess the inhibitory effect of interferon α-2b and oseltamivir in vitro.The nuclear export of viral ribonucleoprotein (RNP) complexes were monitored under fluorescence microscope.Results Virus plaque test showed that influenza A viruses subtype H1N1 were significantly inhibited when 10 μg/μL interferon α-2b and 10 μg/μL oseltamivir were added,and the numbers of plaques were 7.5 × 108 and 15 × 108 PFU/mL,respectively;the inhibitory effect of oseltamivir was better than that of interferon α-2b.Influenza B/Y viruses were also inhibited when 10 μg/μL interferon α-2b and 10 μg/μL oseltamivir were added,and the numbers of plaques were 1.1 × 108 and 1.5 × 108 PFU/mL,respectively.Quantitative RT-PCR results showed that the cycle threshold (CT) values of influenza A virus subtype H1N1 and influenza B/Y virus were much higher when 10 μmol/L interferon α-2b and 10 μmol/L oseltamivir were added.CT values of influenza A virus subtype H1N1 were 16,26 and 35 before and after inferferon α-2b and oseltamivir were added.CT values of influenza B/Y virus were 18,27 and 31 before and after interferon α-2b and oseltamivir were added.Reduction in the nuclear export of viral RNP in influenza A virus subtype H1N1-infected Vero cells was also observed when 10 μmol/L interferon α-2b were added.Conclusion Interferon α-2b has significantly inhibitory effect on both influenza A virus subtype H1N1 and influenza B/Y virus in vitro.