Objective To evaluate the short and mid-term effects of fixing comminuted posterior acetabular wall fractures with structural autologous iliac bone graft combined with mini screws.Methods From January 2010 to January 2014,29 patients with comminuted posterior acetabular wall fracture were treated by structural autologous iliac bone graf combined with mini screws.They were 21 males and 8 females,with a mean age of 44.2 years (range,from 22 to 58 years).The mean time form injury to operation was 7.8 days (range,from 1 to 25 days).The operations were performed through the Kocher-Langenbeck approach,with the patients in the lying position on the uninjured side.The fragments were reduced and fixed by mini screws and the ischemic ones were removed.Structural autologous iliac bone graft was used to reconstruct the posterior wall of acetabulum before a reconstruction plate was applied to compress and maintain it.The functional outcomes were evaluated by the modified Merle d'Aubigne and Postel clinical grading system at the last follow-ups.The radiographs were graded according to the Matta criteria.Results By the Matta criteria,10 cases achieved excellent reduction,16 good reduction,and 3 poor reduction,giving a good to excellent rate of 89.7％.Of this series,29 patients were followed up for 31.5 months on average (range,from 12 to 48 months).By the modified Merle d'Aubigne and Postel criteria,the functional recovery was rated as excellent in 16 cases,good in 9,fair in 3 and poor in one,giving a good to excellent rate of 86.2％.Two cases developed femoral head necrosis according to the magnetic resonance imaging 18 months postoperation.Three patients developed traumatic arthritis two years postoperation.Five patients developed heterotopic ossification postoperation,with no obvious clinical symptoms.Two patient with injury to the sciatic nerve recovered 4 months postoperation.Conclusions Structural autologous iliac graft combined with mini screws can reconstruct the integrity and stability of the fractured acetabular posterior wall,avoiding osteonecrosis of the acetabulum.This surgical technique is effective and safe in treatment of comminuted fracture of the acetabular posterior wall.

OBJECTIVE:To investigate the effects of extracts of different constitutes of Vernonia Anthelmintica Willd different on the serum levels of Cu and Zn in mice METHODS:Different groups of mice were given separately with (B) 1/10,(C)1/30,(C′)1/50 doses of LD50 of extracts of different constitutes of Vernonia Anthelmintica Willd for 7 days,and the levels of Cu and Zn in serum were determined RESULTS:The levels of Cu and Zn in serum were different in different groups of mice(P

0.05) but there was significant difference between CARG group and control group(P

objective To compare the technical survival between Tenckhoff double-cuffed straight catheter (TC)and swan-neck curled tip catheter (SNC) in peritoneal dialysis (PD). Methods Clinical data of 208 patients received PD in the Peritoneal Dialysis Center of Peking Union Medical College Hospital from January 1999 to December 2007 were analyzed retrospectively. All the patients were divided into two groups according to indwelling catheter. Technical survival and complications associated with the catheter between two groups were compared. Results Demographics and basic information were similar in both groups. The exit-site infection (ESI) rates of TC and SNC were 22.1% and 19.8% (P=0.786), and peritonitis rates of TC and SNC were 31.1% and 22.1% (P=0.159), which were slightly lower in SNC group, but the difference was not significant. Removal of the catheter was found in 27 (13.0%)patients, including 17 cases in TC group (13.9%) and 10 cases in SNC group (11.6%)(P=0.680).The median survival times of catheter in TC group and SNC group were 25 months and 22 months respectively without significant difference (P=0.103). Conclusions There are no significant differences of ESI rate, peritonitis rate and catheter survival between these two catheters in PD. The expensive swan-neck catheter offers no additional advantage. Doctors should choose the catheter according to the economic status of patients.

objective To analyze the clinicopathological features and prognosis of antiglomerular basement membrane(GBM)disease,and evaluate the efficacy and safety of double filtration plasmapheresis(DFPP). Methods A total of 35 hospitalized patients diagnosed as anti-GBM disease in our department were enrolled in the study.All the patients were divided into 3 groups according to the manifestations at admission.Group Ⅰ∶24 patients with severe pulmonary hemorrhage or rapidly progressive glomerulonephritis(RPGN)received pulse methylprednisolone with or without DFPP,and then followed by prednisone and CTX.Group Ⅱ∶5 patients without severe pulmonary hemorrhage and RPGN received prednisone and CTX.Group Ⅲ∶5 ESRD patients and 1 normal renal function patient did not receive immunosuppression therapy.Anti-GBM antibody titer of pre-and post-DFPP in 4 patients was measured consecutively,and removal rate was calculated.Results The mean age of all the patients was(41.1±16.6)years.Sixteen patients(45.7%)presented Goodpasture's syndrome.Eighteen patients(51.4%)had anti-GBM glomerulonephritis alone,whereas one suffered solely from pulmonary hemorrhage.20%patients had positive P-ANCA serology.54.2%crescentic glomerulonephritis and 7 with other glomerulonephritis were revealed by kidney biopsy in 24 patients.Patients in Group Ⅰ showed more severe manifestation at admission:higher Scr level,higher titer of anit-GBM antibody,greater percentage of crescents.Within the follow-up period,7 patients died and kidneys of 50%patients survived.No patient died in Group Ⅱ and Ⅲ.The elder age,anemia,higher Scr(＞300 μmol/L),oliguria or anuria,emergency hemodialysis at admission,and more glomerular sclerosis were predictors of poor prognosis.The anti-GBM antibody was negative after 4 to 6 sessions of DFPP.and the mean removal rate was 55%.During total 94 DFPP sessions,there was no unacceptable morbidity. Conclusions Different therapy strategy is necessary for anti-GBM disease with different clinical manifestations.DFPP is an effective and safe clearance way of anti-GBM antibody.

Objective:To estimate the radiation dose (RD) to the public from patients undergoing 177Lu-prostate specific membrane antigen (PSMA)-617 therapy, and provide reference for the formulation of radiation protection measures. Methods:From July 2020 to January 2021, 10 patients with prostate cancer (age (71.1±5.9) years) who received 177Lu-PSMA-617 therapy in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed. According to the different doses of 177Lu-PSMA-617, the patients were divided into the low-dose (5.55-6.29 GBq) group and high-dose (6.70-8.94 GBq) group. Respectively at 5, 30 min and 1, 2, 4, 24, 48, 72, 96, 144 h after intravenous injection of 177Lu-PSMA-617, whole-body initial dose-equivalent rate (DR) was measured with a radiation-survey meter at 0.3, 1.0 and 2.0 m from the patients. The statistics of ROI were analyzed by HERMES, and the corresponding equations were obtained by fitting the curve regression with double exponential function model. On the basis of human social contact model proposed by the National Council on Radiation Protection and Measurements (NCRP), the RD to the public from the patient discharged from the hospital at different times after completing the 177Lu-PSMA-617 injection was estimated. Results:All patients were discharged from the hospital at 72 h after treatment. The initial DR at 0.3, 1.0 and 2.0 m were (12.6±3.3), (4.7±1.2) and (1.6±0.4) μSv/h, respectively, and the RD to the co-sleeping partner, family members and colleagues who were in contact during the day were (999±253), (121±29) and (160±39) μSv, respectively. If the patients were discharged at 48 h after treatment, the RD to the adult family members could be controlled ≤5 mSv, and the RD to colleagues and children could be controlled ≤1 mSv. Starting from the injection of 177Lu-PSMA-617, the restriction duration for co-sleeping partner and colleagues were both 2 d and the restriction duration for children were 2 d (high-dose group) or 1 d (low-dose group). The patients needed to limit the time for public transportation from the 1st to 4th day after treatment, and there was no restriction from the 5th day. Conclusion:According to the current RD restrictions on the public, 177Lu-PSMA-617 is a relatively safe treatment modality for prostate cancer if good safety precautions are taken.