Twenty six patients with fracture of tibial plateau was under arthroscopy assisted reduction, the joint surface of bone graft, and USES the steel plate fixation treatment. Average surgery time was 65 min (70-120 min), average fracture healing time was 15 weeks (12-17 weeks), joint surface anatomical reattachment rate was 92.9%. Using break knee function criteria evaluation of curative effect: 18 cases great 6 cases wed, 2 cases ok, fine rate was 92.3%. No infection, deep venous thrombosis and small leg fascia chamber syndrome and other complications. Conclusion is that treatment of tibial plateau fractures under arthroscope has advantages of small trauma, check intuitively and reset accurately, functional recovery of patients are satisfied, the treatment has certain clinical application value.
Adult ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective To investigate the effect of hepatic microcirculatory disturbance induced by intestinal endotoxemia in liver injury. Methods The model of rats with intestinal endotoxemia induced by thioacetamide(TAA) was established. 25 Male Wistar rats were divided into 4 groups as normal control group (N), Heparin control group(H), TAA treated group(T), and TAA + heparin treated group(T +H). The changes of plasma biochemistry and hepatic histopathology were measured. Results The plasma endotoxin level, alanine transaminase (ALT) activity and malondialdehyde (MDA) content in TAA treated rats were markedly higher than that in the control ones (P < 0.05), while plasma endotoxin level was lower ( P > 0.05) and ALT as well as MDA were decreased significantly ( P < 0.05) in TAA + heparin group than in TAA group. Conclusion Intestinal endotoxemia could induce disturbance of hepatic microcirculation, which results in ischemia and hypoxia of liver cell. Heparin could not only correct disturbance of hepatic microcirculation induced by intestinal endotoxemia, but also reduce liver injury induced by ischemia and hypoxia.

Objective To evaluate the parenteral complications and their risk factors and to study the immune status by detecting immunoglobulin and lymphocyte subsets in children with rotavirus enteritis. Methods Sixty-four children with rotavirus enteritis who were treated in Shengjing Hospital of China Medical University between January 2007 and December 2008(observation group) and 18 healthy chiIdren for health screening at pediatric health care center (normal control group) were reeruimd.Clinical manifestations were collected,stool specimens were detected for rotavirus using ELISA,lymphocyte subsets were detected using flow cytometer,and immunoglobulin.liver enzyme and myocardial enzyme were detected.Results Rotavirus enteritis may be complicated by parenteral complications(liver,myocardium,respiratory and nervous system).The activity of ALT,AST,LDH,CK and CK-mB were higher in observation group than that in normal control group(P<0.05).In observation group,liver injury rate in children younger than 12 months was higher than that in children older than 12 months,and the activity of CK and CK-mB were highcr in severe diarrhea cases[CK(324.5±995.5)U／dl,CK-mB(93.8 4±61.5)U／dl]than that in mild diarrhea cases [CK(252.8±130.4)U／dl,CK.mB(59.6±32.6)U／dl](P<0.05).The level of IgG was lower in observation group[(4.46±1.56)g／L]than that in control group[(5.80±1.67)g／L](P<0.05).Lymphocytes subsets study revealed that the activity of CD4+ in observation group[(29.0±4.18)％]was lower than that in control group[(38.6±3.97)％](P<0.05),the activity of CDl9+ [(38.8±3.94)％]was higher than that in control group[(23.1±7.70)％](P<0.05)and the CD4+／CD8+ ratio was reverse in observafion group.Conclusion Rotavirus enteritis may be complicated by parenteral injuries which get liver,myocardium,respiratory and nervous system involved.Children with rotavirus enteritis Call lead to low immune function.Determination of liver enzyme,myocardial enzyme,immunoglobulin and lymphocyte subsets has important clinical significance to monitoring the change of condition and guiding treatment.

Objective To investigate the expression and clonality of TCR V? subfamily T cell in 11 patients undergoing chronic hemodialysis before and after renal transplantation.Methods The CDR3 of TCR V? 24 subfamily genes were amplified in samples of peripheral blood mononuclear cells which were drawn before hemodialysis and at 20th day post-operatively. To observe the usage of TCR V? repertoire, the RT-PCR products were further labeled with fluorescent and analyzed by genescan technique for CDR3 size.Results (1) One patient was attacked by acute cellular rejection (ACR) and one suffered from delayed graft function (DGF) diagnosed by renal transplant biopsy. (2) 1-10 TCR V? subfamilies T cells could be identified before transplantation, and most of TCR V? subfamily T cells expressed as polyclonality. The most frequent expression of TCR V? genes was V?3. (3) Only 1-5 TCR V? subfamilies T cells could be detected post-operatively, most of them expressed as oligoclonality. The TCR V?3 subfamilies still were the most frequently expressed (in 9 cases). (4) There were no TCR V? subfamilies T cells before pulse of methylprednisolone, and were 5 subfamilies during pulse of methylprednisolone expressed as oligoclonality or biclonality, 2 subfamilies after ACR expressed as polyclonality. In DGF patient, there were 4 TCR V? subfamilies during DGF, and 5 following DGF.Conclusion (1) The significantly skew distribution of TCR V? subfamily T cells could be found in all patients with chronic renal failure and chronic hemodialysis. (2) Furthermore, the skewing distributions of TCR V? genes came to more significant at 20th day post-transplantation than before. (3) ACR might be closely associated with some special clones of TCR V? subfamily T cells, which subsided immediately after ACR. (4) The expression as polyclonality after ACR and DGF may indicate that the immune function partially was inclined to normalization even though immunosuppressed.

Objective In order to assess the present status of the prophylaxis and the eliminating process for iodine deficiency disorders (IDD) in Guizhou province. Methods Guiyang, Douyun and Kaili regions were selected as IDD monitoring spots of Guizhou province. In these districts, the monitoring indicators for IDD were determined and compared with those ten years ago. Results From 1999 to 2000 in Guiyang, Douyun and Kaili: (1) Themeansofiodineconcentrationiniodized salt of households were 43.6 mg/kg, 43.2 mg/kg and 45.3 mg/kg, respectively, and the qualified rates were 97.5%, 95.8% and 97.9%, respectively, all of them were obviously higher than those ten years ago (P5 mIU/L were in 18.0%, 21.8% and 20.0% infants, respectively, obviously descended from those ten years ago (P

Objective To evaluate the surgical outcomes in patients with lumbar disorder treated with enlargement of the spinal canal through spinous process osteotomy. Methods Posterior central incision was used for unilateral exposure of lamina. Osteotomy was done at the base of the spinous process; complete exposure of the lamina was done by retracting the interspinous and supraspinous ligaments. Ligament flaven was resected at the superior and inferior margin of the lamina. Undermining enlargment of the central spinal canal and the neural canal were then carried out; in some cases the intervertebral disc was resected. Thirty seven patients suffered from lumbar spinal stenosis were treated with the above mentioned procedure; among them decompression of a single segment was done in 24 cases, in two segments in 13 cases. Postoperatively, Oswestry evaluation score and imaging observation were carried out. Results Thirty four cases had follow up for one year and the excellent and good results was seen in 82.4%; 27 cases had follow up of 3 years, the rate of excellent and good results was 81.5%. Both sagittal and transverse diameter of lumbar vertebrae canal were increased notably in postoperative CT scanning. 87% of osteotomized spinous processes had bony fusion. Conclusion Spinal canal plasty by spinous process osteotomy for patients with lumbar disorders affords easy performing procedure with less complications and satisfactory surgical results.

Objective To evaluate the result of anterolateral interbody fusion combined with transpedicle fixation for patients with kyphosis due to tuberculosis of the thoracic spine. Methods There were totally 17 patients, 11 male and 6 female in this study. The average age was 36.4 years, ranging from 23 to 56 years old. All tuberculous lesions were located in low thoracic spine, two vertebral bodies were involved in 9 patients and three vertebral bodies involved in 8 patients. The average kyphosis angle was 25 degrees, ranging from 15 to 34 degrees. Mild neurological function deficiency (Frankel Grade C or D) were present in 5 patients. All patients were treated with one stage posterior transpedicle fixation and anterolateral interbody fusion combined with 9 month antituberculous medication. Results All patients were followed up for 2 to 4 years postoperatively. All incisions were healed up primarily. Interbody fusion was achieved in all patients from 4 to 6 months after operation. All patients were cured and there was no recurrence within follow up period. The average kyphosic angle was 7 degree postoperatively, and the average correction of kyphosis angle was 18 degree, which was maintained well within follow up period. Patients with neurological function deficiency achieved complete recovery one year after operation. Conclusion Anterolateral interbody fusion combined with transpedicle fixation provides rigid fixation and good stability for early fusion and facilitates tuberculous kyphosis correction. This one stage procedure is effective in decreasing duration of antituberculous medication and increasing curing rate of spinal tuberculosis.

Objective: To observe the change of blood cell,marker of vascular endothelium and lung of rabbits during experimental severe decompression sickness(DCS) and to compare each parameter between survival group and dead group.Methods: 14 rabbits were put into the chamber.They stayed for 35mins under 0.55 MPa,and another 35 mins under 0.7 MPa,then decompressed to 0.1 MPa in 4 minutes.Samples were drew before the compression and after decompression for testing count of white blood cell(WBC),neutrophilic leukocyte,lymphocyte and platelet(PLT) and the concentration of ET-1 and the vWF.The tissue of lung of all the rabbits was observed under light and electron microscope.The changes of above parameters of survival rabbits were compared with that of the dead.Results: After rapid decompression,there were 8 rabbits died within 30 minutes,while the other 6 rabbits survived without any symptom of decompression sickness after 24 hours observation.Before the compression,the total count of WBC of dead rabbits was?(11.13?2.37)?10~(9)/L,which was higher the that of survival rabbits,(8.87?2.11)?10~(9)/L.After decompression,the decrease of PLT of dead group,(273?(63)?)10~(9)/L,was more than that of survival group,(148?63)?10~(9)/L.Ttissuedamage of lungs of both dead and survived rabbits was observed as partial alveoli collapse,interstitial edema,local emphysema,various emboli in microcirculation and thickening of respiratory membrane.The damage of lung of dead rabbits was much worse than that of the survival.Conclusion:Experimental DCS induced the increasing of circulation tension,WBC obturation,various emboli,thickening of respiratory membrane,consumption of surface active substance in the body of rabbits.Those rabbits who reacted too severe and had bad compensation ability would die,on the contrary,those rabbits who had a good compensation could survive.

OBJECTIVE: To evaluate the preoperative virtual CT endoscopy about the simple congenital middle ear malformations and its clinical application. METHOD: Thirteen cases (16 ears) with simple congenital middle ear malformations were undergone high resolution CT scannig to collect the original image data, followed by 3-dimensional reconstruction to process the images to evaluate the possible lesions of the ossicular chain. Then, a comparative analysis was made between the finding of virtual CT endotoscopic and the finding that actually found during the operation of the ossicular chain lesions. RESULT: We found malleus and upper strcture of incus abnormity or embeded in upper inner wall of atticus in 5 ears; malleus, incus and stape all abnormity or absence in 3 ears, in the former two conditions we both selected auricular incision through attic pathway remaining intact canal wall; we found crus longum incudis hypoplasia orstructure suprastapedialis absence,stapes aberrance or absence in 8 ears, then we selected vestibular window fenestration and artificial stapes surgery. Postoperative external auditory canals and tympanic membranes were intact in 16 ears,and speech frequency hearing improved by average of 25-45 dB. The coincidence between virtual CT endoscopy and the ossicular chain abnormity under operating views were 100% in cases with congenital ear deformity. CONCLUSION Virtual CT endoscopy is a reliable reference for preoperative evaluation on congenital middle ear malformations.
Adolescent ; Adult ; Ear, Middle ; abnormalities ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Young Adult

ObjectiveTo investigate the effect of surrounding-acupuncture on scalp on hemiplegia.Methods90 patients were divided into three groups. First group were treated with surrounding-acupuncture on scalp, second group with traditional scalp-acupuncture, the third group was control group. ADL and Mannal Function Test (MFT) were used to evaluate the function pre- and post treatment. ResultsThere were no significant differences among the three groups on ADL and MFT at beginning, that were improved significantly after treatment. However, the first group improved more significantly than that of the other two groups for ADL and low limb MFT. The first group showed significantly improvement for Hamilton Rating Scale for Depression pre- and post treatment.ConclusionThe surrounding-acupuncture on scalp is effective method for hemiplegia.