AIM: To observe the curative effect of internal fixation of patellar fracture by cannulated compression screws combined with circumferential loop and tension band wire. METHODS: From May 2001 to February 2006, 24 cases of patellar fracture treated with cannulated compression screws combined with circumferential loop and tension band wire were enrolled at Department of Orthopaedics, Renmin Hospital, Wuhan University. It involved 15 males and 9 females, averagely 32 years (18-60 years). There were 14 cases of transverse fracture, 10 cases of comminuted fracture, and all cases were closed fracture. The operation was performed 2-6 hours after injury. X-ray was done at weeks 4, 6, 8 and 10 after operation respectively to observe the material and host reaction. Function was assessed by curative effect assessment criteria made by Lu et al. RESULTS: Totally 22 cases were followed-up. Follow-up period was 4 months to 24 months (mean 10 months). One patient was followed up for 4 months, 5 cases for 6 months, 5 cases for 8 months, 4 cases for 10 months, 3 cases for 12 months, 2 cases for 14 months, 1 case for 18 months and 1 case for 24 months. ①Reduction rate of fracture was 100%. Incision was primary healing. The fractures healed 4-10 weeks after operation, averagely 6 weeks. ②Twenty patients had excellent curative effect, and two patients had good curative effect. ③No corrosion, cinch and breakage were found after operation. ④Peplos appeared at the junction of steel-wire when the fracture was healed. CONCLUSION: Cannulated compression screws combined with circumferential loop and tension band wire is the ideal implant for the patellar fracture. No pain or steel-wire cinch induced by soft tissue stimulation is found.

Objective To investigate the surgical indications and suigical procedures of traumatic posterior fossa epidural hematomas of 17 cases in children.Methods Clinical data of 17 children who admitted into our hospital from 2010 to 2015 with posterior fossa epidural hematomas were retrospectively reviewed.We summarized he surgical indications and operation selection of posterior fossa epidural hematomas in children.Results The suigical procedures of all patients in our group included the following:8 patients were treated with traditonal craniectomy,9 patients were treated with drilling skull plus urokinase.All patients recovered well after operation.Complications:hydrocephalus in 2 cases,epilepsy in 1 case.The outcome evaluated using the Glasgow outcome score(GOS) was good in 15 patients,mild disability in 1,severe disability in 1.Conclusion The clinical status of posterior fossa epidural hematoma can progress rapidly in children.It is crucial for early diagnosis and timely surgical intervention when it is indicated.In addition,the surgical procedures should be selected properly,the overall prognosis is excellent.

BACKGROUND:In the comminuted fractures of the shafts of long bones, the fracture repair process may be halted after internal fixation by locking compression plate and a higher bone nonunion rate occurs due to severe soft tissue damage, inadequate blood supply, poor cortical apposition, or unstable fracture fixation. ＜br> OBJECTIVE:To examine the effect of bone morphogenetic protein in the prevention of nonunion of long bone comminuted fractures after internal fixation by locking compression plate. ＜br> METHODS:Total y 145 long bone comminuted fracture patients were enrol ed and randomly divided into test and control groups according to the wishes of patients. The test group included 78 patients (48 males and 30 females, 18-70 years old;57 cases of closed fractures and 21 cases of open fractures) who were treated with internal fixation by locking compression plate combined with bone morphogenetic protein;the control group included 67 patients (42 males and 25 females, 18-71 years old;49 cases of closed fractures and 18 cases of open fractures) who were treated with internal fixation by locking compression plate. The fracture healing time and rate of non-union were detected and compared in the two groups after a postoperative fol ow-up of 6-18 months. ＜br> RESULTS AND CONCLUSION:In the test group, the average fracture healing time was 6.17 months, without non-union. In the control group, the average fracture healing time was 7.24 months, and the rate of non-union was 7%. Compared with the control group, the fracture healing time was shorter and the rate of non-union was lower in the test group (P＜0.05). The use of bone morphogenetic protein is an effective method to shorten fracture healing time and prevent non-union of long bone comminuted fractures after internal fixation by locking compression plate.

How to select effective therapy has been a troublesome problem in Orthopaedic Surgery. The authors introduced several operative approaches and discussed some commonly used operative methods to correct deformity, improve life and professional exercise ablilty.

Since its discovery, the retinoblastoma (RB) tumor-suppressor protein has become a focal point of caner and cell cycle research, and subsequently discovered members(pRB,p107,p103) of the RBfamily have been proved to play a important role in the cell cycle and the development of cancer. RB regulates the cell growth, development and differentiation via the interactions with E2f and some other cytokines,and its alternation even make the tumor formation. In comparison with some other tumors, colorectal cancer(CRC) has the different expression of RB.We may assume that the different causes of CRC and some unique functions of RB in CRC lead to the alternation.

Objective To study the writing characteristics and related focuses in brain in patients with Uighur and Chinese agraphia.Methods Aphasia Battery of Chinese (ABC) and Uighur ABC were used to examine the characteristics of speaking and writing. The focues were observed with CT and MRI. Results 67 patients were with agraphia, in which 37 were Uigur and 30 were ethnic Han. Both groups mostly showed aphasic agraphia, the focuses were found in various areas in the brain, and mostly located on the left frontal, parietal, temporal lobes and basal ganglion. Conclusion The characteristics of writing were various with the types of agraphia, but similar between Uighur and Chinese cases with same writing characteristics.Writing behavior relies on the cooperation of the whole neuromechanism.

Objective To compare the time-course of relaxant effect of rocuronium between patients of Uygur and Han nationalities.Methods Thirty ASA Ⅰ or Ⅱ patients (15 Uygur nationality,15 Han nationality) of both sexes,aged 20-55 yr weighing 45-73 kg were divided into 2 groups (n=15 each):group U Uygur nationality and group H Han nationality.Anesthesia was induced with midazolam,propofol,fentanyl and suxamethonium chloride.Tracheal intubation was performed and the patients were mechanically ventilated.Recuronium 0.6mg/kg was then given iv.Neuromuscular function was monitored with acceleromyograph using single stimulation of the ulna nerve.The onset time (time from injection of recuronium to maximal paralysis),nonresponse time (duration of maximal twitch depression),clinical duration (time required for the twitch to return to 25% of control height after injection of initial dose),75%recovery time (time for twitch to return to 75%of control height after injection of initial dose) and recovery index (time for twitch height to return from 25% to 75% of control height) were recorded.Results There was no significant difference in the onset time between the two nationalities.The time of nonresponse period,clinical duration and 75% recovery time were significantly shorter in Uygur patients than in Han patients.Recovery index was significantly shorter in Uygur patients.Conclusion There is a significant difference in the time-course of muscle relaxant effect of recuronium between Uygur and Han nationalities.The influence of nationality on recommended dosage of recuronimn should be considered.

Objective To investigate the diagnosis,treatment and prognosis of isolated epidural hematoma (EDH) in children.Methods Clinical data of 83 children,45 males and 38 females (at age of 0.7-14 years),with EDH treated between January 2012 and October 2014 were retrospectively reviewed.Slipping and falling were the most commonly causes of injury.While motor-vehicle accident was noted with increased age.In 16 patients lesion of hematoma was frontal,in 28 patients temporal,in 13 patients parietal,in 9 patients occipital and in 17 patients posterior fossa.Results Of the 28 patients treated surgically,the outcome evaluated using the Glasgow Outcome Score (GOS) was good in 22 patients,mild disability in 2,moderate and severe disability in 1 and death in 3 (one died of venous sinus rupture and one large area infarction).Of the 55 patients treated conservatively,the outcome was good in 52 patients,mild disability in 1,and death in 2 (both presented with bilateral cerebral hernia on admission and one of them was unable to breath spontaneously).Conclusions Overall prognosis of the patients with isolated EDH in children is excellent.Complications of venous sinus rupture,foramen magnum hernia and large area cerebral infarction may contribute to poor prognosis.

OBJECTIVETo explore the association between C825T polymorphism of G protein beta3 subunit (GNB3) gene and different Hilit types of essential hypertension (EH) in the Uygur nationality of Xinjiang.

METHODSAccording to Uygur medical theories, EH patients (as the EH group) and non-EH patients (as the control group) were assigned to four Hilit groups. The C825T polymorphism of GNB3 was detected in 161 EH patients and 379 non-EH subjects of different Hilit types by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to explore the difference of the genotypes and allelic frequencies and hypertension.

RESULTS(1) In Xinjiang Uygur population, the distribution frequencies of GNB3 C825T polymorphism were in accordance with Hardy-Weinberg (chi2 = 0.871, P = 0.647). (2) There was no statistical difference in the distribution frequencies of three genotypes and two alleles of GNB3 between the EH group and the control group (P > 0.05). (3) There was statistical difference in distribution frequencies of three genotypes between the abnormal Sapra and non-abnormal Sapra group (the sum of abnormal Sewda, abnormal Kan, and abnormal Balhem) (chi2 = 6.905, P = 0.032), especially between the abnormal Sapra and abnormal Balhem groups (chi2 = 10.404, P = 0.006), but there was no statistical difference in distribution frequencies of alleles between the two groups (P > 0.05). (4) In 161 EH patients, there was statistical difference in the distribution frequencies of three genotypes and two alleles between the abnormal Sapra and non-abnormal Sapra group (chi2 = 9.034, P = 0.011; chi2 = 4.701, P = 0.03).

CONCLUSIONSBoth TT genotype and T allele of GNB3 C825T polymorphism might not be associated with EH patients in Xinjiang Uygur populations. However, they were correlated with hypertension patients of non-abnormal Sapra, indicating the pathogeneses of EH with different Hilit types might be different.

Adult ; Aged ; Alleles ; Case-Control Studies ; Essential Hypertension ; Female ; Gene Frequency ; Genotype ; Heterotrimeric GTP-Binding Proteins ; genetics ; Humans ; Hypertension ; classification ; diagnosis ; genetics ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Minority Groups ; Polymorphism, Genetic

Objective To analyze the clinical characteristics of children massive cerebral infarction after traumatic brain injury. Methods The clinical data of 33 children with massive cerebral infarction after traumatic brain injury were retrospectively analyzed. Results Among the 33 children, 24 cases suffered from falling, 10 cases were involved in traffic accidents, 1 case suffered from violence and 1 case was hit by falling object. The massive cerebral infarction occurred in all objects: 9 cases in 1 day after head trauma, 14 cases in 1 - 3 days, 7 cases in 4 - 7 days, and 3 cases after 7 days. Eighteen patients were performed operation to evacuate the intracranial hematoma and decompression. Antiplatelet agents, calcium antagonist and low molecular dextran were administered in all patients after exclusion of bleeding tendency. The follow-up period of all children ranged from 6 months to 24 months. According to Glasgow outcome score (GOS):18 cases showed a good outcome, 6 cases were moderately disabled, 1 case was severely disabled, 1 case survived in a permanent vegetative state and 7 cases died. Conclusions The main causes of children massive cerebral infarction with traumatic brain injury are falling and traffic accident. With proactive treatment, the prognosis of children survivors is acceptable.