Acetabular is an important human joint for weight bearing. Quadrilateral plate is a crucial structure of medial acetabulum with special morphology and important function. Quadrilateral plate fractures are common fracture in acetabulum. Quadrilateral plate fracture is hard to expose and reduction because it is in the medial of acetabulum. At the same time,the bone in the quadrilateral plate is not easy to fixed for thinning bones and adjacent to the articular cavity. The operator should know well about the anatomy and choose the suitable internal fixation. After quadrilateral plate fractures, the femur head maybe displace medially even break into pelvis. That make reduction and treatment always be a challenge. With different kinds of fractures,the efficacy of treatment is not the same. This paper intend to review the relation of anatomic features,approaches, internal fixations, key point of treatment and efficacy.
Acetabulum ; injuries ; surgery ; Animals ; Fracture Fixation, Internal ; instrumentation ; methods ; trends ; Fractures, Bone ; surgery ; Humans

Objective To investigate the effects of hippocampal?sparing intensity?modulated radiotherapy ( IMRT) on dose distribution of target volume and organs at risk ( OARs) in locally advanced nasopharyngeal carcinoma. Methods A retrospective dosimetric analysis was performed among 11 patients with locally advanced nasopharyngeal carcinoma. The MONACO ? v5. 10 Treatment Planning System was used to design three treatment plans:routine volumetric modulated arc therapy ( VMAT ) , hippocampal?sparing VMAT, and nine fixed?fields IMRT. The D98%, D50%, D2%, Dmean , conformity index ( CI ) , and homogeneity index (HI) of planning target volume (PTV) and PTVnx as well as dose distribution of the hippocampus and OARs were evaluated. Using single factor analysis of variance,two group comparative was LSD or paired t?test. Results For the above three plans,the D2% values of PTVnx were ,7 513,and 7 462 cGy,respectively (P=0. 016);the D98% values of PTV were 5837,5812,and 5914 cGy,respectively (P=0. 029);the average D2% values of PTV were 7 399,7 380,and 7 333 cGy,respectively ( P=0. 047);the HI values of PTV were 0. 239,0. 241,and 0. 220,respectively (P=0. 016);the V10 values of the brain stem were 97. 2%,88. 1%,and 90. 3%,respectively ( P=0. 001);the V20 values of the brain stem were 74. 2%, 62. 3%,and 67. 1%,respectively ( P=0. 032);the V30 values of the brain stem were 50. 9%,35. 8%,and 45. 5%, respectively ( P= 0. 020 );the V40 values of brain stem were 24. 4%, 14. 4%, and 23. 3%, respectively ( P=0. 018);the Dmean values of hippocampus were 1 518,899,and 896 cGy,respectively ( P=0. 000);the D40% values of hippocampus were 1 379,642,and 639 cGy,respectively ( P=0. 000);the V10 values of the hippocampus were 54. 1%,25. 1%,and 3. 8%,respectively ( P=0. 000);the V20 values of the hippocampus were 26. 2%, 12. 6%, and 12. 0%, respectively ( P=0. 001 ) . Conclusions Hippocampal?sparing VMAT and nine fixed?fields IMRT can significantly reduce the dose to the hippocampus without affecting dose distribution of target volume and OARs. VMAT may be superior to IMRT because VMAT can simultaneously reduce the dose to the brain stem.

Objective To explore the clinical characteristics and diagnosis of Epstein-Barr(EB) virus encephalitis(EBE) in children. Methods The verification of EBE was based on detection of EBV DNA in cerebrospinal fluid (CSF) by fluorogenic quantitative PCR(FQ-PCR) and Nest-PCR. The clinical and CSF changes of 27 EBE cases and 26 controls were analyzed and compared. Results EB-DNA in CSF by FQ-PCR of 13 cases of EBE was (2.82?2.03)?10 3copies.There was no significant difference in clinical manifestations between EBE and HSE groups, except that WBC in CSF of EBE was lower than those of HSE.Conclusions EBE is not infrequent, about 10 % of encephalitis in children. EBE is always present independently, which is not a complication of infectious mononucleosis(IM).Detection of EBV-DNA in CSF is a sensitive and specific test for diagnosing of EBE. Early treatment may be beneficial to the prognosis of EBE.

[ABSTRACT]OBJECTIVETo study the mRNA expression of glucocorticoid receptor(GR) in peripheral blood mononuclear cells in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and its clinical significance. METHODSReal-time fluorescent quantitative PCR was used to detect GRα mRNA and GRβ mRNA exprssion in PBMC of 30 male patients with moderate to severe OSAHS and 27 healthy male subjects. The relationships between the expression of glucocorticoid receptor mRNA and the apnea hypopnea index, body mass index, neck circumference, waist circumference, the lowest oxygen saturation, the average oxygen saturation, the Epworth sleepiness scale(ESS) score, fasting blood glucose, heart rate and blood pressure were analyzed.RESULTSCompared with the control group, the expression level of GRα mRNA was lower in the OSAHS group(t=2.25,P<0.05) and the expression level of GRβmRNA had no difference between the two groups(t=1.43, P>0.05). We had not found the significant correlation between the expression of GRα mRNA and the clinical parameters above in OSAHS patients.CONCLUSIONThe expression of GRα mRNA in PBMC in moderate to severe OSAHS male patients have a downward trend compared with healthy group, but the mechanism remains unclear.

Objective:To compare the taxol content in different parts of Taxus madia and Taxus chinensis var. mairei to provide reference for the future researches. Methods:The active ingredients were extracted by a mixed solvent (50% acetone and 50% ethyl acetate) , the target compound taxol was separated by a neutral Al2 O3 solid phase column, and then the taxol content was analyzed and compared among the different parts of Taxus madia and Taxus chinensis var. mairei by HPLC. Results:Taxol in velamen of Taxus ma-dia had the highest content among all the samples, which was 0. 0439% and 88 times as high as that in the bark of Taxus chinensis var. mairei. Conclusion:Among all the samples of Taxus madia and Taxus chinensis var. mairei, velamen of Taxus madia has the highest taxol content.

OBJECTIVETo study the medium and long term effects of perfusion of bone marrow stromal stem cells through optional artery for the treatment of non-traumatic femoral head avascular necrosis.

METHODSFrom January 2000 to December 2004,62 cases(78 hips) with non-traumatic femoral head necrosis accepted optional artery marrow stromal stem cells infusion treatment and had complete follow-up data, including 43 hips of 35 males and 35 hips of 27 females with an average age of 36.3 years old (22 to 54). According to preoperative imaging data, 16 hips were ARCO I stage, 52 hips were II stage, 10 hips were III a stage. Harris score was 64.94 +/- 8.12 preoperatively. Postoperative Harris score at the last follow-up, imaging changes,DSA vascular changes were analysis.

RESULTSThe patients were followed up for 9 to 13 years (means 11 years). By the end of the follow-up, a total of 18 hips got artificial joint replacement, 10 hips of preoperative ARCO I, II period got artificial hip joint replacement, 8 hips of IIIa period got hip artificial joint replacement. Harris score was 71.21 +/- 0.19 at the end of the follow-up, it was obviously enhanced compared with preoperative. DSA showed blood vessels of supply the femoral head increased thickening.

CONCLUSIONPerfusion of bone marrow stromal stem cells through optional artery can effective treat non-traumatic femoral head necrosis of ARCO I, II period, it can make the femoral circumflex artery and its branches increased thickening.

Adult ; Angiography, Digital Subtraction ; Arthroplasty, Replacement, Hip ; Female ; Femur Head Necrosis ; therapy ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Middle Aged

Although Germany is an important cradle of Western medicine, traditional Chinese acupuncture and moxibustion are widely accepted and have been developed hardly in Germany for several centuries. This paper reviews the development courses of acupuncture and moxibustion in Germany, and gives an introduction to the level of acupuncture and moxibustion science, acupuncture in medical insurance, acupuncture research, acupuncture clinics, acupuncture organizations, acupuncture journals and trend of acupuncture development in Germany.
Acupuncture ; education ; Acupuncture Therapy ; history ; Germany ; Medicine, Chinese Traditional ; history ; Moxibustion ; history ; Science

OBJECTIVETo compare the differences between computer aided identification and ultra-thin layer slicing in measuring the lesions of femoral head necrosis,and to confirm the accuracy and practicability of computer aided method.

METHODSFrom June 2012 to December 2013, the X-ray and MRI of 24 patients (24 hips on unilateral) were reviewed, who had avascular necrosis of the femoral head (ANFA) at late stage (stage III and IV) according to the ARCO international staging system. There were 15 males and 9 females, with an average age of (65.1 ± 8.8) years old, ranged 33 to 74 years old. Based on the software system with seeds point identification, the ragional adaptive search method with computer aid was used to calculate the volume of necrotic lesion in femoral on MRI. Then the pathological slices of those intraoperative femoral heads were made to measure the gross volume of necrotic lesion in femoral head,and the values were compared with the data in the computer.

RESULTSFor 24 hips, by the calculation of computer, the necrotic volume was (20.00 ± 3.04) cm (ranged, 18.72 to 21.29 cm³). Under the pathological section, the necrotic volume of the femoral head was (19.89 ± 3.17) cm³ (ranged, 18.55 to 21.23 cm³). In computer and pathology two kinds of measurement, the two entire femoral head volume had no significant difference using these two measurements (t = -1.227, P = 0.232).

CONCLUSIONComputer aided identification for necrotic area of femoral head adaptive can demonstrate the morphology of femoral head necrosis accurately and reliably, which will help surgeon better understand the morphology and orientation in femoral head.

Adult ; Aged ; Diagnosis, Computer-Assisted ; Female ; Femur Head Necrosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

Acupuncture ; Acupuncture Therapy ; Germany ; History, 20th Century ; Humans ; Moxibustion

BACKGROUND:Triggering receptor expressed on myeloid cel s 2 (TREM-2) is highly expressed throughout the synovial tissue in active rheumatoid arthritis patients, but the role of TREM-2 in the pathogenesis of rheumatoid arthritis stil remains unclear.
OBJECTIVE:To explore the TREM-2 expression in the synovial tissue of col agen type II-induced arthritis rats.
METHODS:The col agen-induced arthritis models were established in rats. The activity indicators and pathological changes of arthritis synovial were dynamical y observed. The mRNA levels of TREM-2, tumor necrosis factor-α, interleukin-1β, and interleukin-10 were detected in synovial tissue of rats by RT-PCR. The protein expression and location of TREM-2 were measured with western blot assay and immunohistochemistry, respectively.
RESULTS AND CONCLUSION:At day 13 after immunization, the paws of model rats appeared red and swel ing, the arthritis index scores were increased (P<0.01). At day 19-25 after immunization, the inflammation reached the peak. Hematoxylin-eosin staining showed that, the synovium of col agen-induced arthritis rats were proliferated and were infiltrated by inflammatory cel s, cartilage was destroyed. Compared with the control group, the expression of TREM-2 mRNA and protein, the mRNA levels of tumor necrosis factor-αand interleukin-1βin synovial tissue of the model rats were significantly increased (P<0.05 or P<0.01), while interleukin-10 mRNA expression was significantly decreased (P<0.05). Experimental findings indicate that, TREM-2 is a crucial inflammatory regulator and the increasing expression of TREM-2 plays an important role in the pathogenesis of col agen-induced arthritis.