Objective To discuss the clinical effects of external fixator combined with limited internal fixation in treatment of serious comminuted distal radius fractures. Methods 35 patients with serious comminuted distal radius fractures were treated by external fixator combined with limited internal fixation from January 2001 to May 2004. There were 16 males and 9 females with an average age of 47.3 years. According to AO/ASIF classification, 9 fractures were A3 type, 9 C2, and 17 C3. Reduction was achieved and maintained in 27 cases by longitudinal traction and external fixation, 5 by external fixator with percutaneous K-wire, and 3 by external fixatator combined with ulnar limited internal fixation. Results All the patients were followed up from 5 months to 30 months (12 months on average). According to the anatomical alignment, 9 were excellent, 24 good, and 2 fair. It was necessary to restore the anatomy of distal radius both on sagittal and coronal planes in order to obtain good functions. Preoperatively, the radial inclination angle was -15? to 15?(10.5? on average), and the palmar tilt angle was -30? to 0?(-10? on average). After operation, the two angels were reduced to 20? to 35?(25? on average), and 0? to 20?(11.5? on average)respectively. The joint function was assessed by Dienst criteria, the results suggested that 12 were graded as excellent, 21 good, and 2 fair. No severe complications were found. Conclusion The treatment of serious comminuted distal radius fractures using external fixator combined with limited internal fixation is of easy performance, reliable fixation, satisfactory effect, and lower complications. It offers a new method which can obviously improve the union of the fractures and decrease the infection rate postoperatively for the treatment of the fractures of distal radius.

[Objective]To preliminarily explore the method and evaluate the effect of volar LCP fixation for dorsally displaced and unstable distal radial fractures.[Method]Thirty-five patients with the fractures were treated with volar LCP combined with the techniques of K-wires and bone grafting, whose effects were evaluated preliminarily through comparing and analyzing the volar tilt, radial inclination, radial shortening and wrist function.[Result]Followed up from 9 to 24 months (average 17months), 20 patients achieved excellent, 12 good and 2 fair with 1 poor, according to Sarmiento scale.[Conclusion]Volar LCP fixation is a safe and effective treatment for unstable and dorsally displaced distal radial fractures, which could prevent reduction lost, reduce need for bone grafting and avoid tendon irritation.

Objective To evaluate the effects of external fixators combined with vascularized bone graft in treatment of talar neck fractures. Methods We retrospectively reviewed the records of seven patients who were treated for fractures of talar neck from January 2004 to March 2005 in our department. Of them, six were type Ⅱ and one was type Ⅲ according to the Hawkin s classification. One case was managed with closed reduction and six with open reduction and internal fixation with percutaneous cannulated screws. In addition, all the patients were treated with transarticular external fixators combined with vascularized bone graft. Bone healing, osteonecrosis and hindfoot functional recovery were documented. Results All the patients were followed up for 13 to 24 months (average, 17 months). All of them achieved bony union. According to the Maryland hindfoot scoring system, five cases were excellent and two were good. No avascular necrosis was found. One patient complicated with talar body fracture developed posttraumatic arthritis that was later managed by tibiotalar fusion. Conclusions External fixators combined with vascularized bone graft can effectively prevent avascular necrosis of the talus, but the long-term effects of this method need further observation.

Objective To investigate the stability of lumbar column after limited selective posterior rhizotomy(LSPR) and observe the healing of exscinded laminae and the deformation of lumbar column. Methods One hundred and twenty five children with spastic cerebral palsy were divided into six groups(A, B, C, D, E, F)according to the age(

Objective To analyze the clinicopathologic features of primary cutaneous CD30 positive lymphoproliferative disorders. Methods A clinical, pathological and immunohistochemical analysis was carried out in 4 cases of lymphomatoid papulosis and 5 cases of primary cutaneous anaplastic large cell lymphoma. Results Lymphomatoid papulosis was divided into 3 subtypes, A, B and C. The lymphomatoid papulosis of subtype A was pathologically characterized by pleomorphic anaplastic large cells or Steinberg-reed cells scattered or patchly distributed among many inflammatory cells; subtype B showed pathological changes characteristic of granuloma fungoides, and manifested as a broad infiltration zone of lymphocytes in dermis with scattered small- to middle-sized atypical gyrus-like lymphocytes; subtype C was characterized by a diffuse distribution of anaplastic large cells and could clinically subside spontaneously. Primary cutaneous anaplastic large cell lymphoma clinically manifested as subcutaneous nodules or papules, and was pathologically characterized by large, pleomorphic, round or ellipse cells with plentiful, eosinophilic or bicolor cytoplasm, large nuclei and obvious nucleoli. The neoplastic cells characteristically expressed CD30 antigen in both lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and all the cases showed a favorable prognosis.Conclusions Primary cutaneous CD30 positive lymphoproliferative disorders are a spectrum of cutaneous T cell lymphoma with favorable prognosis, and a synthetic analysis of clinical, histopathological and immunohistochemical findings is beneficial to the diagnosis of these entities.

Objective To detect Pneumocystis carinii (Pc) DNA by loop-mediated isothermal amplification (LAMP). Methods After injected with hydrocortisone acetate for 8 weeks, the bronchoalveolar lavage fluid (BALF) of Wistar rats were collected and a portion of BALF were examined for identifying Pc organisms using microscope. Then Pc DNA was extracted by phenol-chloroform extraction. Four primers which recognized 6 distinct regions on the mtrRNA gene of Pc were designed and used for LAMP assay. To evaluate the specificity of the assay, M. tuberculosis, M. pneumoniae, C. pneumoniae, P. gondii and rat leucocyte were used as negative controls. To compare the sensitivity of the LAMP to that of conventional PCR, Pc DNA were 10-fold serially diluted and was amplified by LAMP and PCR. LAMP results were judged by naked eye, electrophoretic analysis and restriction digestion. Results Pc organisms were detected from BALF of rats injected with hydrocortisone acetate. After LAMP reaction, positive signal was observef rats injected with hydrocortisone acetate. By contrast, no positive signal was observed for the negative controls in the study. The amplified product digested by restriction enzyme demonstrated 3 bands (82, 135, 189 lip) upon agarose gel electrophoresis, in good agreement with the predicted sizes. The detection limit of LAMP assay was 1 pg/μl of Pc DNA per reaction and that of PCR was 10 pg/μ1 of Pc DNA per reaction. Conclusion LAMP assay has usefulness for rapid detection of Pc.

To localize and characterize the hypothetical protein CT358 in the chlamydial infected cells. CT358 gene from the Chlamydia trachomatis (C. trachomatis) serovar D genome was amplified and cloned into the pGEX and pDSRedCI vectors. The recombinant plasmid pGEX-CT358 was constructed and expressed as GST fusion proteins. The GST-CT358 fusion protein was used to immunize mice to raise the antibodies, which specifically recognized CT358 without eross-reacting with other unrelated proteins. The antibodies were then used to localize the endogenous CT358 protein and determine the expression pattern in Chlamydial infected cells using an indirect immunofluorescence assay (IFA). Meanwhile, pDSRedC 1-CT358 recombinant plasmid was transfected to HeLa cells to evaluate the effect of CT358 expression on the subsequent chlamydial infection. The hypothetical protein CT358 was identified in the inclusion membrane of C. trachomatis-infected cells for the first time,and it was detected as early as 12 h after C. trachomatis infection and remained in the inclusion membrane throughout the rest of the infection cycle. Cytosolic expression of CT358 via a transgene failed to affect the subsequent ehlamydial infection. These observations together have demonstrated that CT358 is a newly identified chlamydial inclusion membrane protein, giving the potentially importance for further understanding the mechanisms of chlamydial intracellular parasitism.

Objective To detect Toxoplasma gondii DNA by loop-mediated isothermal amplification(LAMP). Methods DNA was extracted by phenol-chloroform extraction from T. gondii tachyzoites. Four primers which recognized 6 distinct regions on the B1 gene of T. gondii were designed and used for LAMP assay. To evaluate the specificity of the method, Plasmodium vivax, P. falciparum, Pneumocystis carinii, Schistosoma japonicum, and mouse leucocytes were used as controls. The parasite extract (T. gondii) was 10-fold serially diluted for evaluating the sensitivity of LAMP, and was amplified by LAMP. LAMP results were read with naked eye and analyzed by electrophoresis. Results After LAMP reaction, positive amplification was observed with T. gondii, but no positive signal was toted for the negative controls in the study. The sensitivity of LAMP assay reached up to 2-3 T. gondii tachyzoites/ml per reaction. Conclusion LAMP assay shows proper specificity and sensitivity for the detection of T. gondii.

To localize and characterize the hypothetical protein CT358 in the chlamydial infected cells.CT358 gene from the Chlamydia trachomatis(C.trachomatis) serovar D genome was amplified and cloned into the pGEX and pDSRedC1 vectors.The recombinant plasmid pGEX-CT358 was constructed and expressed as GST fusion proteins.The GST-CT358 fusion protein was used to immunize mice to raise the antibodies,which specifically recognized CT358 without cross-reacting with other unrelated proteins.The antibodies were then used to localize the endogenous CT358 protein and determine the expression pattern in Chlamydial infected cells using an indirect immunofluorescence assay(IFA).Meanwhile,pDSRedC1-CT358 recombinant plasmid was transfected to HeLa cells to evaluate the effect of CT358 expression on the subsequent chlamydial infection.The hypothetical protein CT358 was identified in the inclusion membrane of C.trachomatis-infected cells for the first time,and it was detected as early as 12 h after C.trachomatis infection and remained in the inclusion membrane throughout the rest of the infection cycle.Cytosolic expression of CT358 via a transgene failed to affect the subsequent chlamydial infection.These observations together have demonstrated that CT358 is a newly identified chlamydial inclusion membrane protein,giving the potentially importance for further understanding the mechanisms of chlamydial intracellular parasitism.

Objective To evaluate the clinic effectiveness and safety of transcatheter closure of ventricular septal defect using homemade Amplatzer VSD occluder. Methods From Jan 2003 to April 2005,16 patients (11 males,5 femles) with VSD underwent an attempt of catheter closure using homemade Amplatzer occluder.The mean age of patients was (13.98 ?11.05) years (ranged from 3.5 to 41 years);the mean weight of patients was (32. 1 ?17.59) kg (ranged from 12.5 to 59 kg);the mean diameter ofVSD measured by transthoracic echocardiography (TTE) was(5.34?1.75)mm(ranged from 3.7 to 9mm). All patients underwent closure under TTE or transthoracic echocardiography(TEE)guidance. Results The devices were deployed successfully in 12patients.There was complete closure in 11patients immediatelly,and residual sbunt in 1 patients.After proccdure, bundle branch block(right and left bundle) were occurred in 7patients.Hemolysis was in 1patients.There were no other servere complications.Conclusions Transcatheter closure of VSD using this new occluder is safe and effective. Early results are good.Further clinical trials are underway to assess the long-term results.