[Objective]To evaluate the clinical effects of retrograde interlocking intramedullary nail(RIIN) for internal fixation of the femoral shaft fractures distal to the isthmian.[Method]Thirty-seven cases(39 limbs) of femoral shaft fractures distal to the isthmian were treated with RIIN from October 1999 to January 2005.Their outcomes were reviewed retrospectively.There were 8 limbs of open fracture and 31 limbs of close fracture.All fractures were fixed statically.[Result]All patients were followed up for 8~24 months,with the average time of 15 months.Two limbs suffered suoerficical infection, all limbs had bony union within 9~20 weeks,with the average time of bone union of 15 weeks.No deep part infection,malunion and nail failure were observed.The rate of being excellence with Merchan evaluation was 97.4%.[Conclusion]Internal fixation with RIIN for femoral shaft ftractures distal to the isthmian can demonstrating good biomechanic property lead to high union rate of fraeture with less complications.The technique of RIIN must be performed strictly during operation and early active functional rehabilitation is the key to obtain good isthmion clinical result.

[Objective]To investigate the treatment method and clinical outcome of posterior midline approach and internal fixation with Y-shaped plate for complex distal 2/3 humeral fracture.[Method]From November 2001 to February 2006,33 patients with complex distal 2/3 humeral fracture were treated with posterior midline approach and Y-shaped plate internal fixation.There were 5 females and 28 males,with a mean age of 37.6 years(ranging from 19 to 57 years).According to AO/ASIF classification,type C1 fracture was found in 21 cases,type C2 in 3 cases and type C3 in 9 cases.Seven of these were open fractures(4 cases of Gustilo-Anderson type Ⅰ and 3 cases of type Ⅱ).Measures of auto-ilium transplant(21 cases)and homolegous allograft bone transplant(12 cases)were also taken.The operation was performed at 2.5 hours～7 days after injury with mean 3 days.[Result]Thirty-three patients were followed up for a mean period of 15.6 months(6～28 months).Fractures of 31 patients healed at 19 weeks after the treatment.Delayed union occurred in two patients.The function of the elbow was evaluated according to Morrey's scale,the results showed excellent in 24 cases,good in 7 cases,and poor in 2 cases.At the last follow-up,the muscle strength of elbow extension was about 4～5 grade.[Conclusion]Posterior midline approach and Y-shaped plate internal fixation of complex distal 2/3 of humeral fracture is a safe and effective technique.Protecting the radial nerve and ulnar nerve,prophylactic bone grafting and reasonable postoperative rehabilitation are very important to obtain satisfactory clinical outcome.

Objective:Tiapride has been used effectively in the clinic for the treatment of dyskinesias and tic disorders including Tourette syndrome. The purpose of the retrospective study is to evaluate the effectiveness of tiapride with the horn of saiga tatarica in treatment of hemifacial spasm. Method:Twenty-eight patients with idio-pathic hemifacial spasm, who were previously treated with carbamazepine, or acupuncture, or botulinum toxin injection, but refused to continue the previous therapies, were treated with tiapride, at a dosage of 50 mg /time once to thrice per day, combined with the horn of saiga tatarica at a dosage of 0. 15 g to 0. 30 g/time once per day. The dosage of tiapride can been up to 100 mg/time once to thrice per day in some cases if necessary. The effectiveness of the therapy was evaluated from the time of three months after the beginning of the treatment. The main efficacy parameter was the degree of spasm reduction, that is, the classification of spasm before versus after the treatment. Result:The duration of following up is between 3 months and 12 months. Twenty-five cases out of 28 patients have demonstrated a significant reduction of spasm. Of which, eight cases were completely relieved, 12 cases marked relieved and 5 cases partially relieved. The effective rate is 89. 29%. Conclusion:Tiapride combined with the horn of saiga tatarica was effective and safe in reducing hemifacial spasm. However, further data from blinded trials and long-term following up are required before this treatment can be considered to be one of the main medical treatment options for hemifacial spasm.

Objective To investigate the effects of hyperoxaluria on rat renal tubular epithelium intracellular calcium concentration ([Ca~(2+)]i) and cell apoptosis, and explore the protective effects of calcium antagonist-nifedipine. Methods Sixty male SD rats were randomly divided into six groups (n=10). Rats in water-drinking group were treated with deionized water, nifedipine group with deionized water and nifedipine 10 mg·kg~(-1)·d~(-1), calculi-induced group with deionized water containing 1% ethylene glycol, and three calculi-induced+nifedipine-intervening groups with deionized water containing 1% ethylene glycol plus nifedipine 3, 6 and 10 mg·kg~(-1)·d~(-1), respectively. Four weeks later, the 24 h oxaluria concentration was measured, the apoptosis index of renal tubular epithelial cells was detected with TUNEL method, and Ca~(2+) fluorescence intensity of cells of renal proximal tubules was determined by flow cytometry using Fluo-3/AM staining. Results The 24 h oxaluria concentrations in calculi-induced group and calculi-induced+nifedipine-intervening groups were higher than those in water-drinking group and nifedipine group (P＜0.01). The apoptosis index and Ca~(2+) fluorescence intensity were significantly higher in calculi-induced group than those in water-drinking group (P<0.01). The Ca~(2+) fluorescence intensity in calculi-induced+nifedipine (3, 6 and 10 mg·kg~(-1)·d~(-1))-intervening groups was 76.7%, 62.7% and 56.4% of calculi-induced group, respectively, with a significant dose-effect relationship (r=0.839, P<0.01). The apoptosis index of renal tubular epithelial cells was significantly correlated with Ca~(2+) fluorescence intensity (r=0.826, P<0.01). Conclusion Hyperoxaluria can increase apoptosis and [Ca~(2+)]i concentration of renal tubular epithelial cells in rats, and nifedipine can effectively protect renal tubular epithelial cells to resist hyperoxaluria.

BACKGROUND:Curcumin is proved to possess anti-inflammatory, antioxidant and anti-apoptotic roles. OBJECTIVE: To summarize and discuss the mechanisms and effects of curcumin used for the treatment of osteoarthritis METHODS: PubMed, Embase, Elseveir databases were retrieved for relevant articles published from 1973 to 2014, with the key words of “osteoarthritis, curcumin, chondrocyte, articular cartilage” in English. After the quality of the included studies was evaluated, valid data were extracted and analyzed. RESULTS AND CONCLUSION:Curcumin prevents the occurrence and development osteoarthritis by inhibiting oxidative enzyme and scavenging free radicals. Curcumin increases production of colagen type 2 through suppressing the reduction of cartilage matrix by matrix metaloproteinases. Anti-inflammatory reaction of curcumin can be achieved by inhibiting cytosolic phospholipase A2, cyclooxygenase-2, and 5-lipoxygenase. Curcumin inhibits interleukin-1β-induced apoptosis of chondrocytes and mitochondrial sweling. Results from clinical trials suggest that curcumin or its derivatives can reduce joint pain and improve the function of knee joints in patients with osteoarthritis. High-concentration curcuminin vitro have been demonstrated toxic effects.

Objective To know the ability of degrading oxalate of three species of Lactic acid bacterium and their mixing bacteria coming from yoghurt in vivo culture broth. Methods Identifying the species of Lactic acid bacteria obtained from 6 brands of yoghurt.Three species of bacterium and their mixture was cultured separately for 72 h in MRS broth which contained three different concentration of ammonium oxalate,and the broth without inoculum of bacteria was prepared as a control.The concentration of ammonium oxalate in culture were detected. Results Three species of Lactic acid bacteria (L.bulgaria,L.acidophilus and L.thermophilus) were detected in every band of yoghurt.After 72 h incubation,the concentration of oxalate in all the broth containing bacteria was lower than that in the control ones.L.acidophilus showed the best degrading activity,and in the presence of ammonium oxalate 5 mmol/L,the 11.0% of oxalate was degraded by the bacteria.The higher concentration of oxalate was,the more the amount of oxalate degraded was,but the lower the percent of degrading was. Conclusions All the species coming from yoghurt have the ablitiy of oxalate degrading which become greater as the increasing of the concentration of oxalate in culture.

Objective To compare the effects of laparoscopy and open surgery of ligation of spermatic vessel cluster or internal spermatic vein for the treatment of varicocele.Methods By using randomized controlled trial,120 cases with varicocele who stayed and were treated in our hospital were divided into 4 groups(30 cases every group) from Jun.2007 to Oct.2011.The efficacy of 4 groups was observed and compared.Results Four operations were performed successfully.Laparoscopy approached less than open surgery in terms of the days of stay in hospital (P ＜ 0.05).The quality of semen in four groups was all increased by comparing spermatozoa density,motility rate before and after operation(P ＜ 0.05),but no difference was found among four groups (P ＞ 0.05).In 0.5-1 year follow-up,follow-up rate was 92.5％,without atrophy of testes.Conclusion The operation of laparoscopic spermatie vessel cluster ligation in patients with varicoceh has the advantage of confirmed effect,which is an alternative operative method of treatment for patients with varicocele.

Objective To evaluate the clinical value and relating problems in treating bilateral tibial fracture by using interlocking intramedullary nail and/or AO external fixator.MethodTotally 33 patients of bilateral tibial fracture treated with interlocking intramedullary nail and/or AO external fixator from April 1998 to January 2006 were retrospectively reviewed.There were 26 males,7 females,with an average age of 34.4 years.According to the AO/ASIF classification,there were type A 9 limbs,type B 13 limbs and type C 17 limbs.According to Gustilo classification there were type Ⅰ 10 limbs,type Ⅱ 6,ⅢA 5,type ⅢB 4 and type ⅢC 2.Duration from injury to operation was 5.5 days(3 hour～12 days). ResultAll patients were followed up for 6～36 months,with the average time being 16 months.All fractures had bon union.The union time averaged 16 weeks in closed fractures and 18 weeks in open fractures.Delayed union occurred in 4 limbs.There were 3 limbs of superficial infection.The results were excellent in 19 cases,good 11 cases,fair 3 cases according to the criteria of Johner-Wruh.Rate of excellent and good result was 90.9%.No fat embolism syndrome,deep in fection,failure of fixation and malunion were not found in this group.ConclusionThe advantages of interlocking intramedullary nail and/or AO external fixator in treatment of bilateral tibial fracture has advantages of easy performance,reduced destruction of blood supply to the fracture ends,rigid fixation,high union ratio of fractures,promotion of early functional extercise and satisfactory effect.The selection of the fixation device should be adopted according to the types of the fracture.

[Objective] To summarize the clinical characteristics of type C2 fractures of tibia,to study the surgical management and its results of type C2 fractures of tibia through intramedullary interlocking nail and minimal invasive internal fixation.[Method]From May 2000 to March 2006,30 patients of type C2 fractures of tibia were treated surgically through intramedullary interlocking nail and minimal invasive internal fixation.The patients included 21 men and 9 women with a mean age of 41.5 years(range 20~ 63 years).Forteen closed fractures were treated by the limitedly reamed interlocking intramedullary nail.Sixteen open fractures(including Grade I and Ⅱ injuries)were treated by the unreamed interlocking intramedullary nail.All fractures were fixed statically.The mean time from the injury to surgery was 4.5 days(rang,2 hours~ 12 days).[Result]Mean follow-up period was 16.5 months(7~ 21 months).All patients had bony union within 4~9 months,with the average time of bone union being 6.2 months.The function recovery was evaluated by Johner-Wruch system in which 24 cases were excellent,3 cases were good.No osteofascial compartment syndrome of the lower leg,deep part infection,anterior kneeache,broken nails and screws and malunion were found in this series.Two cases were found delay union.[Conclusion]The type C2 fractures of tibia are often caused by high energy injuries.Most of type C2 fractures happen at the field of tibial shaft.The treatment of type C2 fractures of tibia using intramedullary interlocking nail and minimal invasive internal fixation has advantages of easy operation,less trauma,rigid fixation,high healing rate,lower complications,and satisfactory effect.It is a perfect method.The standard and less invasive operative methods should be paid more attention.

[Objective]To discuss the feasibility and efficacy of the treatment of low subtrochanteric femoral fracture(LSFF) by using general interlocking intramedullary nail(GIIN).[Method]Between March.2000 and January.2006,47 cases(38 males,9 females) of LSFF were treated with limited incision and 6IIN.The mean age of the patients were 41.2 years(range 25 to 78 years).29 of them were injured in a traffic accident,7 in falling,6 in crush by a heavy object and 5 in pedestrain injury.According to Seinsheimer classification,11 cases were type IA,10 cases were type lB,19 cases were type ⅢB,and 7 cases were type Ⅳ(8 combined with other fractures)6 of these were open fractures(4 cases of Gustilo-Anderson type Ⅰ and 2 cases of type Ⅱ).The procedure included following step: all patients were treated with limited open reduction.The pyriform sinus entry point were localized with retrograde reamed;then,intramedullary nail was performed through the anterograde approach after limited reamed.All fractures were fixed statically.The operation time were from 50 minutes to 130 minutes(averaging 90 minutes).[Result]All the cases,were followed up for 11 to 34 months,with an average time of 33 months.The alignment of fracture was good.The bone union time were 2.5～6 months,the average 3.9 months.Fracture union rate was 100%.The functional evaluation was done by Sanders traumatic hip rating scale.of the 47 cases,31 were excellent,14 good and 11 fair.The excellent and good rate was 95.7%.There were no infection,implant breakage,limb shortening and varus deformity.[Conclusion]In treatment of LSFF,the GIIN is worth to recommend because it is simple for use,no need of X-ray monitoring during the operation,reliable,high union rate,rare complications,and good effects.Reasonable application of GIIN,better fracture reduction and early active functional rehabilitation(earlier activities and later weight bearing) are the keys to obtain a good clinical result.