[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.

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 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.

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.

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.

[Objective]To investigate the efficacy and the application value of interlocked intramedullary nailing(IIN) for bilateral femoral shaft fracture(FSF).[Method]Twenty-one cases of bilateral FSF were treated by IIN between March 1998 and March 2005.Their average age was 39.6(ranged 29～48).Thirty-five limbs of them were closed fractures,and 7 limbs were opened.Among them,18 limbs had fractures in the upper third of the femoral shaft,11 limbs in the middle third and 13 limbs in the lower third.The continuous passive motion began averaging 5 days after operation.[Result]The average follow-up period was 11.5 months(6 to 32 months).Clinical bone healing was achieved after 15.5 weeks(10~30 weeks).NO fat embolism syndrome(FES),shortening,infection or break of nail occurred in all patients.The long term effect was evaluated according to Ma Yuanzhang's evaluation standard,90.5%(19/ 21) showed excellent function of joints and limbs.[Conclusion]IIN provides a satisfied approach to the treatment of bilateral FSF.It has the advantages of fewer invasions,less blood loss,steady fixation,short healing time,early function recovery and less complication.This kind of treatment is worth to be recommended for the bilateral FSF,prevention of FES should be emphasized on.

[Objective]To summarize the surgical management and clinic results of the minimally invasive percutaneous plate osteosynthesis(MIPPO) technique in treatment of proximal metaphyseal fractures of tibia.[Method]Twenty-five patients with proximal metaphyseal fracture of tibia underwent the MIPPO operation in our department.There were 18 males and 7 females,with a mean age of 42.6 years(ranged from 21 to 66 years).According to AO classification,17 cases were type 41-A,and 8 cases were type 41-C,of the 25 cases,8 were multiple injuries,4 of these were open fractures(2 cases of Gustilo-Anderson type Ⅱ and 2 cases of type ⅢA).According to creiteria of Johner-Wruch,excellent in 14 cases,good in 9 cases,fair in 2 cases,the excellent and good rate was 92%.[Result]The average intra-operative time was 90 minutes(ranged from 70 to 115 minutes).The average blood loss was 260 ml.No patient received blood transfusion.There were no superficial and deep infection occurred in this group.All patients were available for follow-up at an average of 1.8 years(ranged,1 to 2.5 years) after surgery.The mean time for bony union on X ray was 13.8(10～20)weeks,while the mean time for full weight bearing was 14.5(11～28) weeks.No malunion and failure of fixation were observed.[Conclusion]MIPPO is a safe and effective technique for the proximal metaphyseal fracture of tibia with the advantage of less invasion,steady fixation,low infection rate and higher union rate,which is accordant with biological fixation.

[Objective]To investigate the surgical techniques and clinical result of the treatment of subtrochanteric femoral fracture(SFF) with the reconstruction interlocking nail(RIN).[Method]A total of 40 cases(27 males and 13 females,at age ranged from 22 years to 75 years,mean 43.5 years) with SFF were fixed with RIN in our hospital from June 1998 to May 2005.The fractures were classified according to Seinsheimer,the type Ⅱ 5 cases,type Ⅰ 13,type Ⅳ 21 and type Ⅴ 1.33 patients sustained high-energy injury,and 7 low-energy Three cases were open fractures.[Result]The followed-up period ranged from 8 months to 2 years and 6 months with an average of i year and 8 months.The average time for bony union on xray was 4.2 months (from 3.2 to 6.5 months).According to HAN's scoring system there were 26 excellent cases,12 good cases and 2 fair cases.The excellent and good rate was 95%.There was no severe complications,such as incision infection, fixation failure,deformity or ischemic necrosis of femoral head.[Conclusion]RIN is an effective operation for treatment of SFF.This method has obvious advantages of reliable fixation,few complications and the high bone union rate.Meticulous surgical techniques is the key of success for the operation.