[Objective] To discuss the method and clinical effects of coronal fractures of the femoral condyle treated with open reduction plus cancellous lag screw internal fixation.[Method]From May 1998 to June 2006,17 cases of coronal fractures of femoral condyle were treated with open reduction 'and cancellous lag screw internal fixation by using anterolateral for typ Ⅰ or typ Ⅲ lateral femoral condylar fracture(LFCF)/anteromedial for type Ⅰ or type Ⅲ medial femoral condylar fracture(MFCF)or posterolateral for type ⅡLFCF/posteromedial approach for type Ⅱ MFCF.There were 15 males and 2 females with the average age 39.5 years,ranging from 19 to 48 years.According to Letenneur classification,there were type Ⅰfracture 7 cases,type Ⅱ 4 cases,and type Ⅲ 6 cases.Among them,14 cases were closed fracture,3 eases were open fracture.Auto ilium transplant or homologous allograft bone transplant(5 cases)were also used.All patients were treated with plaster external fixation after operation.The interval between injury and surgery averaged 3.6 days(2.5 hours to 8 days).[Result]All patients were followed up for 8～26 months with an average of 18.2 months.All fractures got bone union with average union time 3.6 months.Knee joint function was rated based on Letenneur evaluation system and showed excellen and good in 14 cases,fine in 3 cases and no poor.There were no deep infection,implant failure or bone necrosis.[Conclusion]Open reduction plus cancellous lag screw internal fixation is an ideally safe and effective operation to treat coronal fractures of the femoral condyle.Accurate choice of approach,satisfactory reduction and rigid internal fixation have important influence on clinical outcomes.

Objective To investigate the efficacy and safety of low-dose prednisone combined with methotrexate (MTX) and hydroxychloroquine (HCQ) in the treatment of rheumatoid arthritis (RA).Methods In this 12-week study,150 patients with active rheumatoid arthritis were randomly divided into two groups:prednisone group (70 cases who were received prednisone 5 ～ 10 mg/d + MTX 10 mg/w +HCQ 0.2 g/d) and control group (80 cases who were treated by Meloxicam 7.5 mg/d + MTX 10 mg/w +Leflunomide (LEF) 20 mg/d).The primary end-points were tender and swollen joint counts,visual analogue scales (VAS),and global physician and patients assessments of disease.The secondary end-points were morning stiffness time,C-reactive protein,erythrocyte sedimentation rate,the Health Assessment Questionnaire (HAQ),DAS28 and ACR20,ACR50.Results After 12 weeks,in terms of primary endpoints,tender and swollen joint counts,VAS and global physician assessments in the prednisone group were improved significantly [(4.5 ± 2.5),(3.2 ± 3.36),(21 ± 15),(24.2 ± 16.4),(20.2 ± 10.4) vs (6.4 ±5.84),(6.6±5.5),(46±14),(37.9±19.7),(34.1±12.4),P ＜0.05orP ＜0.01].In terms of secondary end-points,the prednisone group produced higher response rates [HAQ score (0.93 ± 0.52),CRP(10.2 ± 5.8) mg/L,ESR(30 ± 14) mm/h,morning stiffness time (32.0 ± 32.3) min,DAS 28 score (3.1±0.9) vs (1.22 ±0.81),(16.3±10.1)mg/L,(33±29)mm/h,(54.7±45.4)min,(4.9±1.9),P ＜0.05 orP ＜0.01].The incidence of adverse events was similar between two groups (43％ vs 49％,P ＞ 0.05).Conclusions Low-dose prednisone combined with MTX and HCQ produced rapid and relevant improvements in RA signs and symptoms.

Objective To investigate the oxalate-degrading abilities of 10 strains of lactic acid bacteria for yoghourt fermentation. Methods Ten different strains of lactic acid bacteria (L.acidophilus, L.paracasei, Enterococcaceae faecium, B. lactis, B. adolescentis, B. infantis, B.longum, Lactococcus lactis subsp. Cremori, L.bulgaricus and S. thermophilus) were cultured separately in culture fluid containing 5 mmol/L oxalate. Seventy-two hours after culture, the concentrations of oxalate and lactic acid bacteria were detected. Besides, blank control cultured without lactic acid bacteria was established. Results Seventy-two hours after culture, the concentrations of all the 10 strains of lactic acid bacteria were significantly higher than those before culture (P<0.01). Compared with blank control, the concentrations of oxalate in the culture fluid with 10 strains of lactic acid bacteria decreased 72 h after culture, and were significantly different from those before culture for L.acidophilus, Lactococcus lactis subsp. Cremori, B.longum, B. adolescentis and B. lactis (P<0.05 or P<0.01). The oxalate-degrading rate of B. lactis was the highest (29.03%), and that of Enterococcaceae faecium was the lowest (0.23%). The correlation analysis revealed that there was no significant correlation between times of proliferation and oxalate-degrading rates (r=0.435 7, P=0.208 2). Conclusion All of the 10 strains of lactic acid bacteria for yoghourt fermentation have the ability of oxalate degrading, and there is no correlation between lactic acid bacteria proliferation and oxalate degradation.

Objective To compare the effects of kidney calcium oxalate calculus resistant acidophilus milk (KCOCRAM) versus commercially available acidophilus milk (CAAM) on urinary oxalate excretion in rats. Methods Fifty SD rats were randomly divided into 5 groups (n=10), and were bred with KCOCRAM (KCOCRAM group), CAAM (CAAM group), sterilized KCOCRAM (sterilized KCOCRAM group), sterilized CAAM (sterilized CAAM group) and water (blank control group), respectively for a consecutive 20 d, with 4 mL/d for each rat. The data of body weight and 24 h urinary oxalate excretion volume were obtained 1 d before breeding and every 4 d during breeding. Results During breeding, body weight and 24 h urinary oxalate excretion volume of each group increased with time. There was no significant difference in urinary oxalate excretion volume among sterilized KCOCRAM group, sterilized CAAM group and blank control group (P>0.05). The increase tendency of KCOCRAM group and CAAM group was weaker than that of the other three groups. The urinary oxalate excretion volume was significantly lower in KCOCRAM group than that in sterilized KCOCRAM group from 8 d after breeding, and that was significantly lower in CAAM group than that in sterilized CAAM group from 12 d after breeding (P<0.05). The urinary oxalate excretion volume was significantly lower in KCOCRAM group than that in CAAM group from 16 d after breeding (P<0.05). There was a positive correlationship between body weight and 24 h urinary oxalate excretion volume in each group (r＝0.97-0.99, P<0.01). Conclusion Both KCOCRAM and CAAM can reduce urinary oxalate excretion in rats, and the former has a more favourable effect.

Objective To evaluate ocular surface changes following minimal vitreoretinal surgery in postmenopausal women patients with proliferative diabetic retinopathy (PDR).Methods Sixty-one women PDR patients (61 eyes) underwent vitreous microsurgery were recruited in this prospective study,including 31 postmenopausal women (PMW group) and 30 non-postmenopausal women (non-PMW group).The contralateral eyes were considered as the control group.Corneal fluorescein (FL) staining,tear break-up time (TBUT),Schirmer I test (SIT),central corneal sensitivity and ocular surface disease index (OSDI) were estimated.All tests were carried out 1 day preoperatively and 1 day,10 days,1 month and 3 months postoperatively.The student's t test or Mann-Whitney U and ANOVA for repeat measurements test were used.Results Preoperatively,TBUT of surgery and non-surgery eyes in PMW were shorter than non-PMW (t=-2.115,-2.035;P＜0.05),but higher OSDI scores were found in PMW (t=2.482,2.208;P＜ 0.05).TBUT reduction rate (Z=-2.771,-1.993;P＜0.05) and OSDI rising rate (Z=2.539,2.157;P＜0.05) of surgery eyes in PMW were higher than non-PMW 1 day and 10 days postoperatively.The lower SIT of surgery eyes in PMW were observed at 1 day and 10 days (t=-2.403,-2.029;P＜0.05) after surgery.At 10 days after surgery,FL and OSDI scores of surgery eyes in non-PMW returned to preoperative level (Z=-0.447,-0.513;P＞0.05),but in PMW,the recovery process experienced 1 month (Z=-1.500,-0.853;P＞0.05).TBUT and SIT of surgery eyes in two groups both reached preoperative level at 1 month following surgery (Z=-0.715,-1.266,-1.531,-0.522;P＞ 0.05).Conclnsions PMW with PDR had ocular surface dysfunction,which resulted in aggravated dry eye after minimal vitreoretinal surgery.

Objective:To investigate the changes in the expression of COX-2 in acute spinal cord injury of rats. Methods:Sixty adult SD rats were randomly divided into two groups: Trauma group (n=48) subjected to laminectomy and bounce of spinal cord; control group (n=12) only received laminectomy. The activity of COX-2 was detected using immunohistochemistry and Western blot analysis in cytoplasm of spinal cord. Results:The expression of COX-2 increased at 2-hour after injury and reached the top level at 24-hour. The expression of COX-2 dropped at 48-hour after injury and returned to basal level at 72-hour. Conclusion: The expression of COX-2 could be regarded as an index of inflammation on acute trauma spinal injury. Inhibition of COX-2 might be an new therapeutic method for spinal cord injury.

Objective To evaluate the biomechanical effect of horizontal, vertical, and cruciate suture repairs and partial meniscectomy on contact mechanics. Methods Control group (complete meniscus), buckethandletear group and suture repaired group were recorded. The contact map of the control group was firstly recorded; simulated bucket handle medial meniscal tears were then created. Tears were treated with 1 of 3 suture repair techniques or partial meniscectomy. The 24 samples were treated randomly and thus there were 6 samples evaluated for every operation method. Instantaneous contact area (CA), mean contact pressure (MCP), and peak contact pressure (PCP) measurements were recorded with a pressure sensing system. CA, MCP, and PCP for intact stifles (control), stifles with simulated tears, and stifles after treatment were recorded and compared using 1-way repeated measures ANOVA. Results Stifleswithbuckethandletearshadsignificantlydecreased CA, increased MCP and increased PCP when compared with control group. All meniscal repair techniques reestablished normal contact mechanics. When comparing meniscal repair and partial meniscectomy, stifles with partial meniscectomy had lower CA, higher MCP and PCP than stifles undergoing repair (P = 0.851 and 0.987, respectively). Conclusions Contact mechanics obtained from each repair technique were mechanically superior to partial meniscectomy. Performing meniscal repair instead of partial meniscectomy with select meniscal tears may mitigate the development of degenerative joint disease.

Objective To prepare long-circulating temperature-sensitive liposomes with paclitaxel( LTSLP ),develop methods for determination of paclitaxel,related substances and monostearoyl phosphatidylcholine( MSPC ) in LTSLP,and the haemolysis of LTSLP in vitro. Methods HPLC-UV methods for paclitaxel content and related substances and HPLC-CAD method for MSPC in LTSLP were established and validated. Spectrophotometric method was used to determine hemolysis in vitro. Results There was a good linear relationship between peak area and concentration within the range of 60. 39-181. 17μg·mL-1 . Recovery and precision of the method for determination of paclitaxel content met the requirements. Specificity,sensitivity,and system suitability for related substances were consistent with requirements. There was a good linear relationship between peak area and concentration within the range of 1. 5-50. 0μg·mL-1 for the determination of MSPC with good specificity,sensitivity and recovery. Paclitaxel contents in three batches of self-prepared LTSLP were between 90. 0% and 110. 0%,single related substances were below 0. 5% and total impurities were below 2. 0%. There was almost no hemolysis in vitro. Conclusion The methods for determining paclitaxel content,related substances and haemolysis can be used to assess the quality of LTSLP. Self-produced LTSLP consistently meet the quality standards.

BACKGROUND:Since cannulated screw has been applied to femoral neck fracture, it is not uncommon that the screw wear penetrates or refunds. What factors affect the stability of cannulated screw for treatment of femoral neck fractures in adults remains unclear. ＜br> OBJECTIVE:To explore factors related to internal fixation failure by cannulated screws in treatment of adult femoral neck fracture and improve the stability of the adult femoral neck fracture by cannulated screws. ＜br> METHODS:A total of 92 adult patients of femoral neck fracture were treated by cannulated screws in our department between June 2007 and June 2011. Their data were retrospectively analyzed. According to clinical information and fol ow-ups, we selected factors such as age, gender, Garden type of fracture, preoperative skeletal traction, timing of surgery, Garden index, standards of pedicle screws, pedicle screw shapes, partial weight bearing time and postoperative complications, which may affect the success rate of cannulated screws for ＜br> treating femoral neck fracture. The selected factors were then grouped and assigned, after unrelated factors were excluded by one-way χ2 analysis, multiariable Logistic regression analysis was performed. ＜br> RESULTS AND CONCLUSION:The involved 92 patients were fol owed up for 18-72 months. According to Harris assessment criteria, hip function was excellent in 28 cases, good in 25 cases, fair in 17 cases, and poor in 22 cases at the final fol ow-up, the excellent and good rate was 58%. Radiographic results showed that, the patients were divided into two groups according to the presence of the displacement, GardenⅠ (n=22) and GardenⅡ (n=29) as a group, and Garden Ⅲ (n=25) and Garden Ⅳ (n=16) as the other group, the fixation failure rate was 12%and 39%, respectively. In normol and abnormal Garden Index groups, the fixation failure rate was 16%and 59%, respectively. In nail position standards and non-attainment standards groups, the fixation failure rate was 19%and 70%, respectively. In the complication and non-complication groups, the fixation failure rate was 14%and 55%, respectively. These factor groups showed significant differences (P＜0.05). Multiariable Logistic regression analysis showed that, Garden type of fracture, Garden index, standards of pedicle screws, and postoperative complications are the risk factors for internal fixation failure using cannulated screws in treatment of the adult femoral neck fracture.