[Objective]To seek for a method to rebuild radial head for comminuted radial head fractures,and recommend a new technique of bipolar radial head replacement.[Method]Five patients with fresh comminuted radial head fractures were treated by Tornier cement stem and bipolar radial prothesis.Among them,three were females and two were males,with the average age of 37.4Y(29-48Y).Four cases were to Mason type Ⅲ and one Mason type Ⅳ.All the patients underwent operation within 3-11 days with an average of 6 days after injury.Rehabilitation began in Mason type Ⅲ radial head fracture patients 48 h postoperatively.Both medial and lateral ligaments were repaired in one case of Mason type Ⅳ fracture.Plastic brace were used for 3 weeks during functional rehabilitation.The postoperative elbow joint was evaluated clinically by Broberg and Morrey score.[Result]All the patients healed by first intention were followed up for 7 to 50 months,with an average of 30 months.According to elbow functional evaluation criteria by Broberg and Morrey scores,there were excellent results in three and good in two respectively with an average of 92.2 points.[Conclusion]Cement stem and bipolar radial head prothesis replacement is a good technique for treating comminuted radial head fractures because it meets the designing principle of modern orthopaedics.

85%) in 18 patients (21.4%) and a partial resection (

Objective To detect the positivity of circulating autoantibodies against cardiac troponin Ⅰ (cTnI) in acute myocardial infarction (AMI) and myocarditis patients and investigate the interference of the antibodies with the detection of cTnI. Methods cTnI ELISA was established for assessment of sera obtained from 121 patients with AMI, 24 with myocarditis and 210 healthy subjects. Binding specificity of cTnI antibody from positive sera by ELISA was confirmed with Western Blot. The recovery of cTnl studies was employed to evaluating the effects of cTnl autoantibodies on cTnI immunoassays. Results Thirteen of the 121 AMI patients (10.74%) and 2 of the 24 myocarditis patients (8.3%) had positive anti-cTnI antibodyas compared with none in the healthy subjects. The recovery of cTnI by adding cTnI-C fusion proteincorresponding to final cTnI concentration of 0.625-100 ug/L to sample with anti-cTnI antibody wasinhibited significantly (Spearman correlation coefficient r=0.943, P=0.005 ). There was no significantchange of recovery of cTnl when adding it to a normal sera(Spearman correlation coefficient r=0.377,P=0.461). When cTnI-C complex corresponding to 20 ug/L cTnI was added, 5 of the 15 sera with anti-cTnIantibody were found with the inhibition of recovery (<80%). Conclusions Autoantibodies against cTnIwere increasing in patients with AMI and myocarditis, yet it appears that these autoantibodies could interferenegatively with the cTnI immunoassay. Thus, it should be paid more attention to cTnI immunoassays.

Objective To study whether p38 mitogen-activated protein kinases (p38MAPK) signal pathway were activated in the process of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) which then induces rheumatoid arthritis (RA) fibroblast-like synoviocyte (FLS) to synthesize matrix metalloproteinase-1 (MMP-1) and look for the relative mechanisms of how TWEAK was involved in the destruction of articular bones and cartilage. Methods RA FLS were primarily cultured and stimulated with TWEAK. FLS were pretreated with SB203580 or not. ELISA was used to detect the concentration of MMP-1 in cell-cultured supernatant. Western blotting was used to detect the expression of p-p38MAPK and P65 in RA FLS. Results TWEAK (100 ng/ml) could induce RA FIS to synthesize MMP-1. SB203580 could partially inhibite the expression of MMP-1 producted by RA FLS which was induced by TWEAK. TWEAK could make p38MAPK phosphorylated and increase the expression of P65 protein in the cell nucleus. Conclusion TWEAK induces RA FLS to synthesize MMP-1. In this process, p38MAPK signal transduction pathway is activated and then induce the expression of NF-κB.

Objective To investigate the diagnosis and the effect of microsurgery in patients with acute spontaneous spinal epidural hematoma (ASSEH). Method Five patients with ASSEH treated with microsurgery and confirmed pathologically were retrospectively analyzed. Results The main clinical presentations were root pain and palsy. The main manifestations of MRI were long-segment epidural lesion of high intensity in T1 and T2-weighted images without enhancement. With the microsurgery system, laminectomy via posterior approach and hematoma removal were successfully undergone with full recovery in all cases. Conclusions MRI assisted with the main clinical symptoms may aid preoperative diagnosis in symptomatic ASSEH. Microsurgery is an effective method for treating ASSEH. Postoperative (rather than preoperative) spinal DSA is advantageous for exclusion of spinal vascular malformation in treating ASSEH.

Objective To investigate the expression level of endogenetic nitric oxide(NO) in the reproduction process of human anterior cruciate ligament cells. Methods Anterior cruciate ligament cells were isolated and subcultured from the human anterior cruciate ligament. LPS was used to induce the anterior cruciate ligament cell to express the inducible nitric oxide synthase(iNOS ), and N-monomethyl -L-Arginine (L-NMMA) was used as the interdiction of nitric oxide. They were alone or together added in the culture medium of anterior cruciate ligament cells in different groups. The level of NO was indirectly measured in the medium of HACL. Results LPS promoted significantly anterior cruciate ligament cells to produce endogenetic nitric oxide, compared with the control group(P

Objective To explore the effect of the JAK/STAT signal pathway on the apoptosis-related gene in the synovial tissue of rat rheumatoid arthritis (RA).Methods Fifty rat models of collagen-induced arthritis,whose arthritis index was more than 2,were divided into the model group,the low dose of AG490 group,the medium dose of AG490 group and the high dose of AG490 group.In addition,6 rats were treated intraperitoneal injection.Then,the arthritis index and the change of apoptosis-related genes were compared.Multiple-sample average was analyzed by single-factor x2 test and LSD-t or Tamhane's T 2 test were used for two-two comparison.Results The arthritis index of the model group increased evidently,and the apoptosis inhibitor Bcl-2,Bcl-xl gene and protein expression was up-regulated,which was significantly different when compared with that of the control group(0.931±0.035 vs 0.351±0.024,0.920±0.037 vs 0.271±0.029,0.322±0.047 vs 0.230±0.031 ).The expression of apoptosis promoting factor Bax wasslightly up-regulated.The blockage of JAK/STAT pathway cotld down-regulate the expression levels of the gene and protein of survivins Bcl-2 and Bcl-xl,and up-regulate the gene and protein expressions of Bax.Conclusion In the process of RA development,apoptosis inhibitor Bcl-2,Bcl-xl gene and protein expression is up-regulated.JAK/STAT signal transduction pathway regulates the apoptosis process.

AIM: To study the expression of nuclear factor kappa B (NF-?B) in the L 1-L 4 spinal ganglions of adjuvant arthritis (AA) rats, to explore the neuroendocrinoimmunological mechanism of rheumatoid arthritis (RA). METHODS: The expression of the NF-?B protein was detected by immunohistochemistry method and the alteration of the active NF-?B protein (nuclear protein) was investigated by Western blotting analysis. RESULTS: The expression of NF-?B protein in L 1-L 4 spinal ganglions of AA rats was much higher than that in the healthy controls ( P

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system for determine the margin of early gastric cancer and precancerous lesions.Methods From February 2008 to October 2011,a total of 51 patients with early gastric cancer or high-grade intraepithelial neoplasm who received ESD were enrolled and randomly divided into experimental group to determine lesion margin by FICE (n =26) and control group to identify lesion margin by indigo carmine (n =25).Histological complete resection rate (the lateral and vertical margins were free of cancer),operation time,complications,post-ESD ulcer-healing rates and local recurrence were assessed.Results The histological complete resection rate,acute minor bleeding rate and post-ESD abdominal pain rate in experimental group were 2.3％ (24/26),88.5％ (23/26),15.4％ (4/26) and 73.1％ (19/26),which were not significantly different from those of control group,i.e.,92.0％ (23/25),84.0％ (21/25),12.0％ (3/25)and 72.0％ (18/25) (P＞0.05).The mean operation time of in experimental group was shorter than that of control group (P ＜ 0.05).No massive bleeding,delayed bleeding or perforation occurred in either group.Follow-up showed no local residue or recurrence.Conclusion FICE is safe and effective to determine the tumor demarcation of early gastric cancer and high-grade intraepithelial neoplasm,and needs less operation time.

Objective To explore the possible negative interference of circulating cardiac troponin Ⅰ(cTnI) autoantibody on the immunoassay of cTnI in five commonly used cTnI detection systems. Methods Thirteen patients with positive cTnI autoantibodies in their serum samples were firstly screened and selected from 121acute myocardial infarction (AMI) patients using ELISA assay. The serum cTnI values and their recovery rates were then carefully measured and analyzed. Results cTnI values in these 13 samples showed amazing difference in the five detection systems, demonstrating various degrees of pseudo-drop, or even false-negative. One sample with low recovery was detected in Access-2 system. One sample with low recovery as well as one sample with moderate recovery were detected in Architect i2000 (Abbott). Two samples with moderate recovery and one sample with low recovery were detected in Axsym(Abbott). Three samples with moderate recovery and two samples with low recovery were detected in Dimension X Pand (Dade Behring)and one sample with moderate recovery together with four samples with low recovery were detected in Vidas (Biomerieux). And the serum levels of autoantibodies (A450) positively correlated with the degrees of their negative interference for the detection of cTnI. The R2 and P values on each system were 0. 841 (P <0. 01)vs Access-2, 0. 808 (P < 0. 01) vs Architect i2000 (Abbott), 0. 772 (P < 0. 01) vs Axsym (Abbott), 0. 707 (P < 0. 01) vs Dimension X Pand (Dade Behring) and 0. 424 (P < 0. 05) vs Vidas (Biomerieux), respectively. Conclusion Circulating autoantibodies of cTnI can induce considerable negative interference in all the 5 commonly used cTnI detection systems, which might then lead to incorrect judgments of the obtained results of cTnI in daily clinical work.