Objective To introduce a new CT classification system we designed for Hoffa fractures and compare the interrater reliability between the CT and X-ray classification systems.Methods A total of 20 isolated Hoffa fractures from January 2008 to December 2011 were randomly selected for the present analysis of their imaging data (anteroposterior and lateral X-ray films of the knee joint and three-dimensional CT reconstruction of the femoral condyle).At the same time,a total of 20 independent observers (clinicians with junior,intermediate and senior professional qualifications) were selected for classification of the Hoffa fractures in the same manner respectively according to the Letenneur's X-ray system and our self-designed CT system.We used Kappa statistics to evaluate the interrater reliability among the clinicians between the 2 classification systems for Hoffa fractures.Results According to the CT classification of the 20 Hoffa fractures by the 20 clinicians,type Ⅰ,Ⅱ and Ⅲ fractures accounted for 66.0％,30.5％ and 3.5％ respectively.In type Ⅰ fractures,type Ⅰb involving zone b accounted for the most (50.0％),next by type Ⅰc(31.0％) and type Ⅰa (19.0％).In type Ⅱ comminuted fractures,fracture fragments were mostly seen in zone b.The overall incidence of fractures involving zone b by CT classification was 67％.According to the X-ray classification,type Ⅰ,Ⅱ,Ⅲ and Ⅳ fractures accounted for 31.4％,14.3％,28.0％ and 26.3％,respectively.The interrater reliability for CT classification agreement (Kappa =0.681) among clinicians was higher than that for X-ray agreement (Kappa =0.261).Conclusion For Hoffa fractures,communicated ones in particular,our CT classification system may be better than the X-ray classification system.

Objective To explore the anti-sliding plating for Hoffa fractures by comparing the me-chanical properties of anti-sliding plates and cancellous bone screws. Methods Twenty cases of the same type of Hoffa fracture in the model femur were randomly divided into 4 even groups. Group A used 2 antegrade cancellous bone screws; Group B used 2 retrograde cancellous bone screws forwards; Group C used anti-sliding plate and locking screw fixation; Group D used anti-sliding plate and cancellous bone screw fixation. All the samples were subjected to the cycle fatigue and the maximum failure load tests. Results The fatigue test revealed no significant difference in the mean maximum displacements at the 10, 100, 1000, 10 000 cycles between the 4 groups. In the maximum failure load test, there were significant differences between Group A [(1224±72) N] and Groups C and D [(2183±227) N and (2124±235) N], as well as between Groups B [(1405±235) N] and Groups C and D; there was no significant difference between Group A and Group B, neither between Group C and Group D, Conclusions In the initial period after secure fixation for Hoffa fractures, anti-sliding plates and cancellous bone screws can all provide satisfactory mechanical stability and strength. But anti-sliding plating is recommended for cases of long healing expected, patients with great body mass index, and patients with poor compliance.

Objective To evaluate the surgical method and results of the treatment of chronic rupture of the Achilles tendon using V Y tendinous flap. Methods Nine cases with old rupture of the Achilles tendon, with a mean course of illness of 112 days, were treated with V Y tendinous flap and the tendon gap was 3.2～ 6cm,averaging 4.6cm. Results The mean period of follow up was 2.7 years. The Arner Lindholm method was used to assess the results of surgical treatment, 7 cases of the 9 had excellent results (77.8% ) and 2 cases had good results (22.8% ), with the excellent and good rate being 100% . Conclusion The V Y tendinous flap is a simple and good method for treatment of old rupture of the Achilles tendon.

Objective To search for the most appropriate subzero nonfreezing temperature,and explore the effect of subzero nonfreezing preservation of rat kidney by comparing with the kidney preservation with conventional temperature (4 ℃,0 ℃) and freezing temperature (-4 ℃).Method The thermocouple probeand the temperature data logging device were used to detect the temperature decreasing curves in different parts of the rat kidney and determine the freezing point of the kidney.The perfused kidneys in rats were removed and put into the sterile tubes containing 2.5 mL hypertonic citrate adenine.Following 6 group were set up:-0.8 ℃ group (subzero nonfreezing),-0.5 ℃group (subzero nonfreezing),0 ℃ group (zero nonfreezing),-4 ℃ group (control group),-1 ℃group(subzero freezing)、-4 ℃ group (subzero freezing).After the cryopreservation for 24 and 48 h,the preservative fluid was harvested for measurement of the contents of LDH and AST,and the paraffin sections from the upper pole of the kidney were made for observation of the pathological changes and apoptosis.Result The freezing temperature of kidney was-1℃ and the most appropriate subzero nonfreezing temperature for preserving the rat kidney was-0.8 ℃.Subzero nonfreezing significantly inhibited the basal metabolic rate of the histiocytes,reduced the contents of LDH and AST released due to the membrane damage,and decreased the apoptosis rate [48 h:-0.8 ℃ (40.1 ± 7.0) ％ vs.4 ℃ (47.1 ± 7.6) ％].Under the light microscope after preservation for 48 h,the pathological changes in-0.8 ℃ group were less than in 4 ℃ group.Conclusion Compared with the organ preservation in conventional temperature (0 ℃-4 ℃),the subzero nonfreezing (-0.8 ℃) can further inhibit the basal metabolic rate of histocytes obviously,reduce its energy consumption,and lower the apoptosis caused by low temperature damage.

Objective To explore the relationship between the expression of human telomerase RNA component (TERC) gene , human papilloma virus (HPV) infection and mutation of chromosome 3 number with cervical lesions .Methods 81 women received the treatment in the Gynecology Department of the Second Affiliated Hospital of Kunming Medical University from June 2008 to February 2009 ,including the healthy group(normal pathological examination ,20 cases) ,CIN1 group(28 cases) ,CIN2 group(12 ca‐ses) ,CIN3 group(9 cases) and cervical cancer group(12 cases) .The TERC gene expression in uterine epithelial exfoliated cells was detected by using the fluorescence in situ hybridization (FISH) method ,meanwhile the HPV infection was detected by using the real time fluorescence quantitative polymerase chain reaction (FQPCR) technology .The correlation between cervical cancer with TERC gene and HPV was analyzed .At the same time the number of chromosome 3 mutations in 81 cases was recorded .Results In the cervical lesion detection ,the detection positive rate had no statistical difference between the TERC gene detection and HPV detec ‐tion (P> 0 .05) ,their positive rates in the CIN 1 ,CIN2 ,CIN3 and cervical cancer groups were significantly higher than that in the healthy group (P< 0 .05) ,the difference between the CIN1 group and the CIN2 group had no statistical significance (P > 0 .05) , while between the CIN3 group and the cervical cancer group had statistical significance (P< 0 .05) ,the higher the malignant degree , the higher the positive rate .The abnormal mutation rate of chromosome 3 number was 0% in the healthy group and the CIN1 group ,16 .7% in the CIN2 group ,66 .7% in the CIN3 group and 100 .0% in the cervical cancer group ,the positive rate in the CIN3 group and the cervical cancer group was significantly higher than that in the healthy group ,CIN1 group and CIN2 group ,the differ‐ences were statistically significant (P< 0 .05) .Conclusion The TERC abnormal gene expression ,high risk HPV infection and mutation of chromosome 3 number could play an important synergistic effect during the process of occurrence and progression of cervical cancer .

OBJECTIVE:To optimize the extraction technology of total saponins from Coreopsis tinctoria. METHODS:Etha-nol leaching technology was adopted. Based on single factor test,the extraction technology was optimized by orthogonal test using extraction temperature,ethanol volume fraction,extraction time,solid-liquid ratio as factors,extraction rate of total saponins as in-dex. The optimized technology was validated. RESULTS:The optimal technology was that ratio of solid to liquid was 1:30 (C. tinctoria-60% ethanol),extracting for 2 h at 50 ℃. Validation test showed that average extraction rate of total saponins was 6.8%(RSD=0.85%,n=3). CONCLUSIONS:The optimized technology can be used for the extraction of total saponins from C. tinc-toria and keep stable.

Objective:To assesss the effectiveness of dapoxetine in the treatment of premature ejaculation.Methods:Both English and Chinese studies involving men with prematrue ejaculation who were treated with dapoxetine from the Cochrane Library,MEDLINE,EMBASE and CNKI,CBM,VIP between 1979 and 2009.were included in the randomized controlled trials(RCTs) and the data processed by RevMan.Results:Five RCTs involving 4433 patients were included in the Meta analysis,of which 3 were of grade A and 2 were of grade B according to the quality evaluation of methodology.Intravaginal ejaculatory latency time(IELT),patient-reported global impression of change(PGI),satisfaction with sexual intercourse(SWSI),perceived control over ejaculation(PCOE),personal distress related to ejaculation(PDRE) were used for assessment.Meta analysis based on included studies of patients having been treated with dapoxetine for 9-24 weeks showed that:(1) the difference of the patients' IELT between treatment group and control group was statistically significan [P

Objective To investigate the surgical efficacy for the treatment of ruptured anterior communicating artery aneurysms with different dome projections in acute phase via supraorbital lateral approach.Methods From January 2014 to March 2017,the clinical data of 79 patients with acute ruptured anterior communicating artery aneurysm with different dome projections in acute phase treated via supraorbital lateral approach in the First Affiliated Hospital of Soochow University were retrospectively analyzed.The operative efficacy was analyzed.The Glasgow outcome scale (GOS) score was used to evaluate the prognosis at 3-36 months after procedure.Results In the 79 patients,34 were superior dome projections,37 was inferior dome projections,and 8 were complicated dome projections.All the anterior communicating artery aneurysms were successfully clipped.The patients were followed up for 3-36 months after procedure.GOS showed good prognosis in 70 cases (88.6％),of which 26 were superior dome projections,36 were inferior dome projections,and 8 were complicated dome projections;9 suffered mild disability (11.4％),of which 8 were superior dome projections and 1 was inferior dome projection.There were no severe disability,persistent vegetative state,and death.The prognosis in patients with inferior dome projection was better than that of superior dome projection (97.3％ [36/37] vs.76.5％ [26/34]).The difference was statistically significant (χ2=5.19,P<0.05).Conclusions The lateral supraorbital approach is an effective option for treating ruptured ACoAA with different dome projections in acute phase.The prognosis in patients with inferior dome projection is better than that of superior dome projection.

Objective:To investigate the etiology of high myopia and the correlation between best corrected visual acuity and myopic diopter and fundus lesions.Methods:The clinical data of 112 patients (198 eyes) with high myopia diagnosed in Yuyao Hospital of Traditional Chinese Medicine from December 2018 to December 2019 were retrospectively analyzed. The factors that influence high myopia were analyzed. Myopic diopter, the type and severity of fundus lesions, and best corrected visual acuity were evaluated. The correlation between observation indexes was analyzed.Results:The occurrence of high myopia was related to partial lens opacity, fundus aberrations, corneal pannus and heredity. Unconditional multivariable logistic regression revealed that parental myopia [73 (83.91%) vs. 39 (57.34%)], outdoor activities < 4.17 h [47 (89.36%) vs. 24 (61.54%), 26 (68.42%), 20 (65.42%)] are the risk factors of high myopia ( χ2 = 13.427, 10.300, P < 0.05 or P < 0.01). Pearson linear correlation analysis showed that myopia diopter was negatively correlated with best corrected visual acuity ( r = -0.729, P < 0.001). Tigroid fundus, tilted optic disc, β-zone parapapillary atrophy and posterior polar annular choroidal dystrophy were positively correlated with best corrected visual acuity ( r = 0.461, 0.732, 0.528, 0.825, P < 0.05 or P < 0.001). The severity of lesion was negatively correlated with best corrected visual acuity( r = -0.673, P < 0.001). Conclusion:The myopia diopter and fundus lesion characteristics in patients with high myopia are closely related to best corrected visual acuity, which can be used to evaluate patient's condition and provide guidance for prevention and treatment of high myopia.

One hundred patients with rheumatoid arthritis (RA) were randomly assigned to the medication group (n=38) or combined therapy group (n=62). The quality of life was investigated through the questionnaire before and after 6 months' therapy. Data showed that there was statistically significant difference between the two groups in physical, social, and emotional functions, and self-recognized health status (19.0±9.1 vs 6.6±4.8, 10.0±6.9 vs 3.8±3.3, 6.6±3.2 vs 3.0±1.8, and 11.4±7.6 vs 5.3±3.4) ( all P<0.05 ). Combined therapy could significantly improve the quality of life in RA patients.