[Objective]To study the indication and methods of bone grafts used in tibial plateau fracture and compare the character of allograft with autograft.[Method]A retrospective study was done in 105 cases of hospitalized from Jan.2000 to Aug.2004.Seventy-four cases accepted bone graft.These 74 cases were divided into two groups.Patienets in group A accepted autograft (n=40),the patients were 19 to 75 years old,with a mean age of 45.3 years.Among them,there were Schatzker type Ⅱ in 13 cases,type Ⅲ 13 cases,type Ⅳ 5 cases,type Ⅴ 4cases,type Ⅵ 5 cases.Patients in group B accepted allograft(n=34),the patients were 21 to 74 years old,with a mean age of 43.6 years,including Schatzker type Ⅱ in 12 cases,type Ⅲ 11 cases,type PC 3 cases,type Ⅴ 4 cases,type Ⅵ 4 cases,We have straight longitudinal and parapatellar incision,fixed with semiscrewed、L-plate、T-plate.According to the Schatzker classification,we use corresponding methods in bone graft.The two groups with operation time,complication,bone healing period,height lost were compared during the 6～12 months.we use Lysholm evaluation system.[Result]Among all 105 cases,there are 74 cases accepted bone grafted.The patients were followed up 6 months to 4 years,with an average of 27.6 months.Compared with group B,group A has a short operation time,more blood loss,a shorter healing time of suture.There was no significant difference in bone healing period,height loss during the 6～12 months and Lysholm evaluating.Complication of group A was mainly in donor site,11 cases have pain in donor site,1 case has a fracture of ilium.In group B,complication were mainly in recept site,8 cases have wound effusion,3 cases have delayed wound healing.[Conclusion]Bone graft is one of the most important step in treating tibial plateau fracture,mastering its application and methods is crucial to the prognosis.Allograft and autograft have their own characters,allograft is an advertising method.

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1st,1993-Dee 12th, 2008 in PLA general hospital. Results 1)Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, > 90 years accounted for 0.41%. 2) The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome (MODS) in the elderly(P <0.05 ). 3) The first four complications of hypertension were diabetes(33.5%), cerebrovascular disease (31.9%), myocardial infarction(13.2%) and heart failure(12.3%) in 70-74 years group (P<0.05), cerebrovascular disease (42.8%), diabetes (32.8%), heart failure (16.5%) and myocardial infarction(15.9%) in 75-79 years group (P<0.05), cerebrovascular disease (45.4%), diabetes (35.0%), heart failure (21.1%) and myocardial infarction(15.9%) in 80-84 years group (P<0.05), cerebrovascular disease(42.5%), diabetes (35.8%), heart failure (23.1%) and renal dysfanction (17.7%) in 85-89 years group(P<0.05 ),and cerebrovascular disease (45. 2%), heart failure(31.5%), diabetes (26.0%) and renal dysfanction (20.5%) in patients more than 90 years group (P<0.05). Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

Objective To verify the dose delivery accuracy of volumetric-modulated arc therapy plan by log-file analysis of linear accelerator that can be created when a dynamic delivery occurs.Methods Accelerator log file in binary format recorded the accelerator execution plan for each control point corresponding to the gantry angle,multi-leaf collimator leave position,cumulative machine monitor units ( MU).These information were read from the accelerator log file with Matlab7.1,then the original control points in the plan file replaced the corresponding information for the log,which generated a new plan.New plan was exported into the planning system to reculculate the dose.The volume dose histogram (DVH) and dose distribution was contrasted to determine the accuracy of the accelerator plan of implementation between two plans.Results Compared with the original plan,antry angle difference over ± 1° accounted for about 35％ of the entire arc of control points in 4 of 12 arcs and the percentage of the leave error of ±0.5 mm was about 95％.MU error of a single control point was larger,but the cumulative MU for each are was small which was located between-0.09％ to 0.11％ in the selected 12 arcs.Between the targets,the maximum dose,minimum dose,the mean dose differences were from-0.07％ to 0.42％,-0.38％ to 0.40％,0.03％ to 0.08％,respectively.The maximum dose and mean dose differences of organs at risks were located from-1.16％ to 2.51％,-1.21％ to 3.12％,respectively.Conclusions Accelerator log-file analysis to verify the VMAT plan nan be supplyed to the experimental method supplement.

Objective: To investigate the awareness of acquired immune deficiency syndrome (AIDS) knowledge and AIDS-related behaviors among youth students in gay dating sites, and to provide evidences for AIDS prevention education through the internet.Methods: The students in gay dating sites, selected by a snowball sampling, were interviewed by questionnaires.Chi-square tests were used to analyze the awareness of AIDS knowledge among the students of different characteristics.The Logistic regression was used to analyze the factors associated with ever testing for HIV.Results: In the study, 469 youth students in gay dating sites filled in the questionnaires, and a total of 442 (94.2%) valid samples were collected.The awareness of HIV/AIDS knowledge for the public among the youth students in gay dating sites was 83.9% (371).The awareness of HIV/AIDS knowledge for the youth students was 77.1% (341), and the rate of ever testing for HIV was 52.0% (230).The awareness of HIV/AIDS knowledge for the public in the students were different in different age groups (P=0.001), different marital statuses (P<0.001), different sexual orientations (P<0.001), and different genders of the first sexual partner (P<0.001).The awareness of HIV/AIDS knowledge for the youth students were different in different age groups (P=0.010), different marital status (P=0.004), different sexual orientations (P<0.001), and different genders of the first sexual partner (P<0.001).The rate of ever having sexual intercourse among the youth students in gay dating sites was 75.1% (332), and the rate of multiple sexual partnerships among the youth students was 41.3% (137).Compared with homosexual orientation, sexual orientation as heterosexual (OR=0.282,95%CI:0.151 to 0.528) and not sure (OR=0.175,95%CI: 0.035 to 0.885) were risk factors of ever testing for HIV.Multiple sexual partnerships (OR=2.103,95%CI:1.278 to 3.462) were promoting factors of ever testing for HIV.Conclusion: The rate of high-risk behaviors among the youth students in gay dating sites was high.The concern should be raised to heterosexual male students who had tendency to homosexual behavior.The AIDS prevention education should be developed in gay dating sites, to improve the self-protection awareness of the youth students.

Objective To discuss the significance of platelet rich plasma in promoting bFGF and VEGF expression in would healing of rabbit buns .Methods The 24 rabbits were randomly divided into control group and experimental group .The sulfadiazine silver paint to the wound for control group and the platelet rich plasma gel evenly spread to the wound for experimental group .At 7th ,10th ,14th day ,4 rabbits of each group were randomly selected to sacrificed after anesthesiaed ,wound healing rate was compare in 2 groups ,HE staining and testimmunohistochemistry were conducted in each group .Results At 7th ,10th ,14th day ,the wound healing rate of experimental group were higher than those of control group .At 7th d ,the focal granulation ,cells and vessels inten-sive were more significant in experimental group than in control group ,at 10th day ,the wound fibroblast cells and capillary number are more significant in experimental group ,and at 14th day ,the most of fibroblasts translate into fiber cell and the capillary number decreased ,the fibroblasts proliferation was still active and fiber cell was less in the control group .At 7th ,10th day ,the expression of bFGF and VEGF were both higher ,but experimental group is obvious higher than control group(P<0 .05) ,but at 14th day ,the ex-pression of bFGF and VEGF were gradually declined and was not obvious statistics differences in the two group (P>0 .05) .Conclu-sion The platelet rich plasma could promote the big white rabbit scald wound healing ,while the main mechanism maybe the ex-pression of bFGF and VEGF increased in the early .

Objective To investigate the biological function of IFN-λ in 7 human esophageal carcinoma cells. MethodsThe gene expression of IL-28α, IL-10β and antiviral molecule was examined with PCR. The MHC molecules expression and the profiles of cell cycle were analyzed with flow cytometer. Cell proliferation was evaluated with MTT assay. ResultsAll of esophageal carcinoma cells express the gene of II-28α and IL-10β. IFN-λ induced or augmented the gene expression of antiviral molecules, 2′5′-OAS and MxA. IFN-λ enhanced the MHC class Ⅰ molecule expression. IFN-λ inhibited the growth of esophageal carcinoma cells through the regulation of cell cycle distribution. ConclusionEsophageal carcinoma cells express the IFN-λ receptor complex. IFN-λ has the antiviral, anti-proliferative and immunoregulation activity.

Objective To investigate the clinical characteristics,treatment effect,long-term follow up results,guanosine triphosphate (GTP) cyrclohydrolase Ⅰ (GCH Ⅰ)gene and tyrosine hydroxylase(TH) gene mutations in patients with dopa-responsive dystonia (DRD).Methods The clinical features of 3 families with 4 affected members were analyzed and all of 4 patients were screened for mutations of the GCH Ⅰ gene and TH gene with DNA sequences.Results Four patients were females,average age at onset was (15.3 ± 5.6) years (range:from 9 to 20 years).The initial symptoms were a gait disorder,stiffness or tremor of the lower limbs in all patients presented with diurnal fluctuation.As the increase of disease duration,bilateral hand tremor was found in three patients,systemic torsion was found in one patient and torticollis was found in one patient.All patients' symptoms were in complete remission after administration of low dose of levodopa.Four patients were followed up for 0.5 to 10.0 years,and all were still responsive to the levodopa treatment and effective dosage was decreased as the increase of the disease duration.No longterm side effects of levodopa had occurred after long-term treatment.One patient was found to have c.607G ＞A(p,Gly203Arg) heterogenetic mutation in GCH I gene.Molecular analysis revealed a compound heterozygous mutation in the TH gene (p.Y447Ter and p.V468M) in one patient.No point mutations in both genes were found in other patients.Conclusions DRD patients have dramatic and sustained response to levodopa and no long-term side effects of levodopa after long-term treatment.The detection of GCH Ⅰ and TH gene mutations is helpful in early diagnosis but the negative results could not exclude the diagnosis of DRD.

Objective To study the pathological and immunohistochemical features of alimentary tract mesenchymal tumors and compare with computed tomographic virtue endoscopy (CTVE) imaging technology to evaluate the diagnostic value of CTVE in alimentary tract mesenchymal tumors. Methods Seventy-four pathological specimens of alimentary tract mesenchymal tumors were collected. The pathological features and the expression of CD117, CD34, SMA and S-100 were observed by immunohistochemical method with light microscope. The pathological types and characteristics were determined by pathologists and compared with CTVE imaging technology. Results In the 74 cases of alimentary tract mesenchymal tumors,40 cases were diagnosed as stromal tumor with pathological and immunohistochemical methods (54. 1%).Sixteen of them were malignant, accounting for 40% of the stromal tumor while 33 cases were diagnosed as leiomyoma(44. 6%)and 1 case as schwannoma(1.4%) . In the 74 GIMTs cases ,33 were jejunum GIMTs,21 were ileum GIMTs and 20 were large intestine GIMTs. Immunohistochemistry assay in the 74 GIMTs cases showed that 51.4% GIMTs were positive for CD117, approximately 36. 5% were positive for CD34 , 62.2% were positive for smooth-muscle actin (SMA) and 1. 4% were positive for S-100 protein. In the 74 GIMTs cases,69 cases were diagnosed right in the accuracy for location with CTVE(93. 2%) with 51 cases in small intestinal (94. 4%) and 18 cases in large intestinal (90. 0%). The sensitivity and the specificity of CTVE to distinguish benign from malignant stromal tumors by CTVE characteristics were 84. 2% and 85. 7%respectively. Conclusions GIST is common in GIMTs and is often originated from the small intestinal. The immunohistochemistry has great value in diagnosing alimentary tract mesenchymal tumors. The CTVE imaging technology also has great value in diagnosing alimentary tract mesenchymal tumors which can show the localization, shape size and artery of the tumor clearly. The diagnostic sensitivity and specificity of CTVE are high to distinguish benign from malignant alimentary tract GISTs. CTVE plays an important role in guiding the clinical management of GISTs.

Objective To compare the mid-term results of video-assisted pulmonary veins isolation and box-lesion for lone atrial fibrillation.Methods Between June 2010 to November 2012,80 lone atrial fibrillation(LAF) patients underwent minimally invasive surgical ablation in Beijing Anzhen Hospital,and all of them received left atrial appendage excision and Marshall ligament break in the surgery.Among them,37 cases were performed two epicardial ablation lines in order to created box-lesion based on PVI(14 paroxysmal AF and 23 persistent AF).Follow-up was finished after discharge.Results Mean follow-up was(18.8 ± 7.4) months,and 2 patients were died with non-cardiac disease.The success rate is 78.8％ (Paroxysmal AF 87.9％;Persistent AF 72.3％).In the paroxysmal AF patients,the success rate for PVI and Box lesion treatment was 84.6％ (11/13) and 92.9％ (13/14),P =0.45;in the persistent AF patients,the success rate for PVI and Box-lesion was 58.3％ (14/24) and 87.5％ (14/16),P =0.04.Conclusion Addition of epicedial ablation lines might increase the cure rate for lone AF therapy,especially for persistent AF.

Objective To study the effects of angiotensin Ⅱ(AngⅡ) on cardiac cAMP accumulative levels induced by isoprenalin(Iso) and AngⅡ on positive inotropic response induced by Iso stimulation ?-adrenoceptor (?-AR) in 3.5- and 12.0- months-old rats. Methods Radioimmunoassay and functional experiment of isolated left atrias were applied to measure the levels of cAMP and cGMP and the positive inotropic response in the hearts. Results Iso increased cAMP accumulation in 3.5-month-old rats〔(1 027?169)pmol/mg vs (1 400?267)pmol/mg,P