Distal tibial fractures (Distal tibial fracture) is a common clinical fractures type, more for high-energy damage, fracture type is more complicated. Because of the distal tibia special anatomic structure (soft tissue is less, less blood supply), if the operation method is not suitable or fixed equipment selection is not reasonable, because fracture healing, osteomyelitis, also can damage the function of the ankle joint. Treatment shall be based on the fracture position, type, in the process of the polluted situation and surrounding soft tissue trauma injury and so on many factors that determine the way and the internal fixation methods. This paper reviews recent year different types of distal tibial fracture fixation and fixed ways of literature research, in the treatment of distal tibial fracture clinical practice to provide the reference of objective reasonably select fixation and evaluation standard.

BACKGROUND:For distal clavicle fracture, clavicular hook plate and Kirschner wire tension band were used in the clinic, but they cannot keep the dual function of stability and functional protection. However, the application of microporous locking plate of distal clavicle makes it possible to double efficacy. OBJECTIVE:To compare and analyze the clinical outcomes of distal clavicle microporous locking plate and clavicular hook plate. METHODS:From March 2011 to March 2013, 40 patients with distal clavicle fractures were involved in this study. They were divided into two groups with the voluntary principles:distal clavicle microporous locking plate group and clavicular hook plate group. We compared and observed perioperative indicators (operation time, blood loss, and hospitalization days), clinical curative effects (University of California at Los Angeles scoring system and American Shoulder and Elbow Surgeons Scale), the score of shoulder joint function (Karlsson standard) and the overal treatment (removed the plate and functional training costs). RESULTS AND CONCLUSION:Al patients successful y underwent surgery. At 1 year after surgery, internal fixators were taken out. Necessary relevant rehabilitation training was performed for more than 3 months. There was no significant difference in perioperative indicators (P>0.05). However, clinical curative effects and the score of Karlsson shoulder joint function showed significant advantages in the microporous locking plate group (P<0.05). Although the distal clavicle microporous locking plate material cost was high, but there was no significant statistic difference in the overal treatment for better protection shoulder function (P>0.05). We draw the conclusion that distal clavicle microporous locking plate can effectively reconstruct the stability of the fracture site, and better retain the function of the joints at the same time.

Objective To summarize the clinical experience in repair of aortic arch obstruction associated with intracardiac anomalies in children retrospectively.Methods From March 2010 to March 2014,73 children diagnosed as coarctation of the aorta (CoA,n =68),interrupted aortic arch (IAA,n =3),and double aortic arch with CoA (n =2) underwent surgical management.Six of them were complicated with complex intracardiac anmalies,including tetralogy of Fallot (TOF,n =2),transposition of great arteries (TGA,n =1),total anomalous pulmonary venous connection (TAPVC,n =1),double outlet of right ventricle (DORV,n =1),and Shone's syndrome (n =1) ; the rest 67 patients were associated with ventricular septal defect (VSD) and other simple anomalies.Twenty eight cases had hypoplasia of the aortic arch.All the patients had one-stage repair except for one.The aortic arch reconstruction was end to end anastomosis between the descending aorta and the arch in 42 patients,end to side anastomosis in 22,and the aortic arch were enlarged using autologous pulmonary artery patch in 9.The associated intracardiac anomalies were repaired in the same stage.Results There were 2 deaths.The operative mortality was 2.7％.Renal failure was occurred in 2 cases who were cured afterwards by peritoneal dialysis.All survivors were followed up for 3 ～ 36 months,anastomotic restenosis was found in 1 case who underwent reoperation 14 months after the first operation.No neurological complications were occurred.Conclusions One-stage complete correction of CoA and IAA with intracardiac anomalies through median sternotomy can achieve excellent short-and mid-term surgical results.

[Objective]To explicate whether the telomerase activity is regulated by human telomerase reverse transcriptase (hTERT) in human bone marrow mesenchyme stem cells(hBMSC).[Method]hBMSC were cultured and transfected with eukaryotic expressing plasmid pCIneo-hTERT encoding hTERT. After selection with G418 to stabilize the transfection,expression of hTERT mRNA was detected with TR-PCR, detecting the expression of hTERT protein was detected with Western Bolt, and the telomerase activity in untransfected and transfected cells were detected by RT-PCR.[Result]The hMSCs grew well after transfecting plasmid pCIneo-hTERT.The cells began to suspend and die after the day of the G418 selection. At the tenth day,all the untransfected cells were dead, but the transfected cells began to clone proliferation. So the density of G418 subdued to 100 ?g/ml for maintaining selecting, at the twentieth day,there were obvious anti-G418 cell clones. After stable transfection, hTERT was expressed at mRNA and protein level in these anti-418 cell clones, and meanwhile telomerase activity was positive and obviously raise up in these transfected cells.[Conclusion]In human' bone marrow mesenchyme cells,telomerase could be activated by exogenous hTERT. This is a foundation to establish immortalized human bone marrow mesenchyme stem cell line.

[Objective]To observe the degradation process of PDLLA in the intervertebral fusion.[Method]Twenty goats were divided into 4 groups as experimental group,and their L_(3~4)intervertebal spaces were implanted with PDLLA cage containing pieces of graft bone.Animals were sacrificed at 4,8,12,16 wks and specimens were taken for observation of the degradation process and bone fusion by gross observation and electronic microscope.Another 12 goats were used as normal fusion control group.Their L_(3~4)space were grafted with bone block for fusion.[Result]The degradation rate was non-lineal.In the early stage of fusion,the main degradation and decrease of molecular weight was shown at the superficial decomposition.With the proceeding of fusion and degradation,as the kydrolyzation speeding-up,internal decomposition by self-catalyse resulted into the collapse and total disassemble of the PDLLA.The PDLLA cage maintained its shape in the early stage and its biomechanical strength decrease in late stage but was still enough to keep the structure from collapse,till the fusion was achieved in the bone implant area.[Conclusion]The velocity of degradation of PDLLA is slower than the speed of bone regeneration of bone fusion,so the PDLLA cage could provide sufficient support during the process of intervertebal fusion and is a suitable choice of degradative material for cage in the intervertebal fusion.

With data support from abundant research ,epithelial growth factor receptor ( EGFR) signaling pathway is associated with radiotherapy resistance .EGFR inhibition has become one of methods to increase radio-sensitivity.As the first EGFR monoclonal antibody developed by China and Cuba ,nimotuzumab demonstrates its distinct clinical characteristics and has been extensively explored in head and neck cancer , esophageal cancer , high grade glioma .This article mainly reviews the present situation and recent advances on the radiosensitivity re -search of nimotuzumab .

Normal cells have limited proliferation ability.After certain cycles of proliferation,they will lose the response ability to growth factors and finally cease division and start the course of aging. In current opinion,lacking of the terminal end of a chromosome(telomere)is the cause for cells to loss the proliferation ability and leads cells to aging and death.The human telomerase catalytic subunit 1(hTERT)can activate telomemse which prolong DNAs of the terminal end of chmmosome and help cells gain genomic stabilization.The discoveries of telomere,telomerase and hTERT provide new idea for studying of cell aging and the findings are also applied in the establishment of immortal cell line. Also they may play an important role in the studv of biological feature of seed cell in tissue engineering and the establishment of cell bank.

To assess whether the Shuxuening injection influences liver function, this paper analyzes the hospital information system (HIS) data from 20 national hospitals. The patients were divided two groups: patients (5 353 cases) using Shuxuening injection acted as the exposed group, then the patients (4 863 cases) not using Shuxuening injection acted as the unexposed group. Take the abnormal changes of alanine aminotransferase and aspartate aminotransferase indexes as the result. Control confounding factors by stratification analysis, classic logistic regression analysis, before logistic regression based on propensity score weighting method and logistic regression based on generalized boosted models (GBM) of propensity score weighted combination of covariate adjustment. Then, the study analyzes the effects of Shuxuening injection on liver function by observing the changes of the indexes. Analysis of the impact of parenterally administered Shuxuening on ALT shows that, before logistic regression based on propensity score, then the regression is -0.232 (P value is 0.017). However, after logistic regression based on propensity score method the regression became -0.150 (P value is 0.370). Whereas, analysis of the impact of parenterally administered Shuxuening on AST shows that, before logistic regression based on propensity score, then the regression is -0.034 (P value is 0.767). However, after logistic regression based on propensity score method the regression became -0.091(P value is 0.538). Thus, propensity score method can control a large number of confounding factors, making the results more close to the clinic. Hence, based on existing electronic medical data, this study didn't find that parenterally administered Shuexuening influences ALT and AST.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Electronic Health Records ; Female ; Humans ; Injections ; Liver ; drug effects ; metabolism ; Logistic Models ; Male ; Middle Aged ; Young Adult

Cardiomyopathies ; complications ; Diverticulum ; complications ; Hematoma ; complications ; Humans ; Male ; Middle Aged

BACKGROUND:The application of virtual reality technology in preoperative simulation can reduce the risk in operation effectively and improve the quality of surgery. Virtual reality technology has very important practical significance in the application of surgery. OBJECTIVE:The reverse engineering and virtual reality technology were used to achieve the preoperative simulation of a case of Pilon fracture. METHODS:The affected bones were reconstructed according to the CT data using the patient’s ankle portion in MIMICS software, and the separated bone fractures were restored. According to the characteristics of virtual reality technology, further processing on bone model was carried out using Geomagic software;the models of the fractured bones were exported with STL format. The restored bone fragments were checked up to determine integrity in the virtual reality operation platform. These models were used to do simulated operations in the virtual reality operation platform. RESULTS AND CONCLUSION:A case of Pilon fracture was simulated by using reverse engineering and virtual reality technology preoperatively. The processed 3D model was introduced into the virtual reality system to simulate the operation and help doctors choose the type, position and direction of the surgical approach and plate;the effect is good.