[Objective]To report the polyaxial locking plate and its primary clinical results in the treatment of the tibial plateau fractures.[Method]From July 2006 to August 2007,38 patients with tibial plateau fractures,including 26 males and 12 females,were treated with surgical reduction and internal fixation with polyaxial locking plate.The mean age of the patients was 30.6 years(18-65 years).According to Schatzker classification,there were 3 of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,6 of type Ⅳ,16 of type Ⅴ,3 of type Ⅵ,of which 34 were closed fractures and 4 open fractures.The follow-up period ranged from 7 to 18 months with a mean of 13.7 months.Function of the knees were assessed according to HSS system and radiological examination.[Result]Solid arthrodesis were obtained in all patients at 3-6 months after operation.Skin flap necrosis and incision infection happened respectively in 2 cases of type Ⅴ and type Ⅵ fractures.The score of HSS system was 92.8(range 78-98) averagely half year after operation and no reduction loss was observed.[Conclusion]The polyaxial locking plate is an effective fixation technique for the surgical treatment of the tibial plateau fractures because of its convenience and stability.The locking screws can be implanted in various directions and reduction loss is avoided post-operation.

[Objective]To analyze the relative factors of reoperation to lumbar disc herniation(LDH)and to discuss the three methods for reoperation.[Method]By retrospectively studying and analyzing etiopathogenisis in 102 cases,who were made at least one reoperation,and other(1 327) LDH patients underwent an initial standard discectomy in our department from 1999 to 2004.Then studied several relative factors,such as age,interval time between the initial operation to the first reoperation,was made stastistic analysises.Combined with the statistic results,the clinical outcomes of patients who underwent three different reoperative methods were evaluated.[Result]A total of 102 cases underwent at least one reoperadon,11 of them had multiple(two or more)reoperations.Among these patients 58 cases suffered from recurrent LDH,40 suferred from postoperative stenosis or instability and 4 had postoperative intervertebral-space-infection.Forty-eight cases(47.06%)were performed single discectomies again,20(19.61%)undergone decompressions by laminectomy and 34(33.33%)had decompressions,bone-grafting and fixed with spinal instrumentations.There were 16 patients in all interbody-fusion surgeries and the number increasd year by year.Higher reoperation rate was seen in patients with the initial operation taking place less than 1 year comparing,more than those with the initial operation performing more than 1 year ago(P

[Objective]To approach clinical outcomes and experiences of low-grade spondylolistbesis patients treated with posterior lumbar interbody fusion(PLIF)and transpedicular instrumentation.[Method]Consecutive 53 cases suffered from low-grade spondylolisthesis were analyzed retrospectively.All patients were treated by posterior lumbar ioterbody fusion and transpedicular instrumentation.Pre-operative and post-operative Boxall index,angle of slipping,intervertebral height were oberserved in all patients.Curative effects,fusion fate,operation-methold and complications were analyzed in all patients.[Result]All patients were followed up from 9 to 21 months with an average of 16 months.Forty-nine(92.5%)patients were assessed to bony fusion postoperatively.Comparement about preoperative and postoperative Boxall index,angle of slipping and intervertebral height were observed in all patients.There were great changes in all these indexes(P

OBJECTIVE:To investigate general regularity and characteristics of adverse drug reactions/events(ADR/ADE)in-duced by Dezocine injection,and to provide reference for safe and rational drug use in clinic. METHODS:Retrieved from Jiangsu Province ADR Database during Jan. 2009-Aug. 2016,ADR/ADE induced by Dezocine injection was analyzed statistically in re-spects of patient's gender and age,usage and dosage,organs/systems involved in ADR,clinical manifestations and outcome. RE-SULTS:Among 1290 ADR/ADE induced by Dezocine injection,there were 40 cases of severe ADR/ADE(3.10％);medical insti-tutions were main reporting units (1276 cases,98.81％). In ADR/ADE cases,female was more male,with ratio of male to fe-male was 1:1.45. ADR/ADE mostly occurred in 45-65 age group(43.49％). Intravenous medication was main route of administra-tion (1137 cases,88.14％). Initial dose of 577 cases was excessive dose (50.75％). ADR/ADE mainly involved gastrointestinal system (54.99％),central and peripheral nervous system (24.72％) and systemic lesions (5.20％). Severe ADR/ADE manifested as anaphylactic shock,palpitation and dyspnea,etc. But anaphylactic shock was not mentioned in drug package inserts. 1283 ADR/ADE(99.46％)were cured or improved . CONCLUSIONS:It is necessary to strengthen drug safety reevaluation of Dezocine injec-tion after being on the market,improve drug package inserts and enhance patients education as so as to reduce and avoid the occur-rence of ADR/ADE.

Objective To review the relevant causes for and treatment of nerve injuries in the anterior cervical surgery. Methods From January 2008 to December 2009,859 cages of cervical spondylosis,ossification of cervical posterior longitudinal ligament and cervical spine trauma were treated by anterior cervical surgery.This study retrospectively analyzed the clinical data of seven cases who were with worsened symptoms of spinal cord injury and related nerve injury. Results Of 859 cases,five cases(0.58%)were with spinal cord injury,one(0.12%)with recurrent laryngeal nerve injury and one (0.12%)with laryngeal nerve injury.Hematoma occurred in four cases after surgery caused spinal cord injury and all the four patients recovered to normal after removal of the hematoma and timely treatment with mythylprednisolone and hyperbaric oxygen.Cervical spine trauma was worsened in one patient after the anterior cervical surgery.The patient restored to its original level of spinal cord gradually through some measures such as tracheotomy,ventilator support,hormone therapy and hyperbaric oxygen treatment.Laryngeal nerve injuries in two cases recovered to normal after conservative treatment with hormone,dehydration and other drugs within three months after surgery. Conclusions Anterior cervical surgery of cervical spondylosis,ossification of cervical posterior longitudinal ligament and cervical spine trauma are likely to induce the related nerve damage.The good prognosis can be obtained under timely prevention and treatment.

Background and purpose:Rectal small cell carcinoma is high malignant tumor and prone to early metastasis. It is rare in the clinical and its prognosis is poor. The aim of this article was to analyze clinical characteristics and summarize the diagnosis,treatment and prognosis of rectal small cell carcinoma.Methods:Clinical data of 16 cases with rectal small cell carcinoma conifrmed by pathology from Jan. 2001 to Jan. 2013 in the Tumor Hospital Affiliated to Zhengzhou University Hospital were analyzed retrospectively.Results:Among the 16 rectal small cell carcinoma patients (mean age is 58.5 years), 9 were male, 7 were female; 4 cases in stageⅡ, 7 cases in stageⅢ and 5 cases in stageⅣ. Ten cases underwent surgical treatment, of which 6 cases underwent radical surgery, 4 cases underwent palliative surgery;6 cases received chemotherapy alone, 2 cases received chemoradiotherapy, 2 cases did not receive any treatment postoperatively. Five cases were lost opportunity for operation, of which 3 cases underwent chemotherapy alone and 2 cases underwent chemoradiotherapy. One case did not receive any treatment. Among 10 cases of resection of the lesions, 5 cases had vascular invasion and 7 cases had local lymph node metastasis. All patients received 7-65 months of follow-up. The median survival was 15.4 months. The 6 months, 1 year, 2 years, 3 years and 5 years survival rates were 58.4%, 46.2%, 26.6%, 13.1% and 6.2% respectively. The prognosis of patients was associated with tumor staging, presence of vascular invasion and lymph node metastasis, and type of operation (P<0.05); but not related to age, gender and tumor size (P>0.05).Conclusion:The biologic behavior of rectal small cell carcinoma which is a rare disease and similar to small cell lung cancer, and its prognosis is poor. Treatment methods include surgery, radiotherapy and chemotherapy. The overall result is poor.

Objective To establish a rapid and accurate method, and to determine the density of mice and rats sperm with enzyme-labeled instrument.Methods ①The optimal wavelengths and the regression equation set up: After six Kunming mice and six Sprague-Dawley rats were sacrificed, the left epididymis was separated and fully cut up in phosphate buffer saline.With water bath, the sperm were fully dissociated.Using the enzyme-labeled instrument to detect the wavelength absorbance respectively under different wavelength and fitting absorbance curve.The best wavelength will be the most close to 1 of the correlation coefficient ( R2 ) and the standard deviation of minimum.After ten Kunming mice and ten Sprague-Dawley rats were sacrificed,the sperm suspension of different concentration gradient were got.The regression equation of the sperm density and absorbance was established by using enzyme-labeled instrument and haemocytometer.②The test of sperm absorbance stability: Mice and rats,six respectively,were used to make the sperm suspension.Samples were put in room temperature (25℃) or 37℃water bath continued,and after water bath about 0,20,30,40,50, 60 min,the change of absorbance was recorded.③The regression equation verification:The mice were administrated orally with 20% ethanol solution for 30 days to make oligospermia.In order to verify the new method, two different method were used to get the sample sperm.Results The optimal absorbancy-sperm density curve could be established at 380 nm.The means of KM mice sperm count ( x1 ) and absorbance ( y1 ) are showed to be the linear function,and the linear regression equation is y1 =2 ×10 -9 x1 +0.0648, R2 =0.9743.The means of SD rat sperm count ( x2 ) and absorbance (y2) are showed to be the linear function,and the linear regression equation is y2 =5 ×10 -9x2 +0.0621,R2 =0.9940.SD rat sperm suspension liquid after 60 min in water bath, absorbance value at 0 min significantly decreased(P<0.05), but at room temperature after 40 min significantly increased ( P<0.05); KM mice sperm suspension in the water bath and under the condition of normal temperature after 50 min, compared with the 0 min, absorbance value increased significantly(P<0.05).Compared with control group, sperm density of ethanol oligozoospermia group by enzyme standard detector and standard curve calculation were significantly decreased ( P <0.05 );compared with absorbancy-sperm density equation, determination of ethanol oligozoospermia group of sperm density by cell counting plate method had not significant difference.The results suggested absorbancy-sperm density equation could effectively detect the reduction of the mice sperm in oligospermia.Conclusion Using enzyme-labeled instrument to set up the curve of absorbancy-sperm density equation can estimate the sperm density of mice and rats rapidly and exactly.

Objective To find the different plasma-associated proteins of rheumatoid arthritis (RA) by using two-dimensional gel electrophoresis for understanding the pathogenesis of RA. Methods The total protein from either RA patients or normal ones was prepared by means of immobilized pH gradient based on two-dimensional gel electrophoresis. After silver staining, gel-image analysis was performed by using PDQuest. The differentially expressed proteins were identified by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF-MS). Results 2-DE patterns of plasma from controls and RA patients were presented. The results showed that average number of protein spots was 592 and 563 respectively, and the corresponding average matching rate was 89% and 87% respectively. Gel-image analysis revealed that there were 24 differential protein spots. A total of 15 differential protein spots were successfully identified by MALDI-TOF-MS, of which 6 proteins were up-regulated as compared with control. Conclusion The differentially expressed proteins can be observed in plasma from RA and controls, which can be used to elucidate the pathogenesis of RA for further study.

To investigate the CT appearances in early stage of clustering lung paragonimiasis,9 cases of two clustering lung paragonimiasis caused by eating raw stone-crab and laboratory examination were included in the study.Eight cases consulted by doctors in the hospital and their appearances were retrospectively analyzed.There were pleural effusion of varying degree (n=8) and random distribution sub-pleural pulmonary infiltrative lesions (n=7).The accompany appearances of the latter had lunar halo sign,characteristic tunnel sign (n=1) and peri-bronchitis (n=1).If CT detects pulmonary infiltrative lesions of random distribution within sub-pleura or tunnel sign,combining with the history of eating raw stone crabs and other freshwater fishes,with the rise of eosinophilic granulocytes in peripheral blood,the diagnosis of paragonimiasis should be suggested.

ObjectiveTo understand the possible role of some proteins expressed by human synovial fibroblasts(SFs)in the pathogenesis of rheumatoid arthritis.MethodsThe expression difference of synovial fibroblast proteins between rheumatoid arthritis(RA)patients and healthy controls was analyzed by 2-DE.The differential expression spots were identified by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry(MALDI-TOF-MS),followed by bioinformatics analysis,some of which were validated by Western blot.ResultsUsing 12% SDS-PAGE following pH 4-7 IPG strips in IEF,averagely 837 and 852 protein spots were detected in RA patients and normal subjects,respectively.Gel image analysis revealed that there were 49 differential protein spots.By peptide mass fingerprinting strategy,we identified 40 protein spots derived from gels of SFs in RA patients among differential spots and 23 valid proteins were obtained.Western blot analysis showed that expressions of Enolase ?,Annexin I,Cathepsin D,SOD2,Peroxiredoxin 2 were significantly higher in SFs from RA patients than those from normal subjects,which was consistent with proteome analysis.ConclusionThe differential proteins might be involved in inflammation of synovitis in RA.