Objective To investigate the clinical therapeutic effect of adefovir dipivoxil on Hepatitis B virus related primary hepa-tocellular carcinoma after transcatheter hepatic arterical chemoembolization combined with radiofrequency ablation.Methods 30 pa-tients with Hepatitis B virus related primary hepatocellular carcinoma were randomly divided into study group and control group,1 5 cases in each group.All 30 patients were administrated comprehensive interventional therapy,while the study group took medicine of adefovir dipivoxil 10 mg/day additionally.Then all patients were followed up and evaluated the survival quality and mortality after operation.Results The high and medium quality survival rate were compared between two groups of patients in 48 weeks after oper-ation,and there was a significant difference (P <0.05).During 60 weeks,the high quality survival rate was different significantly (P <0.05).The mortality,and the medium quality were significantly different (P <0.05)during 72 weeks.while the difference was more significantly in the low quality survival (P <0.01).Furhtermore,the differences between the medium and low quality survival during 84 weeks and 2 years were also significantly different (P < 0.01 ).Conclusion Comprehensive interventional therapy com-bined with adefovir antiviral therapy can improve the survival quality and prolong the lifetime of patients who had Hepatitis B virus related primary hepatocellular carcinoma.

Objective To explore the feasibility of hand-assisted laparoscopic splenectomy and azygos-portal disconnection. Methods Hand-assisted laparoscopy was performed in 12 patients with hypersplenia secondary to post-hepatitic hepatocirrhosis and a history of rupture and bleeding of esophago-gastric varicose vein.An ultrasound knife was used to dissect the ligaments of the spleen.The Endo-Cutter was used to cut off the pedicle of the spleen.Then the spleen was removed in a plastic bag.All of the varicose vessels around the fundus and the lower segment of the esophagus(6~8 cm in length) were dissected and disconnected according to the criteria of open surgery.Results The operation was successfully completed in 10 patients,while conversions to open surgery were required in 2 patients because of massive hemorrhage during the operation.The operating time was 2.5~5 h(mean,3.4 h) and the hemorrhagic volume was 100~500 ml(mean,250 ml).Postoperatively,1 patient experienced an intraperitoneal hemorrhage and received open surgery for hemostasis while the remaining patients had an uneventful recovery without complications.A total of 10 patients were followed for 0.5~2 years(mean,1.5 years).Four patients died of liver failure.Six patients presented small volumes of relapsed upper gastrointestinal bleeding around 1 year after operation.Gastroscopy showed portal hypertensive gastropathy in 3 patients,gastric ulcer in 1 patient,and ruptured varicose esophageal veins in 2 patients.All the 6 patients were cured by conservative medical treatment.Conclusions Hand-assisted laparoscopic splenectomy and azygos-portal disconnection is a feasible,effective,and safe surgical procedure.

Proximal humerus fractures are clinically common upper limb injury,accounting for about 4％ to 5％ of all human fractures.At present,displaced proximal humerus fractures are often treated by locking plate fixation,but complications may follow.Of them,a locking screw piercing the humeral head has the highest incidence and is thus the most common reason for surgery.Such a screw tends to cause claws of the glenoid cavity,leading to severe pain.Therefore,it is an unavoidable challenge how to effectively prevent postoperative screw piercing for orthopedic surgeons who use locking plating to treat proximal humerus fractures.In this paper,the progress in research will be reviewed on the causes and management of screw perforation after locking plate fixation of proximal humerus fracture.

BACKGROUND: Forceful fixation and enough blood supply in fracture site are the fundament for treating bone nonunion. OBJECTIVE: To investigate the outcome of autologous iliac bone-grafting and plate fixation in treatment of the ununited distal ulnar fracture with osseous defects. DESIGN, TIME AND SETTING: The own control study was performed at the Department of Orthopaedics, Sixth People’s Hospital, Shanghai Jiao Tong University from August 2002 to May 2006. PARTICIPANTS: Of 21 cases of the ununited distal ulnar fracture with osseous defects, 13 cases were induced by ulnar and radial fracture, and 8 cases were induced by ulnar fracture. There were 15 cases of open fracture and 6 cases of closed fractureof first onset. Bone defects were 1.5 cm-5.0 cm, averagely 3.1 cm. METHODS: Bone defects were filled with intercalary iliac grafts. Length and axial ray of ulna were controlled. Ulna was fixed utilizing 5-8 wells 1/3 tubular plate, reconstruction plate or locking compression plate. At least two screws were used at the distaend, and 3 or 4 screws were fixed in the proximal end. Follow-up was conducted once per month to observe clinical appearanceand radiograph in each patient. MAIN OUTCOME MEASURES: Fracture nonunion, dorsal extension and palmer flexion of wrist joint, pronation and supination othe forearm were measured. RESULTS: All 21 cases were followed up for a mean time of 14.7 months. All the patients obtained bony union, and a mean timof 4.6 months (ranged 3 to 7 months). The distal ulnar healed with

Objective To clone human papillomavirus type 16 genome from Anhui province, analyze genome se-quence of HPV16 and study its genomic characteristics. Methods Five pathological specimens of cervical cancer from Anhui province were collected and the total DNA was extracted. Specific primers were designed to clone HPV16 genome in four fragments. The sequence of four fragments was assembled manually and nucleotide sequence was analyzed after sequencing. Results A cervical pathological sample containing HPV16 was detected and the genome sequence with full length of 7 906 nts (GenBank accession number:KC935953) was obtained. Sequence alignment of genome nucleotide sequence showed that HPV16 of Thailand and HPV16 of Japan were more similar to HPV16 of Anhui (HPV16-Anhui) than other HPV genome nucleotide sequence, their similarity reached 99. 5%. Phylogeny tree analysis demonstrated that HPV16-Anhui and other 7 HPV16 clustered into a single branch. Con-clusion HPV16 genome nucleotide sequence is obtained from Anhui province for first time with great significance for further understanding of HPV16 variation from Anhui even east China.

BACKGROUND:Forceful fixation and enough blood supply in fracture site are the fundament for treating bone nonunion. OBJECTIVE:To investigate the outcome of autologous lilac bone-grafting and plate fixation in treatment of the ununited distal ulnar fracture with osseous defects. DESIGN,TIME AND SETTING:The own control study was performed at the Department of Orthopaedics,Sixth People's Hospital,Shanghai Jiao Tong University from August 2002 to May 2006. PARTICIPANTS:Of 21 cases of the ununited distal ulnar fracture with osseous defects,13 cases were induced by ulnar and radial fracture,and 8 cases were induced by ulnar fracture. There were 15 cases of open fracture and 6 cases of closed fracture of first onset. Bone defects were 1.5 cm-5.0 cm,averagely 3.1 cm. METHODS:Bone defects were filled with intercalary lilac grafts. Length and axial ray of ulna were controlled. Ulna was fixed utilizing 5-8 wells 1/3 tubular plate,reconstruction plate or locking compression plate. At least two screws were used at the distal end,and 3 or 4 screws were fixed in the proximal end,FoUow-up was conducted once per month to observe clinical appearances and radiograph in each patient. MAIN OUTCOME MEASURES:Fracture nonunion,dorsal extension and palmer flexion of wrist joint,pronation and supination of the forearm were measured. RESULTS:All 21 cases were followed up for a mean time of 14.7 months. All the patients obtained bony union,and a mean time of 4.6 months (ranged 3 to 7 months). The distal ulnar healed with < 10° of angular deformity in a coronal plane in one patient and with 15° of angulation in a sagittal plane in another one,while others (19 patients) obtained satisfactory alignment. The excellent and good rate was 90.5％. CONCLUSION:Intercalary bone-grafting with autologous lilac and secure fixation for treating the ununited distal ulnar fracture with osseous defects can reconstruct ulnar length,correct deformities,and obtain good bone healing and functional recovery.

0.05). According to the HSS system, the score was 89.6 (range, 75-98) averagely one year after operation. No any complications occurred, such as necrosis of the incision, deep infection, the loosening and breakage of the internal fixator. Conclusion The technique with modified dual plating for the complex fractures of the tibial plateau provides satisfactory function of the knee, it has many advantages, such as stable and durable fixation, avoiding the replacement and change of the knee mechanics, as well as diminish the problems about the incision and soft tissue.

Objective To explore the relationship between plasma Tumor necrosis factor-alpha(TNF-α),Interleukin-6(IL-6) levels and brain edema caused by hypertensive intracerebral henorrhage.Methods 62 patients with hypertensive intrscerebral hemorrhage( the observation group) and 50 healthy persons( the control group) were selected.The expression of plasma TNF-α and IL-6 were determined by ELISA pre-therapy and 1d,3d,7d,14d after treatment in two groups;The volume of cerebral edema was measured by CT.The relationship between plasma TNF-α,IL-6 levels and brain edema caused by hypertensive intracerebral hemorrhage were analyzed.Results Before treatment,the levels of TNF-α and IL-6 in the observation group were( 15.62 ±9.49)μg/L and (67.47 ±6.31 )ng/L,which were significandy higher than(8.28 ± 3.36) μg/L and(31.02 ± 3.51 ) ng/L of the control group( t =9.17,64.28,P =0.01 ),and Spearman analysis showed that the levels of TNF-α and IL-6 were positively correlated with the volume of cerebral edema(r=0.934,P=0.02;r=0.922,P =0.026).Conclusion There was an up-regulation of TNF-α and IL-6 levels in the plasma of patients with hypertensive intracerebral hemorrhage.TNF-α and IL-6 may promote the formation of cerebral edema during the course of hypertensive intracerebral hemorrhage.

[Objective]To discuss the operative treatment for adult flatfoot deformity with severe pain.[Method]From August 2002 to October 2004,operative treatment for 12 cases of unilateral adult flatfoot deformity with severe pain underwent operative treatment,which included 7 males and 5 females with an average age of 35 years(range,20 to 56 years),left side was involved in 8 cases,and right side was affected in 4 cases.According to etiological factor,stageⅡ~Ⅲ posterior tibial tendon dysfunction were 6 feet,congenital flatfoot were 3 feet,neurological flatfoot were 2 feet and postoperative equinovarus was 1 feet.Every case received special operative treatment,for instance lateral column lengthening,medial displacement calcaneal osteotomy,arthrodesis,repair posterior tibial tendon,sping ligament reefing,FDL tendon transfer and so on.All patients were fixed with plaster cast at inversion position for 4~6 weeks,then changed to plaster splint fixing at neutral position for 4 weeks.Functions of ankle and foot were evaluated before and after operation.[Result]All patients were followed up for an average of 22 months(ranged,16 to 28 months).The total excellent and good rate was 83.3% according to Marryland foot score.The specific index of X-ray improved obviously(P

Objective To explore the possible mechanism by which protein kinase C (PKC) involves in the neuronal apoptosis induced by cerebral ischemia/reperfusion Methods After the model of ischemia/reperfusion was established in male Wistar rats, PKC activity, FOS protein expression and neuronal apoptosis in their brains were observed The effect of PKC inhibitor, Dengzhanghua, on above indexes were studied at the same time Results Cerebral ischemia/reperfusion resulted in transloactional activation of PKC, accompanied with the increase of FOS expression and neuronal apoptosis Dengzhanghua prevented against the above changes Conclusion Activated PKC is involved in ischemia/reperfusion induced neuronal apoptosis by regulating FOS expression