Objective To investigate the method and curative effect for the operative treatment of acetabular fractures.Methods Forty-one patients with acetabular fractures were treated operatively from March 2001 to March 2006.All fractures were classified according to the Letournel-Judet classification,22cases were simple fractures and 19 cases were complicated fractures.Kocher-Langenbeck (K-L) approach were adopted in 31 cases (14 cases through osteotomy of greater trochanter additionally),ilioinguinal approach were adopted in 8 cases and anterior combined posterior approach were adopted in 2 cases.Different fractures were fixed by reconstructive plates and screws.Results All the patients were followed up for 16-36 (24.31 ± 5.31 ) months.According to the reduction criteria of Matta radiography,there were 27 cases with anatomic reduction,8 cases with satisfactory reduction,3 cases with poor reduction and 3 cases with joint contour reduction.According to the Merle D' Aubigne clinical criteria for joint functions,14 cases showed excellent results,18 cases were good,5 cases were fair and 4 cases were poor,and the excellent-good rate was 78%( 32/41 ).Necrosis of the femoral head was found in 3 cases,heterotopic ossification in 4 cases,traumatic arthritis in 3 cases,sciatic nerve injury in 4 cases,femoral nerve injury in 1 case,all the nerve injury recovered in 6 months.Lower extremity deep venous thrombosis in 3 cases,all of them were recovered by given anticoagulation.No death,infection or nonunion were found.Conclusions K-L approach or ilioinguinal approach are adopted in the most of the operative treatment of acetabular fractures.Dual reconstructive plates or single.reconstructive plate combine lag screws can fix solid.It can make hip to do early exercise.

Objective:To observe the clinical efficacy and safety of knee-balancing Tuina(Chinese therapeutic massage)manipulation for pes anserina bursitis(PAB). Methods:A total of 64 patients with PAB were enrolled and divided into a Tuina group and a medication group by the random number table method,with 32 cases in each group.The medication group was given votalin for external use,and the Tuina group was given knee-balancing Tuina manipulation based on treatment according to structure differentiation.Both groups were treated for 7 consecutive days.The visual analog scale(VAS)score,Lyshlom score,knee joint range of motion(ROM),and total effective rate were compared between the two groups.Adverse reactions were observed in both groups. Results:During the treatment,there was 1 dropout case in the medication group.The total effective rate was 93.8%in the Tuina group and 83.9%in the medication group.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS score in both groups decreased significantly(P<0.05),and the Lyshlom score and knee joint ROM increased significantly(P<0.05).The differences in the VAS score,Lyshlom score,and knee joint ROM between the two groups were all statistically significant(P<0.05). Conclusion:The knee-balancing Tuina manipulation based on treatment according to structure differentiation can effectively relieve pain and improve knee function in PAB,and its efficacy is superior to that of external use of votalin.

BACKGROUND: Spinal cord can regenerate after injury in certain microenvironment. Olfactory ensheathing cells (OECs)have the characteristics of astrocytes and Schwann cells and can accelerate the spinal cord axonal regeneration.OBJECTIVE: To make injured thoracic cord rat models and observe the effect of OECs on injured spinal cord axonal regeneration.DESIGN: Observational experiment.SETTING: Second Affiliated Hospital of Sun Yat-Sen University.MATERIALS: The experiment was performed at the Second Affiliated Hospital of Sun Yat-Sen University from January 2001 to November 2002.Totally 20 adult SD male rats with the body mass of (380±20) g were provided by Experimental Animal Center of Sun Yat-Sen University (number of institution license SYXK2004-0020). There were DMEM culture solution with low glucose (L-DMEM, GibcoBRL), fetal calf serum (FCS) (Hyclone), myelin basic protein (MBP) (Sigma) and nerve growth factor receptor antibody (Sigma). They were divided into cell transplantation group and control group by the method of random digits table with 10 in each group.METHODS: The adult SD rats were anaesthetized and decapitated to obtain the whole olfactory bulb and then isolate olfactory nerve with a sterile operation. Thoracic cord injury models were established by modified Allen method. 10μL OECs suspension (2.5×1010 L-1) was injected into injured spinal cord of the cell transplantation group, whereas DMEM/F12 (1:1) culture solution of the same dose was injected in the control group. The influence of OECs on spinal cord axonal regeneration was observed by histological and immunohistochemical method 6 weeks after transplantation.MAIN OUTCOME MEASURES: ①OECs were identified by nerve growth factor receptor antibody staining. ②Repair of myelin sheath was observed by MBP staining. ③Nerve axonal regeneration was observed by argentaffin staining. RESULTS: Two rats in the cell transplantation group and 3 rats in the control group died, so totally 15 rats were involved in the result analysis. ①In the cell transplantation group,injured spinal meninges were integrated,but spinal cord became thin as compared with the normal spinal cord. By hematoxylin-eosin (HE) staining, multipolar cells appeared in injured region and the cells were fused excessively with myeloid tissues. It proved that survival OECs were integrated well within the host. New axons were clustered in bundles and infiltrated by small round lymphocytes. By argentaffin staining, regenerated axons grew in tissues of injured region, which mostly accompanied with fascicular-arranged multipolar cells. In the control group, spinal cord became thin markedly and spinal meninges were integrated. No new axon appeared in the injured spinal cord by HE staining. No regenerated axon appeared by argentaffin staining, either. ②In the cell transplantation group, most multipolar cells were clustered in bundles. A mass of positive granules of nerve growth factor receptor antibody appeared in cytoplasm, which further verified that OECs still survived and integrated well within the host 6 weeks after transplantation. Linear MBP positive fibers appeared in the injured region by MBP staining,which indicated that myelin-like substance appeared and drew closely in both ends of injured region. At the same time,MBP positive substance also appeared in the multipolar cells, which illustrated that transplanted OECs could induce the occurrence of myelin-like substance. No regenerated axon was found in the control group.CONCLUSION: Delayed transplantation of OECs can survive and induce the occurrence of myelin-like substance in injured spinal cord of adult rats.

ObjectiveTo investigate the radiological characteristics,morphological characteristics of fracture fragments and treatments of posterior bicondylar tibial plateau fractures.MethodsA total of 47 patients with posterior bicondylar tibial plateau fractures treated between March 2005 and February 2009 were enrolled in the study.Characteristics of fractures and morphologies of fracture fragments were measured precisely with CT-chip Starpacs system.A retrospective study was carried out on the therapeutic results of the 47 patients undergone lateral condylar plate and medial condylar lag screw fixation via anterolateral combined with anteromedial tibial plateau approaches.Results Posteromedial condylar fracture was split one with small displacement,but the fracture was unstable.In the meantime,the fracture fragments were inverted three prism in shape and remained quite intact.Posterolateral condylar fracture was compression one and was often associated with soft tissue injury of knee joints.According to the Rasmussen radiology score,the results were excellent in 24 patients,good in 18,fair in three and poor in two.According to the Rasmussen function score,the results were excellent in 13 patients,good in 27,fair in two and poor in five.ConclusionsThe morphous of posteromedial condylar fracture is similar with that of Hohl type E fracture.The posterolateral condylar fracture is compression one.Anterolateral combined with anteromedial approaches for posterior tibial plateau fractures allow stage Ⅰbone fusion with internal fixation,simultaneously repair recombined injuries and achieve excellent radiological and clinical results.

AIM: To study the quality standard for Shuwei Capsule (Resina Ferulae, Rhizoma Corydalis, Radix Aucklandiae, etc.). METHODS: Radix Aucklandiae, Rhizoma Cyperi were identified by TLC, and ferulic acid was determined by HPLC. RESULTS: TLC spots developed were fairly clear, and the blank test showed no interference. Ferulic acid showed a good linear relationship in the concentration range of 0.007～0.056?g and the average recovery was up to 98.51%, RSD was 2.64%. CONCLUSION: The method is simple with strong specificity and good reproducibility, and can be used as the quality control of this preparation.

Objective:To study dynamic change of brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF)and prognosis improvement in patients with acute anterior myocardial infarction (AAMI)complicated hy-poxemia after noninvasive mechanical ventilation therapy.Methods:A total of 60 patients with AAMI complicated hypoxemia,who were hospitalized in our hospital from Mar 2011 to Oct 2013,were divided into noninvasive venti-lation group (n=28)and routine treatment group (n=32)according to number table.Dynamic change of BNP, LVEF and prognosis were observed and compared between two groups.Results:After treatment,BNP level and LVEF significantly improved in both groups (P<0.05 all),compared with routine treatment group,there was more significant reduction in BNP level [24h:(263.6±23.3)μmol/L vs.(126.2±21.9)μmol/L]and significant rise in LVEF [(40.6±13.1)% vs.(47.3±14.7)%]in noninvasive ventilation group after treatment (P<0.01 both);af-ter 30d follow-up,there were significant rise in 6min walking distance (percentage of 426~550m,59.3% vs. 75.0%),LVEF [(41.1±11.7)% vs.(49.4±12.5)%]and survival rate (90.6% vs.96.4%),and significant re-duction in rehospitalization rate (12.5% vs.7.1%)in noninvasive ventilation group,P<0.01 all.Conclusion:Ear-ly noninvasive mechanical ventilation therapy can significantly improve cardiac function,exercise tolerance and short-term prognosis in patients with acute anterior myocardial infarction complicated hypoxemia.

Objective To investigate the clinical efficacy of drug-eluting stent( DES) combined with clopi-dogrel therapy in patients with coronary heart disease. Methods 123 patients underwent percutaneous coronary intervention (PCI) were randomly divided into observation group (DES) of 60 cases and the control group ( bare-metal stent,BMS) of 63 cases. The observation group was given the treatment of DES combined clopidogrel, the control group was given the treatment of BMS combined clopidogrel. The stent implantation and the follow-up two-year MACE were observed. Results (1) The average implanted stent length of the observation group was longer than that of the control group(P<(0.05) ,the angiography in vascular disease and complexity between the two groups had no significant difference ( P > 0. 05 ) ; the success rate of surgery in the two groups was 100% , after operation the TIMI flow reached grade 3. (2) The incidence of angina pectoris and revascularization rate of the observation group was significantly lower than that of the control group (P < 0.05); the rate of coronary angiography, recurrent myocardial infarction and the incidence of cardiac death between the two groups had no significant difference ( P > 0.05). Conclusion DES combined with clopidogrel maintenance therapy for a year in patients with coronary heart disease had a good long-term efficacy.

BACKGROUND:Nerve growth factor has been shown to play an important role in bone healing, but little is reported on the effect of growth factor composite scaffolds via the immediate implantation in the repair of canine bone defects. OBJECTIVE:To analyze the effect of nerve growth factor composite scaffolds via the immediate implantation for the repair of canine bone defects. METHODS:Nerve growth factor composited strontium apatite scaffolds were prepared. Canine mandibular defect models were established and divided into three groups, fol owed by implanted with composite scaffold (experimental group), strontium apatite (positive control group), or nothing (blank control group). The three-dimensional CT reconstruction and hematoxylin-eosin staining of canine mandibular bone defects were observed. RESULTS AND CONCLUSION:In the blank control group, there were few new bones surrounding bone defect. Trabecular bones spread from the defect center to the surrounding tissues in the experimental and positive control groups. The bone density, volume, thickness, and implant-bone contact were significantly increased, while the trabecular separation was significantly decreased in the experimental group compared with the positive control and blank control groups (P<0.05), and al above indicators in the positive contro group were significantly higher than those in the blank control group (P<0.05). Hematoxylin-eosin staining showed that in the experimental group, there were a large number of new bones that contacted with the surrounding bones closely, and trabecular bones arranged regularly. In the positive control group, newborn osteoid, trabeculare, and a smal amount of debris were found. In the blank control group, few new bones were connected with the surrounding bones untightly and trabecular bone arranged irregularly. These results indicate that the nerve growth factor composite scaffold can promote the bone regeneration in the canine bone defects after immediate implantation.

Objective To investigate the association between rs7744 polymorphism in the 3'?untranslated region(3'?UTR)of myeloid differen?tiation factor 88(MyD88)gene and the risk and severity of coronary artery disease(CAD)in a North Chinese Han population. Methods The CAD and control groups consisted of 540 patients and 270 subjects,respectively. The genotypes of rs7744 were detected by polymerase chain reac?tion?restriction fragment length polymorphism(PCR?RFLP),and clinical data were collected. Results The distributions of MyD88 rs7744 were in HWE(P>0.1). In the<50?year?old age group,a lower risk of CAD was observed for subjects carrying the variant AG genotype in comparison to subjects carrying the wild AA genotype(OR=0.38,95%CI:0.17-0.93,P=0.029). The MyD88 rs7744 polymorphism was also related to the modified Gensini score(P=0.011),which was lower in subjects carrying the variant GG genotype than the wild AA genotype(5.23±3.85 vs 7.49± 4.96). Conclusion Our results revealed that MyD88 rs7744 polymorphism in the 3'?UTR is correlated with the risk and severity of CAD.

Child ; Facial Paralysis ; etiology ; Humans ; Male ; Wounds and Injuries ; complications