Objective To discuss the characteristics, treatment method and prognosis of tibial tuberosity avulsion fracture in children. Methods From January 1995 to December 2007, there were 25 cases (23 boys and 2 girls). The age at injury ranged from 12 to 16 years(average 13.5 years). All cases were unilateral involved (10 of left, 15 of right). All of the injuries resulted from participation in athletic activities, 10 in basketball, 7 while jumping, and 8 in football game. According to the classification of Ogden, there were 1 type 1A, 4 type 1B, 5 type 2A, 7 type 2B, 4 type 3A, and 4 type 3B fractures. One type 1A fracture was treated nonoperatively with east immobilization, and other 24 fractures with open reduction and internal fixation. Results All of 25 cases were followed from 14 months to 7 years (average 43 months). The range of motion of knee joint was 0°-140° 3 months after operation, and all of them recovered to pre-injury levels of activity by 6 months after operation. According to Mosier clinical assessment system, the final outcome was evaluated as excellent in all. Wound healed primary, no compartment syndrome was found. The time of bony union ranged from 2 to 5 months, with the mean time of 3 months. No complications of infection, ex-tremities deformity and inner fixation failure were found. Conclusion The tuberosity avulsion fracture in children is an uncommon and special type of epiphyseal injury. These fractures occur in the narrow range of 13 to 16 years of age. The majority of patients are males, and most of them are unilateral involved. This in-jury has an excellent outcome without deformity or functional loss, once adequate reduction and fixation of fracture fragments have been achieved.

Objective To explore the relationship between apolipoprotein E ( ApoE ) genotype and diabetic nephropathy (DN) in Chinese Han population of Guangdong province. Methods 63 cases of DN patients were selected as group A; 57 diabetes patients without complications as group B; 55 healthy persons as group C. ApoE genotype of all objects were measured. Results ApoE2 in the group A was the highest, while the differences in other groups were not obvious. Detection of ApoE3 and ApoE4 was not obvious in three groups. The Level of triglyceride (TG) was highest inε2 group, and the level of total cholesterol (TC) and low density lipoprotein LDL-C were highest in ε4 groups. Conclusions In Chinese Han population of Guangdong province , ApoE gene polymorphism and DN are closely interrelated , and the occurrence ofε2 is proportionate to DN.

Objective: To establish a dissolution determing method for the two primary ingredients atenolol and nifedipine in YakepingⅡcapsules. Methods:A small glass method was adopted with the rotation rate of 50 r·min-1 . According to the dissolution conditions in Japan “quality of medical drugs information set” with appropriate adjustments in accordance with the actual situation of the samples, different YakepingⅡ capsules were determined by HPLC respectively in pH 1. 2 artificial gastric solution ( containing 0. 5% sodium dodecyl sulfate), pH 4. 0 acetate buffer(containing 0. 5% sodium dodecyl sulfate), pH 6. 8 phosphate buffer(contai-ning 0. 25% sodium dodecyl sulfate) and water(containing 0. 25% sodium dodecyl sulfate). Results:The assay displayed a good lin-earity over the concentration range of 10-30 μg·ml-1 for atenolol and nifedipine(r=0. 999 6 and r=0. 999 8), and the recovery of the two components in the different medium was 99. 64%(RSD=0. 73%), 99. 55%(RSD=0. 65%), 99. 53%(RSD=0. 47%)and 99.54% (RSD=0.51%), 99.52%(RSD=0.67%), 99.52%(RSD=0.72%), 99.51%(RSD=0.63%)and 99.61%(RSD=0. 59%)(n=9). The dissolution of different batches of YakepingⅡcapsules in the four media showed the similar behavior. Conclu-sion:The method is simple, accurate and reproducible in the dissolution determination of atenolol and nifedipine in YakepingⅡ cap-sules.

Objective: To prepare an immunoconjugate of anti-EGFR monoclonal antibody (ETS) and adriamycin(ADR) and to investigute it's inhibitory effect on human epidermoid carcinoma (A431) in vitro and in vivo and it's side effect on C57BL/ 6J mice.Methods:The immunoconjugate(ETS-ADR) was prepared with an improved glutaraldehyde conjugate method and the cytotoxicity effects of EQ75-ADR on A431 cells and Wish cells were measured by MTT assay. A431 tumor-bearing nude mice and C57BL/6J experimental model were established and were used for testing the inhibitory edicts of EQ75-ADR. The side effect of EQ75-ADR was compared with ADR. Results:The EQ75-ADR showed specific cytotoxicity on A431cells,the ytotoxicity of EQ75-ADR was 50-fold, 14-fold and 10-fold more efficient than that of EQ75, ADR and mixture of EQ75 and ADR (EQ75+ ADR) respectively.The effect of EQ75-ADR on with cells was 10-fold less efficient than that of ADR and EQ75+ADR. As compared with the cytoxicity effect of EQ75-ADR on Wish cells with A431 cells, it showed 300-fold less efficient.Similar cytotoxicity results were shown in 2 h treatment experimental group. The EQ75-ADR exhibited significant anti-tumor activity on tumor-bearing nude mice,and the inhibition late is 92.2% (P

Objective:To study the changes of food characters in early swallowing recovery in patients with different laryngeal function preservation surgery.Methods:Collected patients with laryngeal cancer hypopharyngeal cancer who underwent laryngeal function preservation surgery in Lihuili Hospital of Ningbo Medical Center from January 2019 to March 2020. By fiberoptic endoscopic evaluation of swallowing (FEES) combined with Penetration and Aspiration Scale (PAS), prospectively observed the aspiration and invasion of solid, paste, fluid and other food in the early stage of trial feeding in patients with laryngeal hypopharyngeal cancer undergoing open laryngeal function preservation.Results:Among the 69 patients, 21 had vertical partial laryngectomy and 19 had partial pharyngeal partial laryngectomy. 15 days after the operation, 2 groups of patients after solid and paste food adaptability scored (1.14±0.36), (1.29±0.56) and (2.53±2.04), (2.84±2.31) points, Friedman Mtest for comparison difference had statistical significance ( Mvalues were 23.463 and 22.227, P<0.01); the liquid food for adaptability scored (2.10±1.09), (4.42±2.24) points, the pairwise comparison of liquid, solid and paste showed statistically significant differences ( tvalues were-0.976 to 1.105, P<0.05). The pairwise comparison of the adaptability of the two groups on 20 days after surgery showed no statistically significant difference ( P>0.05).Throat on the cricoid cartilage resection-ring hyoid epiglottis anastomosis (SLCP-CHEP) was 17 cases, laryngeal glottis level partial resection was 12 cases; postoperative 15 days the adaptability on the behavior of three kinds of food grade 2 groups of patients (4.65±1.90), (5.59±1.46), (6.53±1.13) points and (6.67±1.07), (4.50±2.07), (6.92±0.79) points, respectively; Minspection differences were statistically significant ( Mvalues were 29.525, 22.136, P<0.01).The pairwise comparison of solid and paste food in the two groups 20 days after the operation showed no statistically significant difference ( P>0.05), while the difference of liquid and paste was statistically significant ( tvalues were-1.375 to-0.853, P<0.05). Conclusion:In the early recovery of patients undergoing laryngeal function preservation surgery, the vertical group and the partial pharyngeal partial laryngectomy group has better adaptability to solid and paste food. The horizontal group has better adaptability to paste, the CHEP group has better adaptability to solid, and the four groups has the worst adaptability to convection, the recovery time of convective mass between the CHEP group and the horizontal group was longer. To understand the adaptability of patients with different surgical methods to food traits at the early stage of trial feeding can help to implement targeted rehabilitation programs, carry out progressive diet training, and reduce the complications of misinvasion, aspiration, aspiration pneumonia and other complications in the recovery cycle.

Blood Gas Analysis ; Hepatopulmonary Syndrome ; therapy ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Treatment Outcome

Objective To study the effects of cryopreservation on the immunogenicity of human umbilical vein endothelial cells(HUVEC).Methods HUVEC were isolated ex vivo and cryopreserved.Lymphocyte stimulation index(SI)was analyzed by MTT in lymphoeyte-endothelial cell co-culture.Both HLA-ABC and HLA-DR antigen expression on fresh or cryopreserved HUVEC,and the effects of IFN-γ treatment on HLA antigen expression in both groups were determined by using flow cytometry.Results No difference in SI was observed between fresh prepared and cryopreserved HUVEC(1.716±0.181 vs 1.686±0.145,P>0.05).The percentage of HLA-ABC expression was(96.6±1.9)%and(96.0±1.4)%in fresh and cryopreserved HUVEC(P>0.05),and the mean intensity for HLA-ABC expression was 84.1±5.7 and 82.4±4.8 in fresh and cryopreserved HUVEC(P>0.05),respectively.However,no HLA-DR expression was observed in both groups.When treated with IFN-γ,HLA-ABC expression was significantly up-regulated,and HLA-DR expression was induced in a dose-dependent manner.No significant difference was found in the HLA-ABC expression between fresh and cryopreserved HUVEC(P>0.05),while the HLA-DR expression in cryopreserved HUVEC was remarkably lower than in fresh HUVEC with the increase of IFN-γ(P<0.01).Conclusion The immunogenicity of HUVEC remains stable by cryopreservation without IFN-γtreatment or treated with low concentration of IFN-γ(≤50 U/ml).However,the HLA-DR expression in HUVEC was remarkably reduced in eryopreserved cells treated with a high concentration of IFN-γ(≥100 U/ml).These data indieated that the effects of cryopreservation on immunogenicity of HUVEC may result from the decreased responses of HLA-DR expression by the stimulation of IFN-γ treatment.

Objective To develop a staged laparoscopic training program for performing the ana-tomic retroperitoneoscopic adrenalectomy(ARA), and to determine its safety and feasibility. Me-thods Five young urological doctors without previous experience in open adrenalectomy were selected third period, trainees acted as camera holder first, then performed simple operations such as laparo-scopic renal cyst unroofing. Finally, they performed 30 ARA independently under the mentor's super-vision. Pheochromocytoma was ruled out for its large tumor size and potential cardiovascular risk. The patient selection criteria were the same as those of the initial 30 cases performed by the tutor. Preope-rative data of the initial 30 ARA performed by each trainee and tutor which included gender, age, body mass index, tumor size, tumor location and pathological diagnosis of tumor were compared between trainees and the tutor. The intraoperative and postoperative data of 150 ARA in the trainees were compared with the initial 30 ARA of the tutor. These included mean operative time, estimated blood loss, length of hospital stay, conversion rate, complication rate. Qualitative and quantitative data were compared between the groups using x2 and t test statistics methods by SPSS 12.0 for Windows, except operative time, which was from a nonnormal distribution. A P value less than 0.05 was consi-dered to be statistically significant. Results Preoperative data of the initial 30 ARA performed by each trainee were marched to those of the mentor (all P>0.05). All ARA were completed successful-ly. No procedure converted to open surgery. The median operative time of the trainees was 82 min (range 59-133 min), which was less than that of the tutor [132 min (range 73-230 min), P< 0.01]. And the trainees' learning curve was flatter than their tutor's. Estimated blood loss and length of hospital stay for the 5 trainees and the tutor were 62.2±22.0 ml, 4.8±1.3 d and 63.9±21.1 ml, 4.5±1.4 d respectively. There was no significant difference between these results (both P>0.05). No major complication was observed. Though the total perioperative complication rates were no diffe-rence between the trainees and their tutor (8.0% versus 13.3%, P>0.05), intraoperative minor complication rates of the trainees (1.3%) was less than that of the tutor (10.0%, P<0.05). Con-clusion The staged laparoscopic training is safe and feasible for young urological doctor to study in performing ARA.

Objective To study the endoscopic anatomical structures in retroperitoneal space and to share experiences of retroperitoneoscopic radical nephrectomy. Methods Between January 2006 and March 2008, a total of 85 patients underwent retroperitoneoscopic radical nephrectomy. Thirty-eight tumors were on the left kidney and 47 on the right side. The mean tumor size was 5.5± 1.7 cm in diameter (2.5 to 10.5 cm). There were 74 cases in clinical stage T1N0M0 and 11 cases in T2N0M0. Following the principle of radical nephrectomy outside the renal fascia, the whole surgical procedure was performed along "2 spaces" and "2 poles". The ventral attachment of the kidney was dissected in anterior pararenal space between peritoneum and anterior renal fascia. The dorsal attachment was dissected in anterior psoas space between posterior renal fascia and psoas fascia. The cepha-lic attachment was dissected up to the subdiaphragmatic and down to iliac fosse. During the proce-dure, important anatomic structures such as parietal peritoneum and its reflexion, anterior renal fasci-a, lateroeonal fascia, posterior renal fascia, psoas muscles, greatvessels and their branches were care-fully identified. Results One case was converted to open surgery because of severe and extensive ad-hesion of the right kidney to the adjacent tissues. The other 84 procedures were successfully comple-ted. The median operative time was 65 rain (range 50 to 165 min) and median estimated blood loss was 58 ml (range 25 to 600 ml). Of all operations, peritoneum perforation occurred in 5 cases and small vessel injuries around renal pedicles were observed in 6 cases. Major complication such as great vessel injury was not observed. Mean follow-up of all 85 patients was 10 months (range 2 to 25 months). No local recurrence and port site tumor seeding was found. Conclusion During retrope-ritoneoscopic radical nephrectomy, studying anatomical features of renal area and recognizing impor-tant anatomic structures will help to improve the safety of the surgery and reduce morbidities.