Docetaxel and vinorelbine, which were plant alkaloids, had showed the good activities as chemotherapy of breast cancer. Combination chemotherapy with docetaxel and vinorelbine had drawn more and more attention. This papers reviewed the docetaxel/vinorelbine combination treatment of breast cancer.

Objective To explore an effective prevention and management of nonunion and malunion due to insidious infection after fracture internal fixation. Methods From January 2001 to January 2006,we treated 26 patients with nonunion and malunion due to insidious infection after fracture internal fixation.They were 15 cases of femoral fractures, 2 cases of ulna fractures, 3 cases of radial fracturos, 3 cases of humerus fractures, and 3 cases of tibial fractures. The patients were treated with irrigation after debridement.In 23 fractures, the internal fixation was dislodged and changed into external fixation. In the 3 cases whose internal fixation remained, instillation and drainage were conducted after debridement. Bone grafting was performed for 20 cases after replacement of internal fixation, and for 3 cases after removal of external fixation.Three patients received no bone graft. Results The preoperative X-ray findings confirmed the diagnosis of insidious infection in 21 cases, while the other 5 cases were diagnosed by bacterial culture or pathological examination of the pus and inflammatory granulation tissue found during surgery. The bacterial culture was positive in 17 cases, including 6 cases of Staphylococcus epidermidis, 8 cases of Staphylococcus aureus, and 3 cases of Escherichia coli. All the patients were followed up for 8 to 48 months, with an average of 23.5 months. Of the 26 cases, 22 obtained bony union, 2 partial union and 2 nonunion. Complications included fistula in 2 patients and infection relapse in 3 patients. Conclusions Insidious infection may be related to the bacterial toxicity, anatomical sites and surgical methods. X-ray changes may help the diagnosis of insidious infection. Surgery is necessary for management of nonunion and malunion due to insidious infection after fracture internal fixation.

Objective To investigate the multi-slice spiral computed tomography (MSCT) features of crush maxillofacial frac-tures in the massive Wenchuan earthquake. Methods MSCT data of 85 patients with crush maxillofacial fractures caused by earth-quake were retrospectively analyzed. The anatomic distribution of fractures was evaluated. Results In 85 patients, single bone frac-tures (59 patients) were more common than multiple bone fractures (26 patients) (P<0.05). The fractures involved isolated mid-face, isolated mandible, and both were found in 49 patients (57.6%), 24(28.2%), and 12(14.2%), respectively. Midface frac-tures were most frequent (P<0.05). The fractures of condyle, posterolateral and anterior wall of maxillary sinus, zygomatic arch and lateral orbital wall accounted for 47.1%(24/51) ,41.5%(22/53) , 37.7%(20/53),71.9% (23/32) and 63.2%(24/38) of the total fractures of the corresponding maxillofacial bones. Conclusion Isolated bone fracture and midface factures are the main fea-tures of crush maxillofacial fractures resulted from the massive earthquake. MSCT and three-dimensional reconstruction images can demonstrate maxillofacial fractures well.

Diverticulitis of colon,the inflammation of colonic diverticulars,is connected with dietary,age and disorder of colonic environment.Due to the different cultures between western contries and orient nations,the morbidity,predilection site,clinical manifestation and management are different in diverticulitis of colons.Computed tomography(CT)has been the key diagnosic method,and it is able to guide transfixion pins to treat diverticulitis of colon.After medical treatment,most of patients can be relaxed,and only someone need operations.

With the age increasing,the lobules in women's breasts undergo progressive involution or regression,which is called age-related lobular involution.It's a physiologic and irreversible process,while the rate and extent of involution vary considerably among individual women.It has been hypothesized that the extent of age-related lobular involution is strongly associated with a reduced risk of breast cancer,and there are some associations between lobular involution and risk factors of breast cancer.

BACKGROUND: Autologous bone marrow transplantation (ABMT) has been widely used in treatment of the malunion of fracture, but this treatment to cure malunion of fracture induced by infection is still not consistent.OBJECTIVE: To observe the application and clinical outcome of ABUT for the malunion of fracture induced by infection.DESIGN, TIME AND SETTING: A retrospective analysis. The patients were all enrolled at Department of Orthopaedics in the Third Affiliated Hospital of Hebei Medical University from January 2001 to January 2006. PARTICIPANTS: A total of 19 patients with malunion of fracture induced by infection, including 13 males and 6 females aged from 18 to 50 years, with an average of 36. The lesioned site contained fracture of tibia 10, fracture of femur 5, fracture of ulna 2 and fracture of humerus 2. Among them, there were 6 cases with bone defect, 9 cases with bone fracture delayed union and 4 cases with bone fracture disunion.METHODS: Nineteen patients treated with percutaneous ABUT. Among the 19 cases, 12 patients received the transplant 3 weeks after infection was under controlled, and other 8 patients received the transplant following autologous bone transplantation.MAIN OUTCOME MEASURES: After ABMT, all patients were checked using X-ray regularly, the pacing of bone union was traced through observing the growth of callus, and the side reaction was also detected.RESULTS: Totally 19 patients were included in the follow-up visit, and 15 cases of them achieved bony union. Clinical healing time was 7-20 weeks. The patients had no obvious discomforts except local gas pains when injecting and at pristine time after injection. Five patients had a small quantity of exudation. No infection relapse or soft tissue ossification were observed at the injection position. Four patients had not achieved bony union, the reason was that bone defect in 2 patients exceed 2 cm; fracture disunion with pseudoarticulation formatted in one patient, the sclerous broken ends of fractured bone was more than 2 cm; another patient's external fixation displaced, we adjusted it and the bone healed after 12 weeks. Three patients received autoallergic ilium bone transplantation in the second time of operation, the fractured bone got bony union. CONCLUSION: ABMT by percutaneous injection into malunion site can induce ossification, repair bone fracture and bone defects. The clinical application is simple and exhibits small wounds without complications. Especially ABMT is effective for the patient with the malunion of fracture induced by infection.

[Objective]To research the effect of using Ilizarov technique in bone transmission and fascia skin flap for large defeciency of bone and soft tissues of lower limb.[Method]There were 12 patients in our group,11 patients had severe compound trauma of the leg,one in arm.Bone defeciency range was 4～12 cm,average 8 cm,cotaneous defeciency was 4?5 cm2～14?5 cm2,and all of them had acute infection.Nine had been treated with leg lateral fascia skin flap,1 had been treated with leg fascia skin flap,1 had been treated with the opposide leg skin flap,1 had been treated with the arm fascia skin flap,in 12 bone transport,elongation range was 4～12 cm,average 8 cm.Eight had been used double arms external fixation device,4 cases had been used circle shape external fixation device.[Result]Totally 12 patients were followed up for 2～10.8 years(average,4.2 years) elongation part and compressed part healed naturally,all of the fascia shin flap were alive.No bone ununion and chronic osteomyelitis appeared.[Conclusion]Using Ilizarov bone transport technique and fascia skin flap is a good way for treating large defeciency of bone and soft tissue.Its advantages:(1)The wound limb can maintain stability by external fixatian device.The methed of the bone transportation can fill big section bone deficiency;(2) In the same time the fascia shin flap may be transported,and repair soft tissue deficiency,provide good condition to bone's healing and control infection;(3)The external fixation device can provide distraction and compression functions,this function makes elongation part and compressed part obtain the reasonable biomechanics condition which would be good to bone healing;(4)The course of bone transmission can stimulate bone repair mechanisms,to enhance the wound limb metabolism,increase blood supply circularation,the grown bone factor aggregation,enhance the body's initiative repair mechanisms and infection controlling mechanism;(5)In the protection of the external fixation device,the patient's wound limb can do early rehabilitation,thus can avoid osteoporosis and joint dyfunction because of the lone-term immobility;(6)To use these methods,the treatment period will be shortened,antibiotic application will be decreased,the treatment cost will be lower than other methods and complications will be decreased as well.

[Objective]To study diagnosis and treatment of insidious infection after the internal fixation of long bone fracture.[Method]Thirteen patients with insidious infection after internal fixation of long bone fracture were treated with irrigation after debridment. Among the 13 cases 8 fractures were dislodged internal fixation and then were fixed with the external fixation. 5 fractures were remained the internal fixation and were instilled after debridment. All of the patients were given with antibiotics for 2～3 weeks after operation.[Result]All the 13 patients were followed up. The follow-ranged from 8 to 48 months with an average of 23.5 months. Among the thirteen patients 11 fractured-bone had bony union, one nonunion and one case had fistula, Infection relapsed in two patients.[Conclusion]Bone defects, fracture nonunion often occur on patients who have insidious infection after internal fixation of long bone fracture. These patients need to be operated. In slight infections fracture can be remained after debridement. Fractures with seriously infectious have to dislodge internal fixation and to be fixed with made according to its radiographic changes.

Objective To explore the influence of Al2O3 nanoparticle (20nm in average) on RP4-mediated conjugation and its mechanism was explored further. Methods Mating was conducted between E.coli HB101(RP4) and Salmonella aberdeen Kauffmann 50312(strR) in saline at 25 ℃ without stirring for 8 h,the concentrations of Al2O3 nanoparticle were 0.005,0.05,0.5,5,50 mmol/L respectively. The initial concentration of donor and recipient were both about 109 cfu/ml(donor per recipient ratio was 1∶3).Later transmission electron microscope(TEM) and laser scan confocal microscope (LSCM) were exploited to investigate cell morphology and structure. Results 5 mmol/L and 50 mmol/L Al2O3 nanoparticle could increase the conjugal transfer frequency by 150-fold and 40-fold respectively. TEM observation on thin section indicated several bacterial were prone to form conjugational junction together in 5 mmol/L and 50 mmol/L Al2O3 nanoparticle treated group,which was rarely seen in control group. Meanwhile the cell envelope of bacterial was significantly damaged upon the treatment by 50 mmol/L Al2O3,which might be the reason why transfer frequency of 50 mmol/L Al2O3 group was less than 5 mmol/L Al2O3 group. LSCM result indicated that Al2O3 nanoparticle might damage cell envelope and the damage was positively related to the accumulation of Al2O3 in bacterial. Conclusion Al2O3 nanoparticle can stimulate RP4 conjugal transfer. Conjugative gene is highly regulated. Al2O3 nanoparticle might modulate conjugative gene expression directly or influence cell membrane permeability and thus modulate the process of conjugation indirectly .

Objective To compare the immediate therapeutic effects between endovenous laser treatment and conventional surgery for lower extremity varicosity.Methods Data of 350 limbs of 275 patients treated by endovenous laser treatment (endovenous laser treatment group) and 310 limbs of 210 patients by traditional surgery (traditional surgery group) were analyzed and compared in terms of operation time,number of the incision,postoperative pain,complications,postoperative hospitalized duration and 1-year recurrence rate.Results Endovenous laser treatment group had shorter operation time,fewer incisions,less postoperative pain and shorter postoperative hospitalized duration than traditional surgery group (P0.05).Conclusion As a safe and effective new treatment for lower extremity varicosity with minimal invasiveness and no left scars,endovenous laser treatment has the potential to replace conventional surgery and extend the surgical indications for lower extremity varicosity treatment.