ObjectiveTo investigate the influence factors of operative effect in complex acetabular fracture. MethodsSixty-seven patients with complex acetabular fractures were selected. All patients were used surgical treatment,the clinical curative effect by Merle d'Aubigne-Postel hip scoring function to evaluate,set the age,sex, operation time,operative approach,the quality of fracture reduction,complex dislocation of the hip fracture and type of complex acetabular fractures with comparative index,the results were statistically analyzed. ResultsPatients were followed up for 6-24 months,the mean time was 14.6 months. Univariate analysis showed that the fine efficacy of surgery taken in no more than 2 weeks [84.0％ (42/50)]was better than more than 2 weeks [64.7％ ( 11/17 )](P ＜ 0.05 ). The high-quality of reduction [86.4％ ( 19/22 )]was better than low-quality of reduction [44.4％ (4/9)] (P ＜ 0.01 ). The compare of age,sex,operative approach,complex dislocation of the hip fracture were no statistically different (P ＞0.05).Complex acetabular fractures of T-shaped fracture healing rate was 85.7％ (12/14),the excellent rate was significantly higher than posterior column with posterior wall fractures[77.8％ (7/9)],transverse with posterior wall fractures [75.0％ (15/20)], anterior column with half of transverse fractures [66.7％ (2/3)],double-column fractures[71.4％ (15/21)],the results were statistically different. Conclusion The necessary conditions for ensuring fracture prognosis is the quality of reduction,timing of surgery,and type of fracture.

Objective To investigate the clinical changing trend and CT imaging diagnosis of thyroid cancer associated with thy-roid disease .Methods 1 120 cases of thyroid cancer patients admitted in our hospital in the past 10 years were selected and devided into different groups according to their admission times :patients admitted before 2003 were in one group;from 2003 on ,patients were divided into groups according to their admission time by a time span of 2 years ;then the changing trend and CT imaging diag-nosis of thyroid carcinoma with nodular goiter (NG) ,thyroid adenoma (TA) and merger trend of Hashimoto′sthyroiditis (HT ) of different times were compared and analyzed .Results There were 518 cases of papillary carcinoma(46 .25% ) ,345 cases of follicular adenocarcinoma ,(30 .80% ) ,158 cases of medullary carcinoma (14 .11% ) ,99 cases of undifferentiated carcinoma (8 .84% ) in 1120 patients .The occurrence rate of thyroid carcinoma with nodular goiter (NG) in 2009-2010 ,2011-2012 and the occurrence rate of thyroid carcinoma with HT in 2007-2008 ,2009-2010 ,2011-2012 were significantly higher than that of 2005-2006 (P<0 .05) . Take 2007-2008 as the deviding line of thyroid combined TA ,and it shows that the occurrence rate increased continuously before this line and started to drop down after that .CT of thyroid cancer shows uneven low-density imaging ,blur edge ,and inhomogeneous enhancement .The CT characteristics differ from different diseases .Conclusion In recent years the incidence rates of thyroid with nodular thyroid and HT increased significantly compared with the years before ,while incidence rate of TA decreased .

?DJ-1 has been reported to act as aredox-activated chaperone and sensor of oxidative stress participated in a variety of activities in cellular, playing an important role in resisting oxidative stress, regulating signaling pathways and gene transcription, and maintaining mitochondria dynamic balance. DJ -1 is closely related to the occurrence and development of various diseases. Recently, the effect of DJ-1 in eye diseases has drawn more attention, and researchers have found its significant role of resistance to oxidative stress in the pathogenesis of Fuchs endothelial corneal dystrophy ( FECD) and age-related macular degeneration ( AMD ) .This review will state the mechanism of DJ-1 against oxidative stress and its role in the development of eye diseases.

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Electrophoresis, Capillary ; Esters ; analysis ; Phthalic Acids ; analysis ; Sensitivity and Specificity

The clinical study on acupuncture-moxibustion of traditional Chinese medicine has been attracting more and more global attention. With the development of medical pattern, we hold that, to prove the therapeutic efficacy, not only modern clinical research methods should be adopted, but a scientific and standard evaluation method in accord with the features of acupuncture-moxibustion also needs to be developed. We also believe that, in the clinic of acupuncture-moxibustion, disease differentiation treatment and syndrome differentiation treatment share an equal role, as they are relatively independent but mutually unified, together boosting the completion of treatment for a type a disease in a dynamic variation process.

OBJECTIVETo investigate the short-term clinical outcome of unicompartmental knee arthroplasty for the treatment of spontaneous osteonecrosis of the knee.

METHODSFrom September 2013 to April 2014,5 patients with spontaneous osteonecrosis of the knee underwent unicompartmental knee arthroplasty, included 3 males and 2 females, aged from 65 to 80 years old with an average of 74 years. The courses of disease was from 1 to 6 years with the mean of 3 years. According to the radiographic staging criteria of Koshino, 1 case was stage II, 2 cases were stage III, 2 cases were stage IV. Clinical effects were assessed by VAS score, HSS score, and knee range of motion, tibiofemoral angle before and after operation.

RESULTSAll the patients were followed up from 6 to 7 months with an average of 6.4 months. All incisions obtained primary healing, and there were no complications such as infection, thrombosis, fracture of lower limbs. All 5 patients' pain relieved and their knee function improved significantly after operation, but knee range of motion had no obviously improved. Postoperative HSS scores, VAS scores, tibiofemoral angle were significantly improved than that of preoperative.

CONCLUSIONThe short-term effect of unicompartmental knee arthroplasty in treating spontaneous osteonecrosis of the knee is satisfactory.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Diseases ; physiopathology ; surgery ; Knee Joint ; Male ; Osteonecrosis ; physiopathology ; surgery ; Range of Motion, Articular

OBJECTIVETo investigate the protective effect of melatonin on residual hair follicle cells of scald rats at early stage.

METHODSEighteen male Sprague-Dawley rats were randomly divided into scald group, treatment group, sham group , with 6 rats in each group. The rats in scald group and treatment group were subjected to 30% TBSA partial thickness scald on the back, and were resuscitated with balanced solution after 1 hour, while those in sham group were immersed in water at 37 degrees C for 25 s to simulate scald, and did not receive fluid replacement. Rats in treatment group were intraperitoneally injected with 10 mg/kg melatonin solution at 1 minute, 8 hours and 12 hours after scald, while those in sham group and scald group were given equal volume of 1% alcohol sodium-isotonic saline instead. Tissue samples were harvested at 6, 12 and 24 post scald hours (PSH) for determination of MDA and GSH levels. Apoptosis of residul hair follicle was detected by TUNEL method and immunohistochemistry of caspase-3.

RESULTSThe level of MDA in scald group at each time point was much higher than that in sham group (P < 0.01) and treatment group (P < 0.05), and it peaked at 12 PSH. The changes in GSH were just opposite to that of MDA. Under fluorescence microscope, the residual hair follicle cells were blue, and the apoptotic cells appeared green. The apoptosis rate in scald group at 6, 12, 24 PSH was obviously higher than that in sham (P < 0.01) and treatment groups (P < 0.05), which was (20.2 +/- 3.4)% vs (4.3 +/- 2.3)% vs (10.9 +/- 3.2)%, (31.2 +/- 3.6)% vs (5.1 +/- 2.5)% vs (19.1 +/- 3.7)%, (22.4 +/- 2.7)% vs (4.1 +/- 2.4)% vs (13.1 +/- 3.4)%, respectively. The score of caspase-3 positive cell in scald group was higher than those in sham group (P < 0.01) and treatment group (P < 0.05).

CONCLUSIONSThere is obvious correlation between oxidative stress and apoptosis rate of hair follicle cells in rats with partial thickness scald. Early administration of melatonin may have anti-apoptosis ability for residual hair follicle cells by attenuation of oxidative stress.

Animals ; Apoptosis ; Burns ; drug therapy ; metabolism ; Hair Follicle ; cytology ; metabolism ; Male ; Melatonin ; therapeutic use ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley

Objective To summarize the experience in surgical management of hilar cholangiocarcinoma.Methods The clinical data of 88 patients with hilar cholangiocarcinoma who received surgical treatment at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.All the patients were diagnosed by imaging examination.According to the severity of jaundice and predictive remnant liver volume,19 patients received percutaneous transhepatic cholangial drainage (PTCD) and 4 received portal vein embolization.The fundamental operation consisted of hilar cholangiocarcinoma resection,skeletonization of hepatoduodenum ligament and Roux-en-Y cholangiojejunostomy,and the transanastomotic stent was placed for 6 months.The count data were analyzed using the chi-square test; the survival rate was analysed using the Kaplan-Meier method; the survival was analyzed using the Log-rank test.Results Of the 88 patients,58 patients (including 11 patients who received PTCD) received hilar cholangiocarcinoma resection.Of the 58 patients,43 (including 4 patients who received portal vein embolization preoperatively) received R0 resection,and 15 received palliative resection.Thirty patients received internal and (or) external drainage.Commitant partial hepatectomy was performed on 22 patients (including 9 received left hemihepatectomy,2 received extended left hemihepatectomy,7 received left hemihepatectomy + caudate lobectomy,4 received right hemihepatectomy).Commitant pancreatico-duodenectomy was performed on 7 patients,commitant hepatic artery resection on 3 patients,and commitant portal vein resection on 2 patients.According to the modified Bismuth-Corlette classification,there were 17 patients with type Ⅰ,19 with type Ⅱ,21 with type Ⅲa,20 with type Ⅲb,and 11 with type Ⅳ.Of the 58 patients who received hilar cholangiocarcinoma resection,19 had postoperative complications,and 2 patients died within 30 days after operation.Seventy-three patients were followed up,and the overall 1-,3-,5-year survival rates were 68.5％,28.8％,11.0％,respectively.The 1-,3-,5-year survival rates of patients who received R0 resection were 94.6％,43.2％,18.9％,respectively,which were significantly higher than 78.6％,35.7％ and 7.1％ of patients who received palliative resection (x2=4.77,P ＜0.05).The 1-,3-,5-year survival rates of patients who received palliative resection were significantly higher than 18.2％,0,0 of patients who received biliary drainage (x2 =13.26,P ＜ 0.05).Conclusions R0 resection is the best choice for patients with hilar cholangiocarcinoma,and biliary drainage with no resection is the last choice.Sufficient preoperative treatment,optimized choice of surgical procedure and exquisite surgical techniques are important for the improvement of the prognosis.

Objective To study the pathogenic bacteria distribution and drug resistance characteristics in HIV/AIDS patients with lower respiratory tract infection in Yunnan province, so as to guide the clinical medication. Methods We collected 278 cases of hospitalized patients with sputum,alveolar lavage specimen smear, culture, positive specimens from HIV/AIDS patients with lower respiratory infection in The Third People’s Hospital of Kunming from January 2008 to December 2012. Then we retrospectively analyzed the collected data. Results From 278 cases of sputum and alveolar lavage fluid specimens,we isolated a total of 127 strains of bacteria (45.7%), 53 strains of fungus (19.1%),50 strains of white candida,3 strains of aspergillus,49 strains of mycobacterium, 44 strains of mycobacterium tuberculosis,and the rest of atypical mycobacteria. Gram negative bacilli accounted for 64.6%,followed by pneumonia klebsiella bacteria, pseudomonas aeruginosa,e. coli,acinetobacter,sewer,e. coli, gram-positive bacteria accounted for 15.4%. Fungi accounted for 19.1%, and candida albicans was the common fungus. Mycobacterium tuberculosis accounted for 17.6%. Gram-negative bacilli were sensitive to imipenem, ptilinum ketone/sulbactam and amikacin,gram-positive bacilli were sensitive to vancomycin, nitrofurantoin and imipenem. Conclusions The major pathogenic bacteria are gram-negative bacilli in HIV/AIDS patients with lower respiratory tract infection in Yunnan province,but fungal infection ratio is increasing year by year, and conditional pathogenic bacteria are the major pathogen,which have antimicrobial resistance with different degree,TB infection rate is high and multi-drug resistant TB appears. Antimicrobial agents should be rationally used to delay the appearance of pathogen resistance.

OBJECTIVETo observe the clinical efficacy and safety on moderate and severe persistent allergic rhinitis treated with acupuncture.

METHODSSixty-six patients of moderate and severe persistent allergic rhinitis were randomized into an acupuncture group (34 cases) and a western medication group (32 cases). In the acupuncture, group, acupuncture was applied to Dazhui (GV 14), Feishu (BL 13), Pishu (BL 20), Ganshu (BL 18) and Shenshu (BL 23) in the prone, retained for 20 min; then in the supine, at Baihui (GV 20), Yintang (GV 29), yingxiang (LI20) Taichong (LR 3) and Hegu (LI 4), retained for 20 min. Acupuncture was given once every two days, three times a week, continuously for 8 weeks. In the western medication group, cetirizine hydrochloride was taken orally, 10 mg each time, once every day, continuously for 8 weeks. Separately, before treatment, after the treatment of 1 and 2 months and in 1 month after treatment, the total nasal symptom score (TNSS), the scores in the emotion rating scale for Ganzangxiang of TCM (ERSG) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were observed in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTS(1) For TNSS, the results after 1 and 2 months treatment and in 1 month after treatment were all, reduced as compare with that before treatment separately in the two groups (P < 0.05, P < 0.01) The result after 2 months treatment was lower than that after 1 month treatment in the acupuncture group (P < 0.05). In 1 month after treatment, the result in the acupuncture group was lower than that in the western medication group (P < 0.05). (2) For ERSG, the score after 2 months treatment was lower than that before treatment in the two groups (both P < 0.05). The score after 2 months treatment in the acupuncture group was lower than that in the western medication group (P < 0.05). (3) For RQLQ, the score after 1 month treatment was lower than that before treatment and the score after 2 months treatment was lower than that after 1 month treatment in the two groups (all P < 0.05). The score after 1 and 2 months treatment and in 1 month after treatment in the acupuncture group was lower than that in the western medication group separately (all P < 0.05). (4) The total effective rate was 91.2% (31/34) in the acupuncture group and was 90.6% (29/32) in the western medication group, without significant difference between the two groups (P > 0.05).

CONCLUSIONAcupuncture is the safe and effective intervention on moderate and severe persistent allergic rhinitis. Compared with the western medicine group, the efficacy in the acupuncture group presents much more advantageous at its durability.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; diagnosis ; therapy ; Young Adult