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.

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

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.

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 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

Objective To study the ultrastructure of the renal papillary Randall's plaque in calclum oxalate stone formers. Methods The 14 biopsy samples of the Randall's plaque in 12 patients with calcium oxalate stone undergoing PCNL for stone removal were obtained using endoscopic biopsy technique,followed by staining with hematoxylin-eosin or fixing with osmium tetroxide,and then the ultrastructure of the Randall's plaque was observed under light microscope and transmission electron microscope. Results In all 12 patients,72 renal papillae were examined.All kidReys were found to have papillary plaque and 7 of the patients had attached stones.Sixty-three papillae(87.5%)contained plaque.Calcium deposition was seen in the 12 renal papilla tissue by light microscopy.Transmission electron microscopy images of the 2 Randall's plaque samples showed several cluster of sharp and large crystals lied closer to the surface of Randall's plaque.The typical crystals were acicular with light profile. Conclusions Randall's plaque is an interstitial medullary and papillary deposit of calcium oxalate.The appearance of the deposition of calcium oxalate crystals lies upon Randall's plaque,which might be an explanation for the mechanism of calcium oxalate stone formation.

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: Epithelial dysplasia of the esophagus and gastric cardia is precancerous lesion, including mild, moderate and severe levels. In 2000 year, WHO recommended to replace dysplasia with intraepithelial neoplasia. Mild and moderate dysplasia were classified as low-grade intraepithelial neoplasia (LIN). Cardia adenocarcinoma was suggested to be called esophageal-gastric junction adenocarcinoma. The risk of cancer development and the rule of time evolution were detected in esophagus and esophageal-gastdc junction LIN in high incidence area of esophageal cancer in Northern China, in an effort to provide scientific data for the prevention of esophageal cancer. Methods: Between October 2001 and October 2002, two townships of Cixian were chosen to carry out endoscopic iodine staining screening cohort study. The total population aged 0-85 was 22,016, of which 6,596 aged 40-69 (3257 males and 3339 females). Except for thoese with contraindications and those who refused to join the study, 3,506 cases were finally recruited in the study, and the screening rate was 53.2%. According to WHO criteria of the pathological diagnosis, the esophageal squamous epithelium with mild and moderate dysplasia and esophageal-gastric junction with mild dysplasia were classified into LIN groups (including 616 cases). The control group contained a total of 2,478 cases without precancerous lesions and free of cancer in endoscopic screening. Results: From June to September in 2008, the cohort was followed up and 174 cases were lost, with a follow-up rate of 95.0%. Follow-up was 3,970.7 person- years in the LIN group and 16,120.0 person-years in the control group.Carcinomous conversion rates were 251.7 and 68.2/per 100,000 person- years respectively in the LIN group and the control group. The median time in the two groups was 38 and 47 months, respectively. Compared with that of the normal population, the relative risk (RR) of LIN was 3.69 (95% CI=1.57-8.69, P=0.001). Conclusion: Population with LIN are at high-risk for esophageal cancer and endoscopic examination every year is absolutely necessary.