OBJECTIVETo explore the surgical method and its clinical effects of minimally invasive osteosynthesis on the treatment of complex ankle fractures.

METHODSFrom January 2007 to December 2011, 53 patients with complex ankle fractures were treated with minimally invasive osteosynthesis. There were 31 males and 22 females, with an average age of 38.2 years old (ranged, 18 to 65). According to the system of Lauge-Hansen, 32 fractures were supination external rotation injury (grade WV), 13 fractures were pronation external rotation (grade III or IV), 5 fractures were pronation abduction (grade III); and 3 fractures can not be classified due to serious comminution fracture of fibula. According to the system of Denis-Weber, there were 4 cases with type A, 34 cases with type B and 15 cases with type C. Seven cases were open fractures. The duration from injuries to operation ranged from 2 hours to 14 days with an average of 5 days. The sequence of reduction and fixation of ankle fractures was firstly posterior malleolus, then medial malleolus and lateral malleolus, and inferior tibiofibular syndesmosis lastly. The fractures of posterior malleolus were reduced and fixed through anterior ankle approaches; the fractures of medial and lateral malleolus were percutaneously fixed with bolts or blade plate or tensile force band; and inferior tibiofibular syndesmosis were firmly fixed if necessary. Baird-Jackson scoring system was used to evaluate clinical effects.

RESULTSForty-eight patients were followed up from 10 to 36 months with an average of 13 months. The fractures got healing with an average time of 12 weeks (ranged, 10 to 18). According to the Baird-Jackson scoring system, the mean score of ankle function was 94.7 +/- 4.2, and 28 cases obtained excellent results, 15 good, 3 fair and 2 poor. One case experienced superficial infections and was cured by changing dressings, 2 cases experienced fixed syndesmosis screw breakage.

CONCLUSIONThe surgical method of minimally invasive osteosynthesis can ensure the anatomical join restoration, protect the blood supply of fracture end, rebuild the function of ankle joint, obtain satisfactory clinical results in treating complex ankle fractures.

Adolescent ; Adult ; Aged ; Ankle Fractures ; Ankle Joint ; physiopathology ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods

Benign biliary stricture is a challenging problem in hepatobiliary surgery. Benign biliary stricture is associated with major portal vein variation, which is not be found in literatures. A male patient with benign biliary stricture was admitted to the Chinese PLA General Hospital in March, 2010.The stricture was located in the hilar confluence with intrahepatic biliary dilation and hepatolithiasis. The result of computed tomography showed that the hilar biliary confluence was compressed by the left portal vein and right anterior portal vein. The patient was cured after receiving gallbladder interposition, choledocholithotomy and T tube drainage. We suggested that the benign hilar biliary stricture due to portal vein variation may be named as biliary nut-craker syndrome.

Objective To evaluate the image quality of 64-multi detector computed tomography (MDCT)and the clinical accuracy in detecting coronary artery lesions.Methods One hundred and five patients were studied by MDCT.The results were compared with invasive coronary angiography(ICA). Patients were excluded for atrial fibrillation,but not for high heart rate,coronary calcification,or obesity. MDCT was analyzed with regard to image quality and presence of coronary artery lesions.Results The data evaluation of the image quality was based on a total of 1365 segments(13 coronary segments for each patient),of which 1144 segments were considered to have diagnostic image quality,but 221 segments (16.2%)could not be sufficiently evaluated because of severe calcifications(153 segments)and motion artifacts(68 segments).The median calcium score[Agatston score equivalent(ASE)]was 154(range 0—1983).87 of the 105 patients had an ASE of less than 1,000[median 105(range 0—994)],and 18 patients had an ASE greater than 1000[median 1477(range 1115—1983)].For detecting lesions with 50% or greater narrowing(without any exclusion criteria),the overall sensitivity,specificity,positive predictive value,and negative predictive value were 85.7%,97.9%,93.0%,and 95.5%,respectively. When limiting the number of patients to those with a calcium score of less than 1000 ASE,the threshold- corrected sensitivity for lesions with 50% or greater narrowing was 96.0%;specificity,98.9%;positive predictive value,95.3%;and negative predictive value,99.0%.Conclusion Our results indicate high quantitative and qualitative diagnostic accuracy of 64-slice MSCT in comparison to QCA in a broad spectrum of patients.

Previous methods used for nuclear transplantation were further investigated to develop a method that was both easy to carryout and did not require any special apparatus, such as Piezoimpact or Spindle-View. Following the puncture of zona pellucida with two holes by injection pipette that contained donor nuclei or cells, the injection pipette was pulled back to the perivitelline space while the negative pressure was increased in the holding pipette until the polar body and karyoplasm were wiped off completely. Then a reconstructed embryo was completed by the direct injection of the donor nucleus or cell without pulling out the injection pipette. 200 oocytes were manipulated using this method and it cost about 40 seconds with nucleus injection and about 30 seconds with cell injection to complete a reconstructed embryo. The success rates were 62.6% and 86. 0%, respectively, and enucleation rate was about 73.3% validated by Hoechst 33342. Using this method, the nucleus was completely eliminated and another was injected using the microscope and micromanipulator. Moreover, the efficiency of nuclear transplantation and survival rate of reconstructed embryos were greatly improved. Furthermore, it is very easy to manipulate and popularize in practice.
Animals ; Cell Culture Techniques ; methods ; Cell Nucleus ; metabolism ; Cells, Cultured ; Cloning, Organism ; methods ; Embryo, Mammalian ; cytology ; metabolism ; Embryonic Development ; Female ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Inbred DBA ; Mice, Inbred Strains ; Nuclear Transfer Techniques ; Oocytes ; cytology ; metabolism ; Zona Pellucida ; metabolism

Liver X receptor (LXR), a member of the superfamily of nuclear receptors, plays an important role in the activation of transcription factors involved in cholesterol metabolism, glucose homeostasis inflammation and lipogenesis. It is shown that LXR agnoists have the potentiality to be used as drugs for the prevention and treatment of atherosclerosis, which is its best investigated therapeutic indication. There are many compounds being studied in preclinical evaluation and biological assay. This paper will review briefly the LXR agonists in recent years.
ATP-Binding Cassette Transporters ; metabolism ; Amines ; chemical synthesis ; chemistry ; pharmacology ; Animals ; Atherosclerosis ; drug therapy ; metabolism ; Benzimidazoles ; chemical synthesis ; chemistry ; pharmacology ; Cholesterol ; analogs & derivatives ; pharmacology ; Glucose ; analogs & derivatives ; pharmacology ; Humans ; Lipid Metabolism ; Lipogenesis ; Liver X Receptors ; Orphan Nuclear Receptors ; agonists ; physiology ; Quinolines ; chemical synthesis ; chemistry ; pharmacology ; Sterol Regulatory Element Binding Protein 1 ; metabolism

OBJECTIVETo discuss the anti-tumor effect of Xihuang pill on tumor-bearing rats and its effect on the immune clearance function of tumor-bearing organisms.

METHODWalker256 tumor cells were adopted to establish the tumor-bearing rat model. The rats were randomly divided into five groups: the normal control group, the model control group, the lentinan group and Xihuang pill low dose, middle dose and high dose groups, with 10 rats in each group, and continuously treated and given drugs for 14 d after modeling. Blood and tumors were collected from abdominal aorta to calculate the tumor inhibition rate. The content of CD3+, CD4+, CD8+ T cells and adhesion molecule B7-1 (CD80) in peripheral blood were detected by flow cytometry (FCM). The expressions of IL-2 and IFN-gamma in were determined by ELISA.

RESULTThe tumor inhibition rate of the Xihuang pill high dose group was 33. 1 percent. Compared with the model group, the Xihuang pill large dose group showed significantly low IL-2, IFN-gamma, CD3+, CD4+, B7-1 in peripheral blood, with statistical significance in their differences (P < 0.05).

CONCLUSIONXihuang pill could show its anti-tumor effect by enhancing the immune clearance function and increasing IL-2, IFN-gamma, CD3+ T, CD4+ T, B7-1 in peripheral blood.

Animals ; Antineoplastic Agents ; administration & dosage ; B7-1 Antigen ; genetics ; immunology ; Breast Neoplasms ; drug therapy ; genetics ; immunology ; CD4-Positive T-Lymphocytes ; drug effects ; immunology ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Flow Cytometry ; Humans ; Immune System ; drug effects ; Immunologic Factors ; administration & dosage ; Interferon-gamma ; genetics ; immunology ; Interleukin-2 ; genetics ; immunology ; Rats ; Rats, Wistar ; Tumor Burden ; drug effects

Objective To observe the efficacy of Shenfu Yangrong Decoction combined with routine Western therapy in the treatment of viral myocarditis (VMC) of Ⅰ– Ⅲ grades in children. Methods Totally 100 cases of VMC children were selected and divided into observation group and control group according to random number table method, with 50 cases in both groups. The control group was treated with routine Western therapy, while the observation group was combined with Shenfu Yangrong Decoction based on the control group, one dosage a day, twice a day, orally. The TCM syndrome scores, the serum levels of interleukin (IL)-17, IL-27 and nuclear factor - κB (NF-κB), the levevs of troponin Ⅰ (cTnⅠ) and cardiac free fatty acid binding protein (H-FABP) before and after treatment in both groups were compared, and the total incidence of adverse reactions during treatment was monitored. Results The total effective rate was 90% (45/50) in the observation group and 74% (37/50) in the control group. The observation group was significantly higher than the control group (χ2=4.336, P=0.037). Compared with before treatment, the scores of the main symptoms, the scores of the secondary symptoms, and the total scores of the two groups decreased significantly after treatment (P＜0.01). Comparing the two groups after treatment, the scores of main symptoms, scores of secondary symptoms and total scores of the observation group were significantly lower than those of the control group (P＜0.05, P＜0.01). Compared with before treatment, serum IL-17, NF-κB, cTnⅠ, H-FABP levels were significantly reduced (P＜0.01), while serum IL-27 levels were significantly increased (P＜0.01) in both group. After treatment, the levels of serum IL-17, NF-κB, cTnⅠ, and H-FABP in the observation group were significantly lower than those in the control group (P＜0.01), and serum IL-27 level in the observation group was significantly higher than in the control group (P＜0.01). The adverse reaction rate was 12% (6/50) in the observation group and 8% (4/50) in the control group, without statistical significance between the two groups (χ2=0.368, P=0.544). Conclusion Shenfu Yangrong Decoction combined with routine Western therapy for the treatment of viral myocarditis children of Ⅰ– Ⅲ grades can effectively reduce the symptoms of patients, inhibit inflammation, reduce myocardial injury, with high safety.

To study the effect of ligustrum fruit on spermatogenesis and blood gonadal hormones in diabetic rats.Methods: Experimental diabetes was induced in male Wistar rats with streptozotocin. Ligustrum fruit extract was given by gastric gavage at a dose of crude drug 30 g@ kg- 1@ d- 1 for 110 days. The serum gonadadotropic hormones and testosterone were determined on d 60 and testicular histology examined on d 110. Results: In the control diabetic rats, the seminiferous tubules were dilated and the spermatogenic cells irregularly arranged. Spermatogenesis was arrested with the number of spermatids highly reduced and spermatozoa not observed. In the treated rats, all types of spermatogenic cells were practically normal. The serum luteinizing hormone (LH), follicle-stimulating hormone (FSH)and testosterone levels were higher in the treated than in the control rats, but the difference was insignificant. Conclusion: In experimental diabetic rats, ligustrum fruit extract protects the damaging effect of experimental diabetes on spermatogenesis.

Objective To study the dynamic changes of the intestinal function of neurogenic bowel dysfunction rats caused by spi-nal cord injury using X-ray radiography. Methods Twenty-four female Sprague-Dawley rats were divided into control group (n=12) and spinal cord injury group (n=12). The T10spinal cord injury model was established using aneurysm clip (70 grams calibration force) for 60 seconds. The control group exposed the dura only. X-ray Barium was used to observe the dynamic changes of in-testinal function, and HE staining was used to observe the pathology of the colon before and four weeks after modeling. Results Compared with the control group, gastric emptying and intestinal transit function significantly reduced in the spinal cord injury group (P<0.05). Conclusion The spinal cord injury model can be successfully duplicated with aneurysm clip in rats; neurogenic bowel dysfunction occurs after spinal cord injury, gastric emptying and intestinal transit function are weakened.

UNLABELLEDTo evaluate the detection rate of myocardial bridging by 64-slice spiral CT coronary angiography.

METHODSThe data of 3011 patients with suspected coronary artery disease undergoing 64-slice spiral CT coronary angiography were collected and analyzed retrospectively.

RESULTSA total of 174 cases (5.8%) with myocardial bridging were detected by 64-slice spiral CT coronary angiography, among which 168 (96.6%) had single foci of involvement and 6 (3.4%) had were multiple foci. Involvement of the left anterior descending coronary artery (LAD) was detected in 167 out of the 174 cases (96.0%). The length of the myocardial bridge varied between 5 and 120 mm (mean of 30.5 mm), and the depth of the tunneled artery ranged between 1.3 and 2.8 mm (mean 2.3 mm). Seventy-nine of the cases (45.4%) had uncomplicated myocardial bridging and 95 (54.6%) had myocardial bridging complicated by coronary atherosclerosis.

CONCLUSIONMulti-slice spiral CT coronary angiography is a reliable and noninvasive modality for diagnosis of myocardial bridging to allow direct measurement of the length and depth of the myocardial bridge and detection of concurrent coronary and cardiac lesions.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Coronary Angiography ; methods ; Coronary Artery Disease ; complications ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; complications ; diagnostic imaging ; epidemiology ; Retrospective Studies ; Tomography, Spiral Computed ; methods