Objective To compare proximal femoral nail(PFN)introduction by percutaneous K-wire through a small incision with conventional PFN introduction protocol in the treatment of intertrochanteric fractures. Methods From January 2004 to March 2005,51 patients with intertrochanteric fractures were randomly dis- tributed into a minimally invasive treatment group(group MI)and a conventional treatment group(group C).All the fractures were closely reduced.In group MI a K-wire was percutaneously inserted through the tip of the greater troehanter into the center of medullary canal of the pruximal femur before the PFN was inserted under the guidance of K-wire through a small incision made along the K-wire while in group C the PFN was introduced according to the conventional procedure.The operation time,intra-operative blood loss,length of incision,X-ray exposure,duration of in-patient stay and time of bone union in both groups were recorded and compared.Results The mean oper- ation time,mean intraoperative blood loss and mean length of incisions in group MI were 77.20 min,104.20 mL and 5.12 cm respectively and significantly lower than those in group C(P＜0.01).The X-ray exposure and the reduction time in group MI lasted longer than in group C(P＜0.01).The mean time of bone union and in-patient stay in both groups were nearly equal(P＞0.05).At the latest tollow-up,all the fractures united in both groups without nonuuion or delayed union.Conclusion Compared with the conventional protocol,introduction of PFN by a pereutaneuus K-wire inserted into the central medullary canal of the proximal femur is much more minimally in- vasive and effective.

Ergosterol is the important component of the fungal membrane, and having stable structure. This makes it a suitable indicator for growth of fungi. In the paper, isolation and determination techniques of ergosterol as the indicator of the fungal biomass were reviewed. The methods of extracting ergosterol include traditional saponification and refluxing, rapid physical disruption, rapid ultrasonication, supercritical fluid extraction and so on. The ergosterol determination methods are high performance liquid chromatography, gas chromatography-mass spectrometry, liquid chromatography-mass spectrometry, and thin-layer chromatography, et al. The application of these techniques was also introduced. Finally, the paper prospected the feasibility of applying the ergosterol as the indicator of fungal biomass in composting.

Objective To summarize the therapeutic results and experience of the interventional managements for pseudoaneurysms occurred after surgery. Methods Five pseudoaneurysms with different location that occurred after surgery in five patients were treated with different interventional managements. One patient suffered from a ruptured pseudoaneurysm of left common iliac artery, which was treated by obstructing the diseased artery with balloon via the abdominal aorta followed by the replacement of vascular prostheses. One patient had a pseudoaneurysm of right subclavian artery and endovascular covered stent was employed to isolate it. The remaining three patients were affected by pseudoaneurysm of terminal arteries and intraarterial embolization with gelfoam and/or steel coils was camed out. Results Complete closing of the pseudoaneurysm was obtained in all five patients and no therapy-related complications occurred. Conclusion Pseudoaneurysms occurred after surgery can be effectively treated with different interventional managements, it is worth popularizing this technique in clinical practice.

AIM: To evaluate the anatomic and visual outcomes of 25-gauge vitrectomies combined with air tamponade for the treatment of idiopathic macular hole (IMH).METHODS: Thirty eyes of 27 patients with IMH were included in this prospective interventional study.All patients underwent 25-gauge pars plana vitrectomy (PPV) combined with phacoemulsification and air tamponade.Best corrected visual acuity (BCVA, logMAR), perimetry and multifocal electroretinography (mfERG) were conducted before and after the operation.Anatomical changes were evaluated with optical coherence tomography (OCT).RESULTS: The macular holes closed successfully in 28 eyes after the primary vitrectomy.The mean BCVA improved from 0.72±0.22 logMAR preoperatively to 0.29±0.18 logMAR postoperatively (P<0.001).In the visual field of central 10°, the average mean deviation (MD) decreased from-3.59±1.83 dB preoperatively to-2.51±1.36 dB postoperatively (P<0.001) and the average pattern standard deviation (PSD) decreased from 1.86±0.68 dB preoperatively to 1.33±0.32 dB postoperatively (P=0.001).The retinal response densities of mfERG in the foveal and perifoveal area increased significantly, and implicit times of rings 4-6 prolonged significantly (P<0.05).The symptom duration and baseline N1 amplitude densities at ring 1 had a significant impact on postoperative BCVA (P<0.001, P=0.001, respectively).CONCLUSION: The 25-gauge PPV and air tamponade with 1 day prone positioning produce favorable anatomic and functional outcomes.

BACKGROUNDMutation and expression change of p21WAF1/CIP1 may play a role in the growth of osteosarcoma. This study was to investigate the expression of the p21WAF1/CIP1 gene in human osteosarcoma, p21WAF1/CIP1 gene DNA sequence change and their relationships with the phenotype and clinical prognosis.

METHODSp21WAF1/CIP1 gene in 10 normal people and the tumours of 45 osteosarcoma patients were examined using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining. The PCR product with an abnormal strand was sequenced directly. The p21WAF1/CIP1 gene mRNA and P21 protein of 45 cases of osteosarcoma were investigated by using in situ hybridization and immunohistochemistry, respectively.

RESULTSThe occurrence of P21 protein in osteosarcoma was 17.78% (8/45), and p21WAF1/CIP1 mRNA expression in osteosarcoma was 42.22% (19/45). The p21WAF1/CIP1 gene DNA sequencing of amplified production showed that in p21WAF1/CIP1 gene exon 3 of 36 cases of human osteosarcoma, there were 17 cases (47.22%) with C-->T at position 609; 10 normal blood samples' DNA sequence analysis yielded 8 cases (80.00%) with C-->T at the same position.

CONCLUSIONSAlong with the increase of malignancy, the expression of p21WAF1/CIP1mRNA and P21 protein in osteosarcoma tends to decrease. It is uncommon for the p21WAF1/CIP1 gene mutation to occur in human osteosarcoma. As a result, the possible existence of tumour subtypes of p21WAF1/CIP1 gene mutation should be investigated. Our research leads to the location of p21WAF1/CIP1 gene polymorphism of Chinese osteosarcoma patients, which can provide a basis for further research.

Cyclin-Dependent Kinase Inhibitor p21 ; Cyclins ; genetics ; Humans ; Osteosarcoma ; genetics ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; RNA, Messenger ; analysis ; Sequence Analysis, DNA

OBJECTIVETo employ reverse first dorsal metatarsal artery island flap to recover the donor site of great toe after free lateral pulp flap transfer, and decrease the morbidity of microsurgical donor site.

METHODSFrom February 2000 to June 2004, 12 cases of soft tissue defect in thumb and finger were treated by free lateral pulp flap of great toe transplantation, and that the secondary defect of great toes were repaired by reverse first dorsal metatarsal artery flap according to the anatomical communicating between first dorsal metatarsal artery and plantar metatarsal artery. The donor exposure of dorsal pedis were straightly sutured.

RESULTSAll the lateral pulp flaps of great toe and the reversed first dorsal metatarsal flaps survived uneventfully with desirable appearance and sensation. In thumb and finger defect reconstructed with lateral pulp flaps of the great toe, there was in mean static two-point discrimination of 6 mm at 10 month follow-up, that was 10 mm in reverse flaps.

CONCLUSIONSIt is an instructive and practical creation to adopt the reverse first dorsal metatarsal artery flap to recover the raw surface in the lateral aspect of the great toe, which minimizes the morbidity at the donor site and gains the twin-win results.

Adolescent ; Adult ; Arteries ; transplantation ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Metatarsus ; blood supply ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; pathology ; Young Adult

Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Minimally Invasive Surgical Procedures ; methods ; Recovery of Function ; Tibial Fractures ; pathology ; physiopathology ; surgery ; Young Adult

OBJECTIVETo investigate the amplification of EMS1 gene in the carcinogenesis of oral mucosa.

METHODSA total of 78 subjects, including 30 patients with oral leukoplakia (OLK), 33 with oral squamous cell carcinoma (OSCC), and 15 healthy controls, were studied. By using microdissection method, we obtained normal mucosa, hyperplastic epithelia, mild-dysplastic epithelia, moderate-dysplastic epithelia, severe-dysplastic epithelia and primary OSCC tissue. Then we analyzed EMS1 amplification by using differential PCR.

RESULTSEMS1 amplification began from moderate-dysplastic epithelia and occurred in 20.0% OLK cases and 57.6% OSCC cases. In the progress of OSCC, no gene amplification was observed in normal tissues, non-dysplastic OLK and mild-dysplastic OLK, while in the cases with metastasis, amplification frequency increased significantly (P = 0.015).

CONCLUSIONSEMS1 amplification parallels with the progress of oral carcinogenesis, indicating their potential roles in oral carcinogenesis.

Carcinoma, Squamous Cell ; genetics ; pathology ; Case-Control Studies ; Cortactin ; genetics ; Gene Amplification ; Humans ; Leukoplakia, Oral ; genetics ; pathology

OBJECTIVETo investigate the adhesion to buccal epithelial cells of Candida albicans isolates from erosive oral lichen planus (OLP) and nonerosive OLP, and its role in the development of OLP.

METHODSA total of 112 isolates, comprising healthy control (26), erosive OLP (62) and nonerosive OLP (24), were screened for the adhesion by using buccal epithelial cell (BEC) assay.

RESULTSThe adhesion to buccal epithelial cells of the isolates from erosive OLP group was stronger than that of those from healthy control.

CONCLUSIONCandida albicans, some isolates with a special virulence attribute may contribute to the occurrence and progression of erosive OLP.

Candida albicans ; Cell Adhesion ; Epithelial Cells ; Humans ; Lichen Planus, Oral

OBJECTIVETo observe the millimeter wave therapy responses in patients with burning mouth syndrome.

METHODSEighty patients were randomized divided into 4 groups. The first group was treated with both millimeter wave irradiation and routine medication, the second group with millimeter wave irradiation, the third with pretending millimeter wave irradiation and routine medication and the fourth with routine medication. Pain, extravasated blood level and autonomic nerve system condition were double-blindly evaluated either before or after the treatment.

RESULTSStatistically significant difference (P < 0.05) was found as the degree of pain was compared before and after treatment of all the 4 groups. The first and second group, which were affected by the millimeter wave irradiation, had obvious improvements in the extravasated blood level and autonomic nerve system condition (P < 0.05). When the 4 groups were compared with each other, there were significant differences (P < 0.05) between the first and the fourth groups, and the second and the fourth groups regarding the reduction of pain. According to extravasated blood level, significant differences (P < 0.05) were found in the first and third or fourth groups, the second and third or fourth groups.

CONCLUSIONSThe irradiation of holographic point by millimeter wave can improve the patients' pain, extravasated blood level and autonomic nerve system condition. It might provide a new treatment method for burning mouth syndrome.

Acupuncture Points ; Burning Mouth Syndrome ; therapy ; Humans ; Microwaves ; therapeutic use ; Treatment Outcome