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

Saccharmyces cerevisiae 220 has certain resistance to Pb2+ was found through the test of it's cultured on media containing lead cation. Sacchannyces cerevisiae 220 cultured was put into the media cotaining lead cation and it's biosorp-tion to lead cation was studied. The results show this strain has maximum biosorption ratio (96.6%) to 6mg/L lead cation, biosorption-equilibrilium period is 25-30min, biosorption kinitics equation is q-26.318C/ (1 + 0.437C) . Acetic acid is benefit to de-biosorption, glucose and KH2PO4 can improve biosorption ratio to lead cation.

Objective To explore the effect of electrical acupuncture on the cytokines in adjuvant arthritis rats. Methods 60 rats were divided into 5 groups randomly, each with 12 rats. The blank control group and the model group were only bundled; while the Zusanli group, the Guanyuan group, and the Weizhong group were electroacupunctured each single point after bundled, once per 2 d. 32 d later, the swelling of voix pedis was measured and the level of interleukin (IL)-1, IL-2, IL-10, tumor necrosis factor (TNF)-α in plasma was determined in each group. Results After being modeled, the voix pedis of rats were swelling (P<0.05), while the swelling of voix pedis in the Zusanli, Guanyuan and Weizhong groups significantly reduced (P<0.05). The plasma IL-1, IL-2 and TNF-α was significantly higher in the model group than in the blank group (P<0.01), and reduced in Zusanli, Guanyuan and Weizhong groups (P<0.05). Compared with Zusanli and Guanyuan groups, there was a significant difference in the Weizhong group (P<0.01). The plasma IL-10 was significantly lower in the model group than in the blank control group (P<0.05), and increased in the Zusanli, Guanyuan and Weizhong groups (P<0.05). Compared with Zusanli and Guanyuan groups, there was a significant difference in the Weizhong group (P<0.01). The swelling of voix pedis was positively correlated with the level of IL-1, IL-2, and TNF-α (r=0.881~0.912, P<0.01). There was positive correlation among the IL-1, IL-2, and TNF-α (P<0.01). IL-10 was negatively correlated with the swelling, IL-1, IL-2, and TNF-α (r=-0.293~-0.519, P<0.05). Conclusion Electroacupuncture can significantly reduce the swelling of voix pedis in adjuvant arthritis rats, and it may be related with improving immune function by increasing the level of IL-10 and decreasing the level of IL-1, IL-2 and TNF-α in plasma.

Adult ; Aged ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

Pituitary stalk interruption syndrome (PSIS) is a newly discovered rare endocrinological syndrome characterized by structrual defect of pituitary and multiple deficiencies of a series of hypothalamic hormones, and thus leading to a cluster of clinical symptoms. This review will illustrate the genetic pathogenic factors influence on embryonic development, and briefly introduce the current studies of Whole-Exome Sequencing on PSIS.

Objective:To establish a dosimetric method based on the well-chamber to verify the accuracy of the source positioning and dwelling time for the afterloading machine, aiming to provide a new method for the quality control of afterloading machine.Methods:The principle of this method was explained according to the hardware structure of the well-chamber. Then, the precision of this method was analyzed by the simulation test and data fitting. The feasibility test was also performed. And the advantages and disadvantages of this method were compared with those of the traditional method.Results:The precision of this method for detecting the source positioning was 0.07 mm and the dwelling time was 0.09 s, respectively. In the feasibility test, the standard deviation of the measure value was below 3%.Conclusions:The well-chamber method has high precision and convenient operation. It can be applied in the rapid verification of the relative accuracy of the source positioning and dwelling time of well-chamber.

OBJECTIVETo identify possible reasons of rotational mismatch between tibial component and femoral component in total knee arthroplasty and choose a right reference axis for placing the components in the operation and to decrease the complications.

METHODSForty normal Chinese knees were studied. There were 20 men and 20 women, and average age was 34 years (range, 18 - 42 years). The images of cross sections of the distal femur were obtained by spiral CT scanning (0.5 mm thickness). Scan direction was aligned to be in the plane perpendicular to the mechanical axis of the tibia. On the images of the distal femur and the proximal tibia, three baselines for the anteroposterior axis of the femoral component were drawn based on the clinical epicondylar axis and the surgical epicondylar axis and 3 degrees lateral rotated to the posterior condylar surfaces of the femur separately, and a baseline for the anteroposterior axis of the tibial component was drawn based on the medial 1/3 of the tibial tuberosity. The rotational mismatch angles were measured between each component by using the Autocad software.

RESULTSThe mean rotational mismatch angle between tibial component and femoral component is 2.94 degrees for the clinical epicondylar axis, 6.50 degrees for the surgical epicondylar axis and 6.83 degrees for 3 degrees lateral rotation of the femoral component referenced to the posterior condylar axis separately.

CONCLUSIONSLandmarks of each bone were the intrinsic cause of the rotational mismatch in total knee arthroplasty. The clinical epicondylar axis can be chosen for the ideal reference to rotational alignment of the femoral component because of its minimal rotational mismatch between each component.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Knee Joint ; diagnostic imaging ; physiopathology ; surgery ; Male ; Postoperative Complications ; prevention & control ; Range of Motion, Articular ; Tomography, Spiral Computed

Aim To investigate the radio-protective effect of schisandrol B(Sol B)underlying mechanism in alleviating gastrointestinal(GI)toxicity and intesti-nal damage induced by irradiation(IR)exposure dur-ing radiotherapy against abdominal and pelvic malig-nancies or the nuclear accident.Methods The mouse intestinal injury model was established through 4Gy ir-radiation.Immunohistochemistry,immunofluorescence staining,ELISA were used to measure DNA damage,apoptosis,inflammatory reaction,and oxidative stress in the intestine of mice after irradiation.The protective effect of Sol B on intestines injury was evaluated,and the mechanism of the related oxidative stress and in-flammatory response pathway was discussed.Results Sol B significantly improved the survival rates of intes-tinal cells upon IR exposure.The accumulation of DNA damage,apoptosis rate,and inflammatory factors in intestinal tissues were significantly inhibited.The decreased levels of ZO-1 and occludin induced IR inju-ry were rescued by Sol B,indicating the improvement of intestinal structure.The radio-protective activities of Sol B were involved in the stimulation of Nrf2 and the subsequent ferroptosis surveillance.Conclusion Sol B demonstrates a promising agent to ease intestinal in-jury during radiotherapy or nuclear accidents,in which GPX4 related ferroptosis surveillance mediated by Nrf2 is involved in the radio-protective effect of Sol B.

Ninety six female patients with chronic renal failure were randomly allocated into combination group (n =48) and control group (n =48).In combination group patients received both kidney transplantation and hematopoietic stem cell infusion,in control group patients underwent kidney transplantation only.The results showed that chronic rejection in the combination group was lower than that in the control group [2％(1/48)vs.17％ (8/48),P＜0.05)].The 1-,3-,5-and 10 y-survival rates of kidney in the combination group were 98％ (47/48),94％ (45/48),83％ (34/41) and 9/17,respectively,those in control group were 98％ (47/48),90％ (43/48),76％ (31/41) and 7/17,respectively.Infusion of donor hematopoietic stem cells can augment chimerism in early postoperative period and significantly reduce the rate of graft rejection,which is beneficial for the quality of life of the recipients.

AIMTo investigate the pharmacokinetic characteristics of recombinant human acidic fibroblast growth factor (rhaFGF) after external use in rabbits.

METHODS125I-rhaFGF 180 U.cm-2 was daubed to normal skin and scathed skin in rabbits. The radioactivity and paper chromatography were used to determine the 125I-concentrations and distribution in plasma and organs at different times.

RESULTSThe plasma concentration of 125I-rhaFGF increased rapidily, and reach peak plasma level (73.03 pg.mL-1) thirty minutes after administration. Then the concentration of 125I-rhaFGF decreased quickly after thirty minutes, and approached to zero after three hours. Highest radioactivity accumulated in the skin, followed by kidney, lowest in the brain 96 h after administration.

CONCLUSIONrhaFGF can not be absorbed from the normal skin, whereas a small amount of rhaFGF can be absorbed through scathed skin. The t1/2 of rhaFGF in plasma was very short. Cumulative effect of rhaFGF was not observed. Absorbed rhaFGF showed high affinity to skin, and can be distributed to skin far from the site of administration.

Administration, Cutaneous ; Animals ; Female ; Fibroblast Growth Factor 1 ; administration & dosage ; pharmacokinetics ; Male ; Rabbits ; Recombinant Proteins ; administration & dosage ; pharmacokinetics ; Skin ; injuries ; metabolism ; Skin Absorption ; Tissue Distribution