[Objective]To investigate the clinical results of open reduction and internal fixation in the treatment of tibial plateau fractures.[Method]Sixty-four cases of tibial plateau fractures were treated from January 1994 to December 2000 in our hospital.According to Schatzker classification,8 cases were type Ⅰ,40 cases were type Ⅱ,6 cases type Ⅲ,4 type Ⅳ,3 type Ⅴ and 3 cases were type Ⅵ.They were treated with open reduction and internal fixation and allograft implantation for defective fractures.[Result]Fifty-eight cases were followed up from 1 to 7 years,with an average of 2.8 years.All the fractures united.The satisfactory rate was 84.48% based on Hohl scale.[Conclusion]Internal fixation is an effective method to treat tibial plateau fracture,and the operation procedures should be varied with the fracture types.Complications after operation are closely associated with the fracture complexity.Anatomical reduction,bone transplantation,stable internal fixation,and early functional exercises are effective measures of preventing complications.Early treatment of soft tissue injury must be emphasized especially.

Objective To investigate the effect of percutaneous transforaminal endoscopic surgery for lumbar prolapse upwards type disc herniation.Methods According to the digital table,90 patients with lumbar prolapse upwards type disc herniation were randomly divide into the observation group and the control group,45 cases in each group.The observation group was treated with percutaneous transforaminal endoscopic surgery,the control group was treated with conventional open surgery.The curative effect,operation and adverse reactions were compared between the two groups.Results All patients were satisfied with the location,and they were completely removed from the nucleus.Compared with the control group,the operation time[(75.3±23.1)min vs.(103.4±35.4)min]and hospitalization time[(6.8±1.2)d vs.(8.7±1.8)d]of the observation group were shorter,the bleeding volume[(24.5±8.5)mL vs.(51.6±12.7)mL]was lower,the differences were statistically significant(t=4.453,5.632,4.269,all P<0.05).After one month and three months,the VAS score[(2.53±0.65)pints and(1.33±0.48)points]and ODI[(21.40±5.04)% and(12.93±3.50)%]of the observation group were significantly lower,there were statistically differences between the two groups compared with those before treatment(t=6.755,8.765,all P<0.05).And after one month,the VAS score and ODI of the observation group were significantly lower than those of the control group,the differences were statistically significant(t=4.342,3.985,all P<0.05).There was no significant difference between the two groups in the excellent and good rate(86.7% vs.82.2%,X2=1.011,P>0.05).ConclusionPercutaneous endoscopic discectomy surgery in the treatment of lumbar prolapse upwards type disc herniation is reliable,and it has less trauma and shorter hospital stay.

Objective The ultrastructure of the distal CSF-contacting neurons in the dorsal raphe and the relationships with their surrounding tissues were observed and a new morphological evidence for their functional significance was offered. Methods We combined CB-HRP tracing with electron microscopic techniques and observed the ultrastructure of the distal CSF-contacting neurons in the dorsal raphe and the relationships with their surrounding tissues. Results 1.The CSF-contacting neurons have the general cytological structure of neurons; 2.CB-HRP mainly is localized in the trans face of the Golgi apparatus and lysosomes;3.There are two kinds of contrary direction synaptic relationships between the distal CSF-contacting neurons and the non-CSF-contacting neurons.Conclusions 1.There are no obvious differences between the CSF-contacting neurons and other neurons in ultrastructure;2.The Golgi apparatus and the lysosomes may exist the special function in take and transport the material from CSF;3.The CSF-contacting neurons can not only transport the material or deliver the information from the dorsal raphe to CSF,but also from CSF to the dorsal raphe.

AIM: To investigate the changes of cytosolic free calcium concentration ([Ca 2+ ] i) and expression of Bcl-2 in HL-60 cells treated by 6F isolated from Pteris semipinnata L. (PSL), and to discuss the relations between calcium ion and cytotoxicity and DNA fragment induction effects of 6F. METHODS: HL-60 cells were used as in vitro model. [Ca 2+ ] i was measured on fluorescent spectrophotometry using Fura-2/AM as Ca 2+ indicator. Bcl-2 expressing level was measured by flow cytometry. Tetrazolium salt (MTT) and diphenylamine staining methods were applied for cytotoxicity assay and DNA fragmentation detection, respectively. RESULTS: [Ca 2+ ] i increased obviously in a dose and time dependent manner after treated HL-60 cells with 6F. 6F decreased the expressing level of Bcl-2. Adding 2 mmol/L Ca 2+ to the medium, or 1 mmol/L EDTA to chelate Ca 2+ , or 4 ?mol/L calcium ionophore A 23187 to increase the concentration of cytosolic Ca 2+ , the DNA fragment induction by 6F was not affected, whereas the cytotoxicity of 6F was enhanced. 250 ?mol/L Zn 2+ attenuated the DNA fragment induction, and the cytotoxicity of 6F against HL-60 cells was enhanced significantly. CONCLUSION: It was speculated that the decreased expressing of Bcl-2 by compound 6F was related to increased [Ca 2+ ] i in HL-60 cells, and DNA fragment induction was possibly catalyzed by Ca 2+ - independent DNase.

Aim To observe the neuron nitric oxide synthase(nNOS) expression in the distal cerebrospinal fluid contacting neurons(CSF-CNs) of rat brain parenchyma, and investigate the role of CSF-CNs in the development of morphine dependence and withdrawal.Methods Male adult Sprague-Dawley rats, weighed 260?20 g,were experimented with A 3 ?l volume of 30% cholera toxin subunit B with horseradish peroxidase(CB-HRP) was injected into one of the rats′lateral ventricles to trace and locate the distal CSF-CNs of rat brain parenchyma 48 hours before the animals were killed. All animals were perfused and the relative tissue of rats′brain was removed.Frozen serial coronal sections (40 ?m) were cut. Then TMB-ST reaction procedure was used to stain the CB-HRP positive neurons,followed by immunohistochemistry double-labeling of the nNOS with CB-HRP positive neurons. The withdrawal symptoms were observed and scored. The numbers of the CB-HRP, and CB-HRP/nNOS positive neurons on the same segmental brain sections were counted.Results The withdrawal symptoms of the withdrawal group were significant, scores of all signs were significantly higher than those of the dependence groups and control group(P

Objective To evaluate the feasibility,safety and efficacy of perventricular device closure of supracristal or intracristal ventricular septal defects (VSD) using a minimally invasive technique through a parasternal approach.Methods 49 patients,aged 4 months to 53 years [median 4.8 years],were enrolled in this study.A 1.5 to 3 cm parasternal incision was made in the left second or third intercostal space.The pericardium was incised and cradled without entering the pleural space.Two parallel pursestring sutures were placed at the right ventricular outflow tract.After puncture,the specially designed delivery sheath loaded with the device was inserted into the right ventricle.Under transesophageal echocardiographic guidance,the sheath was advanced through the defect into the left ventricle.Then the device was deployed to close the defect.Results Successful implantation of the device was achieved in 47 patients (96％),including 26 in intracristal group and 21 in supracristal group.The concentric,eccentric,and muscular occluders were used in 17,28 and 2 patients,respectively.The mean diameter of VSD was (4.4 ± 1.7)mm in the intracristal group and (2.7 ± 0.9) mm in the supracristal group.The mean device size was (7.0 ± 2.3) mm and (4.8 ± 1.1)mm in the intralcristal and supracristal group,respectively.The mean intracardiac manipulation time was (17 ± 16) min.During the follow-up period of 3 to 24 months,no device-related complications were found.Conclusion The perventricular device closure of small-sized supracristal or under medium-sized intracristal VSD is feasible,safe,and efficacious through a left parasternal approach.

Objective The aim of this study was to evaluate the feasibility,safety and efficacy of peratrial device closure of ventricular septal defect (VSD) through a right parasternal approach.Methods Between May 2011 and July 2012,47 patients (peratrial group),aged 7 months to 37 years,underwent peratrial device closure of VSD through a right parasternal approach.According to the same inclusion criteria,47 patients who underwent perventricular device closure of VSD were randomly chosen as the control group (perventricular group).In the peratrial group,a 1.5 to 2.0 cm parasternal incision was made in the right fourth or third intercostal space.The pericardium was incised and cradled.Two parallel pursestring sutures were placed at the right atrium near the atrioventricular groove.After puncture,a specially designed hollow probe was inserted into the right atrium.The probe was passed through the tricuspid valve into the right ventricle.Under transesophageal echocardiographic guidance,the tip of the probe was adjusted to point to or cross the defect.A flexible guidewire was rapidly inserted into the left ventricle through the channel of the probe to establish a delivery pathway,and the delivery sheath was introduced through the defect over the wire.Then the device was deployed to close the defect.Results Successful implantation of the device was achieved in both groups of patients (100％).In the peratrial group,the entrance and the exit diameter of the VSD were (7.4 ±4.1) mm (range,2.0 to 20.0 mm) and (3.4 ± 1.2)mm (range,2.0 to 7.0 mm),respectively.The mean device size was (6.3 ± 1.5)mm (range,4.0 to 12.0 mm).The mean intracardiac manipulation time is longer in the peratrial group [(15 ± 13) min] than in the perventricular group[(8 ± 5)min],P ＜ 0.01.But the procedure time is shorter in the peratrial group[(56 ± 24) min] than in the perventricular group [(72 ± 16) min],P ＜ 0.01.During the follow-up period of 1 to 12 months,no device-related complications were found.Conclusion The peratrial device closure of VSD is feasible,safe,and efficacious.It has the advantages of less invasiveness,better cosmetic results,and a shorter procedure time.

BACKGROUND:Discectomy is an important therapy for lumbar disc herniation, but a smal number of patients undergoing discectomy wil relapse.
OBJECTIVE:To investigate the spinal stability fol owing posterior pedicle screw fixation combined with interbody fusion cage for treatment of recurrent lumbar disc herniation.
METHODS:Twenty-six patients with recurrent lumbar disc herniation from January 2007 to December 2011 were enrol ed and subjected to posterior pedicle screw fixation combined with interbody fusion cage. Pain relief and lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after posterior pedicle screw fixation combined with interbody fusion cage depending on literature search.
RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 12-36 months. After treatment, al patients effectively al eviated the symptoms of low back pain, and lumbar interbody fusion was good, with a good rate of 96.2%. There was no pedicle screw loosening, broken, non-fusion phenomenon. Posterior decompression and interbody fusion cage combined with posterior pedicle screw fixation for recurrent lumbar disc herniation, characterized as fast symptom relief, strong fixation, exact interbody fusion exact, is an ideal treatment for recurrent lumbar disc herniation.

Objective To observe the changes of hepatic CT perfusion parameters and their correlation with serum aspartate transaminase( AST),alanine transaminase(ALT) and alkaline phosphatase (ALP) in a rabbit hepalic ischemia reperfusion injury (IRI) model.Methods Hepatic IRI was produced in rabbits by inducing left liver lobe ischemia (60 min) followed by 6 h,12 h and 24 h reperfusion (6 rabbits were used for each reperfusion interval ).Additional 6 rabbits were served as sham-operatedcontrols.All the rabbits were scanned with a dynamic iCT protocol.Blood samples were taken from the superior mesenteric vein to measure the levels of serum amylase (ALT,AST,and ALP) in various groups,and liver samples were taken for histological examinations after scanning.One-way analysis of variance (ANOVA) was used to determine differences between groups.The correlations of CT perfusion parameters with serum levels were analyzed using Pearson correlation coefficient.Results Heterogeneity of CT perfusion patterns appeared in the 6 h groups,which presented as low enhanced area [ ( 25.1 ± 9.3 ) ml · 1min-1 · 100mg-1].In reduced perfusion regions of IRI group,HAP of 12 h IRI group [ ( 19.5 ± 13.6) ml · min-1 · 100 mg-1],24 h IRI group [(8.0+2.7) ml · min-1 · 100 mg-1 ],HPP of 6 h IRI group [(10.8±5.5) ml · min-1 · 100 rng-1],12 h IRI group [(14.4±5.2) ml · min-1 · 100 mg-1],24 h IRI group [(7.8±3.3) ml · min-1 · 100 mg-1] and TLP of 6 h IRI group [(35.9 ±14.0) ml ·min-1 · 100 mg-1 ],12 h IRI group [ (33.9 ± 16.1) ml · min-1 · 100 mg-1 ],24 h IRI group [ (16.0 ±5.5) ml · min- 1 · 100 mg-1 ] were lower than those of sham group [ HAP (21.2 + 10.5 ) ml · min-1100mg-1,HPP(63.5±24.0) ml · min-1 · 100 mg-1,TLP (81.4±24.8) ml · min-1 · 100 mg-1](F=8.376,25.950,16.925,P＜0.01).However,HPI of 6 h IRI group [(65.9±3.9)％],12 h IRIgroup [ (54.2 ± 16.7)％ ],and 24 h IRI group [ (48.9 ± 10.0)％ ] were higher compared to sham group [ ( 24.1 ± 7.5 ) ％ ] ( F =43.664,P ＜ 0.01 ).But,the perfusion parameters in the relatively normal area of IRI groups showed decline compared with sham group.The levels of AST,ALT and ALP in IRI groups were significantly higher than those in the sham group ( P ＜0.05).In poorly enhancing tissues,TLP and HPP of IRI groups were inversely correlated with AST and ALP respectively ( P ＜ 0.01 ),and HPI was closely related to the increase of AST ( r =0.751,P ＜ 0.01 ).Conclusion These results demonstrate CT perfusion is sensitive to detect the hemodynamic changes.Perfusion parameters are closely correlated to the degree of liver injury in the rabbit IRI model.

AIM To investigate the effects of tranfection of IL 2R antisense RNA expression plasmids on mouse spleen cells' proliferation in vitro and its possible mechanism. METHODS Spleen cells were transfected with IL 2R antisense RNA eukaryotic expression plasmids using adhesion assisted lipofection method, and then the spleen cells were stimulated by mitogen. Cells' proliferation was tested by tetrazolium salt (MTT) method. IL 2R mRNA and protein expression level were measured by slot blot hybridization assay and flow cytometry method respectively. RESULTS The proliferation of spleen cells was inhibited obviously after transfecting with recombinant plasmids. The inhibitory rate of pcAnti mIL 2R?? and pciAnti mIL 2R?? transfected group was higher than that of pcAnti mIL 2R? and pcAnti mIL 2R? transfected group; the inhibitory rate of pcAnti mIL 2R? tranfected group was higher than that of pcAnti mIL 2R? tranfected group. No inhibitory effect on the growth of NIH3T3 cells was observed when they were transfected with recombinant plasmids. IL 2R mRNA and protein expression level were decreased in spleen cells after transfection of recombinant plasmids. CONCLUSION IL 2R antisense RNA can efficiently inhibit the proliferation of mouse spleen cells in vitro. IL 2R?? chimeric antisense RNA showed higher inhibitory rate than ? or ? antisense RNA. IL 2R? antisense RNA was more effective than ? antisense RNA. It can be concluded preliminarily that the inhibitory effect of IL 2R antisense RNA was exclusively on the growth of cells functionally expressing IL 2R. The inhibitory effect on the spleen cells proliferation was likely due to the blocking of IL 2R expression by antisense RNA.