[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.

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.

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 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 This study is to evaluate the advantages between percutaneous and peratrial device closure of secundum atrial septal defects(ASD) under single transesophageal echocardiographic (TEE) guidance.Methods From December 2010 to December 2012,53 patients with the ASD of≤25 mm in diameter underwent percutaneous device closure under simple TEE guidance(the percutaneous group).The device was implanted through the femoral vascular access.Fifty patients with similar age and similar-sized ASD to the percutaneous group,were selected from 350 consecutive patients who underwent peratrial device closure of ASD and assigned to the peratrial group.The ASDs were occluded through a right minithoracotomy approach.The success rate,intracardiac manipulation time,procedural time,postoperative stay and the follow-up results were recorded.Results When the maximum diameter of ASD was ＜ 20 mm,the success rate of both groups was 100％.When the ASD diameter was 20 mm but 25 mm,the success rate was 84％ in the percutaneous group and 100％ in the peratrial group.Three patients failed in the percutaneous group with the ASD diameter of 20 mm and the aortic rim of 3 mm.They were successfully converted to peratrial device closure.The average intrcardiac manipulation time was(20±7) minutes in the percutaneous group and (5 ± 6) minutes in the peratrial group(P ＜ 0.05).The average procedure time was(24 ± 7) minutes in the percutaneous group and (39 ± 6) minutes in the peratrial group(P ＜ 0.05).The postoperative hospital stay was (3.0 ± 0.8) days in the percutaneous group and(4.7 ± 1.5) days in the peratrial group(P ＜ 0.05).Conclusion The percutaneous device closure of ASD under simple TEE guidance is feasible,safe,and efficacious in patients with the ASD diameter of ≤25 mm.It has the advantages of less trauma,less procedural time,shorter hospital stay and better cosmetic results.However,when the ASD diameter was 20 mm and the aortic rim was 3 mm,the peratrial approach may be a better choice.

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 survey the prevalence of Hyperuricemia (HUA) in elder population of Changchun city,and to detect the correlation between cardiovascular risk factors and the HUA.Methods 900 residents older than 55 years were selected randomly for this questionnaire survey.Physical and laboratory examinations were performed.Results The HUA prevalence rate elder people in Xixin District of Changchun was 16.0％(144/900),while the rates were 13.7％(50/365),15.2％(47/309) and 20.8％(47/226) (P＜0.05) in the elder group (55-65 years),the aged group (66-75 years),and the advanced aged group (older than 76 years) respectively;there was no statistical significant difference in the prevalences between male and female (x2=0.023 5,P＞0.05).The HUA prevalence rate was significantly different between people who had different level of blood pressure,cholesterol,hypersensitive C-reactive protein (hs-CRP),body mass index (BMI),waisthip ratio (WHR).The level of uric acid (UA),total cholesterol (TC) and hs-CRP was significantly different in people with high uric acid when compared with those of normal patients (P＜0.05).There was positive correlation between UA level and TC,triglyceride (TG) level (r=0.364,P＜0.05;r=0.479,P＜0.05).Conclusion The HUA prevalence rate increases significantly as people getting older.There is positive correlation between the increase of uric acid level and the major cardiovascular risk factor.People with hypertension,hyperlipidemia,overweight and obese have high risk for HUA,so change life style and dietary habits may prevent or reduce the occurrence of HUA.

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.

Objective To explore the value of DWI ADC in the diagnosis of hepatic ischemia reperfusion injury (IRI) at 3.0 T and investigate the mechanism by comparison with liver enzyme and pathological findings. MethodsForty-two New Zealand white rabbits were divided randomly into ( n ＝ 6,each) six IRI groups by rank sum test. The IRI animals underwent left lobar ischemia for 60 min and were reperfused 0. 5 h, 2. 0 h, 6. 0 h, 12. 0 h, 24. 0 h and 48. 0 h later. One Sham operative group underwent laparotomy without liver ischemia. T2 WI, T1 WI, DWI and contrast-enhanced T, WI were performed with 3.0 T magnetic resonance imaging scanner in each group respectively. For DWI, b-values of 20, 50, 100,200,300,400,500 and 600 s/mm2 were used respectively. Blood samples were taken to detect the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at different time points. Liver samples were examined histologically after MRI scanning. One-way analysis of variance (ANOVA) was used to determine differences, followed by LSD-t test for multiple comparisons. ResultsOverall, ADC decreased markedly at the early IRI phase ( 0. 5 h), drastically increased in the 2.0 h group, and then ascended slightly from 6. 0 h to 48.0 h after reperfusion, except for a transient decrease at the time point of 24. 0 h. When b values were 20, 50, 100,200 and 300 s/mm2, the ADC values in the Sham group were (3.47 ±0.53) × 10-3, (3.11 ±0.39) ×10-3, (2.87 ±0.19) ×10-3, (2.56 ±0.37) × 10-3 and (1.95 ±0.33) ×10-3mm2/s, (2.63±0.31)±10-3, (2.47±0.32) ×10-3, (2.12±0.38) ×10-3, (2.01±0.51) ×10-3and (1.61 ±0.17) ×10-3mm2/s in the 0.5 h group, (2.72 ±0.09) ×10-3, (2.51±0. 11) ×10-3, (2.28 ±0.30) ± 10-3, (1.96 ±0. 14) × 10-3 and (1.58 ±0. 17) × 10-3mm2/s in the 24.0 h group, respectively. ADC of 0. 5 h and 24. 0 h groups were significantly lower than that of Sham group (P＜0.05) when b value was under 300 mm2/s.In the Sham, 0.5 h, 2.0 h, 6.0 h, 12.0 h,24.0 h and 48. 0 h IRI groups, they were (80±8), (181 ±34), (413 ±62), (474 ±83), (424 ±41 ),(332 ±41 )and(302 ±39) U/L for the levels of ALT,and (79 ± 10), (454 ±55), (547 ±72), (607±31 ), (649 ±79), (785 ±49) and ( 1526 ± 167) U/L for the AST respectively. The levels of AST and ALT in IRI groups were significantly higher than those in the Sham group ( P ＜ 0. 01 ).Histological findings showed diffuse hepatocytes swelling and erythrocytes depositing in the hepatic sinusoids, portal area, central venous and arterials at the initial phase.With the injury aggravated, inflammatory cell infiltration,hepatocyte nuclear condensation of apoptosis, sinusoidal dissociation and coagulation necrosis developed eventually. Conclusion 3.0 T DWI can monitor the pathological process of rabbit liver ischemia reperfusion injury dynamically, and provides a feasible imaging modality for clinical diagnosis and treatment.