The distal humeral fractures are difficult to treat because of the nature of the injury. Although numerous operative approaches have been describe d for them,satisfactory results are difficult to achieve because of the postoper ative complications.We have reviewed relative literature to discuss the incidenc e,cause,prophylaxis and treatment of different complications to deepen the knowl edge of distal humeral fractures.

Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.

Objective To develop a biosensor method with strong specificity and high‐throughput by combining with the surface plasmon resonance (SPR) and gene chip technique and aiming at 9 kinds of common respiratory tract viruses including influenza A and influenza B ,(Influ A ,B) ,H1N1 ,respiratory syncytial virus (RSV) ,parainfluenza virus 1 -3 (PIV1 -3) ,adenovirus (ADV) and coronavirus (SARS) leading to severe acute respiratory syndrome .Methods Firstly the software primer 5 was used to design the specific primer and probe of related viruses in the conserved sequence ;the designed nine kinds of corresponding respiratory virus probes were immobilized in the specific region of SPR chip after chemical modification .The SPR technique was applied to conduct the real time monitoring the hybridization process of the probe with the PCR products .Finally the signal amplification was realized by the biotin and streptavidin system .Results The designed gene chip could detect 9 kinds of respiratory tract viruses by high‐throughput with better detection specificity ;the chip surface could be reutilized after certain regeneration condition ,which avoided the influence of intra‐batch difference on the results ;the detection sensitivity reached the nanomole level .Conclusion The prelimi‐nary study results demonstrate that using the SPR biosensor technique to establish a high‐‐throughput detection of respiratory tract viruses has some practicability and feasibility ,and is expected to become a rapid ,large scale and high‐ throughput measure for screening respiratory tract viruses with good application prospect .

Objective To summarize the clinical experience of laparoscopic repair of esophageal hiatal hernia.Methods A total of 15 cases of esophageal hiatal hernia underwent laparoscopic hernia repair and fundoplication from May 2004 to April 2005 in this division.There were 4 cases of type Ⅰ hernia(all of which presented severe gastroesophageal reflux disease),10 cases of type Ⅱ hernia,and 1 case of type Ⅲ.Surgical procedures included laparoscopic Nissen total fundoplication in 9 cases,Toupet partial fundoplicatin in 4 cases,and Dor partial fundoplication in 2.Symptoms of gastroesophageal reflux disease,including heart burn,dysphagia,regurgitation,chest pain,and belching,were evaluated by using the Visual Analogue Scales(VAS) at preoperative period,1 postoperative month,and 6 postoperative months,respectively.Results No conversion to open surgery was required in this study.The operative time ranged 100~187 min(mean,125 min).The postoperative hospital stay was 2~5 days(mean,2.8 days).All the patients were followed for 1~12 months(mean,8.5 months).No hernia recurrence was found.The VAS scores decreased from 5.0?3.9 preoperatively to 0.9?1.3 at 1 month postoperatively(t=3.823,P

The major surgical managements for tibial plateau fractures are anatomical reduction, firm fixation and bone grafting. There have appeared many new techniques in recent years, such as less invasive stability system (LISS) and arthroscopy assisted treatment. But such complications as loss of reduction, infection, soft tissue lesion around the knee, nonunion, posttraumatic arthritis, and knee stiffness seem to be inevitable. This article introduces the mechanism, treatment and prevention of the complications of the tibial plateau fracture.

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

Objective To study the effects of the active components of eight kin ds of Chinese herbs on cytochrome P450 enzymes (CYP) 1A1,2E1,3A4 and 3A5 mRNA expression. Methods The mRNA expression levels of four CYP enzymes were determin ed by real-time quantitative reverse-transcriptase polymerase chain reaction. Results Baicalin,baicalein and artemisinin induced CYP1A1 expression at differe nt concentrations. Compared with baicalin and baicalein,the effect of artemisin in was weaker. The expression of CYP3A4 gene was significantly obvious after ind uced by sodium aescinate,baicalein and artemisinin. Conclusion HepG2 cells shou ld be an appropriate in-vitro system for investigating potential human CYP indu cing agents. CYP1A1 and CYP3A4 expression could be significantly induced by baic alin,baicalein,artemisinin and sodium aescinate,which would supply the eviden ce for the interaction of herbal medicine and western medicine based on cytochro me P450 and toxicology.

Objective To study the platelet antibody screening and crossing match by surface plasmon resonance(SPR) ,and to find a new way for platelet compatibility testing .Methods The corresponding universal platelet antigen was fixed on the SPR chip surface by the amino coupling method .Platelet antibody positive and negative control serum were analysed by SPR micro-ar-ray ,the stability ,sensitivity and specificity of this technique were discussed ,and compared with MAIPA assay .Finally we used the SPR technology to cross match for ten cases of the platelet antibody positive patients before infusion ,and to evaluate the effect of platelet infusion .Results For the SPR technology ,the stability ,sensitivity and specificity of platelet antibody detection were all better ,106 cases of the repeated platelet transfusion samples were tested by SPR assay and MAIPA method ,there was no signifi-cant difference between them(chi-square=0 .333 ,P>0 .05) ,the total consistency was 97 .2% .The 10 cases of platelet antibody positive patients were crossed match before platelet transfusion by SPR technology ,the good results of 8 cases of them were found by the clinical tracking evaluation ,1 h CCI>7 .5 ,24 h CCI>4 .5 .Conclusion SPR technology for screening platelet antibody mat-ches with MAIPA method in basic quality ,but SPR assay is simple ,rapid ,reliable and intuitive ,label free ,which can satisfy the re-quirements for clinical rapid detection of platelet antibody screening and crossing match .

OBJECTIVE To develop a preparation technique of sample of one-time PCR with common primers based on ribotyping which was combined with the detection system of nanogold-based gene chip to detect clinical bacterial pathogens.METHODS According to the highly conserved regions of rDNA,the common primers were designed and used to amplify each target bacterial ISRs by one-time PCR,and the specific oligonucleotide probes for each target ISRs were designed,utilized to establish the new nanogold-based gene chips.After the characteristics of the chip such as sensitivity,specificity and reliability were determined,the chip was used to detect clinical samples.RESULTS The designed common primers could amplify the 12 target bacteria successfully by one-time PCR.All selected probes were of strong specificity and great reliability.The chip had high sensitivity,specificity and reliability,reaching 50 fmol/L of detection sensibility.Clinical detection results showed the chip had a great accuracy.CONCLUSIONS Compared to multi-PCR chip detection,the detection procedure and complexity of the chip are decreased significantly,and have more practical value in clinical pathogens detection.

Objective To study the differentially expressed genes in the vascular tissue of diabetic gangrene toot and the possible mechanism of diabetic gangrene.Methods The differentially expressed genes in the vascular tissue of diabetic gangrene foots were screened by the functional classific gene chip.Reverse transcription polymerase chain reaction(RT-PCR) detection was used to verify the differentially expressed 3 genes.Results In the detected 113 genes,13 of the gene expression level increased more than 2 times,3 of the gene expression level decreased more than 2 times.Three genes were verified with RT-PCR detection,which were results similar to those with chip testing.Conclusions The abnormal expression in a variety of genes in tissues of vascular lesions plays an important role in the course of development and progression of diabetic gangrene.Analysis of differential gene expression can contribute to understanding of the possible mechanisms of diabetic gangrene.