Objective To explore the efficacy of double fork plate in treating the posterior wall fracture of the acetabulum.Methods Reviewed 11 patients who had treated with open reduction and internal fixation with double fork plates for posterior wall fracture of the acetabulum from July 2008 to July 2012,including 8 male cases and 3 female cases with an average age of 35.3 years(from 22 to 53 years).The average time from getting injury to operation was 7.8 days(from 1 to 19 days).The operations were performed through the Kocher-langenbeck approach.Double fork plates(formed from a three-or four-tubular plate) with an overlapping reconstruction plate used for posterior wall fragments.The functional outcomes were evaluated by the modified Merled'Aubigne and Postel'clinical garding system.The radiographs were graded according to the Matte criteria.Rmults The patients were adopted telephone or outpatient follow-up for 25 months on average(from 12 to 33 months).By the Matte criteria,7 cases achieved excellent reduction,3 good reduction,1 case fair reduction and none poor reduction,with the good and excellent rate of 90.9％.By the modified Merled'Aubigne and Postel'critria,functional recovery of the affected hip at the last followe-up was rated as excellent in 6 cases,good in 3 cases,fair in 2 cases and none poor,with the good and excellent rate of 81.8％.Heterotopic ossification was happened to 1 patient.Neither infection nor ischemic necrosis of the femoral head was recorded.Coclusion Double fork plates with an overlapping reconstruction plate can provid stable fixation and allow for early functional exercise.So the use of Double fork plates have a certain clinical value.

Objective To investigate the characteristics and the operative treatment effect of pelvic fractures complicated with lumbosacral plexus compression injury. Methods From January 2000 to January 2009, 19 patients (13 males, 6 females; mean age 34.7 years) of pelvic fractures complicated with lum-bosaeral plexus compression injury were treated by surgical fixation and neural decompression. The diagnosis of nerve compression were determined by analyzing the clinical manifestation and X-ray and CT imaging findings. The injured nerve were decompressed directly by remove the fracture fragments or callus which compressed the lumbersacralis plexus nerve. Eight cases of nerve decompression were through posterior ap-proach, six through anterior approach, and five through combined approach. Sixteen cases of unstable pelvis fractures were treated by open reducton and internal fixation. Results Seventeen patients were followed up. The mean follow-up time was 27 months (12-72 months). The fractures were clinically healed at 10.6 (8-14) weeks. Regarding the Neural Function of the lower extremity, 12 cases had achieved full recovery, 4 cases had recovered partly, 1 case had no change. Four of the six patients who have bladder and bowel dysfunc-tion had fully recovered while the other two patients still have urinary dysfunction. Conclusion Early and accurate diagnosis of the lumbosacral plexus compression injury accompanied with pelvic fractures were very important. It was key to better outcomes that early decompression the lumbosacral plexus and surgical fixa-tion the pelvis fractures are carried out after injury.

Objective To observe the effect of ammonia silver nitrate on early caries.Methods 100 cases of children with early caries treated in our hospital from April 2015 to December 2016 were admitted to conduct research and analysis.The children were divided into the control group and the observation group by double blind,and random method 50 cases in each group.The control group was treated with caries removal,the observation group was treated with carious worn out joint ammonia silver nitrate.After treatment, the two groups of children suffering from dental pulp tissue TNF-a, IL-8 concentration, the recurrence rate, filling rate falling, the rate of suffering from pulpitis, pain conditions were analyzed.Results After treatment, the observation group with TNF-α, IL-8 concentrations were lower than the control group(t=21.961,t=23.836), the difference was statistically significant (P<0.05);The recurrence rate, suffering from pulpitis rate was significantly lower than the control group, and the difference was statistically significant (P<0.05);the observation group after treatment in children with severe pain and painless was significantly lower than the control group, and the difference was statistically significant (P<0.05).Conclusion Ammonia silver nitrate is an effective and safe treatment for early caries, which can relieve the pain and discomfort in children, it is a safe and effective method of treatment and should be promoted and used in the clinic practice.

Objective By developing ultrasound picture archiving and communication system(PACS),to implement networking of ultrasound imaging equipment, central image storage and standardization of computer-aided diagnosis report.Methods Ultrasound image workstation was develop to acquire, display, manipulate and print ultrasound static and dynamic images using C++ computer language. Also, all ultrasound equipments in department formed the DICOM network . Central image server and ultrasound information system server we re connected together with all workstations by computer Ethernet network, thus, using switch, and connecting to hospital internet WWW server to distribut the image and report. Results Ultrasound DICOM digital images and high quality video image successfully acquired, displayed, processed and network communicated, seamless integrated with hospital information system, functions such as image central storage, computer-aided report and sharing printing were implemented. Conclusions Application of ultrasound image management system improves the administration and increases work efficiency in imaging diagnosis, promotes the reform of working pattern of doctors and provides more convenience for work, research and study. Image systems highly increase the level of patient care service. Standardization of medical reports computer-aided is superior to handwritten report.

Objective To investigate the effect of magnesium sulfate on epidural labor analgesia with ropivacaine in the patients with preeclampsia. Methods Seventy nulliparous parturients with pre?eclampsia, aged 23-34 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, weighing 63-81 kg, with a singleton fetus in vertex presentation, without contradications to neuraxial anesthesia, waiting for vaginal delivery, received epidural analgesia for labor. The patients were divided into magnesi?um sulfate group and control group using a random number table, with 35 patients in each group. In magne?sium sulfate group, magnesium sulfate 50 mg∕kg ( 30 ml) was infused intravenously over 15 min when their cervical dilation was 3 cm, while the equal volume of normal saline was given in control group. Epi?dural labor analgesia was performed with ropivacaine. The up?and?down sequential allocation was used to determine the median effective concentration of epidural ropivacaine ( EC50 ) . The severity of pain was as?sessed with visual analogue scale score. Effective analgesia was defined as visual analogue scale score of≤1. The initial concentration of ropivacaine was 0.15%. Each time the concentration was increased∕decreased according to whether or not analgesia was effective, and the ratio between the two successive concentrations was 0.9. The EC50 and 95% confidence interval ( CI) of ropivacaine for epidural labor analgesia was calcu?lated. Results The EC50 (95% CI) of ropivacaine for epidural labor analgesia was 0.066% (0.062%-0.071%) in magnesium sulfate group. The EC50 (95% CI) of ropivacaine for epidural labor analgesia was 0.078% (0.072%-0.085%) in control group. The EC50 of ropivacaine was significantly lower in magnesi?um sulfate group than in control group ( P<0.05) . Conclusion Magnesium sulfate can enhance the effica?cy of ropivacaine for epidural labor analgesia in the patients with preeclampsia.

[Objective]To introduce micro-trauma technic with small incision treating the vertical fractures of the sacrum by intrasacral rod and evaluate the preliminary clinical outcomes.[Method]A total of 13 cases(9 males and 4 females) were treated with micro-trauma technic by intrasacral rod.The age ranged from 18 to 63 years,mean 36 years.Of all,6 cases were treated with anterior pelvis fixation,7 cases had sacral plexus injury.[Result]The operation lasted for 40～75 minutes(averaged 54 minutes) and hospitalisation period ranged from 8 to 20 days(averaged 11 days).A follow up lasted 9～24 months(averaged 17.5 months) in 12 patients.Ten cases were free from sacroiliac pain,2 cases had a slight pain. In 7 sacral plexus injury patients,6 cases completely recovered.[Conclusion]Micro-trauma technic with small incision treating the vertical fractures of the sacrum by intrasacral rod is a safe and effective method and has the advantages of minor trauma,less complication,short operation time and quick recovery.

[Objective]To evaluate the accuracy of computer-assisted cervical pedicle screw installation and discuss the reasons of screw malposition.[Method]Totally 144 cervical pedicle screws were installed by computer-assisted navigation in 25 patients with lower cervical spinal disease.All the patients were examined by X-rays and CT after operation.Screw position and direction were measured on the sagittal and transsection image of intraoperative navigation and post-operative CT.The result was analyzed statistically.[Result]Two screws perforated the upper pedicle wall,3 deviated from the lateral pedicle wal1.There was no statistical difference in screw position or direction between navigation and CT image.Navigational images were based on the principle of rigid tissue.[Conclusion]Computer-assisted navigation can improve the accuracy of cervical pedicle screw installation.Screw malposition is responsible for the excursion phenomenon.

0.05). Conclusion The recombinant plasmid containing hBMP- 2 cDNA can be transfected and expressed effectively in rabbit MSCs

Objective To discuss the timing and methods of operative treatment of acetabular fractures of AO Type C (double- column fractures). Methods From February, 1999 to January, 2004, we treated operatively 46 cases of AO Type C acetabular fractures, including 23 cases of C- 1 type, 14 cases of C- 2 type, and 9 cases of C- 3 type. 15 cases were treated through ilioinguinal approach, 10 cases through improved Kocher- Langenbeck approach, and 21 cases through combined anterior and posterior approaches. There were 3 groups of patients according to the time from injury to operation: 15 cases got operation within 1st week after injury (Group A); 23 cases within 2nd week (Group B); 8 cases within/after 3rd week (Group C). All of them were checked with radiography and 3D CT scan before and after operation. Results 34 cases( 73.9% ) obtained anatomical reduction, 8 cases( 17.4% ) got imperfect reduction, and 4 cases( 8.7% ) had unsatisfactory reduction. All the patients were followed up for 1 year to 4 years, averaging 31 months. According to D' Aubigne and Postel Hip Score, joint function was rated as excellent in 32 cases( 69.6% ) , good in 5 cases( 10.9% ) , fair in 5 cases ( 10.9% ) and poor in 4 cases ( 8.7% ) . As far as reduction was concerned, there was a significant difference (P0.05). As far as joint function was concerned, there was a significant amelioration in Groups A and B compared with Group C (P0.05) between group A and Group B. Conclusions Good knowledge of AO classification of acetabular fractures combined with particular radiological data can result in correct diagnosis of Type C acetabular fractures. Operations should be carried out within 2 weeks after injury and efforts should be made to ensure anatomical reduction. To achieve good clinical results in treatment of Type C acetabular fractures, suitable approaches and correct reduction and internal methods are essential

Objective To study the genetic basis for biovar conversion of Y. pestis. Methods In silico comparative genomic analysis was conducted and some critical genetic variations of Yersinia pestis were comparatively analyzed by means of PCR and DNA sequencing. Results A 93bp in-frame deletion in glpD gene results in the glycerol negative characteristic of Orientalis strains. A point mutation in the napA gene may cause the negative characteristic of nitrate reduction in Mediaevalis and Microus strains. A 122-bp frameshift deletion in the araC gene may lead to the arabinose negative phenotype of Microus strains. Conclusion In this study, Microtus strains with their unique pathogenic, biochemical and molecular features, were proposed as a novel biovar Microtus. In the light of its differential ability to ferment glycerol and arabinose and to reduce nitrate, Y. pestis can be classified into four biovars-Antiqua(glycerol positive, arabinose positive and nitrate positive), Mediaevalis(glycerol positive, arabinose positive and nitrate negative), Orientalis(glycerol negative, arabinose positive and nitrate positive), and Microtus(glycerol positive, arabinose negative and nitrate negative).