Objective To investigate the clinical effects of surgery treatment of the Tibia plateau fracture.Methods Thirty-two cases diagnosed Tibial plateau fracture were performed internal fixation and bone grafting surgery treatment.Results According to Rasmussen Evaluation,there were the gifted 22 cases(68.8%)excellent,6 cases(18.8%)good,2 cases(6.3%)ordinary,2 cases(6.3%)poor.The good rate Was 87.6%.Conclusions Surgery is effective to trot Tibial plateau fracture.A stable internal fixation,as far as possible,reduces the blood supply to fracture block interference and protects joint subsidiary structure to correct joint function rehabilitation treatment.

BACKGROUND: Bushen Huogu decoction can effectively prevent and treat osteoporosis, but the concrete mechanism of pharmacology is still not clear. 25-hydroxy vitamin D3 and 1, 25-dihydroxyvitamin D3 are important coupling factors, which can regulate bone resorption and formation.OBJECTIVE: To investigate the curative effects of Bushen Huogu decoction on the bone mineral density, bone biomechanics, and level of 25-hydroxy vitamin D3 and 1, 25-dihydroxyvitamin D3 in blood serum, liver and kidney in the ovariectomized osteoporotic rats.METHODS: Totally 108 healthy female Sprague-Dawley rats were randomly divided into model group, sham-operated group, andtreatment group. All rats had been ovariectomized to induce estrogen absence and further establish osteoporotic models, except those in sham-operated group. Treatment group of rats were intragastrically administrated with 2 mL Bushen Huogu decoction,twice a day.RESULTS AND CONCLUSION: Compared with model group, the bone mineral density in the rat femur was significantly increased in the treatment group (P < 0.05), the index of maximal stress and maximal loading of the femoral head were also increased (P <0.05). The concentration of 25-hydroxy vitamin D3 and 1, 25-dihydroxyvitamin D3 in blood serum, liver and kidney were significant higher in the treatment group than those in the model group, and the levels were similar with those in sham-operated group (P >0.05). In the early period of estrogenic hormone absence, the Chinese kidney-tonifying drugs could activate bone metabolism, raise bone mineral density and reinforce quality of bone through up-regulating expression of 25-hydroxy vitamin D3 and 1,25-dihydroxyvitamin D3.

Objective To evaluate the therapeutic effect of endocrine for prostate cancer with bone metastases with MR diffusion-weighted imaging (DWI). Methods Forty patients with bone metastases from prostate cancer were examined with DWI. Seventeen patients underwent endocrine therapy were recruited as the test group, the other 23 were regarded as the control group. There was no relapse of the metastases according to clinical diagnosis in the test group. DWI sequences were based on steady-state free precession with b value (800 s/mm~2). After identifying the metastasis according to the T1WI and T2WI, ROIs were marked at the metastases, normal muscle, normal bone and bladder on DWI, and the ADC values of the ROIs were calculated respectively. Non-parameter two independent samples test was applicated to compare the ADC values of the metastases between the two groups.Results ADC values of the bone metastases were (1.10±0.50)×10~(-3)mm~2/s in the test group and (1.12±0.30) ×10~-3mm~2/s in the control group (P>0.05).Conclusion MR DWI shows no help in evaluating the therapeutic effect of endocrine for prostate cancer with bone metastases.

Objective To investigate the diagnostic efficacy of MRI and bone scintigraphy in the detection of bone metastasis from prostate cancer.Methods One hundred and eighty-three patients suspected of prostate cancer were recruited in this study.All the patients were examined by pelvic MRI and bone scintigraphy.According to the integragted clinical diagnosis,the patients were categorized as metastastic group and non-metastatic group.SPSS 11.0 was used to analyze the data.Results Bone metastasis were identified in 37 of the 183 patients.In the 24 patients whose MRI results demonstrated bone metastasis,all of them were convinced of bone metastasis(24/24,100%).In the 159 patients whose MRI results revealed no bone metastasis,only 4 of them(4/159,2.52%)were detected bone metastasis by bone scintigraphy.The sensitivity,specificity and accuracy of MRI in the detection of bone metastasis was 78.38%,87.0% and 85.25%,respectively.The sensitivity,specificity and accuracy of bone scintigrapy in the detection of bone metastasis was 94.59%,62.33% and 68.85%,respectively.The specificity and accuracy of MRI in the prediction of bone metastasis were higher than that of bone scintigraphy(? 2=23.458,P=0.000;? 2=13.906,P=0.000),whereas the sensitivity of bone scintigraphy in the detection of bone metastasis was higher than that of MRI(? 2=4.163,P=0.041).Conclusion With the negative findings of the pelvic MRI,the probability of bone metastasis diagnosed by bone scintigraphy was fairly low.So even with the limitation range of the pelvic MRI examination,it is useful in the prediction of bone metastasis from prostate cancer.

ObjectiveTo evaluate the consistency of HER2 gene status before and after neoadjuvant chemotherapy in breast cancer by FISH (fluorescence in situ hybridization) and IHC (immunohistochemistry) techniques,and analyze the factor of the difference in the result and the feasibility of HER2 gene tested by FISH in the neoadjuvant chemotherapy breast cancer patients.Methods FISH and IHC for HER2 gene expression status was performed on the archival paraffin-embedded sections of breast cancer tissues before and after neoadjuvant chemotherapy from 135 Chinese female patients,x2 test of paired comparison of enumeration data and Kappa analysis were used to compare the difference and consistency of this two techniques.ResultsThe detection rate of HER2 status in punctured cancer tissues before neoadjuvant chemotherapy by FISH and HER2 did not show statistical difference in our research while the opposite result were showed in cancer tissues after neoadjuvant chemotherapy.Moreover,the two techniques of HER2 test were less concordant in patients accepted taxanes neoadjuvant chemotherapy than CAF treatment.ConclusionsThe consistency of FISH and IHC techniques of cancer tissues before neoadjuvant chemotherapy gained advantage compared to the ones after neoadjuvant chemotherapy.Patients received neoadjuvant chemotherapy especially taxanes should take the test of HER2 gene status by FISH technique.

Objective: To explore the effect of the perforator flap of the proper digital artery on the ulnar or radial side of the finger in the treatment of webbed scar contracture of the same finger in child. Methods: From January 2012 to January 2016, 26 children who were treated with dressing change after burn of finger and then had webbed scar contracture along with growth and development were hospitalized in our unit, involving a total of 50 fingers. There were 14 males and 12 females among the children aged from 2 to 14 years. After the scar was dissected and released, the wound area ranged from 1.6 cm×1.0 cm to 5.0 cm×2.6 cm. The perforator flap of the proper digital artery of the ulnar or radial side of the same finger was used to repair the wound. The flap area ranged from 1.8 cm×1.0 cm to 4.6 cm×1.8 cm. The donor sites were sutured directly. The residual wounds in donor and recipient sites were repaired by full-thickness skin graft collected from inguinal area/adjacent area or adjacent perforator flap. The postoperative development and function of the fingers were followed up and observed. The range of motion of the fingers was evaluated according to the Chinese Medical Association Hand Surgery Society′s upper limb functional evaluation trial standard, the Kantor Scar Cosmesis Assessment and Rating Scale was used to score the scar of finger, and the latest data were recorded. Results: The flaps and skin grafts survived successfully after operation. The patients were followed up for 6 to 24 months. The perforator flaps of the proper digital artery on the ulnar or radial side of the finger survived well at the latest follow-up, with good color and texture and a two-point discrimination distance of 9 to 12 mm. There was no contracture of the fingers, a little pigmentation in the skin graft area, no flexion deformity of the fingers, no lateral bending of the fingers to the flap-harvesting side, and no scar contracture at the webs of the fingers. Compared with that of healthy side, the development of finger was not obviously abnormal. The range of motion of the fingers was excellent in 38 fingers and good in 12 fingers, and the scar score of the fingers was 2-3 points in 31 fingers, 4-7 points in 15 fingers, and 8-10 points in 4 fingers. Conclusions The efficacy of perforator flap of the proper digital artery of the ulnar or radial side of finger in the treatment of the webbed scar contracture of the same finger in child is reliable, with high postoperative survival rate of the flap, better color and texture, and fewer complications, which can avoid the risk of re-contracture of the finger in a short period after operation, and does not affect the growth and development of the finger.

Objective:To investigate the types, incidences, and clinical characteristics of shock in polytrauma patients at different stages after polytrauma.Methods:A retrospective study was conducted on polytrauma patients admitted to multiple trauma centers from June 2020 to December 2021. The inclusion criteria were patients >18 years old and treated due to polytrauma. Exclusion criteria included an admission time of more than 48 h after trauma, a history of malignancy, or metabolic, consumptive, and immunological diseases. The early stage was defined as the period of ≤48 h after polytrauma, and the middle stage was defined as the period between 48 h and 14 days. The patient’s medical history, clinical manifestations, laboratory tests, imaging examination, injury severity score (ISS), and Glasgow coma scale (GCS) were collected. The types, incidences, and clinical characteristics of shock in different stages after polytrauma were analyzed, according to the diagnostic criteria of each type of shock. The differences between the groups were compared by Student’s t test, χ2 test or Mann-Whitney U test. Results:The incidence of the early and middle stage shock after polytrauma were 73.1% and 36.4%, respectively, with statistically significant difference between stages ( P<0.01). There were significant differences in the incidence of hypovolemic shock (83.6% vs. 28.4%), distributed shock (13.7% vs. 80.9%) and cardiogenic shock (3.5% vs. 6.6%) between stages (all P<0.05). The incidence of obstructive shock (8.4% vs. 9.7%, P>0.05) was similar between stages. The incidence of undifferentiated shock was 1.6% and 1.2%, respectively. There were 9.5% patients with multifactorial shock in the early stage and 14.4% in the middle stage. Totally 7 combinations of multifactorial shock were found in different stages after polytrauma. In the early stage, the combination of HS and DS accounted the highest ratio (42.3%) and followed by HS and OS for 28.8%. In the middle stage, the combination of HS and DS was the most common (48.6%) and followed by DS and OS (24.3%). Conclusions:The incidence of shock in polytrauma patients is high. Different types of shock can occur simultaneously or sequentially. Therefore a comprehensive resuscitation strategy is significant to improve the success rate of treatment.