Treatment of sacral fractures,unstable ones in particular,has attracted more and more attention.Despite numerous classification systems for sacral fractures,the commonly used ones are Denis and Tile classifications.Stable sacral fractures deserve conservative treatment,but unstable ones should be treated surgically,by operative reduction,internal fixation to reconstruct stability of the pelvis,and prevention or relief of nerve compression.There are many methods of internal fixation for unstable sacral fractures,and each has its own advantages and disadvantages.This review summarizes the progress in surgical treatment of unstable sacral fractures and makes comments on the latest surgical strategies.

Objective To investigate the expression of VEGF-C in breast cancer and its relationship with lymph node metastasis. Methods VEGF-C expression was assessed by immunohistochemistry in 78 cases of breast cancer. The relationship between expression of VEGF-C and lymph node status and clinicopathological features in breast cancer was analyzed. 20 cases of breast fibroadenoma was taken as control group. Results The expression of VEGF-C was significantly higher in breast cancer group than that in fibroadenoma group(P<0.01). VEGF-C was significantly higher in axillary lymph node-positive group than that in axillary lymph node-negative group(P<0.05). No relativity was found between VEGF-C and patient age, tumor size, estrogen receptor status, progesterone receptor status, and clinical stage. Conclusion The high expression of VEGF-C has a relativity with lymph node metastasis of breast cancer and may be important for the breast cancer's prognosis.

Gastroesophageal reflux disease(GERD)is a commonly seen digestive disease. So far,there is no golden standard for the diagnosis of GERD. The main diagnosis methods used in clinical practice include gastroscopy,24 h esophageal pH monitoring and proton pump inhibitor test,however,these methods are either invasive or complex in procedure and with low diagnostic accuracy rate. Gastroesophageal reflux disease questionnaire(GerdQ)possesses multiple advantages such as simple,non-invasive and easily acceptable. This article reviewed the use of GerdQ in diagnosis of GERD.

Early gastric cancer is the gastric cancer limited to mucosa or submucosa no matter there is lymph node metastasis or not,and its prognosis is relatively good. China is the high morbidity area of gastric cancer,most patients with gastric cancer are diagnosed at an advanced stage losing the chance of operation and the survival rate is low. Therefore, early diagnosis and treatment is crucial for improving the survival rate of patients with gastric cancer. This article reviewed the progress in study on diagnosis of early gastric cancer from the following aspects:serology,imaging,endoscopy and genetics.

ObjectiveTo evaluate the status of ANCA(antineutrophil cytoplasmic antibodies) positivity in Uygur nationality and Han nationality patients with ulcerative colitis (UC); and the possibility of the ANCA as a genetic marker of susceptibility between Uygur and Han nationality patients with ulcerative colitis in the same area. MethodsSerum samples from 39 Uygur and 31 Han patients with UC, 30 Uygur and 30 Han patients with diarrhea of other causes, 30 Uygur and 30 Han subjects as healthy controls were examined for ANCA using indirect immunofluorescence. Results ANCA was detected in 24 of 39(61.5%) Uygur patients with UC, 11 of 30( 35.5%) Han patients with UC, 1 of 30(3.3%) Uygur patients with diarrhea of other causes, none of 30 Han patients nor in the two healthy controls. It showed that the positive rate in Uygur patients with UC was significantly higher than in Han patients with UC (P0.05). Conclusions ANCA is useful in distinguishing patients with UC from other diarrhea diseases. ANCA may be a potential marker of genetic susceptibility to UC.

To study the pathological process and renal patho morphology of crush syndromed.The rabbit model of crush injury crush syndrome was established.Transmission electron microscopy(TEM),biochemistry,radioimmunoassay and immuohistochemistry were employed.The results demonstrated that the serum K + and BUN increased,The serum CO 2CP decreased after crush injury.The degeneration and necrosis of the epithelial cells of the renal tubule and myoglobin casts in the renal tubules were observed in crush syndrome,the serum K + increase was absent.Our results may be regarded as criteria for the diagnosis of the crush injury crush syndrome.The serum K + increase was the cause of death in early stage after crush injury.

AIM: To analyzed the effect of keratoconjunctivitis sicca treated by different medicines after phacoemulsification in patients with diabetes.METHODS: Totally 78 diabetic patients 78 eyes with keratoconjunctivitis sicca (KCS) after phacoemulsification from March 2015 to March 2016 were selected and divided into two groups using random number table.In Group A, 39 eyes were treated with pranoprofen eye drops + artificial tears + Qiming granules.In Group B, 39 eyes were treated with pranoprofen eye drops + artificial tears.the two groups were observed for clinical symptoms, tear film break up time(BUT), corneal fluorescein staining and adverse reaction and so on before and after treatment.RESULTS: Total effective rate of Group A was 97%, significantly higher than that of Group B (64%)(P<0.05).After treatment, symptoms and signs scores of the two groups were significantly lower, BUT were significantly prolonged.At 1, 2wk and 1mo after treatment, symptoms and signs scores of Group A were significantly lower the BUT was longer than those of Group B (P<0.05).Corneal fluorescein staining of Group A at 2wk was lower than that of Group B (P<0.05).CONCLUSION: The combined therapy, pranoprofen eye drops + artificial tears + Qiming granules, is able to quickly and effectively improve the clinical symptoms and signs, with no serious adverse reactions for keratoconjunctivitis sicca after phacoemulsification in patients with diabetes.

Objective To evaluate the outcomes of pregnancy of unknown location (PUL) with serial of serum β-human chorionic gonadotropin (β-hCG) and transvaginal sonography.Methods A retrospective study was performed to analyze the relationship between serial serum β-hCG and transvaginal sonography among 315 women who were diagnosed with nonvisible intrauterine pregnancy during Jan 2015 to Dec 2015.Results The pregnancy outcomes of 315 women included 254 intrauterine pregnancies,43 ectopic pregnancies,and 18 spontaneously resolving miscarriages or spontaneously resolving ectopic pregnancies.The serial serum β-hCG curve was classified as rising hCG levels,declining or plateauing hCG levels.Different pregnancy outcomes could exhibit as rising or declining hCG curves.Conclusions It is critical to perform two or more serial serum β-hCG examinations followed by transvaginal sonography to establish the correct diagnosis for PUL.

ObjectiveTo investigate the expression levels of the red blood cell surface receptors and oxidative stress of patients with hemodialysis,evaluate the immune function of the red blood cells,and identify the cause of infection and high prevalence of tumor in patients with hemodialysis.MethodsForty-five long-term hemodialysis patients from our blood purification center was chosen as the treatment group.Forty-five healthy individuals conducting physical examination at the same period was chosen as the control group.The flow cytometric method was used to detect CD35 surface receptors numbers of the red blood cell.The red blood cells wreath experiments were used to measure the adhesive function.The ELASA method was used to test the changes of oxidative stress index:SOD,MDA,CAT and GSH-PX.ResultsCompared to the normal control group,the treatment group had significantly lower levels of CD35 [ ( 28.62 ±6.95 ) AU vs.( 19.71 4.89) AU,t =5.441,P ＜0.01 ],impaired adhesive function red blood cells[ (0.63 ±0.07) vs.(0.44 ±0.04),t =0.41,P ＜0.05].For the levels of oxidative stress index,MDA [ ( 6.18 ± 0.16 ) μmol/L vs ( 13.47 ± 0.39 ) μmol/L ] was significantly higher in the treatment group than in the normal control group( t =13.14,P ＜ 0.05 ),and SOD( 34 202.00 ± 1634.00) U/( g · Hb),CAT ( 21.70 ± 0.84 ) U/ml and GSH-PX ( 444.00 ± 10.31 ) U/ml were significantly lower in the treatment group than in the normal control group [ SOD:(24 652.00 ± 2179.00)U/( g · Hb),CAT:( 14.80 ± 1.13 ) U/ml,GSH-PX:( 217.89 ± 13.70 ) U,t =20.246,9.496,27.195,P ＜0.05 ].ConclusionPatients with hemodialysis had lower numbers of red blood cell surface receptors CD35 and impaired immune function of adhesion,and higher oxidative stress levels.This may be the cause of infection and tumor of patients with hemodialvsis.

Objective To investigate the application and clinical result of treatment soft tissue defect in the lower leg after severe trauma by using the reversed descending branch of the lateral circumflex femoral artery of the injured leg as the recipient artery for free flaps.Methods Twenty-three patients with soft tissue defect of the lower leg after severe trauma from February 2007 to October 2012 were retrospectively analyzed.The patients were treated with the free flaps (the latissimus dorsi flap or the anterolateral thigh flap) using the reversed descending branch of the lateral circumflex femoral artery of the injured leg as the recipient artery.There were 14 males and 9 females,with an average age of 31.7 years (range,22-49 years).The causes of injury were traffic accidents in 12 cases,crushing injury in 8 cases,and machinery injury in 3 cases.The defect located at the proximal in 4 cases,the proximal and middle in 12 cases,middle and distal in 7 cases.Sizes of the tissue defect were 14 cm×5 cm to 32cm×12 cm,and the flap sizes were 15 cm×7 cm to 34 cm×13 cm.The donor defect was closed directly or resurfaced with a splitthickness skin graft taken from the thigh.Results Twenty-three flaps survived completely.Partial necrosis at the distal edge of the flap occurred in one case,and was healed by secondary intention.No patient needed urgent operative revision due to postoperative thrombosis of the vessels.All flaps completely survived,without evidence of postoperative insufficiency of the blood supply or venous congestion.The donor skin graft survived and the incision healed by first intention.The mean follow-up period was 12.4 months (range,6-21 months).The appearance,texture,color and thickness of flaps in all cases were good at the last followup.The flap achieved protective sensation with the two-point discrimination ranging between 10-25 mm.Conclusion Due to the advantages of reliable blood supply,short treatment cycle,and without postoperative forced position,the reversed descending branch of the lateral circumflex femoral artery of the injured leg can be an ideal choice as the recipient artery for free flaps in repairing the soft tissue defect in the lower leg after severe trauma.