Objective To study the effect of Yiqi Huoxue Tablets on blood coagulation and fibrinolysis system of rats with cerebral apoplexy induced by artificial cold wave. Methods SD rats were randomized into 4 groups. The apoplexy-prone renovascular hypertensive rat model was established by the bilateral renal arteries clamping method. From the 14th day after the modeling operation, the treatment group was given Yiqi Huoxue Tablets (1.89 g·kg-1·d-1), the positive control group was given aspirin (80 mg·kg-1·d-1), and the model group and the blank group were given the same volume of distilled water, once a day. After 112 days, the rats were put into the artificial cold wave box staying for 3 days to inducing apoplexy, and then thrombin-activatable fibrinolysis inhibitor (TAFI) and protein C ( PC) , thrombin-antithrombin complexes ( TAT) and plasmin-antiplasmin ( PAP) levels were measured. Results The plasma levels of TAFI, PC, TAT, and PAP in Yiqi Huoxue Tablets group were lower than the model group, the difference being statistically significant ( P<0.05) . Conclusion The preventive and therapeutic mechanism of Yiqi Huoxue Tablets for cerebral apoplexy is probably related with the regulation of the balance between blood coagulation and fibrinolytic system of apoplexy-prone renovascular hypertensive rats.

Objective To investigate the clinical efficacy of locking compression plate fixation through a modified anterolateral approach for posterolateral tibial plateau fractures.Methods From June 2010 to March 2012,19 patients with posterolateral tibial plateau fractures underwent locking compression plate fixation through a modified anterolateral approach in our hospital.There were 11 males and 8 females,aged from 26 to 55 years (average,38.3 years).The injury causes included traffic accident in 10 cases,fall from height injury in 7 cases and falling injury in 2 cases.Two patients had avulsion fracture of the anterior cruciate ligament.The modified lateral S-shaped incision was adopted for all patients.All the patients underwent early and suitable rehabilitation after operation.The radiographic and clinical results were evaluated by using X-rays and the Rasmussen score,respectively.Results The average operative time was 95 minutes (range,80 to 120 minutes),and the average intraoperative blood loss was 180 ml (range,100 to 400 mi).All the patients were followed up for 12 to 24 months (average,16.2 months).Bone union was obtained in all patients,and the bony union time ranged from 8 to 14 weeks.There was no implant loosening/ breakage,bone nonunion,genu valgum,genu varum,redisplacement of fracture,and knee instability.Anatomic reduction was obtained in 18 patients.For one patient with posterolateral comminuted dislocation fracture,CT scan showed a step-off of 2 mm in joint surface after operation,and at final follow-up,the patient suffered from mild pain and the range of motion of the knee joint was 0 to 105 degree.The range of motion of the knee joint was 5 to 90 degree in one patient.The Rasmussen score ranged from 13 to 30 (average,22.9±4.9); the results were excellent in 10 cases,good in 7 cases and fair in 2 cases,and the excellent and good rate was 89.5％.Conclusion Locking compression plate fixation through a modified anterolateral approach is an effective method for posterolateral tibial plateau fractures,which has several advantages,such as simple and safe operation,stable fixation and less complications.

Objective To evaluate effects of minimally invasive dynamic hip screw(DHS)in treatment of intertrochanteric femoral fractures.Methods The study involved 98 patients with intertrochanteric femoral fractures treated by closed reduction and C-arm fluoroscopy guided minimally invasive DHS from January 2004 to January 2010.According to AO classification,there were 38 patients with type A1 fractures and 60 with type A2 fractures.According to Evans classification,there were nine patients with typeⅠ?fractures,29 with type Ⅱ,36 with typeⅢ?and 24 with type V.Intraoperative blood loss,operation time and incision length were recorded.Results The intraoperative hemorrhage,operation time and incision length were average 250 ml(range,150-450 ml),54.3 minutes(range,45-70 minutes),and 5.2 cm(range,4-7 cm),respectively.All the patients were followed up for 12-38 months(mean 16.8 months).Fracture healing time was 10-14 weeks(average 11.5 weeks).According to Zuekerman functional scoring for hip joint,the results were excellent in 61 patients,good in 30,fair in four and poor in three,with excellence rate of 92.9％.Varus deformity of hip occurred in four patients.No patient presented surgical site infection,implant failure or displacement of fractures.Conclusion Minimally invasive DHS is an effective means in treating intertrochanteric femoral fractures,but the key point of successful treatment is to strictly grasp the correct operative procedures.

Objective To evaluate the clinic effect of reverse less invasive stabilization system (LISS) in treatment of femoral intertrochanteric fracture.Methods The study enrolled 22 cases of femoral intertrochanteric fractures treated with reverse LISS from January 2007 to January 2011.Twelve out of the cases were males and 10 were females,with age ranging from 44 to 86 years (mean,72.5 years).Left fracture occurred in 8 cases and right in 14 cases.Causes of injury included fall on the ground in 15 cases,vehicle accidents in 4 cases,and fall from height in 3 cases.There were 15 cases of type Ⅲ and 9 of type Ⅳ according to Evans-Jensen classification and all fractures were closed injuries.Time from injury to operation was 3-14 days (mean,5.3 days).Results Intraoperative hemorrhage was (130.5 ± 60) ml and operation time was (55 ± 15) min.All cases were followed up for 12-30 months (mean,14.8 months).Fracture healing time was 10-27 weeks (mean,13.4 weeks).Harris hip score was excellent in 11 cases,good in 8,fair in 2,and poor in 1,with excellent and good rate of 86％.Two cases felt greater trochanter pain at follow-up ; one presented with plate breakage and malunion at 6 months postoperatively,but may need no further treatment; the rest healed without complications of surgical site infection,varus deformity of the hip,implant breakage,fracture redisplacement,screw drawing pullout or cutout.Conclusion Reverse LISS plating is an effective treatment for femoral intertrochanteric fractures,but the procedure can not assure 100％ success.

Objective To discuss the operative procedures and clinical result of posteromedial and posterolateral approaches in treatment of posterior condylar tibial plateau fractures. Methods From January 2006 to June 2008, 21 patients of posterior condylar tibial plateau fractures were treated by posteromedial and posterolateral knee approaches. There were 12 males and 9 females. The age ranged from 28 to 68 years, with a mean of 39.5 years. Of the patients, 13 had resulted from a traffic accident and 8 had caused by a fall. As for the state of posterior condylar tibial plateau fractures, 7 patients had a medial condylar.fracture, 8 patients had a lateral condylar fracture and 6 patients had a bilateral condylar fracture. Results A follow-up lasted 12-24 months (mean 16.2 months ) in 21 patients. There was no infection, no varus or valgus of the knee, no nerve injuries and loosening or breakage of the screw. All cases had attained bone union. According to the Rasmussen functional scoring, the results were excellent in 12, good in 7 and fair in 2. The excellent and good rate of clinical results was 90.5%. Radiologic results were graded with the Rasmussen score to evaluate the reduction of fracture. There were excellent in 13, good in 7 and fair in 1. The excellent and good rate of clinical results was 95.2%. Conclusion Posteromedial and posterolateral approaches can facilitate the reduction and fixation for posterior condylar tibial plateau fractures. It has many advantages such as good exposure, less invasion and the excellent clinical results.

Objective To document the impact of conversion to mycophenolate mofetil (MMF)at different time points after transplantation on the renal function of renal function.Methods A longterm,multicenter,non-interventional and observational study was done.Two cohorts were included:One was Switch cohort (340 cases) including renal allograft recipients who switched to MMF at least 6 months after renal transplantation and followed up for 4 years after switch; The other was Stay cohort (123 cases),including renal allograft recipients who received MMF treatment after transplantation and followed up for 4 years after enrollment.Results GFR values of patients in Switch cohort was significantly increased after switch,and the change in GFR slope was 3.1 mL· min-1 · year-1 (P＜0.01).GFR values of patients in Stay cohort kept steady before and after enrollment,and the change in GFR slope was 0.44 mL·min-1 ·year-1 (P＞0.05).Statistically significant difference in the onset time of GFR decline (defined as 20％ decline from the baseline) was observed among subgroups within Switch cohort (P＜0.01),but there was no significant difference among subgroups within Stay cohort (P＞0.05).Stay cohort was 12％ higher than in Switch cohort every year.Conclusion Conversion to MMF ＞6 months or even many years after transplantation can obviously improve the renal function of recipients.The earlier conversion can benefit improvement of the renal function.

P-glycoprotein(P-gp)is an important efflux protein of ATP-binding cassette transporter superfamily. Cells could be protected from detrimental xenobiotics by the up-regulation of efflux pumps.In this review, an extensive literature search for P-gp induction research was conducted, and a focus was brought onto the P-gp induction models,experiment methods and its applications in drug discovery.We mainly introduced the in vitro cell-based models and in vivo rodent animal models for induction research, methods that investigate induction potency by detecting the protein,gene expression and efflux function,as well as co-regulation between P-gp and other transporters or drug metabolism enzymes.P-gp induction can serve as a clinical therapeutic strategy by reducing the intracellular concentration of deleterious xenobiotics significantly,and the in silico P-gp induction pharmacophore model was also discussed.This review could be of great importance for pre-clinical drug design, the screening of new synthesized compounds and the prediction of potential clinical drug-drug interactions.