OBJECTIVETo investigate the applications of percutaneous screw fixation for the treatment of pelvic fractures and its related surgical considerations.

METHODSFrom June 2010 to June 2012,19 patients with pelvic fractures were treated with percutaneous hollow screws. There were 13 males and 6 females, with an average age of 41 years (ranged from 22 to 58 years). Fractures were caused by traffic accidents in 11 cases, by falling down from high place in 8 cases. Based on the Tile classification, there were 15 cases of Tile C type and 4 case of Tile B type. The indexes such as screw inserting time, intraoperative blood loss, complications, functional recovery and reduction conditions were observed. Fixation methods included sacroiliac screws, cannulated screw fixation of the pubic ramus and cannulated screw fixation of the pubic symphysis separation.

RESULTSAnatomical reduction achieved in 7 cases, satisfactory reduction 11 cases, and unsatisfactory reduction 1 case. Union time of fracture union ranged from 8 to 12 weeks (mean 10 weeks). Wound infection,ununion of fracture and nerve injuries were not found. According to the Majeed standards, 12 patients obtained an excellent results, 6 good and 1 fair.

CONCLUSIONPercutaneous screw fixation for the treatment of pelvic fractures under fluoroscopy has several advantages such as less trauma, less blood loss, fewer rates of complications, reliable fixation and no blood transfusion, which can reconstruct the stability of the pelvic ring, but it needs adequate preoperative preparation and high requirements for the surgeon.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography ; Young Adult

OBJECTIVETo compare the difference in the efficacy on low back pain of cold-damp pattern between electric-thermal Bian-stone therapy and moxibustion box therapy.

METHODSForty-one cases of low back pain of cold-damp pattern were randomized into an electric-thermal Bian-stone therapy group (group A, 26 cases) and a box moxibustion therapy group (group B, 15 cases). In the group A, the electric-thermal Bian-stone was placed over Shenshu (BL 23) and Weizhong (BL 40). The temperature of stone was adjusted in accordance with patient's comfort. In the group B, moxibustion box was used over Shenshu (BL 23) and Weizhong (BL 40). The treatment was given once every day or every two days. Ten treatments made one session. The symptom and physical signs score of low back pain and the score of cold-damp syndrome were observed before and after treatment in the patients.

RESULTSThe symptom and physical signs score of low back pain and the score of cold-damp syndrome were all improved in the two groups (all P < 0.01). The changing rate of symptom and physical signs and syndrome were (37.04 +/- 32.68)% and (22.85 +/- 29.95)% in the group A, and were (47.29 +/- 22.08)% and (23.89 +/- 22.53)% in the group B, respectively, without significant difference in comparison between the two groups (all P > 0.05).

CONCLUSIONThe efficacy on low back pain of cold-damp pattern treated with the electric-thermal Bian-stone therapy is similar to that of moxibustion box therapy. This therapy is characterized as more convenient, safer operation and less pollution.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Moxibustion

Objective　To investigate the expression of TGF-β and TGF-β receptor in human breast cancer cell Bcap-37 inhibited by soybean isoflavones. Methods　mRNA and protein of TGF-β1、TGF-βRⅠ in Bcap-37 cells were examined with reverse transcription ploymerase chain reaction(RT-PCR) and immunohistochemistry after cells were treated with daidein or genistein for 1-4 d.The expression of TGF-β1 and TGF-β2 was determined with TGF-β resistance test. Results　The TGF-β1, TGF-β2 and TGF-β recepor increased in Bcap-37 cells at a concentration of 3×10-5 mol/L of genistein. No changes was found when treated with daidzein. Conclusion　Genistein may inhibit the proliferation of Bcap-37 cells and accompany with increasing expression of TGF-β1, TGF-β2 and TGF-β receptor.

Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.

OBJECTIVETo study the effect of tanshinone II A (TSN) on angiotensin II (Ang II) induced proliferation of vascular smooth muscle cells (VSMCs).

METHODSVSMCs were cultured by explant attached method, and induced to proliferative cell model with Ang II. The effect of TSN in different concentrations on calcineurin (CaN) activity was detected by enzyme reaction phosphorus measurement; the CaN mRNA expression was detected by RT-PCR; and the expression of proliferating cell nuclear antigen (PCNA) were observed by immunocytochemical method.

RESULTSCompared with the normal control group, Ang II could significantly stimulate the proliferation of VSMCs, showing obviously elevated degree of proliferation activity (P <0. 01). After being treated with TSN, all the indexes, including CaN activity, CaN mRNA expression and PCNA expression, were obviously reduced in a dose-dependent manner (P<0.05, P<0.01).

CONCLUSIONVSMCs proliferation can be inhibited by TSN in a dose-dependent manner and the inhibiting mechanism may be related to the down-regulation of CaN activities and the inhibition on CaN mRNA and PCNA expressions.

Angiotensin II ; pharmacology ; Animals ; Calcineurin ; genetics ; metabolism ; Cell Proliferation ; drug effects ; Cells, Cultured ; Diterpenes, Abietane ; Dose-Response Relationship, Drug ; Down-Regulation ; drug effects ; Male ; Muscle, Smooth, Vascular ; cytology ; enzymology ; Phenanthrenes ; pharmacology ; Proliferating Cell Nuclear Antigen ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To provide an anatomical basis for endoscope-assisted presigmoid-retrolabyrinthine keyhole approach to the petroclival region. Methods Ten formalin-fixed adult cadaver heads were used in this study. A C-shaped postauricular skin incision about 6 cm in length was made to expose the anatomic structures, which were observed under microscope and endoscope. Results The distance from the anterior margin of the sigraoid sinus to the most posterior point of the posterior semicircular canal was 9.1±1.3 mm on the right and 9.6±1.8 mm on the left side. With appropriate adjustment of the endoscope and the angle of the microscope, the presigmoid-retrolabyrinthine keyhole approach allowed good exposure of the important structures in the petroclival region with also clear display of the cranial nerves and the adjacent blood vessels. Conclusion The facial and vestibulocochlear nerves and the posterior orifice of the internal auditory canal can be used as the landmarks for localization of the peroclival region and its surrounding structures.

Objective To study the anatomical features of medial wall of the glomus jugulare to provide the theoretical direction for surgery of the glomus jugulare. Methods Fifteen (30 sides)formalin-fixed adult cadaveric specimens were dissected under the operating microscope, and their structural features of the medial wall of the glomus jugulare and their anastomosis of nerves were observed; and 5 dry skull specimen were also employed to observe the bone landmark of medial wall of the glomus jugulare. Results The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen, jugular process of the temporal bone and occipital bone, cerebral dura mater and the Ⅸ, Ⅹ and Ⅺ cranial nerves. A curve line was marked on medial wall of the glomus jugulare, finding that the cranial nerves and the cerebral dura mater are at the anteroinferior position and the posterior-up part is composed of the well of the jugular vein adhered to the petrous bone and cerebral dura mater. Cranial nerve Ⅸ travels at the anterosuperior part of its own fibrous sheath and the inferior petrosal sinus ostium separates it from cranial nerves Ⅹ and Ⅺ; cerebral dura mater separates the cranial nerves Ⅸ and Ⅹ. The cranial nerve Ⅹ and the accessory nerve are closely related. Interval of cerebral dura mater between cranial nerve Ⅸ and Ⅹ is clearly seen in 86.67％ (26/30) patients and illegible in 13.33％ (4/30). Hypoglossal canal travels of the bottom of the medial wall of the glomus jugulare. Conclusion The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen,jugular process of the temporal bone and occipital bone, cerebral dura mater and the Ⅸ, Ⅹ and Ⅺ cranial nerves, and this information can help the clinicians during the operations of the jugulare foramen, so that the operation complications can be reduced.

OBJECTIVESTo retrospectively study on malignant giant cell tumor of tendon sheath (MGCTTS) in the hand, and to evaluate its clinical, histologic, immunohistochemical features and biologic evolution.

METHODSBetween January 1991 and December 2001, 10 patients with histologically proven MGCTTS were treated. The clinical material, radiographs and hematoxylin and eosin-stained sections were reviewed. Immunohistochemical studies and nuclear suspensions for flow cytometry were done on paraffin embedded tissue. All patients were followed up.

RESULTSThree of 10 patients in which the diagnosis of MGCTTS was originally considered were excluded after the slides reviewed and immunohistochemical examination performed. In the other 7 patients, one showed malignant and aggressive nature: the lesion recurred several times and the patient eventually died with pulmonary metastases. The immunohistochemical profile of the patient was similar to that reported in benign GCTTS, and the flow cytometry DNA analysis detected aneuploidy. Six cases presented histologic features of malignancy, 4 of them undertook the immunohistochemical examination and their profiles were similar to that reported in benign GCTTS. An aneuploidy DNA pattern was detected in one case on flow cytometry evaluation, diploidy DNA pattern was detected in 3 cases, and their S-phase fraction was 4.5%, 11.6% and 2.6% respectively. All of them had a benign clinical features, they were alive and without evidence of disease from 1.5 to 7.5 years (averagely, 4.5 years) after complete surgical excision or resections with wide surgical margins. None of them had received chemotherapy or radiation therapy.

CONCLUSIONSMalignant giant cell tumor of tendon sheath is an extremely rare malignant tumor, some cases have a poor outcome, the others, despite the histologically malignant features, have a good prognosis if wide surgical excision ablates the tumor completely.

Adult ; Female ; Flow Cytometry ; Follow-Up Studies ; Giant Cell Tumors ; metabolism ; pathology ; surgery ; Hand ; pathology ; Humans ; Immunohistochemistry ; Male ; Retrospective Studies ; Tendons ; metabolism ; pathology

OBJECTIVETo observe different effects of moxibustion on extracellular potassium ion in acupoint under physiological and pathological status and provide experimental evidence for exploring action mechanism of moxibustion on acupoint local.

METHODSForty female SD rats were randomly divided into a blank group, a blank-moxibustion group, a model group and a model-moxibustion group, 10 cases in each one. The complete Freund's adjuvant(CFA) was adopted to establish model of adjuvant arthritis (AA) in the model group and model-moxibustion group. No treatment was given in the blank group and model group while moxibustion was applied at "Zusan-li" (ST 36) for 30 min in the blank-moxibustion group and model-moxibustion group. The tissue fluid in "Zusanli" (ST 36) was collected with microdialysis and real-time analyzed by electrolytic analyzer. The change of concentration of potassium ion in "Zusanli" (ST 36) was observed.

RESULTS(1) Under physiological status, the concentration of extracellular potassium ion in the blank group was not changed within 150 min (P > 0.05); before the moxibustion, the concentration of extracellular potassium ion in the blank-moxibustion group was (1.21 +/- 0.31) mmol/L, and after treatment it was gradually increased and reached its peak at (2.38 +/- 0.42) mmol/L after 60 min (P < 0.05), then it was reduced. 150 min after the treatment, concentration of potassium ion was slightly higher than that before moxibustion as well as that in the blank group. The concentration in the blank-moxibustion group at 60 min was statistically significant compared with that in the blank group (P < 0.05). (2) Under pathological status, the concentration of extracellular potassium ion in the model group was not changed within 150 min, differences of which at each time point was not statistically significant (all P > 0.05). Before the moxibustion, the concentration of extracellular potassium ion was (1.09 +/- 0.12) mmol/L in the model-moxibustion group, and it was immediately increased to (1.96 +/- 0.18) mmol/L after moxibustion. 60 min and 90 min after the moxibustion, it still maintained a higher level, which was (1.87 +/- 0.29) mmol/L and (1.59 +/- 0.16) mmol/L respectively (both P < 0.05). The differences of each time point after moxibustion in the model-moxibustion group were statistically significant compared with those in the model group (all P < 0.05).

CONCLUSIONThe moxibustion could increase the concentration of potassium ion in rat's acupoint local under physiological status but time of effect is short; with moxibustion at "Zusanli" (ST 36) under pathological status, the concentration of local potassium ion is obviously increased and maintains for a long time.

Acupuncture Points ; Animals ; Arthritis, Experimental ; metabolism ; therapy ; Disease Models, Animal ; Female ; Humans ; Moxibustion ; Potassium ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo introduce a method for repairing and restoring hand function of the patients suffering from large surface area burn with scarce normal skin for reconstruction.

METHODSSeven patients (ten hands) were treated in our department from April 1994 to February 2001. The TBSA involved with second- or third-degree burns was 85%-96%. All the hands had severe scar contracture on the dorsum and lost most of their function. A scarred skin flap, based on the ulnar border of the hand was elevated integrally on the dorsum. A random-pattern abdominal flap at a less-scarred area was designed and elevated to cover the defect of the hand while the scarred skin flap of the hand was transferred to the donor site of the abdominal flap.

RESULTSAll patients were followed for 0.5 to 4 years postoperatively. The range of motion of the metacarpophalangeal joint and the space capacity of the first web were greatly improved. All patients regained self-care ability.

CONCLUSIONSThis method is simple and has satisfactory results. Under the circumstances where normal skin was not available for reconstruction, the function of the burned hand could be greatly improved by this method.

Abdominal Wall ; surgery ; Adolescent ; Adult ; Burns ; surgery ; Female ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Surgery, Plastic ; methods ; Surgical Flaps ; Treatment Outcome