A portable glucometer is developed with ferrocene as an electron mediator, which is characterized by being easy to operate and portable with the small size of 94.3mm?49.2mm?17.8mm. With this meter, the detection result can be available in no more than 20 seconds with about 1.5?l of blood drawn. The meter has a measurement range from 50mg/dl to 500mg/dl and a precision of 1mg/dl. The measurements are compared with the ones from USI 2300 Stat Plus approved by FDA. The coefficient of variation is from 3.0% to 7.8%, and the availability of linear relationship (y=1.006x-1.37, r=0.990, n=1.18) and comparability are demonstrated. Error table analysis proves that all of measurements are in the acceptable A and B sections. The meter is a validated diagnostic system for in vitro blood glocuse.

0.05).[Conclusion]Dynamic and static anterior fixation can all provide effective stability for cervical spine.Dynamic anterior fixation can be used in anterior intervertebral decompression and fusion.

Objective To compare treatments of intra-articular calcaneal fractures with and without bone graft in foot and ankle surgery.Methods A comprehensive search was conducted on line for all English research articles published from January 1990 through December 2010 dealing with open reduction and internal fixation with and without bone graft for intra-articular calcaneal fractures.Two reviewers evaluated each study to determine whether it was eligible for inclusion and collected the data of interest.Meta-analytic pooling of group results across studies was performed for the 2 treatments.Results The systematic review identified 32 qualified primary studies with 1281 fractures.No significant differences were found in postoperative infection, osteoarthritis or subtalar fusion between the 2 treatments ( P ＞ 0.05) .The average full weight-bearing time in bone graft treatment was significantly lower (5.4 weeks) than in non-graft treatment (10.5 weeks) .The mean B(o)hler angle was significantly larger and long-term loss of collapse significantly lower in bone graft treatment than in non-graft treatment.The bone graft treatment had a lower American Orthopaedic Foot and Ankle Society (AOFAS) score (71.4 points vs.80.5 points) but a higher Creighton score (89.9 points vs.81.0 points) compared with non-graft treatment.Pooled mean results showed no significant differences in the weighted excellent-to-good rate between the 2 treatments (excellent 35%, good 40%, fair 21% and poor 4% for the bone graft treatment versus excellent 34%, good 42%, fair 14%, and poor 10% for the non-graft treatment).Conclusions Open reduction and internal fixation with bone graft for intra-articular calcaneal fractures may lead to better reduction of B(o)hler angle and early return to full weight-bearing without increased risk of postoperative infection.However, since more cases of joint depression and comminuted fracture have been included in the bone graft group in the present study, a prospective controlled comparative study with a large scale of samples is still needed.

Chinese materia medica (CMM) plays an important role both in the disease prevention and therapy system and also in natural drug screening. Biotechnology exhibits applicable prospects in modern research of CMM with progress of natural science and technologies. Amplification fragment length polymorphism (AFLP), restriction fragment length polymorphism (RFLP), random amplification polymorphism of DNA (RAPD), and microsatellite DNA have been used to discriminate and breed herbal varieties. Genetic transformation and techniques of tissue and cell culture are explored to protect herbal resouces and to produce active components or parts on a commercial scale. High throughput technologies of proteome and biochip are expected to probe molecular targets and routes of CMM with the changes of proteome and gene expression. The results can be helpful to novel drug development and secondary exploitation, so as to promote the modernization process of CMM.

Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82％. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis of femoral neck fractures is high and the patients with high energy trauma hould be highly paid attention to.Lengthened PFNA conforms to characteristics of biomechanical fixation and presents short operation time and solid fixation. Lengthened PFNA achieves affirmatory effects for treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures.

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 compare the curative effect between minimal invasive internal fixation with Mast Quadrant and tra -ditional open internal fixation for treating thoracolumbar fractures .Methods A total of 46 cases suffered thoracolumbar fractures were randomly divided into the minimally invasive group (MQ) and the traditional open group (TO) ,the patients in MQ group re-ceived minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive channel ;the patients in TO group received pedicle internal fixation under traditional open channel .Perioperative related indicators ,imaging indicators and improvements of low back pain were recorded and statistically compared respectively .Results The different of the volume of blood loss ,operation time and length of incision and postoperative volume of drainage between the two groups were statistically significant (P < 0 .05) ,the different of the volume of hospital duration ,postoperative VAS score between the two groups were statistically significant (P <0 .05) .The different of the volume of flange height in injured vertebral fanterior ,Cobb Angle between preoperative and postopera-tive were statistically significant (P< 0 .05) .And comparison between groups had no statistical significance (P> 0 .05) .Conclusion Compared with traditional open operation ,minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive chan-nel has the advantage of more simple operation ,less intraoperative bleeding and postoperative pain less invasive ,fast recovery and short hospitalization stay .

Objective To evaluate the effect of various reduction degrees of large posterior malleolus fracture on contact condition of the tibiotalar joint using biomechanical and finite element methods.Methods Six fresh adult cadaveric calf-foot were tested with different loadings in neutral position,10 degree of dorsiflexion,and 15 degree of plantar flexion.Models included the intact ankle and posterior malleolus fracture (not fixed,fixed with 1 mm step-off,fixed with 2 mm step-off,fixed with 1 mm gap,or fixed with 2 mm gap).Tibiotalar joint contact area,contact pressure,and peak pressure were measured using the Tek-Scan pressure sensor.In addition,a three-dimensional finite element model of the ankle joint was established and tested under the simulated biomechanical conditions.Results Mter a 500 N axial loading in the intact ankle,contact area of the tibiotalar joint was (4.94 ± 0.67) cm2 and loading strength of the tibiotalar joint was (83.4 ± 2.7) ％ of total loading strength.Contact area of the tibiotalar joint in the fracture model fixed with 1 mm gap demonstrated no significant difference in all loading conditions compared with the intact model.In 15 degree of plantar flexion,contact area of the tibiotalar joint differed between the fracture model fixed with 1 mm step-off and the intact model (P ＜ 0.05).In multiple loading conditions,contact area of the tibiotalar joint differed between the fracture models fixed with 2 mm step-off or 2 mm gap and the intact model (P ＜ 0.05).Results of finite element analysis were conformed to the related biomechanical study.Conclusions Anatomic reduction should be pursued for large posterior malleolus fracture.If difficulty exists,fracture displacement should be within 1 mm step-off and 2 mm gap so as to restore the inter-joint congruity.

ObjectiveThe purpose of this study was to analyze the outcomes of surgical treatment of displaced intra-articular calcaneal fractures (ICFs) in children and its characteristics.MethodsBetween January 2004 and October 2008,we review the results of 9 displaced,intra-articular fractures in 8 skeletally immature patients,who were treated with open reduction and internal fixation in our hospital.There were 7 males and 1 female,with the mean age of 13.1 years(range:10 to 15 years).Preoperative radiographs and computed tomographic scans were used to classify fractures.Clinical and radiographic evaluation were performed in postoperative follow-up visits.The functional outcomes were assessed with use of the modified American Orthopaedic Foot and Ankle Society(AOFAS) ankle and hindfoot score.The published literatures of child ICFs treated with ORIF were reviewed.ResultsIn the series,there were 4 tongue-type and 5 joint depression-type fractures according to Essex-Lopresti classification,and according to Sanders classification,we found 5 type-Ⅱ fractures,3 type-Ⅲ and 1 type-Ⅳ fractures.The mean follow-up time was 47.4 months (range:21 to 72 months).All fractures healed within 2 to 4 months.The average preoperative and postoperative Bohler angles were 5.7 and 33.1 degrees respectively,and the mean Gissane angles were 106.5 and 128.0 degrees respectively.The mean modified-AOFAS score was 65.2 points(range:53 to 68 points).Skin necrosis was found in one foot.After the review of literatures,78.6％ (48/61) of displaced ICFs were male in children.Based on the Sanders classification,36 of 67 (53.7％) were type-Ⅱ fractures,25 of 67 (37.3％) were type-Ⅲ and 6 of 67 (9.0％) were type-Ⅳ; And 15 of 37 (40.5％) were tongue-type,22 of 37 (59.5％) were joint depression-type fractures according to Essex-Lopresti classification.ConclusionMost children with displaced ICFs treated with ORIF had a good clinical outcome with few complications.The children and adolescents that were exposed to high-energy trauma suffer calcaneal fractures that were similar to adult fracture patterns.