Objective To study middle-and-long-term results of the conservative management of the supination-eversion fractures of ankle. Methods A retrospective study was done for the 43 patients with supination-eversion fracture of ankle who were treated from February 1999 to August 2004 in our department, and followed up. Five patients belonged to stage Ⅰ , 10 to stage Ⅱ , none to stage Ⅲ and 28 to stage Ⅳ . The average duration of follow-up was 69 months (16 to 84 months). Results The middle-and-long-term results were graded according to the Ankle Hindfoot Clinical Rating System of the American Orthopaedic Foot & Ankle Society(AOFAS). Of the stageⅠ patients, five got satisfactory results. Of the stage Ⅱ patients, nine got satisfactory results and one unsatisfactory. Of the stage Ⅳ patients, 26 got satisfactory results and two unsatisfactory. Conclusions The middle-and-long-term follow-ups show that most of the supination-eversion fractures of ankle can be treated conservatively with a satisfactory result. Surgical treatment should be indicated for those whose conservative management cannot reach satisfactory results.

Objective To study advantages and disadvantages of the super-cutaneous calcaneal locking plate in the treatment of calcaneal fractures. Methods Between October 2007 to June 2008, 12cases of calcaneal fracture were treated with a super-cutaneous calcaneal locking plate. According to the Sanders classification system, 8 cases were of type ⅡA, one case of type ⅡB, one case of type ⅡC, one case of type Ⅲ AC, and one case of type Ⅳ. All the cases were fresh fractures. The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal. In direct observation of the posterior facet and anterior tuberosity, the articular fragments were reduced anatomically. Then the reduced calcaneus was fixed by a super-cutaneous calcaneal locking plate. After bone union was confirmed 3 months after the operation by the CT scans and X-ray films, the super-cutaneous plates and screws were removed in clinic. Results The average time of follow-up was 16 months with a span from 12 to 20 months. There were no incision or pin-hole infections. The reduction of the articular surface and bone union were good. One type ⅡA developed lateral wall exostosis which resulted in peroneal tendonitis and stenosis followed by obvious walking pain. The preoperative X-ray films of the 12 patients showed that the average B(o)hler angle was 11.9°±9.4° and the Gissane angle 86. 8°± 7. 7°. Their postoperative X-ray files demonstrated that the B(o)hler angle was improved to 29. 4°± 7.0° and the Gissane angle to 115.8°± 7.7°, with a significant difference ( P ＜ 0. 01 ). According to the Ankle Hindfoot Clinical Rating System of the American Orthopaedic Foot and Ankle Society (AOFAS),their average score was 91 points (68 to 100 points). Conclusions Using a super-cutaneous calcaneal locking plate to treat calcaneal fractures can result in limited invasion, a low rate of skin infection, satisfactory reduction of the articular surface and stable fixation. Since the fixation can be removed without re-hospitalization, it is a cheaper and less painful alternative for the treatment of displaced intra-articular calcaneal fractures.

AIM: To investigate the anti-DIC effect of the domestic recombinant hirudin (rH) in order to provide preclinical pharmacological basis for its new drug application. METHODS: DIC was induced by constant iv infusion of thrombin (100 U?kg -1 ?h -1 ?1 h) plus PAMBA (50 mg?kg -1 ?h -1 ?1 h). Platelet count (PLT), PT and fibrinogen (FIB) determination as well as plasmaprotamine paracoagulation (3P) test served as diagnostic indexes of DIC, while pathlogical examination of microthrombosis of lungs and kidneys was followed. RESULTS: rH 125,62.5,31.25 and 15.625 ?g?kg -1 iv. gtt demonstrated a dose-dependant inhibitory effect on DIC. The inhibitory effects on DIC of rH(%) were 89.38%, 52.60%, 49.71% and 25.58% for PT, and 100.01% , 61.86%, 58.40% and 32.68% for PLT, and 85.22%, 73.01%, 33.60% and 14.86% for FIB respectively at the descending order of rH doses. CONCLUSION: Domestic rH being tested has powerful anti-DIC effect which is comparable with refludan—an r-hirudin product approved by European Community for marketing.

0.05). Conclusion Although it is expensive, CT scan should serve as a routine examination before operation because it has significant effects on treatment plan and classification of tibial plateau fractures.

Objective:To investigate the expression of AQP4 during the development of presyrinx state of experimental syringomyelia in rabbits.Methods:The experimental syringomyelia models of rabbits were established by intra-cisternal injection of Kaolin.The expression of AQP4,AQP4mRNA and the water content of upper cervical spinal cord were measured with immunohistochemistry,Western blot,RT-PCR and dry-wet measurement on days 1,3,7,14,and 21 after operation,respectively.Results:Compared with animals of control group,the water content increased in those of Kaolin group from the 1st day(68.35%?0.70%),reached its peak on the 7th day(72.92%?0.86%),lasted to the 14th day(72.58%?0.55%),and then began to drop on the 21st day(70.03%?0.77%),while AQP-4 immunoreactive expression decreased on the 3st day[integral optical density(IOD)320.5?44.2],reached its minimum on the 7th day(IOD 258.7?26.5),lasted to the 14th day,and recovered partially on the 21th day approximately(IOD 321.5?46.1).RT-PCR found the decreasing of AQP4 mRNA coincided well with that of AQP4 immunoreactive expression in presyrinx state.The linear regression analysis indicated that expression of AQP4 and its mRNA in cervical cord had a negtive correlation with the change of spinal water content(r=-0.769,P

Objective To study the relationship between the Bado's classification of the Monteggia fracture in adult and their prognosis. Methods Studying the 60 patients in our hospital suffering from Monteggia fracture-dislocation during 10 years between 1994 to 2004, and their clinical data of the follow-up is analysised with statistics. There were 26 cases with Bado type Ⅰ fracture-dislocations, 14 cases with Bado type Ⅱ fracture-dislocations, 19 cases with Bado type Ⅲ and 1 case with Bado type Ⅳ fracture-dislocations. The fractures of the shaft of the ulna were treated operatively with open reduction and internal fixation using plates and screws. The fractures of the radial head were operated with open reduction and internal fixation, or are treated with the resection of the partial or total radial head. For the cases of the dislocation of the radial head without fracture, the most commonly used treatment method was to reduce the dislocation closely and stable the position with external fixation by a plaster cast. For the injury of the radial nerve associated with the Monteggia fracture dislocation, no operation had been done to make an exploration. Rank Sun Test of NoSA system was adopted to analysis the clinical data gained above. Results The average duration of the follow-up was 24 months (12-72 months). The results were graded according to the score system of Broberg and Morrey. In Bado type Ⅰ, 24 cases were considered satisfactory and 2 cases unsatisfactory, satisfactory ratio is 92%; In Bado type Ⅱ, 10 cases satisfactory and 4 cases unsatisfactory, satisfactory ratio was 71%; In Bado type Ⅲ and type Ⅳ, all the cases gained satisfactory results, satisfactory ratio was 100%. Rank Sun Test showed there was no obvious difference on prognosis between every group of the Bado's classification system. But statistical obvious difference could be found between the group with the fractures of the radial head and the group without. Conclusion The classification system of Bado has no prediction prognosis. In adult Monteggia fracture, the final result largely depends on whether there is a fracture of the radial head.

BACKGROUND:Undergoing femoral head replacement in senile osteoporosis patients with intertrochanteric fracture is a chal enging problem.
OBJECTIVE:To explore the clinical effect of the use of joint instal ation and fracture reduction on the treatment of unstable intertrochanteric fractures in elderly patients.
METHODS:A total of 21 elderly patients with unstable intertrochanteric fractures underwent femoral head replacement. Simultaneously, we col ected clinical data of 20 elderly patients with unstable intertrochanteric fractures undergoing internal fixation of dynamic hip screw. Operation time, blood loss amount, time of walking practice after replacement, complications, and Harris score were compared between the two groups. Clinical effects in patients with femoral head replacement were observed.
RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 20 months (ranged from 6 months to 36 months). After replacement, the incision was first healing. The operation time of femoral head replacement was short;blood loss amount was less;the time of walking practice was early. However, no significant difference in Harris score was detected between the two groups (P>0.05). After femoral head replacement, no infection, inversion and shift, or hip joint loose occurred. Results suggested that correct anteversion angle, eccentricity and femoral calcar size should be identified before the implementation of artificial joint replacement for the elderly femoral intertrochanteric fracture. After implantation of the prosthesis, reduction and fixation of trochanter and femoral calcar bony landmarks are simple easily operated surgery. It can reduce blood loss amount, shorten operation time and elevate clinical effects.

Objective To evaluate the quality of immunological diagnosis kits of schistosomiasis. Methods The national reference IgG serum of schistosomiasis was applied for evaluating eight immunological diagnosis kits of schistosomiasis. Results All eight diagnosis kits had no National Production Certificate issued by State Food and Drug Administration. Six kits had good quality with high precision. After the physical examination, two kits did not meet the quality standards. Conclusions The good and bad quality of immunological diagnosis kits of schistosomiasis used in market is intermingled. The quality of these kits should be monitored.

Objective To explore the mechanism by which tumor necrosis factor alpha(TNF-α) induces RIP1 kinase-dependented apoptosis in L929-A fibroblastoma cells.Methods The sub-mitochondrial localization of receptor-interacting protein 1(RIP1),caspase-8 and Bid proteins was detected by dose-gradient trypsin digestion and Western blotting.The levels of reactive oxygen species (ROS),intracellular calcium concentration,mitochondrial membrane potential (MMP),and cellular adenosine triphosphate(ATP) content were determined by fluorescent probe labeling and flow cytometry assay.The mitochondrial respiratory chain complex Ⅰ and Ⅲ activities were detected by commercial kits.Nec-1,A RIP1 kinase specific inhibitor,and RIP1-/-or Bid-/-L929-A cells were used to detect the roles of RIP1 kinase and Bid protein in cell death.Results RIP1,caspase-8 and Bid proteins were co-located in the outer membrane of mitochondrial.TNF-α exposure for 3 h could induce Bid cleavage,inhibit mitochondrial respiratory chain complex Ⅲ activity and reduce MMP.Following these changes and after TNF-α exposure for 6-12 h,the intracellular calcium concentration and ROS were increased,whereas the ATP concentration was decreased,and the cells were killed.Inhibiting RIP1 kinase or knockdown RIP1 or Bid protein could suppress all the cytotoxic effects of TNF-α.Conclusion TNF-α treatment can result in RIP1 kinase-mediated Bid cleavage and inhibit mitochondrial respiratory chains and cell energy metabolism,which ultimately leads to the death of L929-A cells.

Objective To investigate effects of diabetes mellitus (DM) on pharmacokinetics (PK) of cephradine (CED).Methods DM model was induced by iv.alloxan 60 mg·kg-1.A reversed phase HPLC internal standard method was developed for measurement of CED plasma concentration.After blood collection,rats were sacrificed to collect kidneys for calculating kidney index(KW/BW).DM and normal control (CTL) rats were randomly assigned to receive iv.or ig.CED at a dose of 180 or 90 mg·kg-1.The 3p97 program was used to calculate PK parameters.Results The developed HPLC method was validated to have high specificity,precision,recovery and good storage stability,and met requirements for PK study of CED.The CED in rats of both DM and CTL groups showed the iv.two-compartment PK and ig.one-compartment PK and followed the first-order kinetics.Following iv.dosing,a remarkably decreased t1/2β and MRT,increased CLt were evident in DM group as compared with CTL group (P ＜ 0.05).After ig dosing,a significant decrease in t1/2k and t a remarkable increase in CLt and Cm=were observed for DM group as compared with CTL group (P ＜ 0.05).The DM rats showed a trend of decreased t1/2ka vs CTL rats.There was no significant difference in the oral bioavailability between the two groups (P ＞ 0.05).KW and KW/BW in DM group were increased remarkably compared with CTL group (P ＜ 0.05).Conclusion The DM vs CTL results in faster absorption and elimination of CED in rats,but does not have significantly affect in oral bioavailability.The compensatory hypertrophy and hyperfunction of early-stage diabetic kidneys may constitute one of causes of quick elimination of CED in rats with DM.