[Objective]To investigate the injury characteristics and treatment of the Hoffa facture associated with extensor mechanism injury.[Method]Four patients with Hoffa facture associated with extensor mechanism injury treated in author's hospital in recent 6 years were enrolled in this study.All the patients were multiple-injured,and associated with the ipsilateral limb fracture and retinacular and capsule laceration.The site of the extensor mechanism injury included 1 distal patellar tendon disruption,2 proximal patellar tendon disruption,and 1 distal quadriceps tendon disruption.No cruciate ligament injury was found in 3 ipsilateral bicondylar fractures.One unicondylar fracture was associated with anterior and posterior cruciate ligament and medial collateral ligament injury simultaneously.Emergency operation was performed along with the debridement in the three open fractures.In another patient with closed fracture,operation was performed one week after injury.Fractures were reduced and fixed with lag screws.Extensor apparatus were repaired and strengthened with a tension band wire through both patella and tibia.Ipsilateral limb fractures were reduced and internal fixed with hardware simultaneously. The knees were immobilized in extension with cast after operation,and flexion exercise was commenced four to six weeks later.[Result]Four patients wounds reached the first rate healing.There was no infection and necrosis of skin.All patients were followed-up for six months to three years.All 7 condyles of the 4 patients reached bone union.Healing time was about six to twelve weeks.According to Letenneur’s functional assessment system,excellent and good results were in 1 cases,fine in 3 cases.[Conclusion]Hoffa facture associated with extensor mechanism injury are usually accompanied with injuries in other part of the body.In open fracture,emergency operation is mandatory,and fracture reduction and internal fixation and extensor apparatus repair should be performed along with debridement.Tension band wire may strengthen the stability of the extensor mechanism and facilitated early mobilization.

Objective To describe postmedial approach to the knee and discuss the main technique using it to repair and reconstruct posterior cruciate ligament (PCL). Methods 24 patients with PCL injury were operated on with the postmedial approach. 13 cases were repaired directly using the technique of pulling out steel wire and 11 cases were reconstructed by semitendinosus. Prone position was adopted in 16 cases and supine position in 8 cases (21 cases had been followed up over six months). Applied anatomy, main techniques and clinical results were evaluated. Results The postmedial approach saved 30～60 minutes compared with the posteior approach, and was not restricted by body posture. Neurovascular structure did not need to be dissected, PCL repair and reconstruction could be finished in one incision.By a six month follow up evaluation, no symptoms of instability occured and they were completely stable on physical examination. Conclusion The postmedial approach is simple, safe, and yields excellent exposure. It's an ideal approach for repair and reconstruction of the PCL.The technique of pulling and steel wire and semitendinosas drawn out "U" shaped pins fixation are essential methods to repair and reconstruct the PCL.

Two patients who developed typical skin eruptions 24 hours after consumption of shiitake mushrooms are reported.Case 1:a 56-year-old woman suddenly developed widespread itching eruptions one day after intake of shiitake mushrooms.On examination,there were erythematous and edematous linear streaks (flagellate erythema) over the neck,trunk and limbs.Case 2:a 60-year-old man presented with edematous flagellate erythema over the trunk and limbs for four days.He reported intake of shiitake mushroom several days prior to the presentation.Pathological examination revealed focal parakeratosis,intracellular and intercellular edema in the prickle cell layer,severe edema of papillary dermis,evident widening of interfibrous spaces,dilation and congestion of capillaries in the superficial dermis with a mixed perivascular infiltrate of massive lymphocytes and sparse neutrophils.Both patients were diagnosed with shiitake dermatitis,and treated with prednisone and antihistamines.The lesions subsided after 3 and 4 days of treatment in patient 1 and 2 respectively.

Objective To obtain the short peptides from phage-displayed random peptide library through screening the epitope of monoclonal antibody against tumor necrosis factor(TNF-?). Methods Anti-TNF-? was used to immunoscreen a phage random peptide library of 12 amino-acidresidues displayed as a fusion to protein Ⅲ of filamentous phage M13. The positive clones were obtained by three rounds of biopanning, and the reactivity of each clone binding to anti-TNF-? was examined by double-antibody sandwich ELISA and Dot-ELISA. Mixed positive phage clones were used to detect the serum from SLE patients and healthy persons by Dot-ELISA. Results The eluted phages were enriched nearly 100 fold through three rounds of biopanning, 7 phage clones from the third round biopanning were randomly selected and 5 clones of them could bind to the anti-TNF-?. The binding rate of mixed clones with SLE patients was significantly higher than that of healthy persons. Conclusion The phage display technique can be applied to study the anti-TNF-? antigenic peptides, and these epitopes provide the potential for developing immunodiagnostic reagents of vaccines.

Objective To investigate the association betw een systemic lupus erythematosus(SLE)and polymorphismof Fc gamma receptor ty peⅢin Han patients fromHunan province.Methods Genotypes of Fc?RⅢa-158V/F were determined by polymerase chain reaction(PCR)and restriction fragment length polymorphism(RFLP)analysis in 65patients with SLE and 60normal controls.Results①It was found that the frequency of homozygous Fc?RⅢa-158F /F genotype was significantly h igher in patients with SLE than that i n controls(OR=2.23,? 2 =4.69,P=0.03).②The frequencies of both homozygous Fc?RⅢa-158F /F genotype and Fc?RⅢa-158F allele were significantly high er in patients with lupus nephritis c ompared with those in controls(OR=2.67,? 2 =5.36,P=0.02;OR=2.00,? 2 =4.91,P=0.03).Conclusions These results suggest that an abnorm al distribution of Fc?RⅢa-158V/F polymorphism is associated with SLE in the Hans of Hunan province,and the presence of Fc?RⅢa-158F allele is a risk factor for lupus nephritis.These findings support t he hypothesis of a genetic mechanism in the pathogenesis of SLE.[

Objective To evaluate the effect of bladder volume change on the doses to normal tissues in cervical cancer patients undergoing external three-dimensional conformal radiotherapy (3DRT)plus 3D conformal brachytherapy (3DCBT).Methods The study included 56 patients with cervical cancer who were admitted to our hospital from 2012 to 2013 and received radical external 3DRT and 3DCBT.During 3DCBT,the doses to 0.1,1.0,and 2.0 cm3(D0.1 cm3,D1.0cm3,and D2.0cm3,respectively) for the rectum,small intestine,sigmoid colon,and bladder under different bladder filling status (empty,50,100,and 150 ml) were compared and analyzed by paired t-test.Results The rectum D0.1cm3 with bladder volumes of 50and 100 ml were significantly reduced compared with that with an empty bladder (P =0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the small intestine with bladder volumes of 50,100,and 150 ml were significantly reduced compared with those with an empty bladder (P =0.008,0.000,0.000 and 0.000,0.000,0.000 or 0.000,0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the bladder with bladder volumes of 100 and 150 ml were significantly increased compared with those with an empty bladder (P =0.000,0.000 and 0.000,0.000 or 0.000,0.000).Conclusions The doses to the bladder and small intestine are influenced by different bladder filling status,but the doses to the rectum and sigmoid colon show no significant variation.The increase in bladder volume is helpful in reducing the dose to the small intestine.Without any change in the bladder dose,the bladder volume of 50 ml is more beneficial to reduce the dose to the small intestine than those of 100 and 150 ml.

Objective To investigate the effects of siRNA targeting CD 147 gene on the expression of CD147 in melanoma cell line A375, and on proliferation of these cells. Methods Previously prepared recombinant plasmid pSUPER/CD147 siRNA was used. In this study, the recombinant was transfected into the A375 cells. The mRNA expression of CD147 was measured by semi-quantitive RT-PCR, the proliferation of the cells by MTT assay. Results After the transfection with pSUPER/CD147 siRNA1 and pSU-PER/CD147 siRNA2, the mRNA expression of CD147 in the A375 cells was significantly down-regulated by 90.81% (P

Objective To investigate the effects of glucocorticoids o n the expression of Th1/Th2 cytokines at mRNA and protein levels in peripheral b lood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SL E). Methods Th1 cytokine (IFN-IL-10) in PBMCs fro m 48 patients with SLE were detected before and after treatment with glucocortic oids by RT-PCR for mRNA expression and ELISA for protein production. The systemi c lupus erythematosus activity measure (SLAM) scores of patients were compared b efore and after treatment. Results After treatment, the expression and product ion of IFN- versus 1.4094 pg/mL; P

Objective To study the telomerase activity,the keratinocyte apoptosis in condyloma ac-cuminatum(CA)and the correlation between them.Methods CA specimens from30patients were stud-ied,and compared with normal tissue and tumor cell lines.Telomerase activity was detected with telomeric repeat amplification polymerase chain reaction(TRAP)-ELISA.Terminal deoxynucleotidyl transferase(TdT)-mediated biotin dUTP nick end-labeling(TUNEL)was used to evaluate apoptotic cells.Results Increased telomerase activity was detected in27(90%)patients with CA,with A 450 ranging between0.50and2.76(mean1.3022).Apoptotic keratinocytes were found in24out of30CA cases(80%).A statistically signifi-cant inverse correlation was found between telomerase activity and apoptotic index(r =-0.52,P=0.004).Conclusion Keratinocyte telomerase is activated in condyloma acuminata,which is correlated with the downregulation of apoptosis,thus they might be involved in the pathogenesis of CA.

Objective To explore the correlation between the dose measured in the rectum and reference dose in three?dimensional brachytherapy ( 3DBT ) for cervical cancer, and to evaluate the significance of the dose measured in the rectum. Methods Fifty patients receiving radiotherapy for cervical cancer were selected, and 3DBT was performed after pelvic external beam radiotherapy. According to the rectal monitoring method recommended in the report ICRU38, in vivo monitoring was applied to obtain the dose measured in the rectum, reference point dose ( DICRU ) , and D2 cm3 , and the planned dose was obtained from the planning system. The differences in these values were determined by the paired t?test and correlation analysis was performed with Pearson test. Results The dose measured in the rectum was higher than the planned dose (3. 48 vs. 3. 25,P=0. 000), and lower than DICRU(3. 48 vs. 3. 71,P=0. 000) and D2 cm3(3. 48 vs. 3. 87,P=0. 002). A linear relationship existed between the dose measured in the rectum and the planned dose, with a deviation percentage of-20% to 40% and an average deviation of 8. 16%;63%of the patients with cervical cancer had a deviation of<± 10%;the maximum deviation was 60%. The dose measured in the rectum had a strong correlation with DICRU(r=0. 722), but a weak correlation with D2 cm3 ( r=0. 284) . Conclusions During 3DBT for cervical cancer, the dose measured in the rectum has certain deviations, but has a linear correlation with the planned dose. Both the dose measured and the planned dose underestimate the dose at the reference point in the rectum, and in vivo rectal monitoring may be an effective method for quality control.