Objective To investigate the time and implant selection in conversion from external fixation to internal fixation of tibial shaft fracture.Methods Data of 57 cases of tibial shaft fracture fixed externally followed by internal fixation from February 2003 to February 2012 were analyzed.Internal fixation (intramedullary nails or plates) initiated within 2 weeks (Group A,n =.35) and over 2 weeks (Group B,n =22) were compared in outcomes.Results One infection (3％) and four poor bone healing (11％) were observed in Group A.Five infections (23％) and three poor bone healing (14％) occurred in Group B.For intramedullary nail fixation,no infection was observed in Group A but infection rate of44％ was found in Group B.For plate internal fixation,infection rate was 8％ for both groups.Conclusions The conversion from internal fixation to internal fixation had better start within 2 weeks,with better resuhs,lower rate of infection and safer in comparison with that over 2 weeks.In addition,pin-tract infection is the high risk factor for infection after the conversion of the fixation.

Aim To study the anti-inflammatory effect of Yinhuang micro-enema compound (YHMEC) in vitro and its possible anti-inflammatory mechanisms. Methods Peritoneal macrophages (PM?) obtained from Wistar rats were randomly divided into four groups: control group, lipopolysaccharide (LPS)-induced group, YHMEC intervention group and dexamethasone intervention group. The morphological changes of cells were observed under convert microscope. Peritoneal macrophage viability was test with MTT. The levels of tumor necrosis factor?(TNF-?) and interleukin-6 (IL-6) were measured using ELISA. The translocation of nuclear factor-kappa B (NF-?B) p65 was detected with immunocytochemical method. Results The levels of TNF-? and IL-6 were increased significantly when PM? were induced by LPS and p65 were translocated from the cell cytoplasm into the nucleus. TNF-?,IL-6 secretions and translocation of NF-?B induced by LPS were inhibited by YHMEC. Conclusion The anti-inflammatory effects of YHMEC may act at least partly through inhititing the translocation of NF-?B and thus depress the expressions of TNF-? and IL-6.

Objective To explore the effective method for treatment of fracture of scapular neck.Methods A retrospective analysis of 40 patients with fractures of scapular neck was done.The patients were treated by operation or non-operation from August 1995 to August 2005.According to the degree of displacement,40 cases included 22 mild displaced fractures(≤10 mm,≤40°),and 18 severe displaced fractures (＞10 mm,＞40°),26 cases were non-operation and 14 cases by operation.Herscovici score was adopted.Results Forty patients were followed up for 1-3 years.Among 26 patients treated by non-operation,Herscovici score showed that 16 cases achieved the excellent result,2 cases good,3 cases fair and 5 cases poor.of 14 patients treated by operation,Herscovici score showed that 12 cases achieved the excellent result,2 cases good. Conclusion Fractures of scapular neck with mild displacement can be treated by non-operation while fractures of scapular with severe displacement or associated with ipsilateral clavical fractures should be treated by operation to reconstruct the stabihty of shoulder and minimize the complications.

Objective To study the methods and effect of minimally invasive percutaneous plate osteosynthesis(MIPPO) on tibial Pilon fracture.Methods 49 cases of tibial Pilon fracture hospitalized,23 cases(group A) with minimally invasive percutaneous plate osteosynthesis(MIPPO) by indirect reduction and 26 cases(group B) with open restoration internal fixation by prospective contrast investigation.Results Compared with group B,the amount of blood loss and complications in group A markedly decreased,the healing of fracture was faster,the functional rehabilitation of ankle joint was more satisfactory.Conclusion Minimally invasive percutaneous plate osteosynthesis(MIPPO)on tibial Pilon fracture can meet the requirements of biological osteosynthesis,degrade soft tissue operation injury,be beneficial to fracture healing and functional rehabilitation of ankle joint.MIPPO is a safe and effective technique of tibial Pilon fracture.

Objective To determine whether the presence of coronary collateral lfow, as evidenced by angiography, has a beneifcial effect on left ventricular function in ST-segment-elevation myocardial infarction (STEMI) treated by means of early percutaneous coronary intervention (PCI). Methods Between April 2012 to November 2013, 95 patients with STEMI treated with primary PCI successfully were analyzed. According to the Rentrop grade, these patients were divided into 2 groups:collateral circulation group (n=16) and non-collateral circulation group (n=79). The left ventricular function was evaluated within 24 hours after PCI and 30 days later. Results Comparison of 2 groups showed that collateral lfow was associated with better left ventricular ejection fraction within 24 hours and 30 days after PCI. And non-collateral lfwa was associated with more ventricular aneurysm formation. Conclusions The presence of angiographically detectable collaterals has a protective effect on left ventricular function in ST-segment-elevation myocardial infarction (STEMI) treated by primary PCI.

Objective To detect attenuated plaque by using intravascular ultrasound (IVUS) in patients with acute myocardial infarction (AMI) and to investigate the influence of attenuated plaque on perioperative period of percutaneous coronary intervention (PCI). Methods Coronary angiography and IVUS were performed in 85 hospitalized patients with AMI, additional implantation of stent was employed when necessary. According to the presence or absence of attenuated plaque determined by IVUS, the patients were divided into attenuated plaque group(n=35) and non-attenuated plaque group(n=50). The perioperative IVUS findings, the blood flow classification after myocardial infarction thrombolysis (TIMI) and the postoperative peak value of creatine kinase MB (CK-MB) determined were compared between the two groups. Results Among the 85 AMI patients, attenuated plaque was detected in 35 (41.2%) and no attenuated plaque was found in 50(58.8%). No statistically significant differences in the age, sex and risk factors existed between the two groups (P>0.05). The proportion of having attenuated plaque in patients with ST segment elevation myocardial infarction (STEMI) was obviously higher than that in patients with non-STEMI (P<0.01). In performing coronary angiography, the difference in TIMI blood flow classification between the two groups was not statistically significant (P>0.05), but after balloon dilatation the TIMI grade 0-2 in theattenuated plaque group was strikingly higher than that in the non-attenuated plaque group (P=0.003). After PCI, the proportion of patients with elevated CK-MB value and higher peak value in the attenuated plaque group was remarkably higher than those in the non-attenuated plaque group (P<0.01). Conclusion The results of this study indicate that attenuated plaque can increase the incidence of no-reflow and slow reflow after PCI, which is more often seen in STEMI patients. The attenuated plaque carries significantly high risk, and the presence of attenuated plaque is helpful in predicting, the elevated extent of CK-MB value after PCI.

Objective To establish a HPLC method for determination of naringenin and apigenin in Premna fulva. Methods The SHISEIDO￣SPOLAR C18(250 mm×4.6 mm,5μm) was used as analytical column.The mobile phase consisted of methanol￣0.2% phosphoric acid (42:58) with isocratic elution at a flow rate of 1.0 mL.min-1 .The detection wavelength of naringenin and apigenin was 288 nm and 340 nm, respectively.Column temperature was set at 35 ℃ , the injection Volume was 10 μL. Results Naringenin and apigenin had a good linear relationship in the concentration range of 0.180 ~ 3.60 μg (r =0.999 9) and 0. 0052 ~ 0. 1040 μg ( r = 0. 999 9), respectively. Conclusion The method is accurate and reliable. It is appropriate for the quantitative determination of naringenin and apigenin in Premna fulva and its preparations.

Objective:The aims of this study were to compare the efficacy between salvage liver transplantation (sLT) and rehepatectomy (RR) basing on the propensity score matching (PSM), and to explore the prognositc factors of patients with recurrent hepatocellular carcinoma (HCC).Methods:124 patients with intrahepatic recurrence after hepatectomy in our center from January 2012 to August 2018 were divided into sLT group( n=46) and RR group( n=78). 34 patients were selected for data analysis base on 1∶1 propensity score matching (PSM). The advantages and disadvantages of the two surgical methods and the prognostic factors of the patients were discussed by comparing the basic clinical data, OS and DFS of the two groups before and after matching. Results:Before matching, the pre-operative serum total bilirubin, the occurrence of multiple tumors, the proportion of preoperative TACE and the proportion of patients within Milan criteria of the sLT group were higher than those of the RR group, and the maximum tumor diameter of the sLT group was shorter than that of the RR group ( P<0.05); the time of operation, the amount of intra-operative blood loss, the positive of MVI and the proportion of postoperative Clavien grade Ⅲ and above of RR group were higher than those of RR group ( P<0.05). After matching, the operation time, intra-operative blood loss and the proportion of postoperative complications of sLT group were higher than those of RR group; there was nosignificant difference between 1-, 3- and 5- years OS of sLT group and RR group( P>0.05), the 1-, 3- and 5-years DFS of sLT group were better than those of RR group( P<0.05); AFP≥100 μg/L was the independent risk factor of OS, and the type of operation and AFP≥100 μg/L were independent risk factors of DFS. Conclusions:The pre-operative condition of sLT group was more severe, and the operation time, intra-operative blood loss and post-operative severe complication rate of sLT group were higher than those of RR group, and the DFS time of sLT group was longer than that of RR group, but there was no significant difference in OS between the two groups.