OBJECTIVETo investigate the clinical effects of enblock distal radius T-plate fixation in treating trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament (PCL) avulsion fracture.

METHODSFrom September 2008 to November 2011, 5 patients with trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension,were treated with surgery. There were 3 males and 2 females with an average age of 35 years old (25 to 42). Left knee injury was in 3 cases and right knee had in 2 cases; 2 cases caused by sports injury and 3 cases caused by road accident. All patients were undergone emergency treatment. Fractures were anatomically reduced and fixed with T-plate through poples approach. Complications were observed after operation. Bone healing and clinical effects were respectively evaluated by X-rays and HSS system.

RESULTSFive patients were followed up for 1 to 4 years with a mean of 2 years. All incisions obtained healing of I stage. All knee joints recovered well and were stable with inflexion more than 120 degrees, no complications such as knee joint pain, injuries of nerve and blood vessel, infection, internal fixation failure were found. The mean score of HSS system was 94.40 +/- 6.09 and all patients got excellent result.

CONCLUSIONFor the treatment of trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension, enblock distal radius T-plate fixation had advantages of good stability,higher success rate, and knee joint function can recover well.

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; surgery ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo observe the therapeutic effects of steel plate fixation after the failure of arthrodesis of ankle by screw fixation.

METHODSFrom August 2001 to October 2011, 15 patients were with steel plate fixation after failure of arthrodesis of ankle by screw fixation. Among patients, 9 cases were males and 6 cases were females,ranging age from 40 to 65 years old with the average of 56 years old. Ten cases were in left and 5 cases were in right. Screws were removed and steel plate was fixed intraoperatively, and plaster external fixation for postoperation. Clincal effect were evaluated according to AOFAS scoring system from pain, waliking ability and aligment before and after operation, and X-ray was used to evaluate joint fusion after operation.

RESULTSAll patients were followed up, and the duration ranged from 4 months to 4 years with an average of 2 years. The incison were healed in stage I. No ankle pain,injury of blood vessel and nerve,infection and farilure of internal fixation occuerred. The AOFAS score increased from 36.86 +/- 8.32 preoperatively to 85.09 +/- 4.65 (t = -26.366, P = 0.000).

CONCLUSIONSteel plate fixation after the failure of ankle arthrodesis of screw fixation has the advantages of rigid stability, simple manipulation and high success rate, less pain, perfect recovery.

Adult ; Aged ; Ankle Joint ; diagnostic imaging ; surgery ; Arthrodesis ; Bone Plates ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Steel ; Tomography, X-Ray Computed ; Treatment Failure

Adult ; Female ; Hearing Loss, Sensorineural ; Humans ; Male ; Molecular Motor Proteins ; genetics ; Mutation ; Myosin Heavy Chains ; genetics ; Pedigree ; Thrombocytopenia ; genetics

60 Gy.The 5-year local control rates are 92%,71% and 87% respectively(P=0.9194),and 5-year overall survival rate are 68%,62% and 53% respectively(P=0.4194).There is no significant difference of overall survival and local control rate between these three dose groups.Five patients with dose of more than 50Gy died of late toxicities.Conclusions:Adjuvant radiotherapy for Stage Ⅱ and Ⅲ patients with rectal cancer dose not show dose response.There is no improvement of local control and survival due to the escalation of dose.The dose of conventional radiotherapy is better at less than 50Gy.Overdosage may lead to severe toxicities.

OBJECTIVETo observe the effect of Qianliean Pill (QP) on inflammatory factors such as IL-1β, IL-10, and tumor necrosis factor α (TNF-α) in chronic nonbacterial prostatitis (CNP) model rats, and to explore its therapeutic mechanism.

METHODSCNP rat model was established by castration and estradiol benzoate injection. Totally 50 rats were randomly divided into 5 groups, i.e., the model group, the positive medicine group, the high dose QP group, the medium dose QP group, and the low dose QP group, 10 in each group. Besides, 10 normal rats were recruited as a normal control group. Since the 8th day of castration, Pulean Tablet (PT) at 10. 80 g/kg was administered to rats in the positive medicine group by gastrogavage. QP at 11.00, 5.50, and 2.75 g/kg was administered to rats in high, medium, and low dose QP groups by gastrogavage. Distilled water at 2 mL/100 g was administered to rats in the model group and the normal control group by gastrogavage, once daily for 30 successive days. After 30 days of medication all rats were sacrificed and their prostate tissues were extracted. The prostatic index was calculated. Pathological changes of rat prostate were observed under light microscope. Meanwhile, levels of IL-1β, IL-10, and TNF-α were detected using enzyme linked immunosorbent assay.

RESULTSCompared with the normal control group, the prostate index obviously decreased, levels of IL-1β, TNF-α, and IL-10 in the prostate tissue significantly increased in the model group (P < 0.01). Compared with the model group, the prostate index obviously decreased in high and medium dose QP groups, and the positive medicine group (P < 0.01); levels of IL-1β, TNF-α, and IL-10 obviously decreased in each QP group and the positive medicine group (P < 0.01). Compared with the positive medicine group, the TNF-α level decreased more obviously in the high dose QP group (P < 0.05). Compared with the normal control group, inflammatory reactions occurred obviously in rats' prostate of the model group. Compared with the model group, inflammatory reactions were milder in rats' prostate of each QP group and the positive medicine group, and their degrees were improved to some extent.

CONCLUSIONQP could treat CNP, which might be achieved by regulating local immune state of the prostate, relieving inflammatory reactions of the prostate, and lowering levels of IL-β, TNF-α, and IL-10 in the prostate tissue.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Male ; Prostatitis ; drug therapy ; metabolism ; Rats ; Tumor Necrosis Factor-alpha ; metabolism

Objective To evaluate high resolution manometry in the diagnosis of hiatal hernia.Methods Clinical data were reviewed on 20 patients suffering from gastroesophageal reflux who had laparoscopic Toupet fundoplication for preoperative tentative diagnosis of hiatal hernia.Preoperative diagnosis of hiatal hernia was made collectively by endoscopy,X-ray examination,24 hour esophageal pH monitoring and high resolution manometry before surgery.Results Preoperative diagnosis of hiatal hernia was made in 3 patients by X-ray examination,in 9 patients by high resolution manometry.11 patients were finally diagnosed with hiatat hernia intraoperatively.X ray was consistent with intraoperative diagnosis in 27％ cases.Intraoperative and endoscopic diagnoses were 55％.High resolution manometry and intraoperative diagnoses were consistent in 82％.Lower esophageal sphincter length was (1.92 ± 0.38) cm in hiatal hernia group and (2.10 ± 0.92) cm in non-hiatal hernia group (t =0.60,P ＞ 0.05),lower esophageal sphincter pressure (respiratory min) was (0.64 ±0.55) kPa in hiatal hernia group and (1.31 ± 1.07) kPa in nonhiatal hernia group(t =1.80,P ＞ 0.05),and lower esophageal sphincter pressure (respiratory mean) was (1.43 ±0.92) kPa in hiatal hernia group and (2.57 ± 1.33) kPa in non-hiatal hernia group(t =2.26,P ＜0.05).The reflux parameters,including the percent total time pH ＜ 4,and DeMeester score,were significantly greater in hiatal hernia group than in non-hiatal hernia group (all P ＜ 0.05).Conclusions Hiatal hernia patients are with poor esophageal antireflux competency and severe reflux.High resolution manometry is more valuable in the diagnosis of hiatal hernia than endoscopy or X-ray examination.

Objective To explore the surgical strategy and effects for treating complex malignant tumors of the inferior vena cava (IVC) or/and the tumors extending into right atrium/ventricle.Methods Between Dec 2004 and Jul 2008, eight patients underwent surgical resections, among those seven patients with tumors of IVC or the tumors extending into right atrium/ventricle were operated on under deep hypothermia with cardiopulmonary bypass( CPB), and one patient with recurrence of leiomyosarcoma of the IVC successfully underwent en bloc resection and caval reconstruction. The prosthetic graft was used for IVC reconstruction in two patients and vascular patch in the other two patients. Preoperative chest roentgenography, computed tomography, ultrasonography, or magnetic resonance imaging was used to exclude the presence of metastatic disease, to assess local resectability of the tumour and the extent of involvement and obstruction of the IVC. Results One patient died of liver failure postoperatively. The postoperative course was uneventful in other 7 patients. On follow-up two patients died 2 and 5 months later due to functional disorder of the liver. Three patients have been followed up for 14 - 24 months and were

Objective To study the expression of intermediate-conductance-Ca~(2+)-activated K~+ (IKCa1)channels in endometrial cancer and its role in regulating proliferation of endometrial cancer cells. Methods Western blot and RT-PCR were used to examine the expression of IKCa1 channels in 13 normal endometrial specimens and 25 endometrial cancer specimens;and RNA interference(RNAi),[ ~3H ] thymidine incorporation,and inhibitor of IKCa1 channel were used to explore the role of IKCa1 channels in regulation of proliferation of endometrial cancer cells HEC-1A.Results The expression rate and level of IKCa1 mRNA in endometrial carcinoma(84%,0.89?0.52)were higher than in normal endometria(8%, 0.14?0.12;P

Objective To find out the situation of Kashin-Beck disease and it's dynamic changes in Yan'an city, and provide basis for decision-making on prevention and control of the disease. Methods In accordance with the national monitoring program on Kaschin-Beck disease, 21 villages were selected from 6counties in Yan'an, clinical and X-ray inspection of 7 to 13 year-old children were made according to historical illness information from 2006 to 2008. Clinical monitoring on Kashin-Beck disease was made in 2008 for people over 16 years old from 5 villages in 5 counties. Results One thousand and one hundred eighty children were found positive with the illness from 2006 to 2008, with 7 cases of grade Ⅰ , the detection rate was 0.59%(7/1180).One thousand and one hundred sixty-two people were taken X-ray photo on right hand, with no positive case found.In 2008, 1444 adults were taken clinical examination, the detection of grade Ⅰ and over were 160 cases, the detection rate was 11.08%(160/1444), mainly in the age of 36 years[93.75%(150/160)]. Conclusion KashinBeck disease in Yan'an city is in stable condition, but surveillance and preventing measures are stilled needed.

Objective To investigate the distribution of pelvic recurrence in rectal cancer after radical resection and analyze the outcome and prognostic factors of pelvic recurrent rectal cancer treated with radiotherapy. Methods Ninety-three patients with pelvic recurrent rectal cancer who received radiotherapy from August 2000 to August 2006 were retrospectively analyzed. Of them, 21 patients received pelvic radiation alone;56 received pelvic radiation plus chemotherapy and 16 received pelvic radiation plus surgery and/or chemotherapy. Radiotherapy was delivered with 60Coγor 6/15 MV X ray to a median dose of 59. 4Gy (range,20-74 Gy). Conventional fractionation was used in 90 patients. Chemotherapy was given to 68patients with a median number of 3 cycles ( range, 1 - 8 cycles). Concurrent chemo-radiation with 5-FU based regimen was given to 42 patients. After radiotherapy, 16 patients underwent surgical resection, with 7R0 resection and 9 palliative resection. Results The entire cohort included 132 recurrent sites. The most common recurrent sites were peri-rectal region ( 31.8% ), pre-sacral region ( 30. 3% ) and internal iliac nodal region (20. 2% ). The follow-up rate was 92% for the entire cohort, 39 and 4 patients had minimum follow-up time of 2 and 5 years respectively. Overall clinical response ( complete and partial symptomatic relief) was achieved in 83% of the patients after radiation therapy. The 2-and 5-year local progression-free survival rates were 49% and 22% respectively, and the 2-and 5-year overall survival rates were 46% and 14% respectively. Multivariate analysis showed that treatment modality was the independent prognostic factor for local progression-free survival. Patients treated with radiation plus surgery and/or chemotherapy had better local progression-free survival than those treated with radiation plus chemotherapy or radiation alone.Recurrent tumors larger than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were independent unfavorable prognostic factors for overall survival. Conclusions Perirectal region, pre-sacral region and internal iliac nodal region were the most common pelvic recurrent sites in rectal cancer. Radiotherapy is an effective palliative approach for patients with pelvic recurrent rectal cancer.Radiotherapy plus surgery and/or chemotherapy was associated with better local progression-free survival,and recurrent tumors lager than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were unfavorable prognostic factors for overall survival of pelvic recurrent rectal caner.