Objective To explore the early diagnosis and surgical treatment of scapular fractures. Methods Sixteen cases with scapular fractures received operation that had been admitted to our hospital from January 1996 to January 2001 were retrospectively analyzed. AP views of X-ray, two-dimensional CT scannings and three-dimensional CT reconstructions were used to confirm the injuries. According to Hardegger's classification for scapular fractures, There were 9 fractures of the scapular body, 7 fractures of the scapular neck, 2 fractures of the glenoid rim, 1 fracture of the glenoid fossa, 5 fractures of the scapular spine, 3 fractures of the acromion and 2 fractures of the coracoid process. Of the 16 patients, 11(68.8%) cases had complex fractures of the scapula, and 14 cases (87.5%) had associated injuries. On the basis of the fracture patterns, anterior, posterior, posterosuperior approach,and anterior combined posterior approach were performed with plates or(and) lag screws for surgical reconstruction. Results All patients were followed up with an average of 18.6 months. According to Rowes evaluation, 11 cases showed excellent results, 2 good, 1 fair, and 2 poor. The glenohumeral posttraumatic arthritis of the series was found in 2 cases, heterotopic ossification in 1 case, and shoulder joint instability in 1 case. Conclusion 1) Scapular fractures are caused by high-energy violence with a high incidence of serious associated injury. Computerized tomography scanning with three-dimensional imaging is helpful to determine the fracture pattern and degree of displacement; 2) Intra-articular fracture of the glenoid fossa with more than 3 to 5 mm of step-off displacement, the glenoid rim fracture combined with humeral head subluxation, grossly displaced fracture of the scapular neck, some bursting fractures of the body, and floating shoulder injuries should be operated; 3) Open reduction and internal fixation is an useful and safe technique for the treatment of specific displaced fractures of the scapula. It needs at least 12 months to determine the final functional result.

Objective To explore the results of surgical treatment for disp la ced intra-articular glenoid fractures. Methods From June 1997 to June 2002, 19 p atients with more than 5 mms displaced glenoid fractures were open reduced and internally fixed. All fractures were classified according to Ideberg system, ty pe-Ⅰ fractures in 8 cases, Type-Ⅱ in 2, Type-Ⅲ in 3, Type-Ⅳ in 2, and Type-Ⅴ in 4 were retrospectively analyzed. The incidence of associated injuries was 78.9%(15/19). According to their patterns, fractures were exposed through poste rior approach (11 cases), anterior approach (6 cases) and posterosuperior approa ch (2 cases) and fixed with reconstruction plates and lag screws after satisfyin g reduction. Results All patients were followed up for an average of 17.5 months . According to Constant and Murley score, the median score was 93(range 11-100, mean 81). Fractures were manipulated under direct vision and anatomical reductio n was accomplished in 16 fractures. The radiographs showed a residual displaceme nt of more than 2 mm in 3 fractures after operation. The post-traumatic shoulder arthritis was found in 2 cases and the glenohumeral joint instability in 1 case . Conclusion To glenoid rim fractures combined humeral head subluxation, more th an 3-5 mm step-off displaced intra-articular fractures, and superior shoulder su spensory complex injury associated with glenoid fractures, early surgical interv ention is required to restore shoulder joint functions. The prognosis of glenoid fractures is determined by multiple factors such as associated injuries, qualit y of fracture reduction and surgical complications.

Objective To explore the factors influencing the outcome of acetabular fracture treatment and their protective measures. Methods Eighty six patients with acetabular fractures admitted from March 1990 to March 2000 were reviewed. Forty one cases were treated by open reduction and internal fixation and the others were treated by traction. According to Letournel classification, 37 cases were simple fractures, 49 complex fractures. Multiple trauma was found in 45 cases, posterior hip dislocation combined femoral head or neck fractures in 36 cases and primary sciatic nerve injury in 15 cases. Results Seventy five of 86 cases were followed up for an average of 25.6 months. According to Harris hip score, 31 cases were rated excellent, 13 good, 5 fair and 26 poor. Avascular necrosis of the femoral head was found in 9 cases, traumatic arthritis in 15 cases and heterotopic ossification in 16 cases. Conclusion The main factors influencing on the efficacy of acetabular fracture treatment were the types of fractures, patient s age, the method of treatment, timing of surgery, selection of approaches, quality of reduction, combined injury and complications. The functions of joints could be improved by operative internal fixation. However, the quality of reduction was not the only criterion to judge long term results. The essential conditions ensuring satisfactory prognosis were: 1)age

Recently,basic and clinical researches have shown that blood glucose variability is an independent risk factor for diabetic complications.Thus,ideal control of blood glucose is not only to reach the HbA1Ctarget,but also to minimize blood glucose variability.Different glycemic parameters could be selectedaccording to different purpose of evaluation,in which the mean amplitude of glucose excursions(MAGE) and the standard deviation of blood glucose (SDBG) could be used as accurate and simple assessment parameters respectively.

Deep vein thrombosis (DVT) is a serious complication of fractures. The incidence of ankle fracture which occurs most frequently intra-articular is 200/100 000, about 3.9%of all fractures. Domestic and foreign reports of ankle fractures and DVT were allocated and analyzed to review their correlation. Furthermore, different methods of rou-tined thromboprophylaxis was discussed. DVT incident after ankle fractures and the necessity of routined thromboprophy-laxis were reviewed. DVT incidence after ankle fractures was low and routine thromboprophylaxis was not necessary to all ankle fracture patients except the ones who had risk factors of thrombosis which could induce DVT.

The protein band patterns of 102 Chinese male's seminal plasma demonstrated bySDS-PAGGE were analyzed.The common electrophoretic patterns consist of 40 ormore protein bands belonging to 3 divisions.Some band patterns are uniqus for theseminal plasma so that the seminal plasma can be distinguised from the human va-ginal fluid,saliva,colostrum and serum In addition,a variant band called 83kdtentatively was discovered in the seminal plasma.Its frequency is 8. 22?2. 81%.TheSDS-PAGGE pattern was successfully applied to the case work.

Objective To explore the clinical features and operative treatment of chronic bladder entrapment and bowel herniation after traumatic symphysis pubis diastasis. Methods One patient of late pelvic posttraumatic mal-alignment as Tile C2 type, which was associated with serious symphysis separation and combination of chronic bladder entrapment and bowel herniation, was admitted to our hospital in August 2002. The X-ray, three-dimensional CT reconstruction, MRI, and the bladder cystography were performed respectively in order to confirm the conditions. With the usage of ilioinguinal approach, the symphysis pubis diastasis was exposed and restored firstly; then, the malunion site of the left iliac was corrected; finally, after the reduction and internal fixation of the pelvis, the bowel herniation was resolved and the inferior abdominal wall defect was repaired with artificial materials. During the operation, the abnormal conditions were ob-served as follow: 1) The distance of symphysis pubis separation was about 7.5 cm; 2) the full-thick of the ectus abdominis was torn longitudinally tear along the middle line, and the transversalis fascia was fibrosis and adhered to the peritoneum, which consisted of hernia capsule; 3) the small bowel had been entrapped over the bladder through the gap of rectus abdominis and the right Hesselbach triangle. Results The pa-tient was followed up of 6 months. The limb discrepancy had been corrected satisfactory with a sound frac-ture healing and a good gait recovering after operation. The urinary function has recovered with a normal ap-pearance of penis. The patient felt stronger then to relieve the bowels than he did preoperatively. The erected dysfunction did not improve postoperatively. Conclusion The combined osteotomy and rigid fixation through anterior and posterior pelvic ring in the same stage is an effective method to close the symphysis seperation, decrease the volume of pelvic cavity, construct the pelvic floor indirectly, repair the inferior ab-dominal wall defect, cure the bowel herniation, and improve the bladder entrapment.

Objective Alzheimer's disease (AD) is the most common neurodegenerative disorder of aging.Identifying novel AD genetic risk factors is important for understanding its pathogenesis.Presenilin- 2 (PSEN2) is one of the causative genes for familial AD.Polymorphism of the promoter region of PSEN2 has recently been reported to be associated with sporadic AD in a Russian population.The purpose of this study was to determine whether AD is associated with the PSEN2 gene polymorphism in a case-control study.Methods We examined PSEN2 and ApoE genotypes of 160 patients with AD and an equal number of age- and sex-matched controls from the same community by using PCR-RFLP method.Statistical analyses included a Chi-square test for homogeneity and a Logistic regression analysis.Results Examination of PSEN2 genotypes revealed no statistically significant differences in the frequency of the+A/-A polymorphism when compared with the total sample of AD patients and control individuals (P=0.11). However,subgroup of ApoE 84 non-carriers suggested significant differences of the three genotypes of PSEN2 promoter between AD and controls (P=0.038).Logistic analyses indicated ApoE genotypes were related with AD,and after stratification by e4 allele,PSEN2 genotypes were related with AD of e4 non-carriers.In addition,there was no interaction between ApoE and PSEN2 gene.Conclusion The+A/-A polymorphism of PSEN2 promoter may be a minor genetic risk factor for sporadic AD,especially in the group of AD without ApoE ?4 allele.

Objective To investigate the association of the single nucleotide polymorphisms (SNPs)G→A (R219K) in the exon 6 of ATP-binding cassette transporter A1 (ABCA1) gene with sporadic Alzheimer's disease (SAD) in the Han Chinese population.Methods Genotypes were determined by PCR-restriction fragment length polymorphism (PCR-RFLP) in 168 SAD patients and 215 healthy controls. The association between the polymorphism and AD was estimated with the odds ratios (OR).Results The frequency of A allele in SAD cases was significantly lower than in controls (37.8 % vs 48.1%,x~2=8.204, P=0.004),and the frequency of AA genotype in SAD cases was also significantly lower than in control (14.3% vs 22.8%,x~2=8.230,P=0.016).Logistic regression analyses adjusted for age,gender and ApoEe4 status showed that the risk for AD was decreased in A allele (G/A+A/A genotypes,OR 0.57, 95% CI 0.36—0.91,P=0.019) or AA homozygote carriers (OR 0.40,95% CI 0.21—0.77,P= 0.006) compared with GG genotypes carriers.Conclusion Our data indicate a genetic association between polymorphism in exon 6 of ABCA1 gene and the risk of AD and reveal that AA genotype or A allele of ABCAI gene may have a protective effect on AD in the Han Chinese.

AIM:To analyze relevancy between the changes of the retinal thicknesses of children's anisometropic amblyopic macular at Area A1 before and at the end of amplyopia cure and amplyopia cure effect.
METHODS: Through randomly selecting 30 cases ( 60 eyes) of anisometropic amblyopic children as test group and 29 cases ( 58 eyes ) of children with normal vision after the vision correction as control group, the changes of the retinal thicknesses of macular of the test group and the control group at Area A1 by OCT-3 was observed dynamically and analyzed.
RESULTS: Compared with first diagnosis, the comparative difference of retinal thicknesses of macular at Area A1 in control group at 3, 6mo has statistical significance. The test group was divided into amblyopia group and non-amblyopia group. There has statistical significance for the comparative difference between the retinal thicknesses of macular centre at 3, 6mo and the first diagnosis in the non - amblyopia group, the amblyopia group was divided into the invalid cure group, progress group and the cured group according to amblyopic cure effect. Compared with first diagnosis, there is no statistical significance of macular at Area A1 in invalid cure group and progress group at 3, 6mo, and in the cured group at 3mo, but in the cured group at 6mo has statistical significance.
CONCLUSION: There is a certain relationship between the changes of retinal thicknesses of macular of children with anisometropic amblyopic at Area A1 before and at the end of amblyopia treatment and amblyopia cure effect. OCT is a kind of objective auxiliary test method and provides new clues for amblyopia research.