OBJECTIVETo explore the clinical effects of internal fixation with lag screws plus an anti-sliding plate for the treatment of Hoffa fractures of the lateral femoral condyle.

METHODSFrom May 2006 to May 2014, 17 patients with Hoffa fractures of the lateral femoral condyle were treated with lag screws plus an anti-sliding plate. There were 13 males and 4 females, ranging in age from 27 to 59 years, with a mean of 32.5 years. All the fractures were fresh and closed fractures. According to the Letenneur's classification, 8 cases were type I, 4 cases were type II, 5 cases were type III. All the patients had no injuries of the cruciate ligament and the another part of the knee. Operative incision and fracture healing time were observed, knee joint function was evaluated by Letenneur system and HSS standard.

RESULTSThe patients were followed up from 10 to 24 months with a mean of 14.6 months. All incisions achieved primary healing, and no internal fixation breakage, malunion, femoral candyle necrosis, deep vein thrombosis of lower extremity were found. Fracture healing time was from 4 to 9 months with an average of 4.7 months. According to Letenneur's functional assessment, 10 patients got an excellent results, 4 good, 3 fair. Total HSS score was 91.1 +/- 4.7 on average,15 cases obtained excellent results, 2 good.

CONCLUSIONInternal fixation with lag screws and an anti-sliding plate can result in excellent effects for Hoffa fractures of the lateral femoral condyle. The key to a successful surgery is an anatomic reduction and rigid fixation of the fracture.

Adult ; Bone Plates ; Bone Screws ; Female ; Femoral Fractures ; physiopathology ; surgery ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Closed ; physiopathology ; surgery ; Humans ; Ligaments, Articular ; surgery ; Male ; Middle Aged

Integrative Medicine ; Professional Competence

Functional magnetic resonance imaging(fMRI),as a noninvasive technology of measuring human brain function,has been used in neurolingustic research on normal subjects and on patients with brain damage,to investigate the neural basis underlying language processing.Such studies complement and development the classical knowledge accumulated on aphasia,provide new insights into the neural mechanisms of aphasia and the plasticity of recovery from aphasia,and might be helpful to evaluate the capability of language functional recovery and the efficiency of rehabilitative strategies also.

OBJECTIVETo explore the diagnostic value of the radiologic characteristics of osteoporotic Kummell's disease.

METHODSTotal 16 patients with pathologically confirmed osteoporotic Kummell's diseases were reviewed from May 2010 to May 2012, including 4 males and 12 females with the mean age of 73.4 years (ranged, 67 to 83 years old). Radiologic imagings of all patients, including X-ray, CT and MRI, were analyzed retrospectively.

RESULTSIntravertebral linear clefts could be seen on the AP and lateral X-ray films of vertebrae. Sagittal and axial CT scans demonstrated the vacuum cleft phenomenon with liquid and air was identified within the vertebral body. Sagittal MRI showed the callapsed vertebral segment and the area of fluid signal with clear and intact border within the vertebral body. The fluid signal was low on T1-weighted images and high on T2-weighted images and stir images, which was corresponding to an intravertebral vacuum cleft.

CONCLUSIONThe radiologic characteristics of Kurmmell's diseases can provide valuable evidences for the early diagnosis.

Aged ; Aged, 80 and over ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Osteonecrosis ; diagnosis ; diagnostic imaging ; pathology ; Retrospective Studies ; Spinal Fractures ; diagnosis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To explore the difference in Z-score reference range for aorta measurements, and pulmonary artery(PA)/aortic(AO)valve annular diameter ratio(PA/AO ratio)between normal and aortic stenosis(AS)fetuses and to evaluate the diagnostic value of Z-score of aorta in fetuses with AS. Methods A retrospective cross-sectional study of fetal color Doppler echocardiograms were undertook from 300 singleton normal fetuses with gestational age ranged from 16 to 40 weeks.Standardized fetal echocardiographic measurements included AO valve annular diameter and PA valve annular diameter at end-systole,and PA/AO ratio were obtained.With statistical analysis,best model was established for predicting AO and PA using biparietal diameter (BPD)and femoral length (FL)as independent variables.The correlations between standard deviation (SD)and two independent variables (BPD,FL)were analyzed,and the AO Z-score and PA Z-score of normal fetuses were calculated.One hundred and six singleton fetuses with AS were studied whose gestational age ranged from 1 5 to 40 weeks.The AO Z-score and PA Z-score of AS fetuses obtained by using above regression equation and PA/AO ratio were subsequently calculated.The AO and PA Z-scores and PA/AO ratio between normal fetuses and AS fetuses were compared.And the detection rate of AS according to AO Z-score,PA/AO ratio and AO percentile range were assessed.Results Compared with normal fetuses,the Z-score of AO and the PA/AO ratio in AS fetuses were statistically different (P <0.01).While there was no statistical difference of Z-score of PA between two groups (P >0.05).AO Z-score in 96.2% of AS fetuses were found < -3,PA/AO ratio in 95.3% of AS fetuses were found outside 95% CI.The method using AO Z-score had the highest detection rate of AS,the positive predictive value was up to 89.5%,the negative predictive value was up to 98.6%,the sensitivity,specificity and Youden index were 96.2%,96%,and 0.9223,respectively.PA/AO ratio had good but slightly lower diagnostic accuracy than AO Z-score,while AO percentile range performed poor.Conclusions Fetuses whose AO Z-score are outside ±3 and the PA/AO ratio is greater than 1 .4 at the same time are more likely to suffured from AS.Quantification of AO Z-score has important clinical value in the diagnosis of AS,and is more accurate than the percentile range in quantitative assessment of congenital heart growth and development of the fetal pathology of AS.

BACKGROUNDTo study to immunogenicity of recombinant HEV ORF2 protein expressed in pichia pastoris.

METHODSBALB/c mice were immunized with the recombinant HEV ORF2 protein. The ability of antiserum to bind HEV was tested using affinity-capture reverse transcription polymerase chain reaction (RT-PCR). Moreover, the recombinant protein was used to immunize BALB/c mice by different routes with different adjuvants. Serum conversion rate of anti-HEV antibody and the ELISA titer were detected.

RESULTSThe antiserum could capture native HEV for RT-PCR. As to the immunization effect, the immune response by intramuscular route was better than that of the intraperitoneal route. The protein with alum and CpG adjuvant could elicits more significant immune responses than using the alum adjuvant alone. The best way was to immunize with the protein with alum and CpG adjuvant by intramuscular route with a boosted injection on the 4th week after the first immunization. The ED50 was 0.023 microgram. This is the first report that the antibody elicited by recombinant HEV ORF2 protein expressed in pichia pastoris recognizes native HEV. High immunogenicity of this kind of ORF2 was also demonstrated by inducing strong immune response in mice with good ED50 result.

CONCLUSIONSThe high immunogenicity of this kind of HEV ORF2 may make a foundation for the development of new type of hepatitis E vaccine.

Animals ; Antibody Formation ; Female ; Hepatitis E virus ; immunology ; Mice ; Mice, Inbred BALB C ; Pichia ; genetics ; Recombinant Proteins ; genetics ; immunology ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Proteins ; immunology

Objective To investigate the characteristics of the road traffic accident (RTA) casualties in Shanghai in 2003.Methods.The characteristics of RTA casualties were analyzed retrospectively on the data of Public Security Bureau and other related information.Results There were 54 197 RTA cases in 2003 with 1 406 death and 11 178 injured.The incidence rate and fatality of RTA was 311.48/10~4 and 11.17% respectively.The vehicle or population injury rate and mortality were 64.24/10~4,8.08/10~4,83.31/10~5 and 10.48/10~5,respectively.The fatality of suburb was higher than that of urban.Most of the casualties were bicyclist,pedestrians and motorcyclist,ranged mainly from 21 to 50 years old. Head injury and multiple traumas were the leading cause of death.Conclusion The RTA related injury had become a public health problem.The key strategies to decrease the fatality and disability of RTA were to propagandize the traffic safety perception in citizen and enforce the construction of rescue system for RTA including the EMSS.

OBJECTIVETo observe application value of multispectral animal living imaging technology in rats model of osteoarthritis.

METHODSFifteen male SD rats weighed (180 +/- 20) g (3 months old) were received intra-articular injection of iodoacetic acid for establishing osteoarthritis. Articular cavity of left knee of rats were injected into 50 microl iodoacetic acid. The same volume of sterile saline was injected into right knee articular cavity as control. X-ray living imaging and bone mineral density were observed at 2 and 4 weeks after establishment of model. After 4 weeks,rats were sacrificed and their bilateral joints were collected and determined histologically based on Collins classification and Kellgren-Lawrence classification.

RESULTSOsteoarthritis model was successfully established, compared with control group, model group showed typical manifestation of osteoarthritis, including irregular cartilage surface,osteophyte formation,joint deformity and cartilage defect,and combined with significant decrease of bone density (P < 0.01), while the decrease was not obvious in proximal tibia (P < 0.05). After 2 weeks, knee joints in model group was classified as Collins grade 1 and Kellgren-Lawrence grade 2,then classified as Collins grade 4 and Kellgren-Lawrence grade 3 after 4 weeks,control group showed smooth articular surface,normal joint space and intact cartilage surface, knee joints was classified as Collins and Kellgren-Lawrence grade 0, and bone density of distal femur and proximal tibia were normal.

CONCLUSIONMultispectral animal living imaging technology could be used in dynamic observation of living imaging and detection of bone density in the animal model of osteoarthritis, and it is significant for evaluation of osteoarthritis model, and its realted tesearch.

Animals ; Bone Density ; Disease Models, Animal ; Humans ; Knee Joint ; diagnostic imaging ; Male ; Osteoarthritis ; diagnosis ; diagnostic imaging ; physiopathology ; Radiography ; Rats ; Rats, Sprague-Dawley

Knee osteoarthritis is one of the common type of arthropathy, the clinical stage of the typical patients belongs to the middle-late stage, so it urges to improve the early diagnosis. At present, magnetic resonance imaging is most used in clinical diagnosis of knee osteoarthritis, and with the development of different MRI sequences, the sequences of early articular cartilage lesions are used in clinic. In the early diagnosis of knee osteoarthritis, the simple and practical methods such as ultrasonography is becoming a trend, and the specific biomarkers of early knee osteoarthritis have become the hot research. This overview article outlined the methods of early diagnosis from the ultrashort echo time MRI, ultrasonography and biomarkers.
Biomarkers ; analysis ; Early Diagnosis ; Humans ; Magnetic Resonance Imaging ; Osteoarthritis, Knee ; diagnosis ; diagnostic imaging ; metabolism ; Radiography ; Ultrasonography

Content of osteocyte in bone tissue is the most abundant, the most widely distributed, and embedding the cells in the mineralized bone matrix, the life can be close to the life of the body. Osteocyte formed by the cytoplasm dendritic communication network system between osteocyte and bone surface, is of great significance to maintaining the normal physiological function of bone tissue. Bone cells as the direct receptor of bone mechanical stress, through the release of bioactive factors such as PEG2, NO, ATP and classic Wnt/beta-catenin signaling pathway mechanical stress signal can be converted to bone formation and bone resorption of biochemical signals, and the biochemical signals were transfer to the other type cells of the tissue to regulate its function activities and cause bone reconstruction function. The microcracks surrounding osteocyte can disrupt the microtubule network system,cause surrounding osteocyte autophagy. In addition, osteocyte is very important for regulation of the body mineral balance, fat metabolism, and hematopoietic function.
Animals ; Autophagy ; Hematopoiesis ; Humans ; Minerals ; metabolism ; Osteocytes ; physiology ; Signal Transduction ; Stress, Mechanical