Objective To discuss the surgical indications,relative merits and clinical outcomes of anterior reconstruction plate fixation for treating unstable posterior pelvic ring injuries.MethodsA retrospective study was done on clinical data of 36 patients with unstable posterior pelvic ring injuries treated with anterior reconstruction plate fixation from August 2004 to July 2010 and followed up for minimum one year.There were 25 males and 11 females,at mean age of 35.8 years ( range,13-62 years).There were two patients with anterior dislocation of the sacroiliac joint and 34 with posterior dislocation.According to Tile classification,there were four patients with type B fractures ( B1:3,B2:1 ) and 32 with type C fractures (C1-1:17,C1-2:12,C2:2,C3:1 ).Results All patients were followed up for average 2.3 years ( range,1-6 years).Fat liquefaction and superficial infection were founded in two patients who were cured by dressing change and frequent but low-dose blood transfusion.Eight patients were subjected to iatrogenic lateral femoral cutaneous nerve injury.Meanwhile,five of them was recovered after treatment with neurotrophic drugs,but there were still three patients leaving lateral thigh numbness.One patient had L5 nerve root injury due to pull force,and was recovered after three months of neurotrophic drug therapy.According to Matta and Tometta criteria,the reduction results were excellent in 23 patients,good in 11 and fair in four,with excellence rate of 94％.No reduction loss or implant failure occurred.According to Majeed scoring system,the clinical outcomes were excellent in 17 patients,good in 14,fair in four and poor in one,with excellence rate of 86％.Of the seven patients pre-operatively associated with sacral plexusinjury,three obtained full recovery,two got partial recovery and two were free from recovery.Conclusion The anterior reconstruction plate fixation takes advantages of wide surgical indications,simple exposure,low infection rate,satisfactory reduction and solid fixation and may be a main treatment method for unstable posterior pelvic ring injuries.

OBJECTIVETo investigate the effect of baicalein on the gap junction intercellular communication (GJIC) in the TM4 Sertoli cells of the mouse testis and its related mechanism.

METHODSWe measured the cytotoxicity of different concentrations of baicalein on the TM4 Sertoli cells in the mouse testis by MTT, detected the fluorescence transfer of the TM4 Sertoli cells by parachute assay, and determined the expression of the protein connexin 43 ( Cx43) in the baicalein-treated cells by Western blot and immunofluorescence assay.

RESULTSBaicalein produced no obvious cytotoxicity on the TM4 Sertoli cells at the concentration below 60 µmol/L but significantly increased their GJIC at 0-20 µmol/L (P < 0.01). Western blot and immunofluorescence assay showed that 0-20 µmol/L baicalein remarkably elevated the expression of Cx43 in the TM4 cells (P < 0.01) and on the membrane of the TM4 cells.

CONCLUSIONBaicalein at the concentration of 0-20 µmol/L can significantly enhance GJIC in mouse TM4 Sertoli cells by increasing the expression of the Cx43 protein.

Animals ; Cell Communication ; drug effects ; Connexin 43 ; metabolism ; Flavanones ; administration & dosage ; pharmacology ; Gap Junctions ; drug effects ; Male ; Mice ; Sertoli Cells ; drug effects ; metabolism ; ultrastructure

Objective To discuss the technical points and clinical effectiveness of the guidewire looping technique for re-canalizing chronic and total long-segment occlusions of femoropopliteal arteries.Methods The guidewire tip was formed into a U-shaped loop and then the guidewire loop was advanced to the occluded artery and was manipulated to re-open the occluded vessel. The catheter followed the guidewire gradually until the tip of the guidewire came into the true lumen of the outflow tract. Results The chronic long-segment occlusions of femoropopliteal arteries were successfully re-canalized in all 48 patients with a technical successful rate of 92.31% (48/51). The re-canalization procedure was failed in three cases.Conclusion Guidewire looping technique is an effective, safe and simple practical skill for re-canalizing chronic long-segment occlusions of femoropopliteal arteries.

Objective To evaluate the influence of laparoscopic uterine artery ligation on ovarian function. Methods In this retrospective study ,46 patients with laparoscopic myomectomy were selected and randomly divided into Ligation group and Non-Ligation group. The serum concentrations of follicular stimulating hormone (FSH), luteinizing hormone ( LH), estrogen ( E_2) were measured be-fore treatment and 1 ,3 ,6,12 months after treatment. Ovulating functions of ovary were monitored. All results were compared between two groups. Results All patients ovulated after 6 months. There were no significant differences between two groups in the levels of FSH, LH and E_2,.before and after treatment(P>0.05). Conclusions Laparoscopic uterine artery ligation do not affect ovarian function of pa-tients with uterine leiomyoma.

ObjectiveTo evaluate the clinical application of endovascular treatment for severe Takayasu's arteritis (TA).MethodsIn this study,35 target lesions in 32 patients [28 women,mean age (30 ±8) years] with severe Takayasu's arteritis were treated with endovascular merthod.The average length of lesion was 3.1 cm( range 2.7 -5.3).The overall average degree of diameter stenosis was 90％ ± 11％ (range 70- 100)in which 15 lesions were completely occlusive.There were 10 patients whose ESR were higher than 20 mm/h( range 25 -37).Follow-up included physical examination and patency evaluated by color duplex souography/computed tomography angiography/angiography at 6 months and then annually.ResultsRecanalization was unsuccessful in 3 completely occlusive lesions,with a successful rate of 80％(12/15).There was one case in which embolization leading to acute thrombogenesis developed during interventional procedure and resulting in severe stroke.The technical successful rate ( residual stenosis ＜ 50％ ) was 88.6％ ( 31/35 ).The transient cerebral ischemia attack ( TIA ) symptoms disappeared in 31 cases.26 cases were followed up for an average of (19 ± 10) months (range 13 -40).Occipital infarction following severe in-stent restenosis developed 13 months later in one case.Symptomatic in-stent restenosis18monthslaterwasfoundin2cases. Patencyratewas88.5％( 23/26 ).ConclusionsEndovascular treatment is safe and effective for severe TA.Strict indication and accurate targeting the lesions help ensure the success of management.

Objective To evaluate the effects of femoral offset (FO) on the stress level of bone cement total hip arthroplasty (THA) in the elder patients by the three-dimensional finite element analysis. Methods The normal bilateral hip joints in two cases was determined with CT imaging,with parameters including FO,neck shaft angle and neck length.The three-dimensional finite element model of THA was built so as to make Von Mises stress analysis of the changes of different neck lengths,neck shaft angles and FO. Results Stress levels in the prosthesis and bone cement reduced monotonically with the increase of neck shaft angles.In the meantime,the stress levels were lowered when neck length was in a range of 35-44 mm,but beyond the range they showed monotonous increase. Conclusions The reduction of stress levels of prosthesis and bone cement,promotion of femur stress and extension of range of motion of hip joints are closely related to FO.FO reconstruction benefits the restoration of abductor force arm and biomechanical function of normal hip joints.

ObjectiveTo evaluate the clinical safety and efficacy of SilverHawk directional atherectomy for femoropopliteal occlusive lesions. MethodsEighteen ischemia occlusive lesions in 11 patients of the lower extremity were treated with SilverHawk directional atherectomy.The mean lesion number was 1.6 ± 1. 1 per patient. The mean lesion length was ( 3.4 ± 2. 2 ) cm. The average degree of diameter stenosis was 96％ ± 14％. 9 lesions were totally occlusive. Clinical symptoms included claudication in 4 cases ( Rutherford classes: 3) and critical limb ischemia ( Rutherford classes: 4) in 7 cases. Lesions characteristics were divided by TASC classification: TASC B in 7 cases; TASC C in 1 case (in-stent occlusion); TASC D in 3 cases.Mean ABI was 0. 5± 0.4. Patency was evaluated with color duplex sonography or CTA besides clinical examination during follow-up.ResultsNine totally occlusive lesions were recanalizated successfully via intraluminal approach. 18 lesions achieved technical success (residual stenosis ＜50％ ) leaving 15％ ±7％ mean residual stenosis in mean (8 ±3)min, predilation was needed in one lesion ( in-stent occlusion) prior to atherectomy. Clinical symptoms improved or disappeared with mean ABI 1.07 ±0. 12 and Rutherford grades: 0 (n =9) and 1 (n =2). Patency rate was 100％ with mean 0. 93 ± 0. 14 ABI and Rutherford grades remain unchanged after follow-up of mean ( 9 ± 4 ) monthes.ConclusionsSilverHawk directional atherectomy is safe and effective for the treatment of lower extremity ischemia.

Objective To evaluate the functional and oncological outcomes of patients with locally advanced prostate cancer (PCa) treated by hormone therapy combined with extra-fascia1 laparoscopic radical prostatectomy (LRP) plus extended lymph node dissection (ePLND).Methods From January 2004 to June 2016,a total of 255 PCa cases (pT3-4NxM0) who received LRP plus ePLND were enrolled into our study.The mean age of the patients was 67 (range 44-88) years,and median PSA level was 21.2 (range 0.6-454.0) ng/ml.The patients were divided into earlier group (from January 2004 to December 2011,160 cases) and later group (from January 2012 to June 2016,95 cases) according to different treatment periods.The baseline demographics between the two groups were similar.All patients routinely received adjuvant hormone therapy (AHT) postoperatively.The patients in the later group underwent collapsin response mediator protein 4 (CRMP4) methylation study on the prostatic biopsy preoperatively.Those with a CRMP4 methylation level ＞ 15％ or rectum/bladder neck invasion,were treated by neoadjuvant hormone therapy (NHT) for 3-6 months.Positive surgical margin (PSM),progression-free survival (PFS),cancer-specific survival (CSS),overall survival (OS) and postoperative continence rates between the two groups were analyzed and compared.Results The mean operative time of the earlier and later group were (239 ±65) min and (203±51) min,mean blood loss were (109-±65) ml and (96-±44) ml,mean dissected nodes were (19 ± 5) and (21 ± 7),respectively (all P ＞ 0.05).The total PSM rate was 19.2％,and PSM rates of the two groups were 23.1％ and 12.6％ (P =0.04).All the 255 cases received AHT and 25 cases in the later group underwent NHT.The median follow-up time was 73 months (range 10-152 months).The total 5-year PFS,CSS and OS rates were 77.7％,94.3％ and 87.1％,respectively,and the rates between groups were 73.8％ vs.86.1％ (P=0.03),93.1％ vs.98.6％ (P=0.07),and 85.0％ vs.92.8％ (P =0.11),respectively.The 1-year postoperative continence rates were 91.9％ vs.97.9％ (P =0.09).Conclusions Hormone therapy combined with LRP plus ePLND represents an oncological and functional effective option in patients with locally advanced PCa,and improved PFS might be acquired by preoperative tumor staging.

Objective To analyze the causes of misdiagnosis of esophageal leiomyoma.Methods The clinical data of 20 patients who were preoperatively misdiagnosed as esophageal leiomyoma at our hospital in 16 years were retrospectively analyzed.There were 11 males(55%) and 9 females(45%) with a mean age of(45.9 ± 16.4) years(range, 13-71 years).The initial presentations were obstructive symptoms in 12 patients(60%).CT imaging were performed in 9 patients(45%), of which 4 cases were enhanced CT(20%).Results The misdiagnosed patients included 5 cases of extraesophageal lesions(4 cases of paraesophageal lymph node tuberculosis and 1 case of lymph node hyperplasia), 8 cases of begin interstitial diseases(3 cases of neurinoma, 3 cases of inclusion cyst, 2 cases of angioma), 5 cases of malignant interstitial diseases(4 cases of GIST, 1 case of PNET), and 2 cases of esophageal cancer.The 4 cases of esophageal tuberculosis were misdiagnosed due to the absence of CT examination.The patients with esophageal cancer were treated with esophageal resection and reconstruction without clear staging of the tumor.This might be associated with the neglection of the rapid symptom development and the characteristic lumen stenosis under the gastroscope.The characteristic mucosal ulcer in patients with highly malignant GIST was overlooked.The disease relapsed postoperatively because only tumor enucleation was performed.Conclusion Preoperative diagnosis of esophageal leiomyoma is not uncommon.This disease is most often misdiagnosed as paraesophageal lymph node tuberculosis or esophageal GIST.CT examination is useful in distinguishing esophageal leiomyoma and paraesophageal lymph node tuberculosis.The roles of reoperation and adjuvant therapy in the surgical treatment of esophageal leiomyoma need further investigation.

Ten compounds were isolated from the artificially induced dragon's blood of Dracaena cambodiana by various column chromatographies on silica and sephadex LH-20 gel. Based on spectral analysis of NMR and MS, their structures were identified as 3, 4-dihydroxyallylbenzene (1), 3', 4', 5'-trimethoxycinnamylalcohol (2), pinoresinol (3), (2R)-7, 4'-dihydroxy-8-methylflavane (4), (2R)-7,4'-dihydroxy-5-methoxy-8-methylflavane(5),(2S)-7,3'-dihydroxy-4'-methoxy-8-methylflavane(6) ,(2S)-4',7-dihydroxy-6, 8-dimethylflavane(7), 4,2',4'-trihydroxychalcone(8), 4,4'-dihydroxy-2-methoxydihydrochalcon(9) and Cambodianin E (10). Antibacterial activity assay showed that compounds 1, 4 and 10 have inhibitory effect on Fusarium oxysporum f. sp. cuben, Fusarium oxysporum f. sp. niveum, Fusarium oxysporum f. sp. vasinfectum and Ralstonia solanacearum.
Antifungal Agents ; chemistry ; isolation & purification ; pharmacology ; Dracaena ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Fusarium ; drug effects ; Molecular Structure ; Plant Extracts ; chemistry ; isolation & purification ; pharmacology ; Spectrometry, Mass, Electrospray Ionization