Objective To discuss the clinical effects of open reduction and internal fixation with locking compression plate(LCP)to treat elderly women with comminuted distal radius fracture.Methods 32 elderly women(35 sides)with comminuted distal radius fractures were treated by open reduction and internal fixation with LCP from March 2002 to October 2004 in our department.Their mean age was 65 years old.According to AO classification,11 sides were type A3,15 sides type C2 and nine sides type C3.Volar approach was used in 32 sides and dorsal approach in three sides.Bone graft was applied for five sides.Results The follow-up period was 10 to 41 months(mean 21.5 months)and the union period was three to five months.According to Dienst criteria of joint functions,the result s showed that 13 sides were excellent,19 sides good,two sides fair and one side poor.Complications included wound dehiscence and superficial infection in five sides and median nerve injury in two sides.Conclusion The LCP method in this study is one of the good options to treat elder women with comminuted distal radius fractures.

A 66-year-old male patient presented with rhinocnesmus and mild epistaxis. More than 100 maggots were found in the right nasal cavity by nasal endoscopy. The affected nasal mucosa was erythematous, edematous, ulcerated, and mild bleeding on probing was present. No nasal septal perforation or destruction of nose was noted. Middle and inferior meatus, nasopharyngeal mucosa, orbit, facial skin, oral cavity, gingiva and external auditory canal were normal. The maggot was identified as larvae of Chrysomyia megacephala.
Aged ; Humans ; Male ; Myiasis ; Nasal Cavity ; parasitology

Objective To study the clinical results of early surgery for acute cervical spinal cord injury. Methods 24 cases of acute cervical spinal cord injury were treated with early surgery in our hospital from 1999 to 2002. The average interval from injury to surgery was 67 hours. The injured cervical segments were reduced, decompressed and fixed through anterior approach, posterior approach or anterior posterior approach. Results 22 cases got follow ups of 12 to 38 months (mean 18 months), but 2 cases were lost. 2 cases of the 11 patients of ASIA Grade A did not experience any restoration, but all the other patients got significant restoration and an average improvement of 1.8 ASIA grades. Conclusion Operation should be performed as soon as possible for acute cervical spinal cord injury, for good results can be achieved by early surgery.

Objective To investigate the clinical outcomes on implantation of hydroxyapatite orbit after scleral flap especially in the cosmetic results. Methods Implant hydroxyapatite orbital after scleral flap for the treatment of all kinds of patients who should be enucleated, including 14 cases of eyeball atrophy, 5 cases of sclerocorneal staphyloma, 3 cases of absolute glaucoma, 3 cases of neovaseular glaucoma and 7 cases of eyeball rupture. Results We observed that the orbit was full and the orbital movement was smooth in all cases. After 3 to 12 months follow-up we found that no hydroxyapatite exposed or moved. Conclusion Good cosmetic results can be achieved by the implantation of hydroxyapatite orbit after scleral flap.

Objective To compare the efficacy of low temperature controlled plasma technology by nasal endoscopy and cystectomy via labiogingival groove approach in treatment of nasal vestibular cyst. Methods 38 patients with nasal vestibular cyst from Jan 2013 to Nov 2016 were selected and randomly divided into control group (n = 20) and observation group (n = 18). The control group received cystectomy via labiogingival groove approach and the observation group received low temperature controlled plasma technology by nasal endoscopy. The time of surgery, bleeding volume in surgery, hospitalization, postoperative complications and relapse were collected and compared between the two groups. Results We found that the observation group have less surgery time than that in control group [(65.45 ± 27.51) vs (34.72 ± 17.61) min, P = 0.000], less bleeding volume in surgery [(22.35 ± 18.41) vs (3.17 ± 1.69) ml, P = 0.000), less postoperative complications [(6.35 ± 0.75) vs (3.61 ± 1.19) d, P = 0.000] and less postoperative complications (16 vs 1, P = 0.000), but relapse of the two groups have no statistical difference (1 vs 0, P = 0.783). Conclusions Low temperature controlled plasma technology by nasal endoscopy in treatment of nasal vestibular cyst have many advantages than cystectomy via labiogingival groove approach such as shorter time of surgery, less bleeding volume in surgery, shorter hospitalization and less postoperative complications. Therefore it's worth of applying clinically.

10?) and delayed union of tibia in 4 sides. Conclusion Many factors can affect the prognosis of tibial Pilon fracture, but the key points for a successful operation are right procedure and timing of surgery.

According to the three orientation cultivating mode,in order to improve quality of experiment teaching in pathogen biology and cultivate innovative talents of medicine the open experi-ment teaching which based on the research projects is applied to optimize the experiment content design, teaching form and comprehensive assessment. For example, In the choice of subject direction more attention are paid to the students' autonomy; In the design of experiment content students' inter-ests should be fully considered;During the course of experiments, the teachers play the role of visitors most of the time; In the experiment evaluation, students' ability of solving problems and their innova-tive ability are included. By participating in research projects, it not only can arouse the enthusiasm of students, but also can cultivate their scientific spirit of innovation and the rigorous scientific attitude.

Knee osteoarthritis (KOA) is a kind of degenerative osteoarthrosis, which usually involves articular cartilage, subchondral bone, meniscus and quadriceps femoris, which is equivalent to the change of "tendon" in traditional Chinese medicine. The occurrence and development of the change of "tendon" can be explained by the theory of "bone-restoration and tendon-softening" in traditional Chinese medicine. If the force line of the lower limb of the knee joint is normal, it can be indicated by "bone-restoration" in traditional Chinese medicine, that is, the blood around the knee joint runs smoothly, and the "tenons" such as meniscus, ligaments, cartilage, etc. are softened by the blood. This condition of the knee joint can be manifested by the balance of the surrounding soft tissue state. If the force line of the lower limb of the knee joint changes, showing a medial offset and misalignment of the knee joint, it can be indicated by "bone is out of alignment" in traditional Chinese medicine, that is, the structure of the soft tissue around the knee joint and its mechanical characteristics have changed. This condition of the knee joint can be manifested by "the tendons lose their flexibility". In this paper, the theories of modern biomechanics and "bone-restoration and tendon-softening" in traditional Chinese medicine were comprehensively analyzed, the characteristics of the "tenons" when knee osteoarthritis occurs were analyzed, and the characteristics of the occurrence and development of knee osteoarthritis from the perspective of Chinese and Western medicine were discussed.

Objective:To investigate the clinicopathological characteristics and treatment strategies of undifferentiated carcinoma with osteoclast-like giant cells of pancreas (UCOGCP).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with UCOGCP who were admitted to Peking University First Hospital from January 2004 to January 2019 were collected. There were 1 male and 4 females, aged from 33 to 71 years, with a median age of 56 years. Patients underwent preoperative laboratory test, imaging and histopatho-logical examinations. Patients with pancreatic head tumors underwent pancreaticoduodenectomy, and those with tumors in the body or tail of pancreas underwent distal pancreatectomy combined with splenectomy. All patients underwent standard lymph node dissection. Postoperative adjuvant therapy was individually decided by a multidisciplinary team. Observation indicators: (1) preopera-tive examination and treatment; (2) postoperative histopathological situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence of patients up to January 2020. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers. Results:(1) Preoperative examination and treatment: of the 5 UCOGCP patients, CA19-9 was elevated as 65.43 U/mL in only 1 patient preoperatively, while the CA19-9 was normal in other 4 patients. Four patients showed a solid cystic mass on preoperative contrast-enhanced computed tomography (CT) scan, and 1 patient showed a delayed peripheral enhancement of the solid tumor with central necrosis. The magnetic resonance imaging (MRI) scan showed hypointense signals on T1, T2 and weighted diffusion sequences in all 5 patients. Three of the 5 patients were resectable according to imaging data, 1 patient had locally advanced tumor, infiltrating the transverse colon, stomach, and partial small intestine, with the portal vein thrombus, and 1 patient had pancreatic head tumor with a liver metastatic lesion of 0.4 cm diameter which was detected on position emission tomography CT and was diagnosed as UCOGCP by endoscopic ultrasound-guided fine-needle aspiration biopsy. All patients underwent radical resection. Of the 3 patients with resectable tumors, 2 patients underwent pancreaticoduo-denectomy and 1 patient underwent distal pancreatectomy combined with splenectomy. One patient with locally advanced tumor in the body and tail of pancreas underwent distal pancreatectomy + transverse colostomy + partial gastrectomy + portal vein thrombectomy, and 1 patient with pancreatic head tumor and liver metastasis underwent pancreatoduodenectomy combined with left lateral hepatectomy. Of the 5 patients, 2 received postoperative adjuvant chemotherapy with single-agent gemcitabine, 1 received albumin-paclitaxel+gemcitabine combination chemotherapy, 1 received S1 as single agent chemotherapy, and 1 did not receive adjuvant chemotherapy. (2) Postoperative histopathological situations: of the 5 patients, 4 cases showed a cystic solid appearance of gross specimens, and 1 case had a solid appearance with central hemorrhagic necrosis. The tumor diameter was 5.2 cm(range, 2.0?14.0 cm). All the 5 patients achieved negative margins. Of the 5 patients, there was 1 case with portal vein invasion, 2 cases with vascular invasion, 3 cases with perineural invasion, and 2 cases with regional lymph node metastasis. One patient may had multiple tumor invasion and metastasis. Four of 5 patients had paraffin specimens available for immuno-histochemical staining. Four patients were positive for both CD68 and vimentin stains, while 3 patients were positive for programmed death ligand-1 (PD-L1), including 2 samples with 5% positive cells and 1 sample with 25% positive cells. Postoperative pathological examination showed a large number of spindle histiocytoid sarcoma cells scattered with osteoclast like giant cells and pleomorphic carcinoma giant cells. The tumor mutation burden in the 4 patients was 3.23 Muts/Mb(range, 2.61?21.77 Muts/Mb). Microsatellite status was stable in 4 patients. The next generation sequencing of 4 patients showed that all patients had KRAS mutation which was the most frequently mutation in pancreatic ductal adenocarcinoma. Of the 4 patients, 1 case had germline pathogenic mutation in TP53, 1case had somatic mutation in TP53, 1 case had somatic mutation in TP53, BLM, CDKN2A, and 1 case had somatic mutation in ARID1A. (3) Follow-up: 5 patients were followed up for 14?173 months, with a median follow-up time of 46 months. During the follow-up, 4 patients achieved disease-free survival and 1 patient had local recurrence at postoperative 11 months.Conclusions:UCOGCP is a rare variant of pancreatic tumor that exhibits a cystic solid mass in imaging examinations. High expression of PD-L1 is common in UCOGCP. The prognosis for UCOGCP is favorable following radical surgery. Patients may benefit from extended radical surgery even if the tumor has locally progression or distant metastasis.

Objective To investigate the operative indications and operation techniques for augmentative plate fixation in treatment of femoral shaft atrophic nonunions subsequent to intramedullary fixation. Methods Twelve femoral nonunions after internal fixation with intramedullary nailing were treated with augmentative plate internal fixation and bone graft from June 1999 to June 2008. All femoral nonunions were caused by insecure fixation of the intramedullary nailing, in which a rotational instability of the fracture site was verified in all the patients during operation. Minimally invasive removal of the granulation tissue at fracture site and the sclerotic bone was dccorticated. The adequate lilac bone was tiled longitudinally on the nonunion gap and the cortical bone bed. The fixation involved the limited-contact dynamic titanium plate with 5-6 holes, 3.0 mm Kirschner wire and 4-6 double cortex cortical screw fixation.Protective weight-bearing was given after surgery and the tunction was evaluated at 1,3, 6 and 12 months with imaging. Results All patients were followed up for 7-26 months ( average 17.4 months), which showed radiological solid union (7-12 months, average 9.4 months) and clinical union (5-9 months, average 7.1 months ). The operation lasted for 50-120 minutes ( average 77.5 minutes), with blood volume of 150-350 ml ( average 252 ml). There were nine patients with bone pain, of whom the pain was relieved within one month in seven patients and three months in two. No infection, hardware loosening or breaking were found. Conclusion The plate augmentation and cancellous bone grafting leaving the nail in situ can be an effective solution for nonisthmal femoral nonunion, bone defect and failed exchange nailing.