Objective To evaluate the effects of locking calcaneal plate in the treatment of SandersⅢ～Ⅳcalcaneal fractures.Methods 15 feet of 12 patients of SandersⅢ～Ⅳcalcaneal fractures received the treatment of internal fixation reduction with locking calcaneal plate and hone graft.Results All the patients were followed up for 4 to 21 months(average 11 months) with the results that according to Maryland foot score,4 feet were reported ex- cellent,6 good,1 average and 1 poor,with total excellent and good rate of 83.3 %.Conclusion Using locking cal- caneat plate in the treatment of complicated calcaneal fractures was proved to be a good method and had satisfactory effects.

Objective To explore the variance of plasma brain natriuretic peptide (BNP) concentrations in the aged patients after noncardiac surgery and its significance. Methods 101 patients undergoing elective noncardiac surgery were divided into two groups based on the BNP concentrations before surgery: group A: BNP≤100 ng/L，n=61; group B: BNP>100 ng/L，n=40. The BNP concentrations before and after noncardiac surgery and the incidence of cardiac events in both groups were compared. Results There was no significant difference （P>0.05） of BNP concentrations before and after noncardiac surgery in group A, which were (58.2±28.7) ng/L and (53.7±25.9) ng/L respectively, but was significant difference （P<0.05） in group B, which were (147.3±72.1) ng/L and (341.5±92.4) ng/L respectively. There was significant difference （P<0.05） between group A, in which no patient happened cardiac event, and group B, in which 14 patients happened. Conclusion The plasma BNP concentration would be increased significantly in the aged patients with a BNP concentration>100 ng/L before surgery, which may cause more cardiac events.

Endophytic bacteria which was producing indoleacetic acid was screened from Panax ginseng by using the Salkowski method. The active strain was also tested for its ability of nitrogen fixation by using the Ashby agar plates, the PKV plates and quantitative analysis of Mo-Sb-Ascrobiology acid colorimetry was used to measure its ability of phosphate solubilization, for its ability of potassium solubilization the silicate medium and flame spectrophotometry was used, for its ability of producing siderophores the method detecting CAS was used, for its ability of producing ACC deaminase the Alpha ketone butyric acid method was applied. And the effect on promoting growth of seed by active strain was tested. The results showed that the indoleacetic acid producing strain of JJ5-2 was obtained from 118 endophytes, which the content of indoleacetic acid was 10.2 mg x L(-1). The JJ5-2 strain also had characteristics of phosphate and potassium solubilization, nitrogen fixation, producing siderophores traits, and the promoting germination of ginseng seeds. The JJ5-2 strain was identified as Bacillus thuringiensis by analyzing morphology, physiological and biochemical properties and 16S rRNA gene sequences.
Bacteria ; isolation & purification ; metabolism ; Endophytes ; isolation & purification ; metabolism ; Indoleacetic Acids ; metabolism ; Panax ; microbiology

Fracture Fixation ; methods ; Hip Fractures ; surgery ; Humans ; Venous Thrombosis ; prevention & control

OBJECTIVETo assess serum levels of endogenous endostatin in patients with clear cell renal cell carcinoma (CCRCC) and to determine the relationship of these levels to tumor stage, grade.

METHODSFrom March 2004 to October 2008, preoperative serum were obtained from 138 consecutive patients with CCRCC (73 patients in T1, 39 patients in T2, 20 patients in T3, and 6 patients in T4) and 40 healthy controls. Serum levels of endostatin were measured by sandwich-ELISA. Associations between circulating endostatin levels and clinicopathologic factors and clinical outcome were determined.

RESULTSEndostatin levels did not differ significantly between the patients with CCRCC (93.1 microg/L) and healthy controls (78.9 microg/L, P > 0.05). Serum levels of endostatin were significantly higher in the T2-4 CCRCC patients (107.2 microg/L) than those of the T1 patients (80.4 microg/L, P < 0.01). No significant difference was found in the endostatin levels among the T2-4 patients, or between healthy controls and the T1 patients. The serum endostatin concentration was significantly higher in the metastasis group (118.4 microg/L) than in the no metastasis group (89.5 microg/L, P < 0.05), but there was no significant difference between patients with distant metastasis group (122.0 microg/L) and lymph nodes metastasis (110.0 microg/L, P > 0.05). Patients with G3-4 tumors had significantly higher endostatin levels (111.8 microg/L) than those of patients with G1 (80.4 microg/L) and G2 tumors (86.2 microg/L, P < 0.01), but endostatin levels did not differ significantly between the two groups (P > 0.05).

CONCLUSIONPreoperative serum levels of endostatin elevated in patients with CCRCC and associated with higher stage and grade.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; blood ; pathology ; Endostatins ; blood ; Female ; Humans ; Kidney Neoplasms ; blood ; pathology ; Male ; Neoplasm Staging ; Prognosis

OBJECTIVETo evaluate the etiology, diagnosis, and treatment of lower limb arterial occlusion in patients below 45 years old.

METHODSThe clinical data of 58 patients with lower limb arterial occlusion (except for Buerger's disease) below 45 years old admitted to PUMC Hospital from July 1997 to November 2007 were retrospectively analyzed.

RESULTSAmong these 58 patients, 31 patients (53.4%) had confirmed thrombophilic risk factors, including 12 patients had two or more thrombophilic risk factors. Follow-up (ranged 2-43 months, mean 10 months) showed higher rates of revascularization and amputation in patients with thrombophilic risk factors (22.6% and 22.6%, respectively) than in those without thrombophilic risk factors (14.8% and 11.1%, respectively) (P > 0.05). Among patients with two or more thrombophilic risk factors, the rates of revascularization and amputation were 25.0% and 33.3%, respectively.

CONCLUSIONSLower limb arterial occlusion in young adults is often caused by thrombophilic risk factors. Attention should be taken to identify these etiologies before surgical treatment.

Adolescent ; Adult ; Age Factors ; Arterial Occlusive Diseases ; diagnosis ; etiology ; therapy ; Female ; Humans ; Lower Extremity ; Male ; Middle Aged ; Retrospective Studies ; Thrombosis ; complications ; Young Adult

OBJECTIVETo investigate the perfusion restoration of type 1 diabetic mouse under the setting of surgically induced hind limb ischemia and the number and function of bone marrow endothelial progenitor cells (EPCs).

METHODSForty mice were randomly divided into two groups: one group was injected with alloxan through tail vein to induce type 1 diabetes mellitus, and another group was set as control group. All mice were surgically induced to hind limb ischemia. Blood flow was monitored with Laser Doppler perfusion imaging for 4 weeks after artery ligation. Ten mice in each group were sacrificed and muscle tissues were harvested for histological detection. The remaining mice were sacrificed 7 days after surgery, bone marrow mesenchymal stem cells were harvested and EPCs were analyzed by flow cytometry and then were collected to culture for functional detection.

RESULTSAll mice received alloxan injection showed typical symptoms of type 1 diabetes mellitus. Restoration of blood flow was significantly slower in type 1 diabetic mice with lower level of vascular density in ischemic muscles than control group (P < 0.001, P < 0.05). The number and function of EPCs (CD34 and vascular endothelial growth factor receptor 2 double positive cells) in type 1 diabetic mice were significantly lower than that in control mice (P < 0.05).

CONCLUSIONSThe spontaneous angiogenesis is attenuated with a decreased number and function of EPCs in the setting of type 1 diabetes mellitus. This may partly explain why diabetic patients with peripheral artery diseases have more aggressive disease and poorer outcome.

Animals ; Antigens, CD34 ; analysis ; Cell Count ; Diabetes Mellitus, Experimental ; complications ; pathology ; Diabetes Mellitus, Type 1 ; complications ; Hindlimb ; blood supply ; Ischemia ; complications ; physiopathology ; Mesenchymal Stromal Cells ; chemistry ; Mice ; Reperfusion ; Vascular Endothelial Growth Factor Receptor-2 ; analysis

OBJECTIVETo discuss the diagnosis and surgical treatment of carotid body tumour.

METHODSThirty-eight cases (41 carotid body tumours) admitted from 1983 to 2002 were analyzed retrospectively.

RESULTSAll patients were examined by ultrasound and angiography routinely before operation. The diagnostic coincidence rates of ultrasound and angiography are 95% and 98% respectively. Thirty-eight tumours were resected successfully. Twelve patients underwent external carotid artery severed, internal carotid artery repaired and tumour resected operation. Eleven patients underwent external carotid artery severed and tumour resection. Eight patients underwent tumour simple resected operation. Six patients underwent external carotid artery severed and internal carotid artery reconstruction. One patient underwent tumour resection, while common, external, and internal carotid artery were partially resected.

CONCLUSIONSFor suspected carotid body tumour patients, ultrasound and angiography reconstruction of carotid artery should be applied routinely before operation. The early stage and one stage tumour resected operation as well as internal carotid artery reconstruction are the key factors of decreasing operative complication rate.

Adult ; Angiography, Digital Subtraction ; Carotid Arteries ; diagnostic imaging ; surgery ; Carotid Artery Diseases ; diagnosis ; surgery ; Carotid Body Tumor ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Ultrasonography, Doppler, Color ; Vascular Surgical Procedures ; methods

OBJECTIVETo investigate the role of pulse wave velocity on he predication and diagnosis for peripheral artery diseases among diabetic patients.

METHODSAnkle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were detected simultaneously in 1500 type 2 diabetic patients which over 50 years old with one or more risk factors.

RESULTSbaPWV speeded up in enrolled diabetic patients when ABI showed normal; and more faster in female patients compared with males (male vs. female: right, 1647.0 +/- 347.7 vs. 1714.1 +/- 338.0; left, 1638.1 +/- 368.0 vs. 1708.4 +/- 355.5, P < 0.01). Compared with diabetic patients with PAD vs non-PAD, ABI was less than 0.9, baPWV slowed falling down [right, ABI: 0.82 +/- 0.15, baPWV: (1652.6 +/- 428.7) cm/s vs. (1699.1 +/- 316.3) cm/s; left, ABI: 0.80 +/- 0.16, baPWV: (1655.3 +/- 477.2) cm/s vs. (1677.5 +/- 338.6) cm/s, P < 0.01] ABI and baPWV showed a consistently positive relationship with aging (OR = 0.17, 0.33, P < 0.01), diabetes (OR = 0.07, 0.17, P < 0.01), hypertension (OR = 0.18, 0.39, P < 0.01), and rate of ischemic heart disease (OR = 0.25, 0.10, P < 0.01). Aging was an important risk factor for PAD. For diabetic patients with PAD, baPWV was stepped down with aging (per-decade up: 1681.6 +/- 545.9, 1678.2 +/- 494.9, 1598.5 +/- 417.1, 1493.9 +/- 444.8, P < 0.01). For those without PAD, baPWV was expedited with aging (every 10-age-up: 1570.0 +/- 337.8, 1707.7 +/- 356.4, 1829.0 +/- 378.0, 1955.6 +/- 430.5, P < 0.01).

CONCLUSIONSIn type 2 diabetic patients, baPWV shows abnormal even when ABI was normal. When these patients combine with PAD, baPWV slows down, and the phenomena is related with the severity of PAD. These data implicate baPWV could act as a screen and diagnosis factor for PAD as ABI did, and might be a more sensitive alarming predicator for artery lesions.

Ankle Brachial Index ; Blood Flow Velocity ; Diabetes Mellitus ; Humans ; Peripheral Arterial Disease ; Pulsatile Flow ; Pulse Wave Analysis ; Risk Factors

OBJECTIVETo evaluate the results of video-assisted thoracoscopic extended thymectomy for myasthenia gravis.

METHODSWe retrospectively reviewed data from 107 patients received thoracoscopic extended thymectomy from June 1995 to June 2004. All patients had confirmed diagnosis of myasthenia gravis by clinical manifestation and electromyogram. Thoracoscopic extended thymectomy as well as dissection of all fatty tissue anterior to the pericardium was performed.

RESULTSDuring a follow-up of 1-98 months, symptom was significantly improved in 83% of patients, including 34 patients experienced complete remission. There was no postoperative mortality.

CONCLUSIONFavorable results of video-assisted thoracoscopic extended thymectomy can be achieved in patients with myasthenia gravis. The technique is safe and minimally invasive.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; surgery ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thymectomy ; methods ; Treatment Outcome