Objective To study 3D imaging and pelvic angiography for multiple pelvic fracture. Methods 30 cases suspected with multiple pelvic fracture with vascular injury were performed with 3D imaging and pelvic angiography, whose dada were analyzed retrospectively. Results 30 cases had multiple pelvic fracture to different extents, of which 25 ones had no abnormality at lower part of abdominal aorta, left & right common iliac artery, left & right iliac artery, external iliac artery and upper part of left & right femoral artery, and 1 case, complicated with local hematoma, had a raptured left external iliac artery at the middle piece of the ilium, and another two cases, also complicated with local hematoma, had a raptured left iliac artery due to the comminuted fracture of the sacrum and a raptured right anterior femoral artery due to the fracture of light femur respectively. Conclusion 16-slice CT has to be involved in when the patient with multiple pelvic fracture is suspected with vasculaer injury.

Objective To investigate the effect of sedation on respiratory mechanic dynamics, intrapulmonary shunt fraction,oxygen metabolism in patients with mechanical ventilation.Method Sixty patients with mechanical ventilation were divided randomly into control group and sedation group.Propofal was administered to patients,whose ramsay scores were kept atⅢorⅣlevels,in sedation group while the equal amount of normal saline was given in control group.Mixed venous blood and arterial blood samples were taken for blood gas analysis in both groups before and at 2 hours after administration.Heart rate,blood pressure,breathing rate and airway resistance all were recorded at the same time.Results There were no significant differences in oxygenation index,blood pressure,blood lactic acid,total lung static compliance and intrapulmonary shunt fraction between two groups before and after administration.Heart rate,respiratory rate,oxygen uptake and airway resistance of patients in sedation group were lower than those in control group,and partial pressure of oxygen in mixed venous blood of patients in sedation group were higher than those in control group.These differences were statistically significant.Conclusions Sedation can decrease oxygen uptake and airway resistance of patients with mechanical ventilation.However,no alteration in the oxygenation index,total lung static compliance and intrapulmonic shunt ratio can be observed.

OBJECTIVESTo test the hypothesis that urine N-acetyl-beta-D-glucosaminidase (NAG) is a nearly biomarker for acute kidney injury in patients with acute paraquat poisoning.

METHODSForty-four patients with paraquat intoxication and 40 age and gender-matched healthy control participants were recruited. The urine N-acetyl-beta-D-glucosaminidase was determined by spectrophotometric methods.

RESULTSThe urine N-acetyl-beta-D-glucosaminidase activities in the patients with paraquat poisoning were higher than the corresponding values in the control participants (P<0.01); The prevalence rate of mortality was significantly higher in subjects with N-acetyl-beta-D-glucosaminidase activities ≥25 U/g Cr than in those N-acetyl-beta-D-glucosaminidase activities <25 Ulg Cr (34.4% vs 16.7%, P<0.01).

CONCLUSIONSThe urine N-acetyl-beta-D-glucosaminidase could be used as an early biomarker for acute kidney injury and predictor of mortality inpatients with acute paraquat intoxication.

Acetylglucosaminidase ; urine ; Acute Kidney Injury ; chemically induced ; diagnosis ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Young Adult

Objective To analyze the curative effect of minimally invasive incision combined with plate fixation for calcaneal fractures.Methods Retrospectively analyzed the clinical data of 30 cases(30 feet) of calcaneal fractures who were treated with minimal incision(sinus tarsi approach combined with posterior lateral incision) from August 2014 to August 2015.Minimally invasive incision combined with plate fixation were performed for the treatment.X-rays were taken in the regular follow-up,B(o)hler and Gissane angle as well as the complications were measured.The final curative effect was comprehensively assessed according to the ankle hind foot score of American Aryhopaedic Foot and Ankle Society(AOFAS).Results All cases were followed up for an average of 14.5 months (from 12 to 16 months), and all fractures healed with no complication such as incision infection or poor healing.The average B(o)hler angle was improved from preoperative(13.42°±4.2°) to (29.3°±3.8°) at the last follow-up with a significant difference(t=-20.424,P=0.000),and the average Gissane angle was significantly improved from preoperative(97.8°±9.7°) to (123.6°±6.5°) at the last follow-up (t=-17.5,P=0.000).The outcomes were evaluated with AOFAS,resulting in an excellent and good rate of 83.3%.Conclusion Treatment of calcaneal fractures with minimal incision has the advantages of less trauma,lower incision complication rate,stronger reduction and fixation,which can achieve satisfactory outcomes.

Acute Disease ; Adult ; Cholecystitis, Acute ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Humans ; Myocarditis ; diagnosis ; pathology

ObjectiveTo study the clinical effect of the proximal femoral anatomical locking plate in the treatment of ipsilateral femoral shaft and neck fractures.Methods A retrospective study was done on 10 patients with ipsilateral femoral shaft and neck fractures treated with proximal femoral anatomical locking plate in our hospital from February 2009 to February 2011.After treatment,the outcome was assessed regularly by fracture union as was seen on serial radiographs and clinical function was estimated by Friedman and Vyman System.ResultsAll patients were followed up for 6-24 months ( average 16 months).All the fractures were healed within 2.5-4 months (average 3 months) in the femoral shaft and within 4-9 months (average 6 months) in the neck,respectively.According to Friedman and Vyman System,the overall clinical result was good in eight patients and fair in two,with excellent rate of 80％ (8/10).No osteonecrosis of the femoral head and fixation failure were observed during the followup. Conclusion Proximal femoral anatomical locking plate internal fixation is an effective treatment method for ipsilateral femoral shaft and neck fractures.

ObjectiveTo evaluate the feasibility and efficacy of ex-vivo liver resection combined liver autotransplantation for patients with massive primary liver cancer who underwent complex liver resection.Methods The clinical data of 4 patients suffering from massive primary liver cancer who were admitted to the Beijing Chaoyang Hospital from January 2008 to May 2010 were retrospectively analyzed.Regular liver resection could not be carried out because the first,second and third hepatic hilum of the 4 patients were invaded by the tumors,so ex-vivo liver resection combined liver autotransplantation were performed.ResultsThe operation was successfully carried out for the 4 patients.The operation time,the duration of anhepatic phase and the volume of operative blood loss were 690-840 minutes,250-300 minutes and 400-1400 ml,respectively.Portacaval bypass operation was not performed.After ex-vivo liver resection,the inferior vena eava or hepatic vein and portal vein of the 4patients were repaired,and the allogenous blood vessels were kept to extend the superior vena cava of the remnant liver so as to facilitate the anastomosis of blood vessels and reconstruction of the first hepatic hilum. After operation,the hepatic function of 1 patient was back to normal; 1 patient who stfffered from abdominal hemorrhage received reoperation for hemostasia; 1 patient was found with hepatic dysfunction; 1 patient died of hepatorenal dysfunction at postoperative day 5.Compensatory hypertrophy was observed in the 3 patients who survived at postoperative months 1-2.Of the 3 patients,2 were found with multiple pulmonary metastases at postoperative months 8 and 9,and they died at postoperative mouths 13 and 15.Until April 2012,1 patient survived for 37 months with no tumor recurrence or metastasis. ConclusionsEx-vivo liver resection combined liver autotransplantation provides the technical feasibility for performing complex liver resection for patients. The incomplete compensation of liver function and the short-term recurrence of tumors after operation are still the main issues which hinder the development of this technique.

BACKGROUND:L-type calcium channels, as a kind of voltage-dependent calcium channel, is the main way of extracellular calcium ions into the cell, and play an important role in maintaining cellmorphology and physiological activities, characterized by a large single-channel conductance, slow channel attenuation, and longer duration of channel opening. Previous studies showed that basic fibroblast growth factor can promote the proliferation of chondrocytes cultured in vitro.
OBJECTIVE:To explore the effect of the L-type calcium channels on regulating chondrocyte proliferation and differentiation in response to basic fibroblast growth factor with patch-clamp.
METHODS:The chondrocytes were harvested from the joints of 3-day-old New Zealand rabbits. The second passage of chondrocytes was divided into experimental group and control group. Chondrocytes were incubated in media containing 10μg/L basic fibroblast growth factor and media alone separately. The opening of L-type calcium channels under the action of basic fibroblast growth factor was detected by patch-clamp. The intracellular calcium concentration was detected with laser confocal microscopy in the chondrocytes after 2 weeks of culture with basic fibroblast growth factor. Chondrocyte proliferation was analyzed by cellTiter kit after 8 days of culture. Type Ⅱ col agen was assessed quantitatively by immunohistochemistrical staining after 10 days of culture.
RESULTS AND CONCLUSION:Basic fibroblast growth factor has an inhibitory effect on the opening of the L-type calcium channels, resulting in a decrease in intracellular free calcium concentration (P<0.01). cellnumber was higher after culture with basic fibroblast growth factor than that cultured under conventional condition (P<0.01), and staining area of type II col agen significantly increased (P<0.05). Results verified that basic fibroblast growth factor can maintain intracellular Ca2+concentration at a low level by inhibiting the opening of L-type calcium channels, which can promote the proliferation and differentiation of chondrocytes.

Objective To compare the prophylactic effect of laminar closure between titanium miniplate and anchor fixation in open-door cervical laminoplasty.Methods Between January 2010 and December 2010,63 patients with cervical spondylotic myelopathy were treated by open-door laminoplasty.Of them,30 patients underwent laminoplasty by titanium miniplate fixation and 33 by anchor fixation.During follow-up,multi-detector CT was performed preoperatively,at 1 week and 6 months after surgery.At each level,the anteroposterior diameter (APD) of the spinal canal and opening angle (OA) were measured.And the spinal canal expansion rate are calculated.MRI was performed preoperatively and 1 year after surgery to evaluate the severity of cord compression.Results All incisions healed by first intention.The incidence of postoperative axial symptoms in miniplate fixation group and anchor fixation group were 33.3％ (10/30) and 39.4％ (13/33),respectively.The OA,APD,and the spinal canal expansion rate of patients in both groups improved significant postoperatively,but differing from miniplate fixation group.The OA,the APD and the spinal canal expansion rate in anchor fixation group after 6 months were reduced than one week after surgery,and the difference between the groups was statistically significant.Lamina close in two groups was not found.CT images at 6 months showed complete fusion of the hinge area by mature bone or callus in two groups,by cervical sagittal MRI assessment.The severity of spinal cord compression was improved after 1 year.Preoperative and 1 year after the surgery,the severity of spinal cord compression between the two groups showed no significant difference.The severity of spinal cord compression after 1 year in both groups were no more than three grade.Conclusion Open-door cervical laminoplasty by anchor fixation or titanium miniplate can effectively prevent the occurrence of postoperative lamina closure,which can help patients to do functional exercises early,but improvement of spinal cord compression has no significant difference between both of them.However,titanium miniplate fixation for maintenance of the expansive spinal canal is better.

Objective To investigate the serum levels of IL-10 and TGF-β1 and their significance for patients with sys-temic lupus erythematosus( SLE) .Methods A total of 135 cases were available for the study including 63 cases in primary group(A), 40 cases in remission group(B) and 32 cases in healthy control group(C).ELISA method was used to deter-mine the concentrations of IL-10 and TGF-β1 in serum.Finally, the results of group A were analyzed on the basis of System-ic Lupus Erythematosus Disease Activity Index( SLEDAI) .Results The level of IL-10 in serum of group A was significant-ly higher than that of group B and group C.The level of IL-10 in serum of group B was significantly higher than that of group C(P<0.05).The level of IL-10 in group A had active correlation with SLEDAI.The level of TGF-β1 in serum of group A was significantly lower than that of group B and group C.There was no statistical difference between group B and group C(P>0.05).The level of TGF-β1 in serum of group A had negative correlation with SLEDAI.The cases in group A were divided into three subgroups by SLEDAI:21 cases in mild activities subgroup, 30 cases in moderate activities sub-group,and 12 cases in severe activities subgroup, the levels of IL-10 and TGF-β1 in the three subgroups were significantly different(P<0.05).Conclusions IL-10 and TGF-β1 are involved in activity and severity of SLE.