OBJECTIVETo explore the methods and outcomes of a minimally posteromedial transverse incision in the hip knee flexion for the treatment of tibial avulsion fracture at the insertion of posterior cruciate ligament (PCL).

METHODSTwenty-one patients with tibial avulsion fracture at the insertion of PCL treated with a minimally posteromedial transverse incision in the hip knee flexion by cannulated screw fixation from March 2010 to March 2013 were retrospectively analyzed. There were 13 males and 8 females with an average age of 35.1 years old (ranged, 20 to 56 years). Eleven cases caused by traffic accident, 3 caused by falling, 4 caused by sport, 3 caused by heavy pounds. The injury duration ranged from 3 hours to 9 days with a mean of 3.5 days. The results of posterior drawer test were positive in all patients. Lysholm score was used to evaluated knee joint function.

RESULTSAll operations were successful without infection, vessel and nerve injuries and all incisions healed by first intention with the mean length of 5.8 cm (ranged, 5 to 6 cm). All patients were followed up from 7 to 23 months with an average of 12.7 months. The results of posterior drawer test were negative in all patients. X-ray films showed that all fractures healed. The Lysholm score was improved from preoperative 40.76±9.55 to 95.86±2.33 final follow-up (t=30.07, P=0.000).

CONCLUSIONTreatment of tibial avulsion fracture at the insertion of the posterior cruciate ligament through a minimally posteromedial transverse incision in the hip knee flexion with cannulated screw fixation is a better surgical procedure with the advantages of minimal incision, sufficient exposure, effective fixation, small scar and satisfactory effects.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Hip Joint ; surgery ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Posterior Cruciate Ligament ; surgery ; Tibial Fractures ; surgery

Objective: To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment (PSCI) and the effect on neuroelectrophysiology (event-related potentials). Methods: A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table, with 30 cases in each group. The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy. The treatment for both groups lasted four weeks. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores as well as amplitude and latency of potential 300 (P300) were adopted to compare the between-group results before and after treatment. Results: Before treatment, there were no significant differences (all P>0.05) in MMSE and MoCA scores, P300 latency and P300 amplitude between the two groups. After 4 weeks of treatment, the MMSE and MoCA scores and P300 amplitudes were improved in both groups, and the P300 latencies became shorter. The results showed significant intra-group and between-group differences (all P<0.05). Conclusion: Based on the routine treatment, Jin's three-needle therapy is effective for PSCI. The mechanism is probably through its regulation on the patients' neuroelectrophysiology.

Intracorporeal anastomosis in laparoscopic right hemicolectomy of colon cancer is becoming a hot spot in colorectal surgery. A number of retrospective studies have suggested that intracorporeal anastomosis has potential advantages in promoting postoperative recovery and reducing postoperative complications compared with conventional extracorporeal anastomosis. Several randomized controlled trials published recently have also confirmed that intracorporeal anastomosis can promote postoperative gastrointestinal function recovery and reduce postoperative pain, but there is still insufficient evidence to draw a conclusion about the incidence of complications, especially the anastomotic leakage rate. Heterogeneity of surgical techniques and unclear definition of anastomotic leakage are the main difficulties in current studies. Several high-quality prospective randomized controlled trials are currently under way, and high level of evidence is needed to objectively evaluate the laparoscopic right hemicolectomy of colon cancer. The authors review the relevant literatures at home and abroad, systematically elaborate the research status and prospects of digestive tract reconstruction after laparoscopic right hemicolectomy of colon cancer, in order to explore a new direction for the clinical research of colorectal surgery in China.

Objective The radiotherapy is one of main treatments for patients with malignant tumor and leads to ovarian func-tion decreasing in young women .It is very important to protect ovarian function during the process of radiotherapy .The aim of this study is to investigate the effect of melatonin ( MT) agonist on radiotherapy-induced ovarian function damage in female rats . Methods Thirty SD rats were divided into five groups randomly , which received normal saline, 200 cGy radiotherapy+normal saline, 200 cGy radiotherapy+MT(25 mg/kg), 200 cGy radiotherapy+MT(50 mg/kg), and 200 cGy radiotherapy +MT(100 mg/kg), respectively.All rats were de-capitated two weeks after radiotherapy .Levels of serum follicle-stimulating hormone (FSH) and estradiol (E2) were measured by en-zyme-linked immune sorbent assay method;the number of the primordial follicles , the growth follicles and the mature follicle were ob-served;Caspase3 activity was assayed by spectrophotometry . Results In accordance with the normal control group , RT+MT (100 mg/kg) group, RT+MT (50 mg/kg) group,RT group , serum E2 levels decreased, respectively (6.68 ±0.48, 5.73 ±1.36, 4.26 ±0.44, 2.83 ±0.51)pmol/L;FSH levels increased, respectively (0.340 ±0.011, 0.431 ±0.053, 0.479 ±0.023, 0.604 ± 0.028)ng/mL ;the total number of follicles decreased ,respectively (21.67 ±1.97, 18.00 ±2.28, 15.50 ±1.05, 11.50 ±2.43);Caspase3 activity increased,respectively (0.14 ±0.03, 0.26 ±0.06, 0.36 ±0.05, 0.50 ±0.05).Except FSH had no significant difference between RT +MT(50 mg/kg)group and RT+MT(100 mg/kg) group(P>0.05), the rest indexes had significant difference between the two groups(P<0.05). Conclusion MT can diminish radiotherapy-induced ovarian damage in female rats, it may be related to the mechanism that MT inhibits the radiotherapy-induced activation of Caspase 3.

By means of preparative HPTLC and column chromatography over silica gel and Sephadex LH-20, ten sesquiterpenes were isolated and purified from the whole plants of Solanum septemlobum Bunge. Based on the physico-chemical properties and spectral data, their structures were elucidated and identified as: lyratol D(1), solajiangxin B(2), 1 ,2-dehydrocyperone(3), solanerianone A (4), dehydrocarissone(5), ligucyperonol(6), nardoeudesmol A(7), solajiangxin F(8), and lyratol B(9), solajiangxin D(10). For the first time, compounds 1-10 were isolated from Solanum septemlobum, and compounds 5-7 were obtained from the genus Solanum.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Mass Spectrometry ; Molecular Structure ; Sesquiterpenes ; chemistry ; isolation & purification ; Solanum ; chemistry

Objective To explore the effects of dehydroepiandrosterone (DHEA) on learning and memory ability and activities of choline acetyltransferase (ChAT),acetylcholinesterase (AchE),acetylcholine (Ach) in the frontal,temporal,hippocampal area of the aged rat.Methods Forty 24-month-old male SD rats were randomly divided into 4 groups (n=10,each group):control group,solvent group (intraperitoneal injection with equal volumes of DMSO),low-dose group (intraperitoneal injection with equal volumes of DHEA,1 mg/kg),and high-dose group (intraperitoneal injection with equal volumes of DHEA,5 mg/kg).The activities of ChAT,AchE,and Ach were measured by enzyme linked immunosorbent assay (ELISA) method.Learning and memory ability was detected by Morris water maze test.Results The levels of ChAT in frontal,temporal and hippocampal area were (118.5±1.3) U/mg,(120.6±1.5) U/mg,(130.8±1.5) U/mg,respectively in control group,(i39.5±1.6) U/mg,(137.4±1.4) U/mg,(141.46±1.9) U/mg,respectively in high-dose group,(131.8±1.9) U/mg,(132.4±1.2) U/mg,(139.9±1.3) U/mg,respectively in low-dose group.The levels of AchE in frontal,temporal and hippocampal area were (0.5±0.0) U/mg,(0.4±0.0) U/mg,(0.5±0.0) U/mg,respectively in control group,(0.4±0.0) U/mg,(0.4±0.0) U/mg,(0.4±0.0) U/mg,respectively in high-dose group,and (0.4±0.0) U/mg,(0.4±0.0) U/mg,(0.4±0.0) U/mg,respectively in low-dose group,and (0.5±0.0)U/mg.The Ach levels in frontal,temporal and hippocampal area were (26.0±0.8) U/mg,(24.5±1.4) U/mg,(30.1±0.8) U/mg respectively in control group,(28.7±0.9) U/mg,(28.9±1.3) U/mg,(35.9±1.4) U/mg,respectively in high-dose group,and (27.6±0.1) U/mg,(28.0±1.1) U/mg,(34.2± 1.0) U/mg,rcspectively in low dose group.The activities of ChAT in frontal,temporal and hippocampal area were higher in DHEA treatment group than in control group (P＜0.05).The activities of AchE in frontal,temporal and hippocampal area were much lower in DHEA treatment group than in control group (P＜ 0.05).The Ach levels in frontal,temporal and hippocampal area were much higher in DHEA treatment group than in control group (P＜0.05).There were significant differences in the activities of ChAT and AchE and Ach levels between low-dose group and high-dose group (P＜0.05).Compared with control group,the activities of ChAT and AchE and Ach levels had no significant differences in solvent group (P＞0.05).The escape latency was shorter in low-dose group and high-dose group than in control group (P＜0.05,P＜0.01,respectively),and there was a significant difference in escape latency between low-dose group and high dose group (P＜ 0.05).Conclusions DHEA administration can significantly increase the activity of cholinergic system,and improve the learning and memory ability in aged SD rats.

AIM: To study the expression profile of QKI m RNA and protein in rat heart during pathological cardiac hypertrophy. ME THODS: A rat cardiac hypertrophy model was established using continuous norepinephrine (NE) perfusion. Real-time PCR and Western blotting were applied t o examine QKI mRNA and protein expression respectively in rat heart. RES ULTS: Both mRNA and protein of three QKI isoforms were detected in adult rat heart. QKI-5 mRNA and total QKI protein were remarkably decreased in NE-ind uced hypertrophic heart compared with those in control group (P

Objective To study and summarize the successful experience and the safety, easibility, practicality and operation skills of totally laparoscopic extraperitoneal herniorrhaphy (TEP). Methods From October 2006 to May 2008,225 patients in our two hospitals were performed TEP (265 totally laparoscopic extraperitoneal hernia repairs for inguinal hernia), including 55 direct inguinal hernia, 197 indirect inguinal hernia and 13 complex inguinal hernia operations. Among the 225 patients, 185 patients had unilateral hernia and 40 patients had bilateral hernias, including 29 recurrent hernia. Results The operations were lasted for 30 to 182 minutes(the average operating duration was 48 minutes for unilateral hernia and 106 minutes for bilateral hernia). The patients stayed in hospital for 2 to 8 days(the average inpatient hospital stay was 3.0 ± 1.2 days). The most common complication was scrotum bematomas,which appeared in 18 cases. Urinary re-tention appeared in 21 cases. Inguinal pain appeared in 5 cases. Bladder injury appeared 1 case. All the pa-tients were followed up for 3 months- 3 years. There was only 1 case of recurrence. Conclusions The proce-dure of TEP is safe,with faster postoperative recover,less pain,lower incidence of pain,better comfort quality and lower recurrence rate. TEP should be the main laparoscopic procedure for inguinal hernia repair.

Objective To discuss the operative difficulties and management in laparoscopic thyroidectomy.Method The clinical data of 169 cases undergoing laparoscopic thyroidectomy were retrospectively analyzed.Result Among 169 cases,only 2 cases were switched to open surgery.Among the other 167 cases local thyroidectomy for thyroid adenoma Was performed in 37 cases,one side subtotal thyroidectomy in 63 cases,two side subtotal thyroidectomy in 42 cases,laparoscopic subtotal thyroideetomy was done in 20 cases for Grave's disease,and radical thyroidectomy was undeRaken in 5 cases of thyroid carcinoma.Postoperatively fat colliquation occurred in 2 cases,pneumohypoderma,skin bruise and temporary vocal dullness or hoarsness in 1 each case.There was no postoperative recurrent laryngeal nerve injury,nor that of the parathyroid gland. Conclusions Laparoscopie thyroidectomy has its own intraoperative difficulties. Accurate operative skills and careful perioperative management can decrease the occurrence of complications.