[Objective]To investigate the morbidity,classification and treatment of multiple fracture around the knee in adults,and to analyze the significance of AO classification in the treatment.[Method]Multiple fractures in 167 patients from 2003 to 2007 were retrospectively analyzed and grouped according to their ages,occurring years,mechanism of injury and treatment.AO/OTA classification was assessed from the preoperative X-ray result,and healing situation was evaluated according to postoperative X-ray.[Result]All 167 multiple fractures around the knee accounted 23.69% for all lower limb fractures,with 89.2% of male and 10.8 of female.For the patient's age analysis,30-40 years old age group accounted for the largest proportion (29.34%).For the injury mechanism,traffic accident accounted for the largest proportion (53.29%).Distal femur + proximal tibia fracture accounted for 44.3%.patella + distal femur fracture accounted for 31.1%.Proximal tibia + patella accounted for 19.8%.Distal femur + proximal tibia + patella accounted for 4.8%.According to AO classification,A3 fracture was the most common in distal femoral fracture group (25.4%).B1 fracture was the most common in proximal tibia fracture group (21.7).C3 fracture was the most common in patella fracture (31.2).Tthe final good-to-excellent rate was 85.63%.[Conclusion]Distal femoral fracture combined with proximal tibia fracture was the most common in multiple fractures around the knee.The common fracture type is supracondylar fracture in femur,transverse patella and tibia.Application of nail,plate,wire and tension band,et al.can achieve good fixation.

Objective:To summarize the preliminary experience of percutaneous radiofrequency ablation(RFA) in the treatment of early breast cancer(the length of the lesion<15 mm) with negative sentinel lymph node(SLN), and to evaluate its feasibility and efficacy.Methods:From October 2016 to November 2019, 18 patients with early breast cancer(the length of the lesion<15 mm) treated in the First Affiliated Hospital of Zhengzhou University underwent FNAC of axillary SLN under the guidance of CEUS were enrolled. Patients with pathologically negative axillary SLN were treated with percutaneous RFA of breast cancer. The complete ablation rate and the relapse rate were evaluated. Intraoperative pain, postoperative complications and postoperative patient satisfaction were analyzed.Results:Eighteen patients underwent CEUS-guided FNAC of SLN, of which 1 case was positive and 17 cases were negative. Seventeen breast cancer lesions of the 17 negative patients underwent percutaneous RFA. The length of the lesions was 3.3-14.0 (8.2±3.9)mm, the complete ablation rate was 100%, the ablation time was 9-18 (12.8±2.7)min. During the follow-up of 9-46 months, no patient developed tumor progression. There were no serious complications related to RFA after operation. The patients′ satisfactory rate for postoperative appearance was 100%.Conclusions:RFA of early breast cancer(the length of the lesion<15 mm) with negative SLN is feasible and has the advantages of safety, minimal invasion and beauty.

Objective To investigate the biomechanicai characteristics of flexor profundus tendons repaired after decimeter wave therapy, and to observe the effect of decimeter wave therapy on early active mobilization. Methods A total of 56 Leghorn chickens were randomly divided into a therapy group and a control group with 28 chickens in each. The 3rd and 4th toes of their left feet were employed for the establishment of a tendon injury model. The flexor profundus tendons were cut and repaired. Gypsum support was applied and fixed with an adhesive plaster after the operation. The operated sites on toes Ⅲ and Ⅳ were exposed. The external fixation was removed 3 weeks later and the chickens were left free to move. Decimeter wave therapy ( frequency 915 MHz, power 8 Watts) was ap-plied for 10 minutes once daily on the left foot of each chicken in the therapy group from day 1 until 3 weeks after the operation. Sham decimeter wave therapy was applied to chickens in the control group. Four chickens from each group were randomly selected at the 1st, 7th, 10th, 14th, 18th, 21st and 28th days for biomechanical analysis. Biome-chanical parameters including tensile strength of rupture (Pmax), elongation ratio at rupture (δimax) and the tensile adhesion strength of the rupture zone (W0>) were observed at each time point. Results At the 7th, 10th, 14th, 18th, 21st and 28th day after the operation, the differences in Pmax, δmax and W0 between the therapy and control groups were statistically significant. The results of the therapy group were better than those of the control group. Conclusions Local decimeter wave therapy after flexor tendon repair can promote intrinsic healing and reduce ex-trinsic healing. The speed and quality of healing are improved. The elasticity and tenacity of the injured tendons are enhanced. Therefore decimeter wave therapy is helpful for early active mobilization training.

Objective To measure the normal sagittal and coronal diameters of thumb and great toe distal phalanx bottom by ultrasonography. Methods One hundred and twenty volunteers' sagittal and coronal diameters of thumb and great toe distal phalanx bottom were measured by ultrasonography. The measurements was analysed by the statistical method. Results The thumb and great toe distal phalanx bottom showed hyperechoic zone,clear boundary with the adjacent fascia and tendon tissue showed low echo area at cross section by high frequency ultrasound. The sagittal diameters of thumb distal phalanx bottom was (8. 07 ± 0. 67)mm in men, while that of great toe distal phalanx bottom was (8. 34 ± 1. 02) mm( t = 1.73, P =0.86).The coronal diameters of thumb distal phalanx bottom was (11.61 ±0.89)mm in men, while that of great toe distal phalanx bottom was (14. 25 ± 0. 84)mm( t = 16. 77, P = 0. 00). The sagittal diameters of thumb distal phalanx bottom was (7. 52 ± 0. 62) mm in women, while that of great toe distal phalanx bottom was (7. 72 ± 0. 67) mm( t = 1. 72, P =0. 14). The coronal diameters of thumb distal phalanx bottom was (10.94 ± 0.97) mm in women, while that of great toe distal phalanx bottom was (13. 51 ±0. 75) mm( t =16.21, P = 0.00). Conclusions The normal sagittal and coronal diameters of thumb and great toe distal phalanx bottom measured by the ultrasonography can guide the operation of wrap-around flap of a great toe with phalanx ungual for thumb II degree defect reconstruction.

Objective To explore renal transplantation model in non-human primate cynomolgus monkeys.Methods 50 non-human primates' kidneys were transplanted into the lower part of the abdomen with end-to-side anastomosis of renal artery to aorta and renal vein to inferior vena eava,and with end-to-end anastomosis of ureter to bladder.Results In the 50 cases,1 case death as accident of anesthesia;7 cases with postoperative complications,and all with creatinine sudden rise,after ultrasonic examinations showed that 2 cases with renal vein thrombosis,and 5 cases appeared urinary leakage.All animal models were without surgical infections,and with normal serum creatinine,urine output.Conclusion Non-human primate animal kidney transplantation model establishment method is reliable,but should pay attention to the the surgical technique training,complications prevention.The model is valuable for application in the research of immune tolerance,heterogeneous transplant.

Objective To observe the effects of decimeter wave irradiation on the rehabilitation of the acute peripheral nerve injury of rats. Methods Eighty Sprague-Dawley rats(200～250 g)were randomly divided into 2 groups:group A,the decimeter wave irradiation group and group B,the blank control group.The right sciatic nerves of all the rats were crushed with forceps to establish the experimental animal model of acute peripheral nerve injury.Then the rats of group A were exposed to decimeter wave irradiation for 10 minutes every day for 8 weeks.The rats of group B were also fixed on a table as those in group A but receive no decimeter irradiation.At different time points observation with light and electron microscopy,immunochemical staining,axon morphometric analysis,electrophysiological examination were carried out.Results Morphometric analysis showed that at different time points after operation the recovery of nerves in group A was better than that in group B.Axon morphometric analysis showed that the number,the diameter and the thickness of sheath of myelinated nerve fibers in group A were greater than those in group B. Electrophysiological assessment showed that the latency was shorter,the amplitude was higher,and the nerve conduction velocity was faster in group A than those in group B at the end of 8 weeks of decimeter wave treatment after operation.Conclusion Decimeter wave had significant effects on the rehabilitation of the acutely injured peripheral nerves.

Background and objective The value of D-dimer in the risk stratification of patients with coronary artery diseas(CAD)and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear.especially in the elderly.Thisstudy was to evaluate the usefulness of D-djmer as a biomarker in assessing the vuinerable blood in the elderly patients with coronarydisease.Methods Sixty elderly (≥60 years old)male patients with suspected CAD were enrolled in this prospective study.Patients were divided into CAD group(n=41,10 with stable angina and 31 with unstable angina)and control group(n=19)according to their coronary angiography Results Clinicalinformation including age,body mass index(BMI),smoking index,and thecomplications of Primary hypertension or diabetes.and CAD family history was collected.Venous blood was sampled serially for thedetermination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoAl,apoB,glucose,uric acid,homocysteine(Hey),hs-CRP,soluble thrombomodulin(sTM),and marker of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen,etc.The extent of coronary atherosclerosis was assessed.using the Gensini scoring system on the basis of coronary angiography.Results Compared with the controls.the patients with CAD had significantly higher levels of D-dimer.D-dimer level wassignificantly correlated to age.hs-CR P.Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level hadsignificantly higher prevalence of unstable angina compared with patients in the lowest triplicate(OR=4.8,Z=3.28,P=0.001).In anordinal logistic regression.the OR value ofdeveloping more serious CAD augmented 3.1-foid with each increasing triplicate of D-dimer.Patients with unstable angina had a significantly higher level of D-dimer than the controls(P=0.005),and an increasing trend comparedwith patients with stable angina (P=0.059).whereas there was no difference between the patients with stable angina and the controls(P=0.885).D-dimer was significantly correlated with Gensini scores(r=0.3930,P=0.0019).Ordinal logistic regression showed that theOR value ofincreasing one or two triplicates of Gensini's scores augmented 1.44.fold with each increasing triplicate of D-dimer(OR=2.44,Z=2.87,P=0.004). Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderlypatients with CAD.

In line with the new WHO definition for health and reference of comprehensive health assessments of elderly overseas, the paper screened and set the weight for comprehensive health assessment indicators for military officers, establishing a general health assessment model as a result 402 military officers were subject to Comprehensive Health Assessments, and the outcomes were compared with subjective assessment of experts. The results of both methods are highly coincidental. It proves Comprehensive Health Assessment as a scientific quantitative health assessment method, with promising perspectives in health management in the future.

To investigate the features of various hepatitis virus infection in intravenous drug users (IVDU), we conducted an epidemiological survey of hepatitis viruses including hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis G virus (HGV) in IVDU. The correlation of TH lymphocyte cytokine and hepatitis virus infection was examined. A study population of 406 IVDU consisted of 383 males and 23 females. HBV-DNA and HCV-RNA were detected by fluorescence quantitative polymerase chain reaction. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag and anti-HGV were assayed by ELISA. The levels of cytokines of TH1 and TH2 were measured by ELISA. The similar indices taken from 102 healthy persons served as controls. The infection rate of each virus among IVDU was 36.45 % for HBV, 69.7 % for HCV, 2.22 % for HDV, and 1.97 % for HGV, respectively. The co-infection rate of HBV and HCV was detected in 113 of 406 (27.83 %). In contrast, among controls, the infection rate was 17.65 % for HBV and 0 % for the other hepatitis viruses. The levels of PHA-induced cytokines (IFN-gamma and IL-4) and the level of serum IL-2 were obviously decreased in IVDU. On the other hand, the level of serum IL-4 was increased. The IFN-gamma level was continuously decreased when the IVDU was infected with HBV/HCV. In conclusion, HBV and HCV infection were common in this population of IVDU and they had led to a high incidence of impaired TH1 cytokine levels.

To investigate the features of various hepatitis virus infection in intravenous drug users (IVDU), we conducted an epidemiological survey of hepatitis viruses including hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis G virus (HGV) in IVDU. The correlation of TH lymphocyte cytokine and hepatitis virus infection was examined. A study population of 406 IVDU consisted of 383 males and 23 females. HBV-DNA and HCV-RNA were detected by fluorescence quantitative polymerase chain reaction. HBsAg, HBeAg, anti-HBc,anti-HCV, HDV-Ag and anti-HGV were assayed by ELISA. The levels of cytokines of TH 1 and TH2 were measured by ELISA. The similar indices taken from 102 healthy persons served as controls. The infection-rate of each virus among IVDU was 36.45 % for HBV, 69. 7 % for HCV,2.22 % for HDV, and 1. 97 % for HGV, respectively. The co-infection rate of HBV and HCV was detected in 113 of 406 (27. 83%). In contrast, among controls, the infection rate was 17.65 % for HBV and 0% for the other hepatitis viruses. The levels of PHA-induced cytokines (IFN-γ and IL-4) and the level of serum IL 2 were obviously decreased in IVDU. On the other hand, the level of serum IL-4 was increased. The IFN-γ level was continuously decreased when the IVDU was infected with HBV/HCV. In conclusion, HBV and HCV infection were common in this population ofIVDU and they had led to a high incidence of impaired TH 1 cytokine levels.