Objective To investigate the clinical outcomes of intertrochanteric fracture by the fixation using proximal femoral nail (PFN/PFNA).Methods From Jan.2008 to Dec.2010,56 cases with intertrochanteric fracture,including 18 males and 38 females with an average age of 76 years (range,67 -94 ),were treated by fixation with PFN or PFNA.All patients had closed fractures in the shaft of femur.The average time from injury to operation was 3.2 days (ranging from 2.0 days to 10.0 days).All the patients were followed for 1,2,3,6,12 month after surgery,respectively,and then at least once per year.The clinical outcomes were evaluated according to Harris criteria and radiological examinations.Results The mean operating time of all cases was 55 minutes ( ranging from 40 to 80 minutes),and the mean blood loss during surgery was 80 ml (range,50 - 150 ml).All patients was able to walk with walking aid 3 -7 days after surgery.All the patients with fracture healed after 3.5 - 6.0 months ( mean:4 months ).No complications such as infection,lower limb vein infarction,cut-out or breakage of the implants occurred.Four cases had coxa vara shortening deformation,According to Harris criteria,the clinical results were excellent in 43 cases,good in 9,and moderate in 4,with the rate of patients in excellent and good condition was 92.86％ (52/56).Conclusion PFN/PFNA is an effective and minimally invasive method for intertrochanteric fracture,with minimal invasion,high fixation-strength and optimal biomechanics characteristics.This treatment technique produces a high rate of bone re-union,early functional recovery and less complications.

Bone Diseases, Developmental ; surgery ; Female ; Femur ; pathology ; surgery ; Fibrosis ; surgery ; Humans ; Middle Aged

Objective:To analyse ZHOU Zhong-ying’effective combination drugs in preventing and treating the systemic lupus erythematosus(SLE).Methods:Association rules based on Chi-squared analysis and influence degree was used.Results:73 Rules of TCM couples were selected in the high frequency drugs distribution,and the drugs were mainly those for heat clearing,antidote medicines and blood act stasis remove medicines,which was in accordance with the main pathological mechanism factor for SLE given by Professor Zhou.Conclusion:The new method could find out many significant TCM couples in the study of the compatibility of TCM.

A phytochemical investigation on the aerial parts of a Tibetan medicine Meconopsis horridula, by solvent extraction, repeated chromatographies on silica gel, Sephadex LH-20, and preparative TLC techniques, led to the isolation of 9 compounds. By spectroscopic analysis and comparison of its 1H and 13C-NMR data with those in literatures, their structures were identified as oleracein E(1), N-( trans-p-coumaroyl) tyramine (2), chrysoeriol (3), apigenin (4), hydnocarpin (5), p-coumaric acid glucosyl ester (6), stigmast-5-ene-3beta-ylformate (7), 3beta-hydroxy-7alpha-ethoxy-24beta-ethylcholest-5-ene (8), and beta-sitosterol (9), respectively, among which compounds 6-8 were isolated from the genus for the first time,and 1,3 were isolated from the species for the first time. A MTT method was applied to evaluate the cytotoxic activity of compounds 14 against the human hepatocellular liver carcinoma cell line (HepG2), and compound 1 showed significant cytotoxicity against HepG2,with its inhibitory rate of 52.2% at 10 micromol x L(-1).
Medicine, Tibetan Traditional ; Molecular Structure ; Papaveraceae ; chemistry ; Plant Extracts ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Litsea cubeba is one of aromatic medicinal plant belonging to family Lauraceae. The roots, stems and fruits of L. cubeba have been widely applied as folk medicines in some districts in China for relieving rheumatism and cold, regulating Qi (meridian) to alleviate pain. Previous studies revealed that this species contains major alkaloids, in specific aporphines, and minor flavonoids, lignans as well. Related pharmacological investigations demonstrated its activities and clinical applications on cardiovascular diseases, anti-cancer, against rheumatoid arthritis, relieving asthma and anti-allergic effects, as anti-oxidants, and so on. As an effort for further exploration of this bioactive ingredients and potential drug development, this paper summarizes most phytochemical and pharmacological results. Further, future prospects are also included.
Animals ; Drug Therapy ; Humans ; Litsea ; chemistry ; Molecular Structure ; Plant Extracts ; chemistry ; pharmacology ; Plants, Medicinal ; chemistry

A phytochemical investigation on the roots and stems of Litsea cubeba led to the isolation of seven isoquinolone alkaloids. By spectroscopic analysis and comparison of their 1H and 13C-NMR data with those in literatures, these alkaloids were identified as (+)-norboldine (1), (+)-boldine (2), (+)-reticuline (3), (+)-laurotetanine (4), (+)-isoboldine (5), (+)-N-methyl-laurotetanine (6), and berberine (7), respectively. Among them, 7 was isolated from the genus for the first time. The evaluation of these compounds showed weak anti-inflammatory activity against NO production in RAW 267.4 and BV-2 cells.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Litsea ; chemistry ; Molecular Structure ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo investigate the early diagnosis and treatment for trauma around the knee with popliteal vascular injury.

METHODSA retrospective analysis was employed to analyze the clinical data from 15 patients (9 males and 6 females were with a mean age of 39.2 years old,ranging from 26 to 62 years old) with fracture or dislocation around the knee with popliteal vascular injury from January 2007 to January 2013. Combined with clinical symptoms and signs, oxygen saturation monitors, color ultrasound, DSA angiography and interventional surgery were used to determine the vascular injury. The knee fracture and dislocation were fixed with hybrid external fixation and plate-screw fixation, respectively. Then, the blood circulation was reconstructed by thrombectomy, repair and autologous vein graft for individual injured vascular. The average total operation time, average hospitalization days, predictive salvage index (PSI), average blood transfusion amount, average medical expenses and infection cases were recorded to determine the effect of early diagnosis and treatment.

RESULTSThere was one patient with death, 8 patients with amputation, and 6 patients with successful repair surgery for popliteal artery, anterior tibial and posterior tibial arteries. These six patients with surviving limbs were followed up for an average of 28.3 months (ranged, 12 to 60 months). Among the 6 successful patients, the joint function of 4 patients was good and excellent.

CONCLUSIONThe trauma around the knee with popliteal vascular injury is characterized by complex and serious injury, easy misdiagnosis and loss diagnosis, poor prognosis and high risk of amputation. The early diagnosis of trauma around the knee with popliteal vascular injury should depend on the mechanism of trauma, local anatomical characteristics of injury site, clinical presentations and appropriate auxiliary examinations. The appropriate indications for limb salvage and amputation should be used to achieve more effective clinical results.

Adult ; Early Diagnosis ; Female ; Humans ; Knee Injuries ; diagnosis ; surgery ; Male ; Middle Aged ; Popliteal Artery ; injuries ; surgery ; Retrospective Studies

Objective To estimate the value of clinical parameters (such as patients' age,longitudinal melanonychia width and location) for the differential diagnosis of malignant and benign longitudinal melanonychia as well as for the evaluation of the necessity for invasive management.Methods A retrospective study was performed on 28 cases of subungual malignant melanoma collected from 2000 to 2010 as well as on 62 cases of benign longitudinal melanonychia from 2005 to 2010.Clinical analysis was carried out to compare the differences in clinical parameters such as.patients' age,longitudinal melanonychia width and lesional location,between the malignant melanoma and benign longitudinal melanonychia cases.Logistic regression analysis and ROC method were used to determine valuable clinical parameters for the differential diagnosis of malignant and benign longitudinal melanonychia.Results Significant differences were observed in the median age at diagnosis (23.0 years vs.52.5 years,Z =5.44,P ＜ 0.01 ),age at onset (21.0 years vs.48.0 years,Z =4.70,P ＜ 0.01 ),and longitudinal melanonychia width (3.0 mm vs.15.0 mm,Z =5.69,P ＜ 0.01 ) between the patients with malignant melanoma and benign longitudinal melanonychia.The involvement of thumb and hallux was observed in 77.8％ of the subungual melanoma cases,and 48.3％ of the benign cases (x2 =6.57,P ＜ 0.05).ROC method and Logistic regression analysis indicated that the age at onset and diagnosis as well as width of longitudinal melanonychia were of diagnostic value for the differential diagnosis of malignant and benign longitudinal melanonychia.Conclusions Not all longitudinal melanonychia cases need an invasive management at the time of awareness.The age at onset and diagnosis,width of melanonychia and site of the onset appear to be valuable in the differential diagnosis of malignant and benign longitudinal melanonychia,and there is a possibility to guide clinical diagnosis and treatment by establishing a mathematical model with these parameters.

OBJECTIVETo explore optimal choice of surgical treatment and operative approach for closed complex tibial plateau fractures and its influencing factors.

METHODSFrom January 2003 to January 2011, 95 patients with closed complex tibial plateau fractures were estimated Schatzker V and Vl, and treated with three different surgical methods. The methods included single plate through anterolateral incision (Group A, 22 cases), double plates through inside and outside incisions (Group B, 36 cases), and double plates through antero-midline incisions (Group C, 37 cases). There were 56 males and 39 females, ranged the age from 19 to 57 years (averaged, 36.3 years), 50 cases in left, 45 cases in right. According to Schatzker classification, 51 cases were type V, 44 cases were VI. The data of operation time, intraoperative blood loss, complications (infectious of wound, necrosis, bad incision, collapse fracture, loosen of internal fixation, fracture failure)and recovery of function of lower limb joint were collected.

RESULTSThere were no significant difference among three groups in operation time (P > 0.05); blood loss in group A was obvious better than other groups (P < 0.05); collapse of joint surface and failure rate of internal fixation in group A was higher than other groups (P > 0.05); Merchant score after 1 year were higher in group B, C than group A. For lower limb function, 10 cases got excellent results, 5 good, 4 fair and 3 poor in group A; 21 cases got excellent results, 11 good, 3 fair and 1 poor in group B; 23 cases got excellent results, 11 good,2 fair and 1 poor in group C.

CONCLUSIONThe blood loss in group A was least, but fracture exposure and joint surface was not satisfactory, and stable fixation could not be achieved, the long-term result was not good. For fractures with double condyles and dislocated involved, double plates through inside and outside incisions or double plates through antero-midline incisions was suggested,which benefit good reduction of joint surface, stable fixation, and erlier exercise.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation ; adverse effects ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo discuss the electrophysiologic effects of regenerative nerve fibres affected by control releasing of FK506.

METHODSFrom Mar. to Sep. in 2008, the body weigh of 32 Sprague-Dawley rats which was 200 to 250 g,anesthesia was performed with an intraperitoneal injection of 30 mg/kg 1% continal. The sciatic nerve was transected in each rat by the excision of a 10 mm gap just proximal to the trifurcation of the nerve. The 10 mm gap of sciatic nerve had been bridged with the new double channel nerve conduit of fusiform shape, which were randomly divided into two groups basing on the different drug in the channel, each group contained 16 animals. In group A,100 microl of chitin for medical use was injected into the conduit,in group B the two branches of the conduit respectively contained 100 microl of the chitin and 10 microl FK506 (group B2) or physiologic saline (group B1). At 8 and 12 week after operation, the morphology in regenerative nerve and electrophysiologic effects by detect compound muscle active potential (CMAP) and cortical somatosensory evoked potential (CSEP) were evaluated.

RESULTSThere were not significant differences of the regenerative nerve fibres between two channels in group A, but in group B2, the number of the regenerative fibres was much more than that in group B1. The latency of CMAP and CSEP in group B2 was shorter than that in group B1. But its amplitude was higher. There were highly significant difference between the groups (P < 0.01).

CONCLUSIONThe electrophysiologic effects of regenerative nerve fibres can be significantly promoted by FK506, which provide theory base for immunosuppressive treatment of peripheral nerve.

Animals ; Chitin ; administration & dosage ; Delayed-Action Preparations ; Female ; Immunosuppressive Agents ; administration & dosage ; pharmacology ; Male ; Nerve Fibers ; drug effects ; physiology ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Tacrolimus ; administration & dosage ; pharmacology