Tibial plateau fracture,one of the most common fractures,includes simple and complicated fractures.Inappropriate treatment could result in pain and deformity,which has a bad effect on patient life.With the development of the surgical technique,a lot of methods could be selected when an orthopedist deals with these fractures.X-ray,one of the most common assistant examination,is the preferred method for tibial plateau fracture and could diagnose most of these fractures.Due to high resolution,CT scan could find these micro-fractures which X-ray cannot find and it could supplement the Schatzker type.MRI could find ligament,meniscus and arthrodial cartilage injury.Surgical approach includes anterolateral approach,medial approach,posteromedial approach,post approach,anterior approach.Anterolateral approach could be used for most of tibial plateau fractures.Posteromedial approach is used for medial plateau fracture involving post plateau fracture or post plateau fracture alone.Common plate,locking plate,dual plate and external fixation are commonly used fixation method.Dual plate is often used for complicated tibial plateau fracture.However,how to make accurate diagnosis and choose appropriate fixation is crucial for patients.We will summarize the application of X-ray,CT scan and MRI in diagnosis of tibial plateau fracture.Commonly used approaches to the proximal tibia,which together allow for the treatment of any proximal tibia fracture,will be described in this article.

Objective:To provide reference for clinical pharmacists through pharmaceutical care for patients with hyponatremia en-cephalopathy caused by pituitrin. Methods: Clinical pharmacists provided pharmaceutical care for one patient with hyponatremia en-cephalopathy caused by pituitrin. It was suggested by clinical pharmacists that 3% hypertonic saline and 20% mannitol be used in the patient with sodium ions and renal function monitoring. The patient was also told to increase salt in diets and limit water uptake. Re-sults:The ion levels of the patient returned to normal after the pharmaceutical care. Conclusion:Clinical pharmacists play an impor-tant role in the prevention and treatment of hyponatremia encephalopathy caused by pituitrin.

Objective:To investigate the effects of TJU103 on T lymphocytes proliferation and cytokine production in vitro.Methods:MTT and ELISA assays were used respectively to detect the proliferation and the cytokine production of donor T lymphocytes blocked by TJU103.Results:There are significant difference in the inhibition of T-cell proliferation and the cytokine production between groups of with TJU103 or without.Conclusion:TJU103 could significantly inhibit the T-cell proliferation and the cytokine production.

We wished to undertake molecular characterization of the reverse transcriptase (RT) gene and overlapping surface (S) gene in lamivudine-treated patients with chronic infection with the hepatitis B virus (HBV). Sequencing analyses of the HBV RT/S gene of isolates from 25 chronic hepatitis B (CHB) patients with the YMDD mutation and 30 treatment-naïve CHB patients were undertaken. In patients with the YMDD mutation, rtM2041 was the major type of mutation (20/25, 80%). rtL80I was present in most of the patients with rtM204I (14/20, 70%). rtL180M coexisted with rtM204V (5/5, 100%). Patients with the YMDD mutation had a significantly higher prevalence of mutation of the RT gene than treatment-naïve CHB patients (P < 0.05). Classical primary resistance and secondary/compensatory mutations were detected at only five sites (rtL80, rtV173, rtL180, rtM204, rtM250) in CHB patients with the YMDD mutation. The frequency of nucleos(t)ide analog resistance (NAr) mutation within the RT gene in patients with the YMDD mutation was significantly higher than that in treatment-naïve patients (P < 0.05). Amino-acid mutations within the RT gene were also associated with other types of NAr in patients with the YMDD mutation. The rate of amino-acid variants within the S gene region was significantly higher in patients with the YMDD mutation than that in treatment-naïve patients (P < 0.05). sM133L and sG145R variants were also present in patients with the YMDD mutation. These observations suggest that CHB patients with the YMDD mutation also have NAr mutations related to other NA drugs, which might lead to cross-resistance in CHB patients. Variants present in the S gene region could cause changes in the antigenicity of HBsAg, which could result in a false-negative diagnosis of HBsAg and immune in escape of the HBV.
Adolescent ; Adult ; Antigens, Surface ; genetics ; Antigens, Viral ; genetics ; DNA Mutational Analysis ; Female ; Genetic Variation ; Hepatitis B, Chronic ; drug therapy ; genetics ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; RNA-Directed DNA Polymerase ; genetics ; Young Adult

Objective To investigate the imaging appearances of non-ossifying fibromas in healing stage and its clinical value.Methods The imaging features of non-ossifying fibroma in healing stage in 10 cases followed-up clinically(2 cases of them were verified by pathology after operation) were analyzed. All of the cases were examined by radiography,4 cases were examined by CT, 1 case underwent MRI. Results All of the cases were located in long bone of lower extremity. 8 cases were in tibia,2 cases were in femur. 5 cases were shown as homogeneous sclerosis,lucent areas were presented in sclerotic foci in 5 cases. 5 cases were unchangeable after followed-up 1 to 4 years .Conclusion The non-ossifying fibroma is being sclerotic stabilized foci after puberty , no operation is necessary for the healed form non-ossifying fibroma.

Objective To explore the imaging characteristics of SAPHO syndrome in 11 cases.Methods Clinical features and imaging findings from 11 patients (6 male,5 female, 28 to 68 years old)with SAPHO syndrome were analyzed retrospectively Including DR in 9 cases, CT in 10 cases, MRI and radioisotope scanning in 3 cases. Results Multi-bones of anterior chest wall disorders were shown in 9cases on DR images including superior sternum , anterior first rib and clavicle hyperostosis. Bony fusion and bony bridge were also seen in these cases. Hyperostosis osteosclerosis, bone destruction and bony fusion of sternoclavicular articulation and first rib were shown on CT images in 9 cases. Osteosclerosis of the joint between manubrium and midsternum was seen in 1 case on CT image. Thc sign of flying sea gull was seen in 2 cases on axial anterior chest wall CT images. The disorders of anterior chest wall were bilateral in 8 cases and unilateral in 2 cases. Sacroiliitis and osteomyelitis of ilium were found accompanied in 1 case.Osteomyelitis of thoracic vertebrae were found in 2 cases, while sclerosing osteitis of lumbar vertebrae and ostearthritis of bilateral hands were observed respectively in 1 case. The thicken soft tissue surround clavicle head, thoracic vertebra disease with long T1 ,jumbly T2 and high fat suppression signal ,long T1 and short T2signal under sacroiliac joint were shown on MRI. Radioisotope scanning displayed higher radioactive uptake of radionuclides, with T shape in sternoclavicular area in 3 cases. Conclusions Multi-bones of anterior chest wall involvement was the common imaging characteristics in 11 patients. Sacroiliitis, osteomyelitis of vertebrae and ilium, sclerosing osteitis, ostearthritis of hand could be seen in some cases.

Abstract:The present case report retrospectively analyzed 36 cases of injury to posterior pelvic dng who received treatment in the Department of Orthopedics,Yan'an Hospital between January 2004 and April 2007. According to the Denis classification,there were 20 cases of type I injury to posterior pelvic ring,12 of type Ⅰ,and 4 of Ⅲtype Ⅲ; according to Tile classification,there were 16 cases of B3,10 of C1,6 of C2,and 4 of C3. Pedicle screw fixation system was employed. Two curvy incisions were made on the bilateral posterior superior lilac spine and a hole was chiseled on each side to fit the pedicle screw. Then,a universal pedicle screw was driven between the inner and outer lilac plates until the screw were sunk. A rod was finally traversed through erector spinae to connect two pedicle screws. Thirty cases were available at follow-up with a mean of 11 months (range:6-11 months). None of 30 cases presented with nerve or vessel injury and breakage,loosening of screws,or redislocation of sacroiliac joints. According to functional rating scale,excellent results were found in 15 cases,good in 13,and fair in 2 cases. These findings suggest that treatment for injury to posterior pelvic ring with pedicle screw fixation system is simple and reliable with microtrauma and little bleeding; in addition,it affords good recovery and can be employed in primary hospital without monitoring of X-ray,so it will deserve popular practice.

Objective To evaluate the effects of different head-down tilt (HDT) angles on respiratory mechanics and cerebral circulation during laparoscopic radical resection of rectal carcinoma in the patients.Methods Thirty patients of both sexes,aged 40-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index ＜ 30 kg/m2,scheduled for elective laparoscopic radical resection of rectal carcinoma,were included in the study.Anesthesia was induced with midazolam,fentanyl,propofol and cis-atracurium and maintained with targetcontrolled infusion of propofol and remifentanil and cis-atracurium when needed.At 5 min after supine position,5 min after 30° HDT,5 min after 35° HDT,5 min after 40° HDT,and 30 min after pneumoperitoneum (T1-5),airway pressure (Paw),peak airway pressure (PIP),lung compliance (Cpat) and jugular bulb blood pressure (JBP) were recorded.Blood samples were taken from the radial artery and jugular bulb for blood gas analysis and arterial partial pressure of oxygen (PaO2),partial pressure of carbon dioxide in artery (PaCO2),arterial oxygen saturation (SaO2),jugular bulb oxygen partial pressure (PjvO2),and jugular bulb venous saturation (SjvO2) were recorded at each time point mentioned above.Results Paw,PIP,MAP,PaCO2,JBP,PjvO2 and SjvO2 were significantly increased as compared with those obtained when the patients were in supine position,increased gradually with the increasing HDT angles,and decreased to the level obtained when the patients were in supine position at 30 min after pneumoperitoneum.Cpat and PaO2 were significantly decreased as compared with those obtained when the patients were in supine position decreased gradually with the decreasing HDT angles,and increased to the level obtained when the patients were in supine position at 30 min after pneumoperitoneum.Conclusion HDT-induced effects on respiratory mechanics and cerebral circulation increase with increasing angles during laparoscopic radical resection of rectal carcinoma; thus the optimum HDT angle is smaller than 40° for the patients undergoing this kind of surgery.

Objective To evaluate the effects of propofol and sevoflurane anesthesia on cognitive function and amyloid beta protein ( Aβ) deposition in hippocampi of aged mice. Methods Thirty?six SAMP8 mice, aged 6 months, weighing 29-32 g, were randomly assigned into 4 groups ( n=9 each) using a random number table: control group ( group C ) , propofol anesthesia group ( group P ) , sevoflurane anesthesia group (group S) and propofol plus sevoflurane anesthesia group (group PS). In group P, propofol 140 mg∕kg was injected intraperitoneally, when righting reflex occurred, additional propofol 70 mg∕kg was given, and when it occurred again, additional propofol 40 mg∕kg was given. Group S continuously inhaled 1% sevoflurane for 120 min. Group PS continuously inhaled 2% sevoflurane for 120 min, and when righting reflex occurred, additional propofol 40 mg∕kg was given. Anesthesia was maintained for 120 min in P, S and PS groups. Before anesthesia and at 7, 14 and 28 days after anesthesia, Morris water maze test was performed, and the escape latency was recorded. Hippocampi were obtained to determine the expression of Aβ using immuno?histochemistry. Results Compared with group C, the escape latency was significantly prolonged at 7 days after anesthesia, and the expression of Aβwas up?regulated at 7, 14 and 28 days after anesthesia in group S, and no significant change was found in the parameters mentioned above in P and PS groups. Compared with the value at 7 days after anesthesia, the expression of Aβ was significantly down?regulated at 14 and 28 days after anesthesia in group S, and no significant change was found in the expression of Aβ at 14 and 28 days after anesthesia in C, P and PS groups. Conclusion Although sevoflurane anesthesia promotes Aβ deposition in hippocampi, it only causes short?term cognitive dysfunction, however, anesthesia with propofol or with propofol in combination with sevoflurane produces no influence in aged mice.

Objective:To establish the quality standard for Kechuanning granules. Methods: A TLC method was used for the qualitative study on the main ingredients, Radix stemonae,ephedra and bitter almond. An HPLC method was used to determine the con-tents of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin. The separation of targeted compounds was performed on a Tech Mate C18-ST column (250 mm × 4. 6 mm,5 μm) . The mobile phase consisted of methanol(A) and 0. 1% phosphoric acid (B) with gradient elution at a flow rate of 1. 0 ml·min-1. The detection wavelength was 207nm and the column temperature was 35℃. Results:The spots in TLC were quite clear without any interference from negative control. The linear relationship of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin was 1. 826-182. 600μg·ml-1( r=0. 9997),1. 848-184. 815μg·ml-1 (r=0. 9997) and 2. 981-298. 069 μg·ml-1(r=0. 9996),respectively. The average recovery was 97. 00%,97. 40% and 98. 30%(RSD=3.7%,2.5%,1.6%)(n=9),respectively. Conclusion: The method is sensitive,accurate,simple and reproducible,which can be used for the quality control of Kechuanning granules.