Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Recovery of Function ; Spondylolisthesis ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the choice of operative method,timing of surgery and the outcome of tibia Pilon fractures.

METHODSFrom March 1999 to November 2008, 52 patients of Pilon fractures were treated including 38 males and 14 females with the average age of 38 years old ranging from 23 to 59 years. There were 17 cases of open fractures and 35 cases of closed fractures. According to Ruedi-Allgower type,there were 6 cases of type I fracture, 29 cases of type II, 17 cases of type III. Thirty-three cases selected emergency surgery and 19 cases selected the selective operation, the average period between injury and surgery was 8.3 days. According to the type of fracture, open reduction and plate fixation of Trilobal, limited internal fixation combined with external fixation were applied for treatment of different surgical methods.

RESULTSAll patients were followed-up for from 10 to 55 months (averaged 28 months). According to Mazur's criterion, the result of treatment was evaluated as excellent in 28 cases,good in 14 and fair in 10. After operation, 5 cases occurrenced skin and soft tissue infection and necrosis, 1 case of nonunion healed again after bone graft in re-operation, 6 patients occurrenced ankle traumatic arthritis later.

CONCLUSIONAccording to fracture type, degree of injury and timely and effective surgical treatment is the key to achieve a satisfactory effect, which can effectively avoid the occurrence of complications.

Adult ; Female ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Time Factors

OBJECTIVETo investigate clinical efficacy and feasibility of double-plating fixation via anteriormiddle approach in treating type C3 distal femoral fractures.

METHODSFrom August 2008 to August 2011, 12 cases with type C3 distal femoral fractures were treated, including 5 open fractures and 7 closed fractures. Among them, there were 8 males, 4 females with an average of 40 years (ranged, 25 to 55 years). There were 7 in left side, 5 in right side. Nine cases were caused by car accident, 3 cases by falling down. The duration from injury to hospital was form 20 minutes to 5 days (mean 135 min). After tibia bone traction for 5 to 8 days, the operation were performed by double-plating fixation via anteriormiddle approach, and autograft of iliac bone or allograft bone grafting were given to bone defect. Knee joint function was evaluated according to Merchanetal criteria.

RESULTSThe operation time was from 110 to 160 min, with an average of 135 min, the blood loss was from 300 ml to 500 ml,with an average of 400 ml. Post-operative wound were stage I healing. All patients were followed up from 16 to 36 months (mean 24 months). No infection, reduction loss, nonunion, deep vein thrombosis occurred. Bone healing time was for 18 to 24 weeks with an average of 21 weeks. According to the Merchanetal criteria, 4 cases got excellent results, 6 good, 1 fair and 1 poor.

CONCLUSIONDouble-plating fixation via anteriormiddle approach for type C3 distal femoral fractures is an effective way, which has advantages of obvious exposure, simple manipulation, anatomical reduction, stable fixation. However,operation indications and operating instructions should be strictly followed.

Adult ; Bone Plates ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo explore the clinical effects of cervical posterior pedicle screw internal fixation and interbody fusion for the treatment of atlanto-axial vertebral instability fractures.

METHODSFrom July 2008 to July 2013, 21 patients with atlanto-axial vertebral instability fractures were treated with vertebral pedicle screw internal fixation and interbody fusion through posterior approach. There were 14 males and 7 females, aged from 20 to 55 years old with an average of 32 years. Lifted and guided the atlanto-axial vertebral pedicle screw to reduce atlanto-axial vertebral displacement.

RESULTSAll patients were followed up from 6 to 24 months with an average of 12.5 months. Wounds got healed without complication of infection. Clinical symptoms were relieved at 6 months after operation. According to ASIA score standard to assess at 6 months after operation, the items of motion, light touch and needle score had obviously improved, and respectively were 99.45 ±0.27, 111.09 ± 0.47,111.11 ± 0.58. VAS and NDI scores also had obviously improved, and respectively were 1.04 ± 0.38 and 12.56 ± 2.24. Imaging examinations showed internal fixation locations were good, without atlanto-axial joint instability.

CONCLUSIONCervical posterior pedicle screw internal fixation and interbody fusion can effectively restore the stability of atlanto-axial joint, reduce complication and obtain satisfactory effects.

Adult ; Atlanto-Axial Joint ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Instability ; physiopathology ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fractures ; physiopathology ; surgery ; Spinal Fusion ; methods ; Young Adult

To develop a high-yield pyruvate strain, we first engineered a pyruvate-producing Escherichia coli KLPP from wild-type E. coli MG1655 by blocking the pathways for byproduct formation via gene knockout. Then, we built a library of mutant containing 7 197 monoclones by using the pUT Mini-Tn5 transposon vector for random mutagenesis with E. coli KLPP. We developed a high-throughput method for pyruvate detection based on dinitrophenylhydrazine reaction using 96-well microplate reader. After two-round screening we successfully obtained six mutants with increased pyruvate titer using this method, the titer of pyruvate was increased by 38%, 31%, 19%, 28%, 44% and 14%, respectively. The position of transposon insertion was determined by whole genome re-sequencing, and the gene locus possibly influencing pyruvate production was analyzed, which laid the foundation for subsequent strain improvement by metabolic engineering.