BACKGROUND: Posterolateral tibial plateau fracture is a special type of tibial plateau fracture. Because of its special anatomical location, there are many kinds of surgical approaches and implants used in the treatment in and outside China, but no consensus has been reached. OBJECTIVE: To summarize various surgical approaches and implants by analyzing the local anatomical structure and fracture types of the posterolateral tibial plateau. METHODS: The databases of Wanfang Medical Network, China National Knowledge Infrastructure and PubMed were searched by computer. Using the keywords of “tibial plateau fracture; posterolateral tibial plateau fracture; internal fixation; surgical approach” in Chinese and English. According to the inclusion and exclusion criteria, 54 related articles were finally included and summarized. RESULTS AND CONCLUSION: There are local structures of common peroneal nerve, anterior tibial artery and fibular head on the posterolateral tibial plateau, which will affect the operation. The commonly used fracture types are Schatzker, AO/ATO, three-column classification systems and posterior column 4 zone. Posterior column 4 zone has a more definite guiding effect on posterolateral tibial plateau fractures. There are many kinds of surgical approaches and internal plants for the treatment of posterolateral tibial plateau fractures, and the optimal selection should be made according to the fracture characteristics. For simple posterolateral tibial plateau fractures, the posterolateral approach has a certain advantage over other approaches. Posterolateral supporting plate has a better supporting effect on posterolateral shear fracture of tibial plateau.

OBJECTIVE To observe the curative effect of Jieminqufeng decoction to the rats with allergic rhinitis. METHODS Fourty Wistar rats were randomly divided into 4 groups. There were Jieminqufeng decoction group (A),cetirizine group (B),model control group(C) and normal control group (D). The rats with allergic rhinitis were established with ovalbumin. The behavioral changes of the rats were observed. The histological and cellular morphological changes were studied with light microscope and transmission electron microscope. RESULTS The model control (C) group had typical symptoms of allergic rhinitis. By light microscope and transmission electron microscope,a lot of eosinophilic granulocytes were found in nasal mucosa. The mucosal cells were lost or destroyed. However,the histological and cellular morphological changes of nasal mucosa in Group A,B were similar to that in Group D. CONCLUSION The Jieminqufeng decoction is an effective drug to treatment of allergic rhinitis. It can decrease the aggregation and activation of eosinophilic granulocytes,lessen inflammatory reaction and block up the allergy.

· AIM:To investigate the prevalence of juvenile myopia and factors affecting its occurrence in Linxia Prefecture.· METHODS:Totally 8 683 juvenile students who were 6-18 years old were extracted as respondent with stratified cluster sampling method.The eyesight,diopter and axial length were detected,and the gender,age,ethnicity,eye behavior were collected by self-made questionnaire.· RESULTS:The prevalence of myopia was 42.80％.The myopic rates of all ethnic groups were as follows:Tibetan Nationality:59.05％,Han Nationality:46.71％,Dongxiang Nationality:46.36％,Tu Nationality:45.24％,Sala Nationality:41.30％,Baoan nationality:40.61％,Hui Nationality:31.97％.Myopia rate between each ethnic groups had statistical difference (x2 =44.08,P=0.007).Multivariate analyses revealed that outdoor activities during the break was the protect factor for myopia;age,using electronic products on weekends and holidays,using the same lighting in room while studying were risk factors for myopia.· CONCLUSION:The prevalence of myopia increase with age in Linxia.The prevalence in different ethnic groups is different.Education department and family should make joint efforts to increase the outdoor time,improve the environment for teenagers to reduce the occurrence and development of myopia.

The efficacy of traditional Chinese medicine (TCM) treatments for Western medicine (WM) diseases relies heavily on the proper classification of patients into TCM syndrome types. The authors developed a data-driven method for solving the classification problem, where syndrome types were identified and quantified based on statistical patterns detected in unlabeled symptom survey data. The new method is a generalization of latent class analysis (LCA), which has been widely applied in WM research to solve a similar problem, i.e., to identify subtypes of a patient population in the absence of a gold standard. A well-known weakness of LCA is that it makes an unrealistically strong independence assumption. The authors relaxed the assumption by first detecting symptom co-occurrence patterns from survey data and used those statistical patterns instead of the symptoms as features for LCA. This new method consists of six steps: data collection, symptom co-occurrence pattern discovery, statistical pattern interpretation, syndrome identification, syndrome type identification and syndrome type classification. A software package called Lantern has been developed to support the application of the method. The method was illustrated using a data set on vascular mild cognitive impairment.
Data Collection ; Data Interpretation, Statistical ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional

OBJECTIVEThe early experience of treating anterior skull base meningiomas with intra-extracranial extension via pure endoscopic endonasal approach (EEA) was presented, the safety, feasibility and preliminary treatment outcomes were investigated.

METHODSEight patients with intra-extradural meningiomas who were admitted from October 2006 to October 2010 were operated on via EEA in one stage in Xuanwu hospital. In this study, the operative technique was described, the degree of resection, complications and the early clinical outcomes were discussed.

RESULTSThe complete resection of meningiomas with intra-extracranial extension was achieved in all patients using EEA in one stage. Preoperative visual symptoms were improved or resolved in all cases who presented with preoperative visual complaints. No patient in our series experienced a new neurological deficit after surgery or recurrence and death related meningiomas in the follow-up period (33-75 months). One patient experienced postoperative cerebrospinal fluid leak, delayed meningitis and secondary hydrocephalus which responded to therapy. After treatment, the patient was cure.

CONCLUSIONOur limited experience indicates that EEA is feasible and safe for the complete resection of anterior skull base meningiomas with intra- and extracranial extension in one stage in selected cases.

Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Meningeal Neoplasms ; surgery ; Meningioma ; surgery ; Middle Aged ; Nose ; surgery ; Skull Base ; surgery ; Skull Base Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the outcome of emergency adult right lobe living donor liver transplantation for fulminant hepatitis.

METHODSNine cases of adult right lobe living donor liver transplantation were performed from September 2002 to August 2005, the clinical and follow-up data was analyzed.

RESULTSAccording to Child Pugh Turcotte (CPT) classification, 9 patients were classified as grade C before transplant. The Model for End-Stage Liver Disease (MELD) scores of these patients were 26.7 +/- 8.8. The principal pre-transplant complications included hepatic encephalopathy (5 cases), electrolyte disturbance (3 cases), renal failure (2 cases), gastrointestinal bleeding (1 case). The operations in donors and recipients were all successful. The post-transplant complications induced pulmonary infection in 2 patients, acute renal failure in 3 and transplantation related encephalopathy in 1. There were no primary graft non-function and no blood vessel and bile tract complications occurred. One-year survival rate was 55.6%. No serious complication or death found in donors.

CONCLUSIONSEmergency adult to adult living donor liver transplantation is an effective treatment for fulminant hepatitis but the safety of the donors should be assessed strictly preoperation.

Adult ; Critical Illness ; Emergency Medical Services ; Female ; Follow-Up Studies ; Hepatitis ; pathology ; surgery ; Humans ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

In intensity-modulated radiation therapy (IMRT), it is time-consuming to repeatedly adjust the objectives manually to obtain the best tradeoff between the prescribed dose of the planning target volume and sparing the organs-at-risk. Here we propose a new method to realize automatic multi-objective IMRT optimization, which quantifies the clinical preferences into the constraint priority list and adjusts the dose constraints based on the list to obtain the optimal solutions under the dose constraints. This method contains automatic adjustment mechanism of the dose constraint and automatic voxel weighting factor-based FMO model. Every time the dose constraint is adjusted, the voxel weighting factor-based FMO model is launched to find a global optimal solution that satisfied the current constraints. We tested the feasibility and effectiveness of this method in 6 cases of cervical cancer with IMRT by comparing the original plan and the automatic optimization plan generated by this method. The results showed that with the same PTV coverage and uniformity, the automatic optimization plan had a better a dose sparing of the organs-at-risk and a better plan quality than the original plan, and resulted in obvious reductions of the average V45 of the rectum from (41.99∓13.31)% to (32.55∓22.27)% and of the bladder from (44.37∓4.08)% to (28.99∓15.25)%.

OBJECTIVETo establish the association between the geometric anatomical characteristics of the patients and the corresponding three-dimensional (3D) dose distribution of radiotherapy plan via feed-forward back-propagation neural network for clinical prediction of the plan dosimetric features.

METHODSA total of 25 fixed 13-field clinical prostate cancer intensity-modulated radiation therapy (IMRT)/stereotactic body radiation therapy (SBRT) plans were collected with a prescribed dose of 50 Gy. With the distance from each voxel to the planned target volume (PTV) boundary, the distance from each voxel to each organ-at-risk (OAR), and the volume of PTV as the geometric anatomical characteristics of the patients, the voxel deposition dose was used as the plan dosimetric feature. A neural network was used to construct the correlation model between the selected input features and output dose distribution, and the model was trained with 20 randomly selected cases and verified in 5 cases.

RESULTSThe constructed model showed a small model training error, small dose differences among the verification samples, and produced accurate prediction results. In the model training, the point-to-point mean dose difference (hereinafter dose difference) of the 3D dose distribution was no greater than 0.0919∓3.6726 Gy, and the average of the relative volume values corresponding to the fixed dose sequence in the DVH (hereinafter DVH difference) did not exceed 1.7%. The dose differences among the 5 samples for validation was 0.1634∓10.5246 Gy with percent dose differences within 2.5% and DVH differences within 3%. The 3D dose distribution showed that the dose difference was small with reasonable predicted dose distribution. This model showed better performances for dose distribution prediction for bladder and rectum than for the femoral heads.

CONCLUSIONWe established the relationships between the geometric anatomical characteristics of the patients and the corresponding planning 3D dose distribution via feed-forward back-propagation neural network in patients receiving IMRT/SBRT for the same tumor site. The proposed model provides individualized quality standards for automatic plan quality control.

OBJECTIVETo evaluate the value of blood lactic acid (BLA) as a predictor for the severity and prognosis of neonatal shock.

METHODSA total of 326 neonates with shock were enrolled and divided into three groups based on the severity, namely mild group (n=147), moderate group (n=105), and severe group (n=74). BLA level was measured during and early after (about 6 hours later) fluid resuscitation, and lactate clearance rate (LCR) was calculated. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of BLA in neonatal shock.

RESULTSBLA level was high in all subjects prior to treatment, and was highest in the severe group and lowest in the mild group (P<0.01). BLA level was significantly higher among patients with septic shock than among those with hypovolemic, cardiogenic, and asphyxiating shock (P<0.05). BLA level was significantly reduced in patients in recovery after treatment (P<0.05). Mortality was significantly lower in patients with BLA level ≤4 mmol/L or LCR ≥10% than in those with BLA level >4 mmol/L or LCR <10% (P<0.01). BLA at 11.15 mmol/L had 100% sensitivity and 96.8% specificity in predicting severe shock. BLA at 10.65 mmol/L had 88.9% sensitivity and 74.1% specificity in predicting the prognosis (survival or dead) of newborns with shock.

CONCLUSIONSIn neonates with shock, arterial BLA level increases as the disease severity increases and is associated with prognosis, so it is a useful predictor of the severity and prognosis of neonatal shock.

Objective:TThe aim of this study was to observe the changes of the volume and distribution of body fluid after abdominal surgery,and further to explore its characteristics and influence factors.Methods:Sixtyone patients were included between March and June in 2016.The volume of intracellular water (ICW),extracellular water (ECW) and total body water (TBW) was estimated by InbodyS 10 on preoperative day 1 (PreD 1) and postoperative day (POD) 1,3,5 and 7.Furthermore,the patients were grouped according to the age,sex,type of operation,operation time and the daily liquid input,and the influence factors of postoperative fluid volume were analyzed in each subgroup.Results:Comparing to that of PreD1,the ICW,ECW,and TBW,mainly ECW,were increased significantly on POD1 (P＜ 0.05),and the level of postoperative fluid volume was decreased to that of PreD1 between POD3 and POD7.It showed that there was difference in the net increasing of body fluid on POD1 between different type of the patients.Obviously,the net increasing of fluid volume in woman on POD 1 was more than that in man.The net increasing of fluid volume on POD1 was correlated with the operation time and net liquid input.Conclusion:The fluid retention was found in the early stage of postoperative patients,and mainly exists in ECW.The main influence factors resulting postoperative fluid retention were prolonged operation time and increased net fluid input.