Objective:To analyze the clinical outcomes of the locking compression plate(LCP) fixation for the unstable sacral fracture.Methods: Nine patients with unstable sacral fracture were treated with locking compression plate fixation in our department,including 7 males and 2 females,with an average age of 34.8 years(ranged from 25 to 49 years).AO classification system found 1 B_(1),4 B_(2),2 B_(3) and 2 C_(1) type.Dennis classification found 6 Ⅰ section sacral fracture and 3 Ⅱ section sacral fracture.Incisions(6-8 cm) were made from each side of superior iliac spine to ipsilateral inferior iliac spine along iliac crest.After the fractures or dislocations were exposed and reduced,LCPs were chosen and remodeled.The iliosacral posterior ligaments were restored if injured.The LCP was pushed cutaneously to the other incision,placed on both dorsal ilia and fixed with locking screws.Each side of postal LCP was fixed with 3 locking screws for effective fixation.The reduction and fixation of fractures or dislocation were assured by radiostereoscopy.The operations lasted 45 min averagely(ranged from 30-80 minutes) and no patient needed blood transfusion.The average X-ray exposure period was 4 min(from 2-10 minutes).Results: All the patients were followed-up for a mean of 13.8 months,ranged from 6 months to 21 months.There was no iatrogenic nerve injury.The function and the feeling of sacroiliac joint and low extremities recovered to normality.According to the Majeed standards,the results were excellent in 4,good in 4,and fair in 1.Conclusion: The locking compression plate fixation is a simple and effective treatment for the unstable sacral fractures,with less trauma and complications.

The instability of elbow is common among patients who suffered f ro m acute fracture or dislocation or from chronic strain. It is crucial to correct ly deal with the acute injury of the elbow, otherwise it would become chronic in stability of the elbow which is difficult to treat. This paper reviews the liter ature about the clinical representation, diagnosis and treatment of elbow instab ility. The surgical principle is to convert a complex fracture-dislocation patt ern into a simple dislocation pattern. Surgery should try to restore the anatomi c structure of the elbow, including articular surfaces and soft tissues. In inju ries to the ulnohumeral joint, reconstruction of the lateral tissues is the key to restoring joint stability. The premier treatment of recurrent instability of elbow is surgical treatment.

From the roots of Aconitum pseudostapfianum W. T. Warig,ten diterpenoid alkaloids were isolated and identified as 14-benzoyl-8-O-methylaconine (Ⅰ ),aconitine(Ⅱ),deoxyaconitine(Ⅲ),penduline (Ⅳ),yunaconitine (Ⅴ), neolinine (Ⅵ), 15?-hydroxyneoline (Ⅶ), neoline (Ⅷ), talatisamine (Ⅸ)and aconosine (Ⅹ). I has not been previously found in nature.

Objective To explore the clinic results of the locking compression plate fixation for injuries at the posterior ring of pelvis. Methods 5 patients with injuries at the posterior ring of pelvis were treated with locking compression plate fixation. 2 of them resulted from crashing, 2 from crushing and 1 from falling. They included 4 males and 1 female and their average age was 35.6 years. According to AO classification system, there were 1 type B1, 2 type B2, 1 type B3 and 1 type C1; according to Dennis classification system, there were 4 section I fractures and 1 section II fracture. Results All the patients were available at follow-up, with a mean period of 5.8 months (ranging from 3 to 12 months). The average intraoperative time was 50 minutes (ranging from 30 to 80 minutes), and no patient underwent blood transfusion because the intraoperative blood loss was only 100 to 400 mL. There was no iatrogenic nerve injury and all the incisions healed during the primary procedure. The function and sense of sacroiliac joint and low extremities recovered to normal. Conclusion The locking compression plate fixation is one of the effective methods for treatment of injuries at the posterior ring of pelvis, for it is simple and minimally traumatic, and has a low rate of complications.

Objective To evaluate the effect of esophagogastric intramural implantation anastomosis after esophagectomy. Methods One thousand and two hundred thirty-six patients with esophageal and cardial cancers were treated by esophagogastric intramural implantation anastomosis after esophagectomy. The mucosal layer, the esophageal and gastric muscular layers were on three different levels after the anastomosis. Results Among 1236 patients, 842 cases were esophageal cancer,and 394 cases were cardial cancer.The anastomoses were performed in different levels including 15 cases below the pharynx, 193 cases on neck,634 case above the aortic arch and 394 cases below the aortic arch. One of the patients died 24 hours after the operation due to myocardial ischemia, and two of them died of respiratory failure. Anastomotic leakage, stenosis and refluxing esophagitis did not appear in this series. Conclusions Esophagogastric intramural implantation anastomosis can decrease the incidence of anastomotic leakage, stenosis and refluxing esophagitis after esophagectomy.

Objective To investigate the relationship between apoptcsis, expressions of VEGF and clinicopathological characteris- tics, and prognosis in esophageal squamous cell carcinoma (ESCC). Methods Sixty-one surgical specimens of primary esophageal squa- mous cell carcinomas were examined for VEGF by immunohistochemical staining (S-P). Apoptcsis was determined by TUNEL (TdT media- ting dUTP-biotin nick end-labeling) method. Clinicopathologic features were examined by histopathology. The prognostic impacts of these pa- rameters were analyzed by univariate and survival analysis. Results AI and VEGF were well correlated with differentiation, TNM stage. Lower tumor differentiation and higher TNM stage were related to decreasing AI and VEGF. In addition, VEGF in the groups of invasion be- yond muscularis and lymph node metastasis is significant higher than that in invasion reaching muacularis and no lymph node metastasis (P <0.01). But there were no significant correlation between AI and invasion( P>0.05). The simple-factor analysis results showed that the decrease of AI, VEGF, lymph node metastases, lower tumor differentiation, and invasion reaching muscularis were related to decrease of sur- vival rate. However, multivariate Cox analysis demonstrated that only AI and VEGF were the significant prognostic factors. Conclusions Apoptosis and angiagenesis participate in ESCC and promote its growth. VEGF is related to angiogenesis of ESCC. The increase of VEGF may promote invasion and lymph node metastasis. AI and VEGF are significant prognostic factors in ESCC.

Objective To investigate the value of Color Doppler ultrasound in hemodynamic changes of non-alcoholic fatty liver disease.Methods 120 cases with non -alcoholic fatty liver disease were selected and divided into the mild group,moderate group and severe group.According to the degree of fatty infiltration of the liver taxono-my,40 cases in each group,hemodynamic changes of each group were detected in Color Doppler ultrasound equip-ment.Results Hepatic venous pulse waveform analysis and comparison constituted of the three groups and control group,the difference was statistically significant (χ2 =25.343,P <0.05).PPVV,MPVV,HARI of the three groups and control group were compared,the difference was statistically significant(F =34.67,51.03,31.06,all P <0.05).Conclusion Color Doppler ultrasound which is used to detect hemodynamic changes in non -alcoholic fatty liver disease had good clinical value,can assess disease progression in patients,can provide the basis for clinical treat-ment.

Object To investigate the chemical constituents from the roots of Glycyrrhiza uralensis Fisch. Methods The constituents were isolated on normal and reversed silica gel column chromatography and their structures were identified by spectral evidence. Results A new oleanane-type triterpenoid saponin and twelve known compounds, including two triterpenoid saponins, two cumarins and eight flavonoids, were isolated. Conclusion The new compound was elucidated as 3-O-[β-D-(6-methyl) glucuronopyranosyl (1→2)-D-glucuronopyranosyl]-24-hydroxy-glabrolide on the basis of ESI-MS, 1HNMR,13CNMR, HMQC and HMBC spectral evidence.

AIM　To investigate the chemical constituents of Rubus chroosepalus Focke. METHODS The methanol extracts were suspended in H2O and then extracted with EtOAc. Column chromatography was used for separation and purification, while spectral analysis was used for identification. RESULTS　Seven compounds were isolated and identified as 2α,3β-dihydroxy-urs-12,19-dien-23,28-oic acid (I), 2α,3β,23-trihydroxy-urs-12,18-dien-28-oic acid (IIa), 2α,3β,23-trihydroxy-urs-12,19-dien-28-oic acid (IIb), 2α,3α-dihydroxy-urs-12,18-dien-28-oic acid (IIIa), 2α,3α-dihydroxy-urs-12,19-dien-28-oic acid (IIIb), and the acetonide of IIIa and IIIb (IVa and IVb). CONCLUSION　I was found to be a new pentacyclic triterpenoid acid.