OBJECTIVETo compare the clinical effects of interlocking intramedullary nail and micro-invasive internal fixation with plate for the treatment of multiple segmental tibiofibular fractures.

METHODSThe clinical data of 39 patients with multiple segmental tibiofibular fractures received treatment from January 2010 to June 2013 were retrospectively analyzed. In the 39 patients, 18 cases were treated by the interlocking intramedullary nail (intramedullary nail group), there were 12 males and 6 females with the mean age of (40.6 ± 9.7) years old (ranged, 24 to 60 years);7 cases were type C2.1, 11 were type C2.2 according to the AO classification. The other 21 cases were treated by micro-invasive internal fixation with plate(plate group), there were 13 males and 8 females with the mean age of (41.7 ± 8.1) years old (ranged, 22 to 52 years), 7 cases were type C2.1, 13 were type C2.2, 1 was type C2.3. Preoperative preparation time, operation time, intraoperative blood loss, postoperative complications, fracture healing time were compared between two groups. Johner-Wruhs evaluation criteria was used to evaluate the clinical effect at last follow-up.

RESULTSAll the patients were followed up from 10 to 28 months with an average of 15.2 months. Operative time, intraoperative blood loss in intramedullary nail group were (62.1 ± 5.8) min, (70.9 ± 7.1) ml, respectively; in plate group were (64.3 ± 7.7) min, (74.1 ± 8.5) ml,respectively. There was no significant difference in operation time and intraoperative blood loss between two groups (P > 0.05). However, preoperative preparation time, fracture healing time in intramedullary nail group were (5.3 ± 0.7) days, (11.1 ± 1.9) months, in plate group were (7.1 ± 0.8) days, (14.1 ± 2.2) months, respectively. No postoperative complications were found in intramedullary nail group, and five cases developed with complications in plate group. There was significant difference in preoperative preparation time, postoperative complications and fracture healing time between two groups (P < 0.05). According to Johner-Wruhs criteria at last follow-up, 11 cases got excellent results, 4 good, 3 fair in intramedullary nail group; 11 excellent, 5 good, 2 poor in plate group.

CONCLUSIONInterlocking intramedullary nail has advantages of shorter preoperative preparation time, less postoperative complications and faster fracture healing time in treating multiple segmental tibiofibular fractures. But the application scope of interlocking intramedullary nail was inferior to micro-invasive internal fixation with plate , and its indications should be strictly controlled.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To investigate the advantage of separate bolus injection technique in CT urography (CTU) improving the display of the whole urinary tract.Methods Sixty cases of CTU examination,were divided into observation group and control group by random digits table with 30 cases each,observation group used separate bolus injection technique and control group used single bolus injection technique.The scanning included routine scanning,cortical phase,medullary phase and lag phase.Reconstruction of lag phase displayed the whole urinary tract.Then the image quality was compared between two groups.Results The whole urinary tract showed excellent in 12 cases (40.0％,12/30),good in 17 cases (56.7％,17/30),normal in 1 case (3.3％,1/30) in control group,which showed excellent in 23 cases (76.7％,23/30),good in 7 cases (23.3％,7/30) in observation group,there was significant difference in excellent rate between two groups (P ＜ 0.01).The CT value of starting of ureter was (238.6 ± 82.5) HU,middle-lower ureter was (245.9 ± 112.3) HU in control group and (239.0 ± 93.8),(235.3 ± 74.6) HU in observation group,there was no significant difference between two groups (P ＞0.05).There was no difference in developing of urolithiasis between two bolus injection techniques.Conclusion The application of separate bolus injection technique in CTU examination can reduce the dose of the first contrast material and contrast material reaction,and receive high-quality image of the whole urinary tract.

Endoscopes ; Humans ; Nasal Cavity ; surgery ; Nasal Septum ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; Surgical Flaps

ObjectiveTo screen mimetic HIV-1 neutralizing epitopes from plasma with high level neutralizing antibody,and to provide useful information for further study of the interaction between antigen and antibody.MethodsIn order to gain neutralizing antibody recognized mimotopes, we detected neutralizing antibodieslevelsof 11HIV-1infectedslowprogressorsbyPBMC-basedneutralization assays.High-titer HIV-neutralizing antibodies from plasma of SPs was used as the ligand for biopanning by phage-displayed random peptide library.Positive phage clones was evaluated by ELISA,sequenced,and analyzed for homology to HIV-1 env by local BLAST to deduce the neutralizing peptide.ResultsTwenty-two clones were obtained consistent with requirement through three rounds biopanning.After comparison analysis,twelve clones include C8 were obtained as mimotopes of neutralizing antibody,C40 located in gp41Ⅱ cluster with the highest titer by inhibition ratio may be as neutralizing epitope.Conclusion By the use of IgG antibodies from SPs to screen the phage random polypeptide library,one can acquire multiple phage mimetic peptides of HIV related antigen epitope.(Chin J Lab Med,2012,35:838-842 )

Objective To determine the function and clinical significance of OMOM capsule endos-copy. Methods To review the history and outcomes of 65 patients underwent capsule endoscopy from Oct. to Dec. 2004. Results OMOM capsule endoscopy failed to pass the pylorus within the effective working time in one case. The significant pathological findings were revealed in 47 patients among 64 patients (73. 4% ). Inflammatory small bowel diseases in 21 patients including Crohn's disease in 3 patients, small intestinal pol-yps in 8 patients including one Peutz-Jeghers syndrome, angiodysplasia in 9, diverticula in 3, hookworm in 3, submucosal tumor in 3 including one myosarcoma finally diagnosed by operation. OMOM capsule endosco-pies have working time 473 min (360-630) averagely. The duration from oral to anus was 1723 min (690-2370 min) averagely. Conclusion The capsule endoscopy is a highly useful technique in detecting small in-testinal diseases. It can be recommended as part of the routine work-up in patients with obscure bleeding.

OBJECTIVETo study the toxicity of methomyl to acetylcholinesterase (AChE) in different regions.

METHODSThe optimal temperature and time for measurement of AChE activity were determined in vitro. The dose- and time-response relationships of methomyl with AChE activity in human erythrocyte membrane, rat erythrocyte membrane, cortical synapses, cerebellar synapses, hippocampal synapses, and striatal synapses were evaluated. The half maximal inhibitory concentration (IC50) and bimolecular rate constant (K) of methomyl for AChE activity in different regions were calculated, and the type of inhibition of AChE activity by methomyl was determined.

RESULTSAChE achieved the maximum activity at 370 °C, and the optimal time to determine initial reaction velocity was 0-17 min. There were dose- and time-response relationships between methomyl and AChE activity in the erythrocyte membrane and various brain areas. The IC50 value of methomyl for AChE activity in human erythrocyte membrane was higher than that in rat erythrocyte membrane, while the Ki value of methomyl for AChE activity in rat erythrocyte membrane was higher than that in human erythrocyte membrane. Among synapses in various brain areas, the striatum had the highest IC50 value, followed by the cerebellum, cerebral cortex, and hippocampus, while the cerebral cortex had the highest Ki value, followed by the hippocampus, striatum, and cerebellum. Lineweaver-Burk diagram demonstrated that with increasing concentration of methomyl, the maximum reaction velocity (Vmax) of AChE decreased, and the Michaelis constant (Km) remained the same.

CONCLUSIONMethomyl is a reversible non-competitive inhibitor of AChE. AChE of rat erythrocyte membrane is more sensitive to methomyl than that of human erythrocyte membrane; the cerebral cortical synapses have the most sensitive AChE to methomyl among synapses in various brain areas.

Acetylcholinesterase ; metabolism ; Animals ; Cerebellum ; drug effects ; Cerebral Cortex ; drug effects ; Erythrocyte Membrane ; drug effects ; enzymology ; Hippocampus ; drug effects ; Humans ; Inhibitory Concentration 50 ; Methomyl ; toxicity ; Rats ; Synapses ; drug effects ; Toxicity Tests

Adenocarcinoma, Bronchiolo-Alveolar ; metabolism ; pathology ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Hemangioendothelioma, Epithelioid ; metabolism ; pathology ; surgery ; Hemangioma ; metabolism ; pathology ; Hemangiosarcoma ; metabolism ; pathology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Middle Aged ; Vimentin ; metabolism

Intermittent hypoxia (IH), or periodic hypoxia is referred as exposure to hypoxia interrupted by normoxia that occurs under many physiological and pathophysiological conditions. A lot of researches showed that IH adaptation, like ischemic preconditioning (IPC) and long-term high-altitude hypoxic adaptation (LHA), had significant cardioprotective effects including increasing the tolerance of myocardium to ischemia/reperfusion injury, limiting infarction size and morphologic damage, inhibiting apoptosis of myocardial cells, enhancing recovery of cardiac function in ischemia/reperfusion, and antiarrhythmia. However, the precise mechanisms underlying the protective effects of IH against ischemia/reperfusion injury are far from clear. The potential candidates participating in the protective effects of IH include oxygen transport, energy metabolism, neurohumoral regulation, antioxidase, stress protein, adenosine, ATP-sensitive potassium channel, mitochondrion, calcium control, nitric oxide and protein kinase. The effects of IH are affected by the protocol of hypoxic exposure, age and sex of experimental animals. IH adaptation, for longer lasting time than IPC and lesser side effect than LHA, might have a practical value for using.
Adaptation, Physiological ; Calcium ; Energy Metabolism ; Humans ; Hypoxia ; Ischemic Preconditioning ; KATP Channels ; Myocardium ; Myocytes, Cardiac ; Potassium Channels ; Reperfusion Injury ; physiopathology ; prevention & control

Objective To study changes of phosphorylated cyclic adenosine monophosphate(c-AMP) response element binding protein in hippocampus(CA1) of neonatal rats after cerebral hypoxic-ischemia(HI)and effects of gangliosides (GM1)on the p-CREB.Methods An animal model of neonatal hypoxic-ischemia brain damage was established. Changes of p-CREB in hippocampal CA1 was detected with immunohistochemical methods.Results The p-CREB levels in the CA1 of HI and GM1 groups increased transiently and then decreased quickly, but there was no significant difference between HI and GM1 group.Conclusion The p-CREB levels in the CA1 of HI group increase transiently and then decrease quickly after HI ;GM1 has little effect on p-CREB in the CA1 after HI.

Objective:To investigate the association between age and cardiac tamponade after radiofrequency ablation of atrial fibrillation(RAAF).Methods:Clinical data of patients undergone de novo AF ablation procedures at Beijing Anzhen Hospital from January 2013 to December 2016 were retrospectively collected.Patients were divided into an elderly group(age ≥60 years)and a non-elderly group(age <60 years). Logistic regression analyses were used to evaluate the association between old age and the risk of cardiac tamponade complicating RAAF.Results:A total of 5 313 patients were involved in this study, including 41 patients(0.77%)with cardiac tamponade.The proportion of cardiac tamponade was higher in the elderly group than in the non-elderly group(1.1% or 32/2 950 vs.0.4% or 9/2 363, χ2=8.489, P=0.004). One patient with cardiac tamponade in the elderly group required immediate surgical repair whereas none in the non-elderly group did.No patient died in hospital.Multivariate Logistic regression analysis showed that the risk of cardiac tamponade increased in the elderly group, compared with the non-elderly group( OR=2.570, 95% CI: 1.190-5.570, P=0.017). Stratified analysis revealed that among females and patients with oral anticoagulants, left atrium dimension < 40 mm or procedure duration≥ 120 min in the elderly group carried a higher risk of cardiac tamponade than those in the non-elderly group( OR=1.011, 2.914, 3.922 and 3.244, P<0.05). Conclusions:Old age(age ≥60 years)is an independent risk factor for cardiac tamponade complicating RAAF.