Objective To evaluate the effect of selective angiography and embolization for the pa-tients with haemodynamically unstable pelvic fracture. Methods Sixty-two patients with haemodynami-cally unstable pelvic fracture were treated in our hospital from 2002 to 2008. Their pelvie fractures were classified on the basis of their X-ray and CT data. By AO classification, there were 2 cases of type A2, 6 B1, 9 B2, 8 B3, 16 C1, 13 C2, and 8 C. There were 6 cases of open injury (by Gustilo classification, 1 type Ⅱ and 5 type Ⅲ). Of the 46 eases of multiple injuries, 12 had shock. While active fluid infusion and vascular medication were conducted, the angiograph was done for all patients, 59 of whom also received embolization. Results Seventy-nine angiographs were performed for the 62 cases, and 12 of them received more than twice angiographa. Exams revealed that 32 patients had suffered injury to more than 2 arteries. The injured arteries were sequentially superior gluteal artery, iliolumbar artery, lateral sacra] artery, obturator artery, inferior gluteal artery, internal pudendal artery, internal iliae artery and external lilac artery. Of the 59 cases of embolization, 56 were successful. Seven patients died due to severe abdominal organ injury. Forty-five patients got an average follow-up of 14 months (range, 6 to 52 months) . No severe complications were no-ticed. Conclusions Selective angiography and embolization is an effective intervention for patients with haemodynamically unstable pelvic fracture. It is mandatory to conduct recurrent angiographic embolization for patients with multiple artery injuries or delayed artery injuries.

Objective To compare the treatment effects of gastric bypass (GBP) and biliopancrtic diversion (BPD) in non-insulin dependent diabetes mellitus rats,and investigate the mechanism.Methods Forty GK rats with diabetes mellitus were randomly allocated into four groups:GBP group; BPD group; food restriction group ( FR group) and control group with 10 rats in each group.Rats in GBP group and BPD group received GBP and BPD procedures respectively.Rats in FR group were fed with basic feed of 15 g and free access to water.There was no food restriction in rats in control group.The operation time,mortality was recorded.The fasting body weight was measured every week.The plasma glucose,insulin-like growth factor-1 (IGF-1),and leptin concentrations,were measured before treatment and 1,2,3,4,8,16 week after treatment.Results The mean operation time was (25 ± 4) min in GBP group and (35 ± 6) min in BPD group; one rat died in GBP group and 3 rats died in BPD group,and the difference between the two groups was statistically significant (P ＜ 0.01 ).The levels of plasma glucose,IGF-1 and leptin were not statistically significant among these groups before treatment.There was no significant difference in plasma glucose and leptin concentrations in the control group.The levels of plasma glucose and leptin in rats in FR group began to decrease 2 weeks later,at the 4th week,the levels of plasma glucose and leptin was significantly lower than that before treatment,and it lasted for the 16 th week,but the level of IGF-1 were significantly different.The levels of plasma glucose and leptin in rats in GBP group and BPD group began to decrease and IGF-1 began to increase 2 weeks after operation,and it lasted for the 16th week,[plasma glucose:(6.8 ± 1.0),(6.3 ± 0.8 ) mmol/L vs.(13.9±2.6),(14.1 ±2.6)mmol/L; leptin:(16.1±3.3),(17.2±3.2)pg/ml vs.(29.4±3.9)pg/ml,(29.4±3.9); IGF-1:(166.1±8.3),(142.2±8.2)ng/L vs.(119.4±8.8),(109.8±7.9)ng/L,P＜0.01],but the levels of plasma glucose and leptin was not statistically different between the two groups.The level of IGF-1 in GBP group was significantly higher than that in BPD group (P ＜ 0.05).Conclusions Both GBP and BPD can effectively control plasma glucose concentration for rats with diabetes.The possible mechanism is related to decreased leptin and increased IGF-1.Group GBP had a better outcome in operation time,mortality and increasing IGF-1 than those in group BPD.

Objective To investigate the strategy to improve successful treatment for severe acute pancreatitis (SAP). Methods The study period was divided into from 1992 to 2000, and from 2001 to 2009.The patients during these two phases were comparable as regard to sex and age. Results The proportion of patients received anti-inflammatory medications from 2001 to 2009 was 88.7% (94/106), medications which can improve the pancreatic microcirculation were used in 93.4% (99/106), early enteral nutrition was used in 58.5% (62/106), medications which can protect intestinal barrier function were used in 98.1% ( 104/106),all these parameters were significantly higher than those (22.4%, 19/85; 43.5%, 37/85; 29.4%, 25/85;17.7%,15/85) from 1992 to 2000. Also from 1992 to 2000, more patients underwent operation such as basin-shaped open drainage, pancreatic necrosis debridement. While more patients underwent operation such as laparoscopic drainage, CT or B-ultrasound guided percutaneous drainage from 2001 to 2009. The proportion of patients underwent surgical treatment decreased from 56.5% (48/85) to 32. 1%(34/106); the survival rate increased from 68.8% to 84.0%. Conclusions The research progress of medications was the foundation to improve successful treatment for SAP. Operation was an important option during SAP therapy. The individualized treatment was beneficial to improve successful treatment for SAP.

Objective To evaluate the effect of different degrees of pubic symphysis diastasis on the stress distribution of posterior pelvic ring. Methods Eight embalmed pelvis and articulated proximal 1/3 of the femurs were harvested for this study. The samples were positioned as both legs standing straight and loaded to 600 N on the on the CSS-44020 biomechanical machine. The strain gages were adhered to 38 sites distributed symmetrically on the two sides of sacroiliac joint, anterior sacrum and posterior ilium. The strain gages were connected to WS3811 digital strainometer to record strain changes of the intact pelvic ring and at 1,2, 2.5 cm of pubic symphysis diastasis. Results Elastic changes occurred in the cortical bone of the pelvis under 600 N load. The symmetrical sites had similar strain changes without significant difference in the intact pelvic ring and at 1,2, 2.5 cm of pubic symphysis diastasis ( P ＞0.05 ). The sites with more strain changes were distributed on the iliofemoral arch in the intact pelvis.The strain changes were increased significantly frona the posterolateral sites to the iliofemoral arch. But the strain changes on the iliofemoral arch were decreased significantly during pubic symphysis diastasis.Conclusion The conduction of vertical load runs along the sacrofemoral arch in the intact pelvic ring and redistributes posterolaterally during pubic symphysis diastasis.

This study aimed at unfolding the therapeutic effects of freeze-dried powder separated from Shuang Xia decoction (SXD) on female senile drosophila melanogaster with fragmented sleep.Taking drosophilas as the model organisms,the locomotor activity was monitored using the autonomic monitoring software to explore the regulation of fragmented sleep in senile drosophilas by the treatment of SXD.As a result,it was found that the optimum concentration of SXD was 2.50％,while the desirable therapeutic duration was 4 days.In comparison with the control group,35-day-old virgin drosophilas'sleep was prolonged in the SXD group and the positive control group.The positive drug mainly affected their sleep in the daytime,while SXD impacted their sleep at night featuring the prolonged fragmented sleep.In conclusion,it was demonstrated that the freeze-dried powder of SXD effectively alleviated intermittent insomnia in the female senile drosophilas.Compared with positive drug,SXD also mitigated intermittent insomnia at night without significant changes in the sleep of the drosophilas in the daytime.Above all,SXD was beneficial in the regulation of sleep-wake rhythm in the drosophilas.

Objective To study the effects of Rhodiolae Crenulatae Radix ET Rhizoma extracts on sexual behavior of male mice.Methods 50 healthy male mice were randomly divided into the low dose, middle dose and the high dose Rhodiola group, theNanbao capsules group and the normal control group, 10 mice per group. The low dose, middle dose and high dose group were drenched with 0.05, 0.20 and 0.80 g/kg Rhodiola diluent respectively. TheNanbao capsules group mice were drenched with 2.00 g/kg turbid liquid. The normal control group were drenched with saline in the same volume. Liquid is drenched two times each day for 21 days. After 21 days, 50 female mice were matched with to the ratio of 1:1. The number of free movement and swimming test were observed before execution. After the execution, the organ indexes were calculated, and then the contents of SOD and MDA in the testis and liver were measured.Results Compared with the normal control group, capturing latency period of low dose group and middle dose group (20.88 ± 19.94 s, 35.40 ± 22.02 svs.78.11 ± 43.33 s) significantly decreased (P<0.05 orP<0.01). Testicular coefficient of the middle dose group (0.72% ± 0.10 %vs. 0.64% ± 0.08%) was significantly increased (P<0.05); the content of SOD in testicular of the middle dose group, the high dose groups and theNanbao capsules group (152.71 ± 38.10 U/mg, 122.32 ± 52.76 U/mg, 94.38 ± 22.20 U/mgvs. 25.30 ± 14.21 U/mg) increased (P<0.01); the content of SOD in liver of the middle dose group and theNanbaocapsules group (77.71 ± 26.35 U/mg, 74.10 ± 26.04 U/mgvs. 57.92 ± 17.17 U/mg) significantly increased (P<0.05).Conclusion Rhodiola extract can improve the ability of sexual behavior of male mice, and improve the antioxidant capacity of testis and liver.

OBJECTIVETo explore the effect and action mechanism of moxibustion on healing of cutaneous wound in rats.

METHODSTwenty-four SD rats were selected and made into linear full-thickness skin injury model. With randomized digital table, rats were randomly divided into a treatment group and a model group, 12 cases in each one. Then according to treatment time, each group was again divided into a 1d group, a 3d group and a 7d group, 4 cases in each one. The moxibustion at injured skin was applied in the treatment group, 30 min per time, once a day. Hematoxylineosin (HE) staining method was adapted to measure growth status of capillary and number of vascular endothelial cell; immunohistochemical method was used to measure the expression of vascular endothelial growth factor (VEGF).

RESULTSThe wound healing indices in the treatment 7d group were higher than those in the model 7d group on both the 4th day and 8th day after treatment (both P < 0.05). The number of capillary in the treatment 1d group and 3d group was higher than that in the model 1 d and 3 d groups (both 1 < 0.05). The number of capillary in the treatment 7d group was lower than that in the model 7d group (P < 0.05). The number of vascular endothelial cell in the treatment 3d group was higher than that in the model 3d group (P < 0.05). The number of vascular endothelial cell in the treatment 7d group was lower than that in the model 7d group (P < 0.05). The difference of number of vascular endothelial cell between the treatment 1d group and model 1d group was not significant (P > 0.05). Positive cells accumulated score of V EGF expression in the treatment 3d group was higher than that in the model 3d group (P < 0.05). Positive cells accumulated score of VEGF expression in the treatment 7d group was lower than that in the model 7d group (P < 0.05). The difference of positive cells accumulated score of VEGF expression between the treatment 1d group and model 1d group was not significant (P > 0.05).

CONCLUSIONMoxibustion could improve the healing of skin wound in rats, which could be related with regulating vascular endothelial cell and VEGF in wound tissue at different time.

Animals ; Endothelial Cells ; metabolism ; Female ; Humans ; Male ; Moxibustion ; Rats ; Rats, Sprague-Dawley ; Skin ; injuries ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; Wounds and Injuries ; genetics ; metabolism ; therapy

OBJECTIVETo evaluate the therapeutic effect of pedicled muscular flaps combined with partial thoracotomy for treatment of pythorax-resulted wounds and defects.

METHODS35 cases with pythorax-resulted refractory infected wound and dead space, were retrospectively analyzed. The wound and dead space were eliminated with pedicled muscular flaps, including latissimus dorsi muscular flaps and serratus anterior muscle flaps in 21 patients, pectoralis major muscle flaps with rectus muscle flaps in 8 patients, latissimus dorsi muscul flaps and vertical rectus muscle flaps in other 6 patients.

RESULTS34 flaps survived completely except for 1 verticle rectus muscular flap with partial necrosis at distal end. Primary healing was achieved in 29 cases. The other 6 cases were discharged with drainage. Among the 6 cases, 3 cases healed spontaneously, 2 cases underwent reoperation, 1 case need long-term drainage in the fistula.

CONCLUSIONPedicled muscular flap, combined with partial thoracotomy can effectively treat refractory wound and dead space resulted by pythorax.

Combined Modality Therapy ; methods ; Empyema, Pleural ; surgery ; Humans ; Myocutaneous Flap ; transplantation ; Pectoralis Muscles ; transplantation ; Reoperation ; Retrospective Studies ; Superficial Back Muscles ; transplantation ; Thoracotomy ; methods ; Wound Healing

Objective To analyze retrospectively clinical study efficacy and feasibility of one-stage posterior lumbar debridement,interbody fusion,and posterior instrumentation in treating lumbar spinal tuberculosis.Methods A total of 21 patients (14 males and 7 females) with lumbar tuberculosis collected from January 2009 to May 2012,underwent one-stage posterior lumbar debridement,interbody fusion,and posterior instrumentation.The age ranged 19 to 47 years (mean,34.8 years).All patients presented with presented with back pain,7 patients with constitutional symptoms including weakness,malaise,night sweats,fever and weight loss,2 with limbs numb and 1 with intermittence creep.Every patient underwent lumbar spine X -ray,CT scan and MRI examination of pathologic vertebra before surgery.All patients received at least a standard preoperative 2-4 week anti-tuberculosis treatment.Results All patients were confirmed by pathology or microbiology and were followed up for 12-48 months (mean,18 months).Average operation time was 3.1 h (range,2.5 to 4.3 h).Lumbar tuberculosis was completely cured and the grafted bones were fused 10 months after operation in all patients.There was no persistence or recurrence of infection and no nerve,blood vessel injury.After the treatment,the erythrocyte sedimentation rate (ESR) was decreased to normal level in 5.8 months.Conclusion With effective and standard anti-tuberculosis chemotherapy,the pedicle screw was placed due to pathologic vertebral body.One-stage posterior lumbar debridement,interbody fusion,and posterior instrumentation for lumbar tuberculosis could effectively relieve pain symptoms,and reconstruct the spinal stability.

Objective To investigate the possible association between the thrombospandin-1(TSP-1) gene GI678A (Ala523Thr)polymorphism and acute coronary syndrome (ACS) in a Chinese Han population.Method he ease cohort studied was compsed of 412 hospitalized patients with ACS recruited from four participating hospitals between November 2003 and May 2006.The diagnosis of ACS was based on the criteria of AHA/ACC set in 2002.The eontrul group was consisted of 319 age- and sex-matched subjects from partiei pating hospitals,and they were free from coronary artery disease judged by history,clinical examination,electrocardiography,exercise test and angiography.The TSP-1 GI678A polymorphism was determined by polymerase ehain reaction and restriction fragment length polymurphism analysis(PCR-RFLP).Results The prevalence OfAA genotype of the G1678A polymorphismin patients with ACS was significantly higher than that in the control subjects (49.5%% vs.40.4%,P=0.015).The frequencies of GA and GG genotypes were not significantly different between patients with ACS and controls (CA:39.3% vs.46.1%,P=0.070;CA;11.2% vs.13.5%,P=0.340).The frequencies of A allele in the ACS group and control group were 69.2% and 63.5%,respectively (P=0.022).Furthermore,multiple logistic regression analysis showed that the AA genotype was a significant risk factor for ACS (OR=1.52;95% CI:1.11～2.08;P=0.010).Conclusions The present findings suggest that the AA genotype in TSP-1 gene GI678A polymorphism may be associated with a risk factor for ACS in the Hart nationality of China.The AA genotype may be a genetic marker of the liability to the inheritance of AC,S.