Objective To observe the effect of human serum containing Niaoduqing Capsule(NC)on proliferation and transdifferentiation of human renal tubular epithelial cells(HK-2).Methods The in-vitro cultured HK-2 were divided into 6 groups according to the culture media: normal control group,uremic serum groups(at the concentration of 5% and 10%), NC-containing serum groups(at the concentration of 5% and 10%),and Monopril group(at the concentration of 10-6mmol/L).Cell proliferation was measured by methylene blue assay.Cell life cycle and the percentage of cells with ?-smooth muscle actin(?-SMA)expression positive in every group were evaluated by flow cytometry.Results The optical absorption value in uremic serum groups was higher than that in the normal control group(P

[Objective]To preliminarily explore the method and evaluate the effect of volar LCP fixation for dorsally displaced and unstable distal radial fractures.[Method]Thirty-five patients with the fractures were treated with volar LCP combined with the techniques of K-wires and bone grafting, whose effects were evaluated preliminarily through comparing and analyzing the volar tilt, radial inclination, radial shortening and wrist function.[Result]Followed up from 9 to 24 months (average 17months), 20 patients achieved excellent, 12 good and 2 fair with 1 poor, according to Sarmiento scale.[Conclusion]Volar LCP fixation is a safe and effective treatment for unstable and dorsally displaced distal radial fractures, which could prevent reduction lost, reduce need for bone grafting and avoid tendon irritation.

[Objective]To compare the therapeutic effect on femoral intertrochanteric fractures with dynamic hip screw(DHS) and proximal femoral nail antirotation(PFNA).[Method]A retrospective study of 483 patients with femoral intertrochanteric fractures in Changhai Hospital from December 2001 to January 2008 were carried out.Totally 109 patients were treated with PFNA,while 374 patients were treated with DHS.The data of operative time,blood loss,walking time,union time and hip function scores were recorded.[Result]All the patients were followed up for 6～38 months(15.3 months in average).There were significant differences in operative time,blood loss and walking time between two groups.There were no significant difference in union time.There were no significant difference in the excellent rate between the two groups in stable femoral intertrochanteric fractures.The excellent rate of PFNA group was significantly higher than DHS group in unstable femoral intertrochanteric fractures.[Conclusion]Each of them have its own advantages and indications.Both are effective ways to treat stable femoral intertrochanteric fractures.PFNA has more advantages to treat unstable femoral intertrochanteric fractures.

The incidence and proportion of right colon cancer is increasingly high in recent years with a relatively poor prognosis. Right hemicolectomy is the standard procedure for the treatment of right colon cancer. Recently, infrapyloric lymph node (No.206 nodes) dissection has become one of the hot topics of surgical treatment for right colon cancer. The incidence of infrapyloric lymph node metastasis is still unclear, and whether it belongs to the regional lymph node of the right colon cancer is controversial. There are few methods to judge and predict infrapyloric lymph node metastasis, and the accuracy of diagnosis is low. What's more, dissection of infrapyloric lymph node might increase the risk of complications and perioperative mortality, as well as lead to overtreatment. As a result, this series of problems and controversies result in the obscure of the clinical value of infrapyloric lymph node dissection. Therefore, there is urgent need to design more high-quality, multicenter and large-sample prospective randomized controlled trials to explore the standard of routine dissection of infrapyloric lymph node for right colon cancer. Based on research advances at home and abroad, the authors review the incidence of infrapyloric lymph node metastasis, methods for judgement of infrapyloric lymph node metastasis, inluencing factors for lymph node metastasis, value of lymph node dissection, and research of direction in the future.

BACKGROUND:Theoreticaly, lumbar semi-rigid fixation can slow down the degeneration of adjacent segments, but there is stil a lack of biomechanical support. OBJECTIVE:To explore the biomechanical effect of semi-rigid fixation system, taking Isobar TTL for instance, on adjacent segment disc by means of finite element analysis. METHODS: The finite element models of USS and Isobar TTL were constructed by putting respective parameters into a validated L2-S5 lumbar model. The angular displacement and von Mises stress of adjacent segments were recorded when the models were subjected to 400 N preload and 7.5 N?m moment of forces under different conditions: flexion, extension, lateral bending and axial rotation. RESULTS AND CONCLUSION:The angular displacement and inter-vertebral disc stress of adjacent segments in the USS and Isobar TTL models were higher than those of an intact state in every condition. But the values in Isobar TTL model were lower than the USS model in varying degrees. Compared with the USS model, the decrease rates of angular displacement in Isobar TTL model for flexion, extension, left bending, right bending, left axial rotation and right axial rotation were 19.2%, 15.1%, 11.1%, 12.2%, 18.4% and 22.1%, respectively. The decrease rates of von Mises stress were 33.0%, 20.2%, 23.9%, 18.6%, 28.8% and 28.0%, respectively. The results suggested that the Isobar TTL, when compared with the USS, partialy reduced the angular displacement and inter-vertebral disc stress of adjacent segments.

BACKGROUND:Creation of a precise finite element model is an important basis for the finite element mechanical analysis of the spine. The reports on the precise finite element model are less.
OBJECTIVE:To create L 3-L 5 lumbar three-dimensional finite element model and validate this model with normal CT data.
METHODS:A 39-year-old male healthy volunteer with the height of 175 cm and weighted 65 kg was selected, then the L 3-L 5 lumbar spines were scanned with 16 row spiral CT to obtain 101 CT images with the thickness of 1.25 mm. Solid geometric model was established with Geomagic9.0 software, then determined the unit type,
divided the finite element mesh, and established the finite element model for loading and calculating.
RESULTS AND CONCLUSION:A L 3-L 5 lumbar three-dimensional finite element model was established. It
included 213 736 nodes and 799 779 elements. The ranges of motion of L 3-L 4 and L 4-L 5 segments of the model were consistent with cadaveric biomechanical testing results, verified the effectiveness of the model, so the
model could be used for experimental research.

BACKGROUND:For the treatment of distal tibial fractures, open reduction and plate fixation, minimal y invasive percutaneous plate fixation and intramedul ary nail fixation are effective, but each has advantages and disadvantages. OBJECTIVE:To compare the effects of intramedul ary nail combined with blocking screws versus minimal y invasive percutaneous plate fixation in treating distal tibial fractures. METHODS:Fifty-one cases of distal tibial fractures were divided into two groups. The blocking screw group (23 cases) was treated with closed reduction and internal fixation with interlocking nail combined with blocking screws. The plate fixation group (28 cases) was treated with minimal y invasive percutaneous plate fixation. Fracture healing time, recovery of tibial function and complication occurrence were observed during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 8 to 32 months. (1) Except one patient in the plate fixation group, the other patients had bony union. The healing time was (4.6±1.7) months in the blocking screw group and (6.9±2.3) months in the plate fixation group. Significant differences in healing time were detected between the two groups (P<0.05). (2) The excel ent and good rate of tibial function recovery was significantly higher in the blocking screw group (100%) than in the plate fixation group (82%) (P<0.05). (3) No significant difference in the incidence of adverse events was determined between the blocking screw group (13%) and plate fixation group (18%) (P>0.05). (4) Results suggested that interlocking intramedul ary nail combined with blocking screw fixation in the treatment of distal tibial fractures can promote fracture healing and joint function recovery.

Objective To explore the effect of anterior decompression plus posterior intradural release in treatment of old thoracolumbar fractures with paraparesis. Methods A total of 22 patients with old thoracolumbar fractures with paraparesis were admitted to our hospital since January 2004 to Jan-uary 2008. Before admission, all patients were treated with decompression and internal fixation with pos-terior pedicle system, with bony compression to the spinal cord found through CT scanning and intact spi-nal cord found by MRI but without obvious neurofunction recovery. Of all, 20 patients were kept with the original posterior fixation except for two patients that were fixed with Z-plate after removal of posterior hardware. Autologous bone grafts from iliac were utilized in all patients. Intradural release was done 3-6 months after anterior decompression. Results Of all, 19 patients were followed up for 17-49 months (average 28 months). Twenty patients obtained varied recovery of neurofunction after anterior decompres-sion, with ASIA motor scores increasing from average 59.4 points before decompression to 71.3 after de-compression. The followed-up patients won further recovery after secondary posterior intradural release, with ASIA motor scores further increasing to average 80.6 points. Conclusion For patients with old thoracolumbar fractures combined with paraparesis, the release of intradural sear and fibrocompression is also important besides anterior decompression.

Objective To prepare mouse model with heat stress and determine its pathological changes of the lung and brain during heat stress. Methods BALB/c mouse were randomly (random number) divided into two groups, control group and heat stress group. The animals in the control group were sham- heated at a temperature of ( 25 ± 0.5) ℃ and humidity of (35 ± 5 ) %. The animals of heat stress group were placed in a prewarmed incubator maintained at (35.5 ± 0.5) ℃ and relative humidity of (60 ± 5) %. Rectal temperature (Tc) was monitored, and when Tc respectively reached 39 ℃, 40 ℃ , 41 ℃ and 42 ℃, those study animals were killed. The other animals were removed from the incubator and allowed to cool at an ambient temperature of (25 ±0. 5)℃ and humidity of (35 ±5)% , respectirvely for 12 and 24 hrs when Tc reached 41 ℃ , and for 6 hrs when Tc reached 42 ℃. The lung and brain of all the animals were isolated. Hematoxylin and eosin stain and light microscope were used to detect their pathological changes. Results All the animals displayed uniform response to the heat stress. Low degree of heat stress could induced obviously pathological changes of the lung, progressively greater damage to lung with further congestion of lung matrix, asystematic hemorrhage of alveolar space, abscission of alveolar epithelial cell and disappear of pulmonary alveolus tissue structure were detected with the rise of Tc to 42 ℃. However, absorption of congestion and hemorrhage and recovery of pulmonary alveolus tissue structure could also be seen with cooling at ambient temperature. With low degree of heat stress, the brain only showed moderate edema. Neuronal denaturation and necrosis were detected when Tc reached to 42 ℃. Interestingly, the lesions of brain further aggravated even through cooling treatment after Tc reached to 42 ℃ , but recovery could been observed after cooling treatment followed with Tc of 41 ℃. Conclusions The pathological changes of the lung and brain showed distinctive lesions to heat stress and cooling treatment, and these changes were correlated with the timing and time of cooling treatment, which provide the experimental basis to further study the mechanisms between the heatstroke and multiple organ dysfunction syndrome (MODS).

Objective To explore surgical methods and their efficacy for post-traumatic Made-lung deformity complicated with dorsal or volar angulation in the adults. Methods Volar plate or exter-nal fixator, combined with the techniques osteotomy and bone grafting, were selected to treat adult pa-tients with post-traumatic Madelung deformity complicated with dorsal or volar angulation. The effects were preliminarily evaluated through comparing the volar tilting angle, ulnar inclination, radial shortening and the range of joint motion before and after the operation. Results All the patients were followed up for 6-27 months (mean 16 months). The volar tilting angle, radial inclination, radial shortening, range of joint motion of all patients were improved significantly (P<0.05). Conclusions For patients with Madelung deformity complicated with dorsal angulation, internal fixation of volar plate combined with volar osteotomy and bone grafting is recommended; while dynamic eternal fixator combined with combined with dorsal osteotomy and bone grafting is an ideal choice for patients with Madelung deformity complicated with volar angulation.