OBJECTIVETo discuss arthroscopic technique of single Kirschner wire and suture avoiding epiphyseal line fixation for tibial intercondylar eminence fracture and its clinical results.

METHODSFrom May 2008 to December 2012, 21 patients (13 males, 8 females, ranging in age from 6 to 14 years old) with tibial intercondylar eminence fracture were treated arthroscopically with single Kirschner wire and suture avoiding epiphyseal line fixation technique. According to Meyers and McKeever classification, 7 patients were type II, 10 patients were type III, and 4 patients were type IV. Active rehabilitation began at one week after operation. The patients were followed up for 10 to 30 months. X-ray films were taken to evaluate fracture healing at 1, 3, 6 months after operation; range of motion, the anterior drawer test, the lachman test and the Lysholm knee score were used to evaluate clinical effects.

RESULTSAll fractures were healed without displacement at 6 weeks after operation. Anterior drawer test and the lachman test were both negative in all patients at 3 months after operation. Lysholm knee score was 95.5 ±2.5 at 6 months after operation, and postoperative X-ray film did not find epiphyseal line broadening or narrowing.

CONCLUSIONArthroscopic treatment for tibial eminence intercondylar fracture with single Kirschner wire and 8-shaped suture avoiding epiphyseal line fixation technique has many advantages, such as firm fixation,early mobilization, less invasive, less injury of physis and satisfactory effect.

Adolescent ; Arthroscopy ; Bone Wires ; Child ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Sutures ; Tibial Fractures ; surgery

Aging ; genetics ; metabolism ; Animals ; Diabetes Mellitus ; enzymology ; metabolism ; Humans ; Longevity ; genetics ; physiology ; Neoplasms ; enzymology ; metabolism ; Neurodegenerative Diseases ; enzymology ; metabolism ; Obesity ; enzymology ; metabolism ; Sirtuins ; genetics ; metabolism

Objective To study the recogniting patients identity for the safety and reliability of radiotherapy. Methods Through PDCA 4 footwork, namely, plan, do, check, action the technicians in the hospital to improve patients' identity verification.Results After 4 months of PDCA cycle,the patient identity verification qualified rate increase gradually,from 88.17% up to 99.07%,the privacy of patients satisfaction rate rose from 52. 69% to 98. 15%. The patients identification accuracy rate of 100%, technicians working efficiency has been greatly improved. Conclusions The measure of patient identification can improve the working process of radiotherapy for safety and efficiency and can get better privacy protection.

Variant pulmonary vein anatomy (PVA) has been reported to influence the recurrence of atrial fibrillation (AF) after radiofrequency ablation.However,the effects of PVA on AF in patients undergoing cryoballoon ablation (CBA) remain unknown.The present study aimed to examine the impact of PVA on the long-term outcome of CBA for AF.A total of 78 patients (mean age 60.7±10.9 years,64.1％ males) with symptomatic and drug-refractory paroxysmal AF were enrolled in the study.Left atrium (LA) and PVA acquired at computed tomography angiography (CTA) were reconstructed with CARTO(R) 3 SYSTEM.Patients were routinely evaluated by 24-hour Holter monitoring following CBA.Cox regression was used to detect the predictors of AF recurrence after CBA.The results showed abnormal PVA in 30 patients (38.5％) and 18 patients (23.1％) had left common PV (LCPV).Electrical pulmonary vein isolation was achieved in all patients.After a mean follow-up of 689.5±103.8 days,it was found that patients with abnormal PVA had similar AF recurrence rate to those with normal PVA (26.7％ vs.25.0％,P=0.54),and there was no significant difference in AF recurrence rate between LCPV patients and non-LCPV patients (33.7％ vs.23.3％,P=0.29).Cox regression analysis showed that AF duration (72.9±9.0 vs.42.3±43.2 months,HR 1.001;95％CI 1.003-1.014;P＜0.001) and cryo-applications of right-side PVs (3.0±1.6 vs.4.7±1.7,HR 0.661;95％ CI 0.473-0.925;P=0.016) were independent predictors of freedom from AF,but PVA was not identified as a predictor of long-term success.In conclusion,the variant PVA cannot significantly influence the long-term outcome of AF patients undergoing CBA;longer AF duration and less cryo-applications of right-side PVs are associated with higher AF recurrent rate.

Objective To investigate the changes of the expressions of ATP-binding cassette transporter A1(ABCA1)and the retinoid X receptor(RXR?in human carotid atherosclerotic plaques and to explore the possible mechanisms by which ABCA1 affects the formation of carotid atherosclerosis(CAS). Methods 24 carotid atherosclerotic plaque and 10 intestinal artery specimens were respectively collected to compared the expression levels of ABCA1 mRNA.RXR?mRNA and those protein,ABCA1 and RXR?gene expressions were determined by reverse transcriptase polymerase chain reaction(RT-PCR)in the specimens,meanwhile the presence of ABCAI and RXRcprotein was assessed by Western blot.Results ABCA1(0.79?0.04)and RXR?(0.73?0.04)gene expression were significantly elevated in carotid atherosclerotic plaques(P

OBJECTIVETo summarize the clinical and computed tomographic(CT) findings of tuberous sclerosis(TS) associated with hepatic and renal angiomyolipomas.

METHODWe retrospectively analyzed the clinical and CT findings of 7 TS patients with hepatic and renal angiomyolipomas.

RESULTSBrain CT showed calcified nodules and/or the uncalcified nodule in the lateral ventricle subependymal in 7 patients. Abdominal CT showed bilateral renal angiomyolipomas in 7 cases and hepatic angiomyolipomas in 2 cases. Chest CT showed lymphangioleiomyomatosis in one case.

CONCLUSIONSTS associated with merger hepatic and/or renal angiomyolipomas have typical CT findings. Liver angiomyolipomas shows certain correlation with bilateral renal angiomyolipomas.

Adolescent ; Adult ; Angiomyolipoma ; complications ; diagnostic imaging ; Female ; Humans ; Kidney Neoplasms ; complications ; diagnostic imaging ; Liver Neoplasms ; complications ; diagnostic imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberous Sclerosis ; complications ; diagnostic imaging ; Young Adult

OBJECTIVELooking for an objective biomedical index to distinguish types and phases of hemangioma in order to provide an objective basis for selecting clinical treatment to hemangioma.

METHODSELISA (enzyme-linked immunosorbent assay) was used to determine serum VEGF concentration of 15 patients with proliferative hemangioma, 6 with involuted hemangioma, 6 with vascular malformation and 8 infants of the control group.

RESULTSThe serum VEGF concentrations of 15 proliferative hemangioma patients were significantly higher than those of involuted hemangioma patients, vascular malformation patients and control group infants. The serum VEGF concentrations of involuted hemangioma patients were a little bit higher than those of vascular malformation patients and control group infants, but without statistic significance.

CONCLUSIONSELISA could easily and accurately determine the serum VEGF concentration of different types and different phases of hemangioma. The determination of serum VEGF concentration could provide guidance for selecting a protocol of systemic corticosteroid treatment for proliferative hemangioma. Combined with gene expression and distribution of VEGF and its receptors and some other cytokines, the determination of serum VEGF concentration could help elucidate the mechanism of proliferative hemangioma.

Endothelial Growth Factors ; blood ; Enzyme-Linked Immunosorbent Assay ; Hemangioma ; blood ; Humans ; Infant ; Lymphokines ; blood ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

OBJECTIVETo investigate the effects of endothelial microvesicles (EMVs) induced by calcium ionophore A23187 on H9c2 cardiomyocytes.

METHODSHuman umbilical vein endothelial cells (HUVECs) were treated with 10 micromol/L A23187 for 30 min. EMVs from HUVECs were isolated by ultracentrifugation from the conditioned culture medium. EMVs were characterized using 1 and 2 microm latex beads and anti-PE-CD144 antibody by flow cytometry. For functional research, EMVs at different concentrations were cocultured with H9c2 cardiomyocytes for 6 h. Cell viability of H9c2 cells and the activity of LDH leaked from H9c2 cells were tested by colorimetry. Moreover, apoptosis of H9c2 cells was observed through Hoechst 33258 staining and tested by FITC-Annexin V/PI double staining.

RESULTSEMVs were induced by A23187 on HUVECs, and isolated by ultracentrifugation. We identified the membrane vesicles (< 1 microm) induced by A23187 were CD144 positive. In addition, the EMVs could significantly reduce the viability of H9c2 cells, and increase LDH leakage from H9c2 cells in a dose dependent manner (P < 0.05). Condensed nuclei could be observed with the increasing concentrations of EMVs through Hoechst 33258 staining. Furthermore, increased apoptosis rates of H9c2 cells could be assessed through FITC-Annexin V/PI double staining by flow cytometry.

CONCLUSIONMicrovesicles could be released from HUVECs after induced by A23187 through calcium influx, and these EMVs exerted a pro-apoptotic effect on H9c2 cells by induction of apoptosis.

Annexin A5 ; Apoptosis ; Calcimycin ; pharmacology ; Calcium ; metabolism ; Cell Line ; Cell Membrane ; drug effects ; Coculture Techniques ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; Human Umbilical Vein Endothelial Cells ; Humans ; Myocytes, Cardiac ; drug effects ; Staining and Labeling

Objective To evaluate distractor-assisted reduction for Lisfranc injury complicated with compressive fracture of lateral foot column.Methods A retrospective study was conducted of the 18 patients who had been treated surgically at Department of Foot and Ankle Surgery,Zhengzhou Orthopaedics Hospital between May 2014 and March 2017 for Lisfranc injury complicated with compressive fracture of lateral foot column.They were 10 males and 8 females,with an average age of 38.4 years (from 25 to 65 years).The injury involved the right foot in 11 cases and the left foot in 7.Their concomitant injuries were 12 compressive cuboid fractures and 6 compressive fractures of the calcaneal anterior process.According to the Chiodo-Myerson classification,there were 13 cases of three-column injury,3 ones of middle-lateral column injury and 2 ones of medial-lateral column injury.All the injuries were closed.After the condition of foot soft tissues permitted,open reduction assisted by a distractor and internal fixation with a mini locking plate was performed.Functional outcomes were assessed according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scores and visual analogue scale (VAS) at the final follow-ups and complications during follow-up.Results The 18 patients were followed up for one to 4 years (average,2 years).Their AOFAS hindfoot-ankle scores ranged from 55 to 96 points (average,80.4 points);their VAS ranged from 0 to 6 points (average,1.5 points).Radiographic evidence of degeneration was noted in 10 patients.Of them,2 reported persistent pain which was cured by arthrodesis after conservative therapy failed and one presented with symptoms of injury to sural and cutaneous nerves which disappeared after oral administration of neurotrophic drugs for half a year.No such complication as skin necrosis,infection or implant failure occurred in other patients.Conclusion Open distractor-assisted reduction and internal fixation of lateral foot column with a mini locking plate,combined with bone graft if necessary,is an effective treatment for Lisfranc injury complicated with compressive fracture of lateral foot column,because it can effectively restore the alignment of lateral column and result in satisfactory therapeutic effects.

Objective To evaluate the surgical treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation.Methods From February 2014 to June 2017,15 patients (15 feet) with intra-articular calcaneal fracture associated with peroneal tendon dislocation were treated at Department of Foot and Ankle Surgery,Orthopaedics Hospital of Zhengzhou.There were 9 males (9 feet) and 6 females (6 feet),and 8 left feet and 7 right feet.The patients were aged from 20 to 55 years (average,42.5 years).After reduction of calcaneal fractures,titanium plates and screws were used for fixation.The bone canal was established on the lateral malleolus,and the torn superior peroneal retinaculum was fixed to the lateral malleolus by suture after reduction of the peroneal tendon.The ankle joint was immobilized with a plaster brace in the metatarsal flexion for 6 weeks.The postoperative outcomes were evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS) score and visual analogue scale (VAS);complications were recorded.Results All the 15 patients were followed up for 12 to 36 months (average,20.5 months).All the calcaneal fractures fully healed and no re-dislocation of the peroneal tendon occurred.The AOFAS hindfoot-ankle scores ranged from 80 to 95 points,averaging of 87.4 points;the VAS scores ranged from 0 to 5 points,averaging 1.5 points.Delayed wound healing was observed in one case but primary healing was achieved eventually with regular dressing change.Another case presented with symptoms of injury to the cutaneous branch of the sural nerve which disappeared after oral administration of neurotrophic drugs for 6 months.Another case suffered from subtalar arthritis accompanied by persistent pain which disappeared after subtalar arthrodesis.No other complications were observed in the other patients.Conclusion In the surgical treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation,the peroneal tendon dislocation should be treated simultaneously with the intra-articular calcaneal fracture to achieve satisfactory clinical outcomes.