Objective: To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle. Methods: The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs, Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018. They were 9 males and 7 females, aged from 27 to 78 years (average, 51.5 years). By the Schatzker classification, there were 2 cases of type Ⅰ, 8 cases of type Ⅱ, 3 cases of type Ⅲ and one case of type Ⅳ; by the cross classification, there were 10 cases of type Ⅰe, one case of type Ⅱe and 2 cases of type Ⅲe and 3 cases of type Ⅰv. The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015. The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution; the widened distance of the lateral tibial plateau, collapse depth of the tibial plateau, separation of avulsion fracture of medial femoral condyle, maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group. Results: In the observation group, the widened distance of the lateral tibial plateau averaged 7.18 mm, the collapse depth of the tibial plateau 8.74 mm, the separation of avulsion fracture of medial femoral condyle 3.44 mm, the maximum clearance of the medial knee 7.77 mm, and the eversion angle of the tibial plateau 87.03°. There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P=0.002). In the observation group, the average widened distance of the lateral tibial platea for the 13 type e patients (8.49±4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51±2.11 mm) (t=2.706, P=0.017). Conclusion The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv. The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.

Objective To investigate the effects of negative pressure wound therapy (NPWT) on the expression of EDA+ FN in granulation tissues of human diabetic foot wounds.Methods Forty patients with diabetic foot wounds fitting the inclusion criteria,admitted from Jan.2014 to Jun.2016,were randomly and equally apportioned to receive either NPWT or conventional gauze therapy (control) for 14 days.Granulated tissue biopsies were collected before (0 day) and after (14 day) treatment in both groups.All biopsies were subdivided into two parts.One part was preserved in 4％ paraformaldehyde for immunocytochemical staining of EDA+FN,and the other part was stored at-80 ℃ for Western blotting and PCR analysis of EDA+FN.Results The immunohistochemical analysis revealed that the mean area density of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of mean area density was higher in NPWT group than in control group (P＜0.01).Western blotting showed that the relative protein levels of EDA+FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of relative protein levels of EDA+FN was higher in NPWT group than in control group (P＜0.01).The real time PCR analysis demonstrated that the relative mRNA levels of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of relative mRNA levels of EDA+ FN was higher in NPWT group than in control group (P＜0.01).The results demonstrated the higher protein and mRNA levels of EDA+FN in NPWT group than that in control group.Conclusion NPWT obviously enhances EDA+FN expression in granulation tissue of diabetic foot wound,as a result promotes wound healing.

Objective To evaluate the efficacy and safety of single bolus high dose (SD group) ATG-Fresenius induction therapy in kidney transplantation vs.multiple low dose (MD group) administration.Methods A multiple center,prospective,randomized and controlled clinical study was performed on 280 de novo renal transplant recipients from 19 centers.Patients were randomized into 2 groups as follows:SD group,a single high dose (7-9 mg/kg) of ATG-F infused as an induction agent before the vessel anastomoses;MD group,2 mg/kg of ATG-F daily administrated in postoperative 4 days.All the patients accepted maintenance immunosuppressive protocol including tacrolimus,mycophenolate and prednisone.Patients were assessed and data were collected at regular schedule clinic visits on the day 1,3,7,14,30,90,180,270 and 365.The primary end point of efficacy was therapeutic failure rate [the number of death,grafts loss and acute rejection (AR)].The event first occurred should be used in the classification of patients.The non-inferiority evaluation of the two treatment regimens was done based on treatment failure rate.The secondary end points of efficacy were the incidence of AR,delayed graft function (DGF),1-year survival rate of patients and grafts,and serum creatinine at each visiting point.The indicators for safety evaluation included hemotologic variation and incidence of adverse events.Results The therapeutic failure rate in SD group was non-inferior to the MD group (17.24％ vs.23.08％).AR was the major cause of therapeutic failure and there was similar incidence of AR between SD gronp and MD group (12.07％ vs.21.37％).There was no significant difference in the incidence of DGF between SD group and MD group (12.07％ vs.6.84％,P =0.1721).The 1-year patient's survival rate and 1-year graft survival rate in SD group and MD group showed no significant difference (96.55％ vs.98.29％,P =0.6714;94.83％ vs 98.29％,P =0.2750).The serum creatinine level showed no significant differences between two groups at each visit point.There was also no significant difference in total incidence of adverse events between the two groups.In addition,there was also no statistically significant difference in the incidence of concerned and drug-related adverse events between the two groups,including infection,hemotologic abnormality,liver or renal dysfunction,gastrointestinal disorder,etc.After ATG--F administration,peripheral blood lymphocytes in the SD and the MD group immediately decreased but nearly restored to the normal level on the postoperative day 30 and 90 respectively.No severe granulocytopenia,erythropenia or thrombocytopenia occurred in both two groups.Conclusion The efficacy and safety of single high dose of ATG-F induction are non-inferior to multiple low dose ATG-F induction,moreover,single high dose of ATG-F induction is administered more conveniently and economically.

Objective:To study the effect of calcium sodium phosphosilicate(CSP)on the enamel remineralization of primary teeth. Methods:30 extracted human healthy primary molars were collected.Each tooth was cut bucco-lingually and mesial-distally into 4 sections.The sections were assigned randomly into 4 groups(n =30).Demineralization and remineralization cyclic model was estab-lished by etching with 35% phosphate acid for 2 min and then treated by unexposure of the sample to nothing(control,group A),so-dium monofluorophosphat(MFP,group B),CSP(group C)and MFP +CSP(group D).The cyclic was repeated twice daily for 30 d. The enamel surface morphology was observed by SEM and the surface microhardness(SMH)was measured.Results:On the tenth day,squamous morphology was observed on the enamel surface of group A and that of group D appeared less demineralization.The SMH value of group D was significant higher than that of group A(P <0.05).On the thirtieth day,obvious demineralization was ob-served in group A.Group B,C and D appeared surface remineralization.The SMH value of group B,C and D was significant higher than that of group A(P <0.05).Highest SMH value was achieved in group D.Conclusion:CSP combined with fluoride is more ef-fective in the enamel remineralization of primary teeth than the single application of them.

BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.

Objective To compare the effects of peripatellar peripheral nerve partially and totally depolarized in total knee arthroplasty (TKA). Methods 66 TKA patients were divided into partially depolarized group (A, 42 knees) and totally depolarized group (B, 38 knees). The scores of knee-joint, Feller and Visual Analogue Scale were recorded. Results There was no significant difference in all the scores between 2 groups before operation (P>0.05). All the scores improved after operation (P<0.05), however, there was still no significant difference between 2 groups (P>0.05). Conclusion Patellar peripheral nerve partially depolarization technique can reduce postoperative knee pain, which has the same effect with totally depolarization.

Objective To investigate the effects of clearing liver and purging the heart decoction( CLPHD) combined with methimazole on hormone levels in hyperthyroid rats. Methods Rats were administered with levothyroxine (600 μg·kg-1 ) for 3 weeks to establish the hyperthyroid model,and the serum contents of T3,FT3,T4,FT4,TSH and TRAb in hyperthyroid rats treated with CLPHD combined with methimazole were detected. Results Methimazole, CLPHD, and the combination therapy significantly reduced food intake,water intake and body temperature of the hyperthyroid rats. All treatments reduced levels of FT3, T4 and FT4 in hyperthyroid rats. Compared with the CLPHD mono-therapy, the combination therapy significantly lowered serum T4 in hyperthyroid rats,but not the TRAb level. Conclusion CLPHD combined with methimazole can obviously improve the function of thyroid gland in hyperthyroid rats.

BACKGROUND:Compared with bone marrow and autologous peripheral blood stem cells, umbilical cord mesenchymal stem cells are characterized as more primitive, more powerful amplification and lower immunogenicity, no ethical problems, which are more important to the elderly patients with diabetes mel itus. OBJECTIVE:To evaluate the efficacy and safety of umbilical cord mesenchymal stem cells transplantation in the treatment of the elderly patients with diabetic lower limb vascular disease. METHODS:Fifty-six elderly patients with diabetic lower limb vascular disease were randomly divided into observation group and control group. The control group was treated with conventional therapy, while the observation group was treated with umbilical cord mesenchymal stem cells transplantation. RESULTS AND CONCLUSION:Observation group showed a higher efficiency than the control group, with significant difference (P<0.05). After treatment, foot skin temperature, transcutaneous oxygen pressure, and ankle brachial index were al improved in both two groups, and the ankle brachial index showed a better value in the observation group (P<0.05). There were no significant adverse reactions in the two groups. Umbilical cord mesenchymal stem cells transplantation is a simple, safe and effective therapy for the elderly patients with diabetic lower limb vascular disease, with better short-term curative effect.

OBJECTIVE: To evaluate the safety, effectiveness and complications of serial invasive prenatal diagnostic techniques, and to investigate the prenatal diagnosis indication as well as to analyze the abnormal chromosomal karyotype. METHODS: We retrospectively studied all patients from March 2005 to May 2012 who received amniocentesis and cordocentesis in the prenatal diagnosis center of Second Xiangya Hospital. The indication of the procedure, successful rate and complications were evaluated, and 25 abnormal chromosome nuclear types were analyzed. RESULTS: A total of 669 patients received invasive prenatal diagnosis from March 2005 to May 2012 in Second Xiangya Hospital: 598 received amniocentesis and 71 cordocentesis carried out. Compared with the cordocentesis group, the amniocentesis group had higher achievement ratio (91.54% vs 100%, P<0.05), lower spontaneous abortion rate (1.41% vs 0.33%, P<0.05), fewer abnormal karyotypes (11.27% vs 2.84%, P<0.05) and lower expenditure (880 yuan vs 800 yuan, P<0.05). Positive screening, advanced maternal age, and ultrasonography abnormality were the top 3 indications of amniocentesis and cordocentesis. We found 25 abnormal karyotypes, including 6 cases of trisomy 21, 4 sex chromosomal abnormalities, 7 autosomal balanced translocations, 1 marker chromosome, and 7 mosaics. CONCLUSION As a widely used invasive prenatal diagnosis, amniocentesis is safe and effective. The complications of cordocentesis are much higher than those of amniocentesis, which is not a proper routine procedure for prenatal diagnosis of abnormal karyotype. The analysis of karyotype not only can identify fetal chromosome abnormality, but also provide the scientific basis for pregnancy continuation, thus reducing the ratio of birth defect.
Abnormal Karyotype ; statistics & numerical data ; Adult ; Amniocentesis ; methods ; Cordocentesis ; adverse effects ; methods ; Evaluation Studies as Topic ; Female ; Humans ; Karyotyping ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Retrospective Studies

ObjectiveTo investigate the risk factors of metabolic syndrome ( MS ) in obese subjects.Methods A seven-year follow-up study was conducted in 413 simple obese subjects and 196 subjects with normal body weight who were recruited from community residents during physical examination in 2000.There was a 7 years follow-up.Anthropometrics,blood pressure,lipid profile,fasting blood glucose,and 2 h blood glucose after glucose loading were measured.Endothelium-dependent dilatation (EDD) test was also performed.Results Among 553 of 609 subjects who were followed up in 2007,there were 381 simple obese subjects ( simple obese group) and 172 normal weight subjects( normal weight group).Seven-year cumulative incidence of MS was 35.17％ in simple obese group and 8.14％ in normal weight group.In simple obese group,subjects with MS showed greater or higher levels of waist circumference( WC ),waist-hip ratio ( WHR ),triglyceride ( TG ),fasting plasma glucose ( FPG ),fasting insulin (FINS),and homeostasis model assessment for insulin resistance index (HOMA-IR) (all P＜0.05 ),and also decreased EDD( P＜0.05 ) as compared with those without MS.WC,WHR,and FINS were higher( all P＜0.05 ) and EDD was lower( P＜0.05 ) in subjects with MS of normal weight group than those without MS.Logistic analysis showed that the male gender,WC,WHR,FPG,HOMA-IR,and EDD were major risk factors of MS.Conclusion Central obesity,insulin resistance,and endothelial dysfunction are important independent risk factors for development of MS.