OBJECTIVETo study modified ilioinguinal approach through the retrospective analysis on the surgical treatment of 63 patients with pelvic and acetabular fractures through anterior approach.

METHODSFrom January 2006 to January 2013, 63 patients with pelvic and acetabular fractures were treated with the ilioinguinal anterior approach, including 45 males and 18 females, ranging in age from 12 to 68 years old, with an average of (37.71 +/- 13.41) years old. All the patients were divided into two groups: standard ilioinguinal anterior approach group (group A) and modified ilioinguinal anterior approach group(group B). In group A, there were 26 males and 11 females, with an average age of (38.49 +/- 13.64) years old. In group B, there were 19 males and 7 females, with an average age of (36.62 +/- 13.29) years old. Intraoperative and postoperative indicators in group A and B were observed and compared, including operation incision exposure time (from skin incision to complete the ilioinguinal in front of three "windows"), the blood loss, incision close time and treatment effect of Majeed function score.

RESULTSCompared to group A, the incision exposure time of patients in group B was shorter, the blood loss (bleeding during exposure process) was less, and the close incision time was shorter, but the treatment effect of Majeed function score had no significant differences between two groups. All the patients were followed up, and the during ranged from 3 to 36 months, with an average of (18.6 +/- 9.2) months. According to Matta standard assessment reduction of pelvic and acetabular fracture, there were 28 patients got an excellent result, 8 good, and 1 fair in the group A; and 20 patients got an excellent result, 5 good, and 1 fair in the group B. According to Majeed function score for hip function, 20 patients got a satisfactory result, 12 good,4 fair and 1 poor in group A, and the mean score was 82.51 +/- 9.72; and 13 patients got an satisfactory result, 10 good, 3 fair and 0 poor in group B, and the mean score was 80.54 +/- 10.79.

CONCLUSIONThe modified approach has several advantages as follows: providing a good surgical exposure; preventing from the injury of femoral nerve, femoral artery and vein under the inguinal ligament; not needing to open the inguinal canal, which can avoid the occurrence of inguinal hernia, reduce operation prodedures and shorten operation time.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the effect and safety of Nuanxin Capsule (NXC) in treating patients with chronic heart failure (CHF).

METHODSAdopting the randomized, positive controlled, double-blinded design, 150 CHF patients were assigned to the treatment group and the control group equally, they were treated with optimal western medical therapeutic scheme in combining respectively with NXC and placebo for 24 weeks. The indices for effectiveness and safety evaluation, such as Chinese medicine syndrome, grade of heart function, myocardial contraction, as well as the re-hospitalization rate and mortality, were observed.

RESULTSThe total effective rate on heart function in the treatment group and the control group was 78.87% and 64.38% respectively, that on Chinese medicine syndrome was 85.9% and 63.0% respectively, comparisons of the two indices between the two groups all showed significant difference (P < 0.05, P < 0.01). And a better efficacy for improving patients' cardiac contraction function and quality of life was shown in the treatment group (P < 0.05, P < 0.01). The re-hospitalization rates in them were 23.9% and 53.4% respectively (P < 0.05), and 22.54% and 42.5% of the re-hospitalized patients had attack of acute heart failure, a significant difference was found between the two groups (P < 0.05). The mortality in them was 2.90% and 8.95% respectively, showing no significant difference between groups (P > 0.05). No obvious adverse effect was found in both groups.

CONCLUSIONSNXC could improve the heart function of patients, it has obvious curative effect and good safety in treating chronic heart failure.

Aged ; Aged, 80 and over ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

Objective To explore the effects of endoplasmic reticulum stress response(ERS) and its related apoptosis on dopaminergic neurons death.Methods NGF treated-PC12 cells were treated with 6-OHDA,MPP+ and rotenone.MTT assay and flow cytometry were used to measure the cell viability and the rate of cells apoptosis induced by those neurotoxins at different concentrations and times.The expressions of ERS-related gene XBP1,Grp78,CHOP,caspase-12 in drug-treated group and reserpine preincubation group were determined by RT-polymerase chain reaction(RT-PCR) and immunohistochemistry.Results After exposing to different concentration toxins,the vitality of PC12 cells was decreased by 52% at 100?mol/L 6-OHDA,by 44% at 75?mol/L MPP~+,and by 40% at 20 nmol/L rotenone for 24 hours respectively and ws decreased in a dose dependent manner. FCM assay confirmed time-dependent cell apoptosis.The apoptotic cells ratio of 24 h groups were (31.22?3.21)%,(27.46?2.35)%,(29.26?2.53)%,respectively(P＜0.01).In 6-OHDA groups,the gene expressions of XBP1,Grp78 were approximately 2-fold increased after 8 h exposure, CHOP reached peak level at 16 h(149.5?3.3% vs 35.9?1.8%,P＜0.01).The transcription level of caspase-12 was significantly higher than normal control at 16h[(95.4?2.8% vs(23.8?3.0)%, P＜0.01],but was alleviated by reserpine prcincubation(62.15?4.3%,P＜0.05).The increased expressions of Grp78 and CHOP after drug exposure were confirmed by immunochemistry stain.The similar results were observed in MPP~+ and rotenone groups.Conclusions The excessive ERS and ERS-activated cell apoptosis pathway may be involved in selective death of dopaminergic neurons.

AlM: To study the clinical effect of the application of microscopic pterygium resection combined with different concentration of mitomycin C ( MMC) .
METHODS:A total of 110 cases of pterygium patients (120 eyes) were randomly divided into control group (58 eyes) and observation group (62 eyes) according to the odd and even number method. The control group adopted the pterygium resection combined 0. 3mg/mL MMC, and the observation group was given pterygium resection combined 0. 2mg/mL MMC. The cure rate and the recurrence rate, eyesight before and after the treatment, two groups of cornea and sclera wound healing situation, the incidence of postoperative complications were compared.
RESULTS: The cure rate and recurrence rate of the control group was 84. 5% and 15. 5% respectively, and the observation group was 93. 6% and 6. 5% respectively, the differences were statistically significant (P<0. 05). There were statistical differences of vision of the two groups before and after treatment (P<0. 05), and there were no statistical differences of the two groups between the two groups after treatment (P>0. 05). The cornea, sclera, wound healing time of the observation group were less than the control group, and there were statistical differences between the two groups ( P < 0. 05 ). The incidence of complications was 13. 8% in the control group and 3. 2% in observation group, with statistically significant difference (P<0. 05).
CONCLUSlON: The application effect of microscopic pterygium resection combined with MMC is remarkable, and the joint of 0. 2mg/mL concentration of MMC is more safe and effective, and is worth popularizing in clinical application.

This study is to report the establishment of an UPLC-MS/MS method for the determination of plasma concentration of UA carried in self-microemulsifying drug delivery system (SMEDDS) and its pharmacokinetics in rats. It was used for determination and analysis when serum with internal standard was extracted from C18 solid-phase column. Acquity UPLC BEH C18 column (100 mm x 2.1 mm, 1.7 microm) was used for separation. The mobile phase was acetonitrile -0.1% ammonia with gradient elution at the flow rate of 0.2 mL x min(-1). The column temperature was 40 degrees C and the detection wave length was 210 nm. It was detected by negative ion using electrospray ionization source (ESI) and scanned by multiple reaction ion monitoring (MRM) mode. The liner relationship of UA was very good in the range of 1.19-3 815.00 ng x mL(-1) (r = 0.999 0). Recovery rate of different concentrations were 87.42%-89.95%. The precision of inter-day and intra-day were less than 11%. The method developed in our study was proved to be sensitive, rapid and simple. It is suitable for the pharmacokinetic study of UA-SMEDDS in rats.
Animals ; Chromatography, High Pressure Liquid ; Drug Delivery Systems ; Emulsions ; chemistry ; Rats ; Tandem Mass Spectrometry ; Triterpenes ; blood ; pharmacokinetics

OBJECTIVETo evaluate the clinical efficacy of autologous semitendinosus and gracilis tendon grafting with anchor repair for the treatment of chronic achilles tendon rupture and severe scarring.

METHODSFrom April 2010 to October 2012,26 patients with chronic achilles tendon rupture(with Myerson type III ) and severe scarring were treated with autologous semitendinosus and gracilis tendon grafting with anchor repair. There were 19 males and 7 females,with an average age of 32 years old (ranged, 22 to 47 years). The time from injury to surgery was from 3 to 12 months (7 months on average). The plantar flexion strength of all injuried feet attenuated and single heel rise test were positive in 26 cases before operation. Plaster immobilization and routine rehabilitation therapy were performed after operation. Clinical effects were evaluated by Arner-lindholm criterion and complications were observed after operation.

RESULTSAll the patients were followed up from 12 to 24 months with a mean of 16 months. No complications such as achilles tendon re-rupture, wound infection, etc were found during follow-up period. According to the Arner-Lindholm standard, 15 cases got excellent results and 11 good.

CONCLUSIONUsing autologous semitendinosus and gracilis tendon grafts with anchor repair to treat chronic achilles tendon rupture and severe scarring is a perfect surgical procedure.

Achilles Tendon ; injuries ; surgery ; Adult ; Chronic Disease ; Cicatrix ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rupture ; Young Adult

OBJECTIVETo investigate the feasibility and therapeutic effect of free posterior interrosseous artery flap in a bridge fashion for combined skin and bilateral artery defects at palmar side of fingers.

METHODS6 cases with combined skin and bilateral artery defects at palmar side of fingers were treated with long-pedicled free posterior interrosseous artery flap in a bridge fashion. The flap size ranged from 3.5 cm x 2.0 cm to 6.5 em x 3.0 cm. The wounds at donor sites were closed directly.

RESULTSAll the 6 flaps survived completely without any complication, and the wounds healed primarily. The blood supply and vein drainage in all the 6 fingers were normal. 4 cases were followed up for 1-12 months (average, 7 months). Satisfactory cosmetic and functional results were achieved. The flaps looked a little bit thicker than the surrounding tissue.

CONCLUSIONSThe long-pedicled free posterior interrosseous artery flap in a bridge fashion is a good option for reconstruction of the combined skin and bilateral artery defects at palmar side of fingers in one stage.

Arteries ; Feasibility Studies ; Fingers ; blood supply ; surgery ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply ; transplantation ; Transplant Donor Site ; surgery ; Veins

OBJECTIVEThrough observation of the tissue structures of internal organs and skin of Whitmania pigra, to provide basic method for identification of W. pigra and research of its physiological functions.

METHODThis experiment adopted the W. pigras as the material and carried on dissection observing,and W. pigra's cavity, swallow, esophagus, crop, bowel, rectum, parasomal sac stomach, testicle, seminal vesicle, vasa deferentia duct, ejaculatory ball, prostate gland and skin was observed by the method of the paraffin organization slice and microphotography.

RESULT AND CONCLUSIONThe structures and functions of the skin and the organ of the digestive and reproductive system, as well as the types and distributions of the mucous cells were acquired,which provided abasis for further study on the living behaviour, propagating behaviour and breeding environment of W. pigra.

Animals ; Digestive System ; anatomy & histology ; Genitalia ; anatomy & histology ; physiology ; Leeches ; anatomy & histology ; physiology ; Skin ; anatomy & histology ; Skin Physiological Phenomena

OBJECTIVETo study the distribution laws of Chinese medicine syndromes in patients with chronic heart failure (CHF) by clinical epidemiologic investigation.

METHODS512 CHF patients were studied, including 168 items of symptoms and 48 items of tongue and pulse pictures. A database of Chinese medicine syndromes was established, and 9 disease nature elements and 5 disease location elements were extracted. Frequency analysis was performed on all symptoms, tongue and pulse pictures. The variables with frequency constituent ratio less than 10.0% were deleted. Then the features of clinical epidemiology, syndrome patterns, syndrome elements, main symptoms, as well as tongue and pulse pictures were analyzed.

RESULTS(1) The disease nature elements of CHF covered qi deficiency, yin deficiency, and yang deficiency (categorized as the essential deficiency), as well as blood stasis, turbid phlegm, and the retained fluid (categorized to the superficiality excess). Among them, frequencies of qi deficiency and blood stasis (both more than 85.0%) were the highest. The disease location elements of CHF were ordered in frequency as Xin (97.9%), Pi (88.1%), followed by Shen (43.0%), Fei (30. 1%), and Gan (7.0%). (2) In the distribution of syndrome patterns in CHF patients, qi deficiency phlegm-stasis syndrome was the most (59.2%), followed by qi-yin deficiency with phlegm-stasis intermingle syndrome (20.3%), Xin-yang decline with phlegm-stasis obstruction syndrome (7.0%), and yang-deficiency with water overflowing syndrome (5.5%). (3) Patients with heart function grade II, III, and IV mainly manifested as qi-deficiency with phlegm-stasis syndrome. Besides, qi-yin deficiency with phlegm-stasis intermingle syndrome could be often seen in those with grade III. And Xin-yang decline with phlegm-stasis obstruction syndrome and yang-deficiency with water overflowing syndrome could often be seen in those with grade IV.

CONCLUSIONSThe pathogenesis of CHF is essential deficiency and superficiality excess. The essentiality consists of qi deficiency, yin deficiency, and yang deficiency, and the superficiality consists of blood stasis, turbid phlegm, and retained fluid. The disease was located at the five zang-organs, mainly dominated at Xin and Pi, and associated with Fei, Shen, and Gan. Qi deficiency phlegm-stasis syndrome was dominated in Chinese medicine syndrome patterns. Along with the aggravation of CHF, Chinese medicine syndrome pattern shows certain development laws.

Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Heart Failure ; diagnosis ; epidemiology ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Yang Deficiency ; diagnosis ; epidemiology ; Yin Deficiency ; diagnosis ; epidemiology ; Young Adult

Objective To study the effects of erythrecyte on brain edema after traumatic intrace- rebral hemorrhage(TICH)and explore the mechanisms of erythrocyte in brain edema development follow- ing TICH.Methods Firstly,the brain injury model of SD rat was established by applying a free-fall- ing device,then whole blood(WB),lysed RBC(LRBC)or parked RBC(PRBC)were infused with ste- reotactic guidance into injured cortex to produce the model of TICH.All rats were killed at 1,3,and 5 days after injury.The brain water content was measured,immunohistochomistry(SABC)was applied to test HO-1 and TNF-?expressions.Results 1.In WB group,PRBC group and TBI group,the brain water content was the highest on the third day.The brain water content of LRBC group was markedly higher on the first day than on the third and fifth days.Comparison among the four groups showed the wa- ter content was the highest on the 1st day in LRBC group,and on the 3rd day in WB and PRBC groups; there was no significant difference among the four groups on 5th day.2.The positive expression of HO-1 and TNF-?coincided with the change of the water content in groups of WB,PRBC and LRBC.Conclu- sions In rat model of TICH,RBC plays an important role in delayed brain edema formation(3 days after injury),but has no influence at early stage(1 day after injury).The mechanisms of delayed brain edema involves RBC breakdown and inflammation reaction.