Objective To explore the isometric attachment site of the posterolateral structure in the femoral lateral condyle and introduce the method of knee posterolateral complex(PLC) reconstruction with the semitendinosus tendon. Methods Isometric reconstruction of the chronic PLC injury of knee joint in 18 cases, were performed with the semitendinosus tendon from February 2001 to February 2005. Of all patients, there were 12 males and 6 females, average age was 39 years old(range, 19-52 years old). All cases were chronic injuries, with duration of 1.5-14 months. 3 cases were simple PLC injury, 10 cases were PLC injury with posterior cruciate ligament(PCL) injury, 2 of which had undergone PCL reconstruction about 6.5 months. 3 cases combined with anterior cruciate ligament(ACL) injury, 2 cases combined with ACL and PCL injury. To put in the double semitendinosus tendon from the bony tunnel of anatomical insertion of the fibular collateral ligment in caput fibulae and put out from the bony tunnel of anatomical insertion of the popliterofibular ligment in the caput fibulae, then fix them respectively in the isometic bony tunnel of the femoral lateral condyle. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results It was relatively isometric from the femoral attachment site of the popliteal tendon to the anatomical insertion of the popliterofibular ligment in the caput fibulae. The better isometric attachment site was from the anatomical caput fibulae attachment site to 8-10 mm in front of the anatomical femoral attachment site of the lateral collateral ligament. The average follow-up period was 14 months(12-24 months). There was no varus knee instability in full extension. At 30? flexion, one-grade varus instability was found in 2. At 30? and 90? flexion, external rotation range increased by 6? in 3 cases, remained the same in 14 cases, and decreased in 1 case, all compared with the healthy side. Conclusion The method provided good stability for the knee and acquired satisfactory clinical results.

The evaluation of outcomes of cancer therapy in clinic are largely based on volumetric and morphological evidences.These evidences,however,are very limited in assessing the early effects of therapy.Functional and molecular MR imaging allows co-registration of functional/molecular-based information with high-resolution anatomical detail within the same imaging modality,which makes it possible for assessing the early effects of tumor therapy.

Objective To summarize the experience of partial splenctomy in patients with traumatic spleen rupture.Methods Patients were assigned to spleen conservation group in which 59 patients underwent partial splenectomy,control group Ⅰ in which 60 patients underwent splenectomy and control group Ⅱ in which 60 patients underwent gastroinestinal operation. Immunologic function and filtration of red blood cell were detected in the three groups during the preoperation and the first month,the first year postoperation respectively.Results There was no significant difference between the spleen conservation group and the gastroenteric operation group.But IgM,NK-cell activity,T lymphocyte subpopulation and T lymphocyte transformation rate in the spleen conservation group were significantly higher then those in the splenectomy group (P

Objective To analyze the effect of traditional Chinese combined with Western medicine on the treatment of supracondylar fracture of humerus, and provide reference for clinical treatment.Methods122 patients with supracondylar fracture of humerus in hospital the affiliated hospital of traditional Chinese and western medicine;Zhejiang Chinese Medicine University from January 2015 to March 2016 were randomly divided into the observation group and the control group.The control group were given conventional fracture reduction, the observation group were given a new therapy of integrated traditional and western.Treatment outcome, quality of life changes and prognosis in the two groups were compared.ResultsThe excellent rate in the observation group (91.8%) was significantly higher than that in the control group (72.1%) (P<0.05).The fracture healing time in the observation group (4.1±1.1)months was significantly shorter than that in the control group (6.6±2.3) months (P<0.05).Before treatment, there was no significant difference in quality of life scores between the two groups;after treatment the overall health in the observation group (75.69±4.61), physiological function (77.62±4.19), pain (74.63±4.96), social function (76.84±4.28), mental health (76.12±4.18) scores were significantly higher than those overall health(62.74±4.36) in the control group, physiological function (64.51±4.12), pain (67.26±4.25), social function(68.72±4.13), mental health (65.97±4.23) (P<0.05).There were 2 cases with cubitus varus in the observation group, while 3 cases with elbow inversion in the control group.All patients were followed up for more than 6 months.There was no serious infection and abnormal bone development in the two groups.ConclusionIt can improve the treatment effect, reduce the pain of patients, promote the rapid recovery of the disease, improve the quality of life and prognosis, which traditional Chinese medicine combined with Western medicine was used in the treatment of humeral supracondylar fracture, it has the value of use.

Objective To measure the length and diameter of the main bronchus using three-dimensional reconstruction from spi-ral chest computerized tomography scans in Chinese patients,and to evaluate the relationship between the BMI of patients and the length and diameter of main bronchi in order to provide the basis for pre-operative tracheal intubation.Methods 100 males and 100 females,who were scheduled to undergo a chest CT scan for physical examination,the diameter at the carina of the left and right main bronchus were measured.The length of the main bronchi extending from the carina to the line that is vertical to the bronchial wall at the starting point from the branches of the upper lobe was measured at the workstation.Results the length of the men’s right and left main bronchus was (1 9.7±5.2)mm and (50.3 ±4.7)mm.the length of the women’s right and left main bronchus was (18.2±4.1)mm and (46.3±4.5)mm,The length of the left main bronchus(LMB)was about 3-4 times greater than right main bronchus(RMB).the cross-section of the men’s left and right main bronchus was (175.3±29.6)mm2 and (209.4±32.7)mm2 ,the cross-section of the women’s left and right main bronchus was (120.5±24.8)mm2 and (144.4±33.7)mm2 .There was no signifi-cant relationship between the length and diameter of main bronchi and the BMI of patients.Conclusion The results showed that there was no direct relationship between the diameter and the length of main bronchi and the BMI of patients.BMI is not the criteri-on for choosing double-lumen tube (DLT)size.We proposed that three-dimensional reconstruction be used to measure the size of the main bronchi and determine the optimal size of the DLT in a clinical setting.

Objective To evaluate the effects of penehyclidine hydrochloride combined with ulinastatin on brain injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-eight patients of both sexes,aged 20-64 yr,weighing 40-66 kg,of ASA physical status Ⅱ (NYHA Ⅱ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into 4 groups (n =12 each) using a random number table:control group (group C),penehyclidine hydrochloride group (group P),ulinastatin group (group U),and penehyclidine hydrochloride and ulinastatin group (group PU).Penehyclidine hydrochloride 0.02 mg/kg was injected via the right internal jugular vein at 15 min before induction of anesthesia in group P.In group U,the total amount of ulinastatin was 2× 104 U/kg,30％ of the total amount was given via the right internal jugular vein after induction and before surgery,40％ was added to the priming solution,and the remaining 30％ was injected via the right internal jugular vein while the aorta was opened.In group PU,penehyclidine hydrochloride or ulinastatin was given according to the method previously described in group P or U.The equal volume of normal saline was given instead in group C.After induction and before surgery (T1),at 30 min of CPB (T2),and at 30 min and 6 h after termination of CPB (T3,4),blood samples were taken from the left internal jugular bulb and radial artery for blood gas analysis and determination of jugular venous oxygen saturation,jugular venous O2 content,arterial O2 content,and plasma concentrations of S-100β protein and neuron-specific enolase (NSE) (by ELISA).Arteriovenous oxygen content difference (Ca-jrO2) and cerebral O2 extraction rate (CERO2) were calculated.Results Compared with group C,SjvO2 was significantly increased,and CERO2 was decreased at T2.3 in P and U groups and at T2.4 in group PU,and Ca-jvO2 and plasma concentrations of S-100β protein and NSE were decreased at T2,3 in P,U and PU groups.The plasma concentrations of S-100β protein and NSE were significantly lower at T2,3 in group PU than in P and U groups.Conclusion The combination of penehyclidine hydrochloride and ulinastatin produces better efficacy than either alone in attenuating brain injury in patients undergoing cardiac valve replacement with CPB.

Objective To investigate the expression of P21ras and PIK3CA proteins in hepatitis B virus-related hepatocellular carcinoma(HBV-HCC), post-hepatitis B hepatic cirrhosis (HBV-hepatic cirrhosis)and normal hepatic tissues specimen, and their correlation between HBV-HCC and HBV-hepatic cirrhosis tissues.Methods Using immunohistochemistry, the expression of P21ras and PIK3CA proteins in 34 cases of HBV-HCC, 37 cases of HBV-hepatic cirrhosis and 30 cases of normal liver tissues specimen were detected and compared. Results The mean gray scales of P21ras protein in HBV-HCC, HBV-hepatic cirrhosis and normal hepatic tissue specimen were 138.86 ± 2.9, 145. 34 ± 2.06 and 152.07 ± 1.17 (P ＜ 0. 0l), respectively, and were related to the progression of hepatopathy (P ＜0.01). The mean gray scales of PIK3CA protein in HBV-HCC, HBV-hepatic cirrhosis and normal hepatic tissue specimen were 138.20 ± 3. 14, 149.49 ±0. 78 and 154.71 ± 1.29 (P ＜ 0.01), respectively, and were related to the progression of hepatopathy (P ＜ 0. 01).There were apparent correlation between P21ras and PIK3CA in HBV-HCC and HBV-hepatic cirrhosis respectively (r =0. 64, P ＜0. 05; r =0. 42, P ＜0. 05). Conclusion The overexpression of P21ras and PIK3CA in HCC and hepatic cirrhosis tissue suggests that they participate in the tumorigenesis and development of hepatocellular carcinoma and hepatic cirrhosis, and there may be a signal transduction pathway of P21ras-PI3K in HBV-HCC and HBV-hepatic cirrhosis.

Objective To investigate the role of T-type calcium channel in lidocaine-induced neuronal cytotoxicity . Methods SH-SYSY cell line was a gift from cell biology laboratory of our medical university. The cells were cultured in DMEM liquid culture medium at 37℃ in incubator filled with 5% CO2 , and randomly divided into 4 groups ( n = 66 each) : control group (group C)and M, L and ML groups were exposed to 5 μmol/L mibefradil (a T-type calcium channel blocker), 10 mmol/L lidocaine and 5 μmoL/L mibefradil + 10 mmol/L lidocaine for 24 h. Cell morphology was examined by electronic microscopy at 24 h of drug exposure. Cell viability (by MTT) and neuronal apoptosis (by flow cytometry) were detected immediately before and at 1, 6, 12 and 24 h of exposure to mibefradil or/and lidocaine.Results In C and M groups, the cells demonstrated dendritic protrusions, enlarged nerve processes and dense lattice. After being exposed to lidocaine for 24 h, the dendritic protrusions disappeared,the cells decreased in size, shrinked and became round; the cell viability was significantly decreased while the neuronal apoptosis increased. The lidocaine-induced changes were significantly attenuated by co-incubation with mibefradil. ConclusionT-type calcium channel is involved in lidocaine-induced neuronal cytotoxicity.

ObjectiveTo establish a rat model of nerve damage induced by intrathecal(IT) lidocaine.MethodsFifty-five adult male SD rats weighing 200-220 g were randomly divided into 5 groups (n =11 each):group normal control (group C); group dimethyl sulfoxide (DMSO)-the solvent(group D) and groups IT 5％,10％,15％ lidocaine (groups L5.10.15 ).IT catheter was successfully implanted without complication in groups D,L5,L1o,L15.DMSO,5％,10％ and 15％ lidocaine 20 μl were injected IT in groups D,L5,L10,L15 respectively.Motor dysfunction of hindlimb was assessed and scored (0 =normal,2 =complete block) and paw withdrawal threshold to mechanical stimulation (von Frey filaments) (MWT) and paw withdrawal latency to thermal nociceptive stimulus (TWL) were measured before (baseline) and at 1,2,3,4,5,7 d after IT administration in 8 animals in each group.Three animals in each group were sacrificed at 1 d after IT administration.The lumbar segment (L4-5) was removed for microscopic examination.ResultsThere was no significant difference in motor dysfunction score,MWT and TWL among groups C,D and L5.MWT was significantly increased and TWL prolonged at 1 and 2 d after IT administration in group L10,while in group L15 motor dysfunction score was significantly increased at 1,2 d after IT administration and MWT was significantly increased and TWL prolonged at 1,2,3 d after IT administration.There was significant histologic damage to spinal cord in groups L10 and L15.Conclusion Nerve damage can be induced by IT 10％ lidocaine.

Objective To correlate dynamic parameters at contrast enhanced CT and interstitial fibrosis grade of non-small cell lung cancer (NSCLC). Methods Twenty-nine patients with NSCLC were evaluated by multi-slice CT. Images were obtained before and at 20,30,45,60,75,90,120,180,300,540,720,900 and 1200 s after the injection of contrast media, which was administered at a rate of 4 ml/s for a total of 420 mg I/kg body weight. Washout parameters were calculated. Lung cancer specimens were stained with hematoxylin-eosin stain and collagen and elastica double stain. Spearman test was made to analyze correlation between dynamic parameters and interstitial fibrosis grade of tumor. Results Twentynine NSCLC demonstrated washout at 20 min 12. 1 (0. 32-58.0 ) HU, washout ratio at 20 minutes 15.3% (0. 3%-39.2% ), slope of washout at 20 minutes 0. 0152 %/s ( 0. 0007%/s-0. 0561%/s ).Interstitial fibrosis of 29 lesions was graded as grade Ⅰ (10), grade Ⅱ (14) and grade Ⅲ (5). There were significant correlation between washout at 20 min ( r = - 0. 402, P ＜ 0. 05 ), washout ratio at 20 min ( r =-0.372,P＜0.05), slope of washout ratio (r = -0.459,P ＜0.05) and interstitial fibrosis grade in tumors. Conclusion NSCLC washout features at dynamic multi-detector CT correlates with interstitial fibrosis in the tumor.