Objective:To investigate the morphology character of sagittally unstable intertrochanteric fractures and reduction methods.Methods: A retrospective study was used to analyze the clinical data of sagittally unstable intertrochanteric fractures cases,which were treated with proximal femoral nail anti-rotation (PFNA) fixation from March 2009 to June 2016.In the study,36 cases were followed up completely,in which 17 cases accepted open reduction,and the other 19 cases accepted minimally invasive reduction.The operation time,amount of bleeding,the fluoroscopy times,postoperative radiographic measurements,such as tip-apex distance (TAD) and sliding distance of the spiral screw,and hip Harris scores were analyzed.The morphology character of the fractures was documented and investigated.Results: The average follow-up time was 15 months.The amount of bleeding of the open reduction group was (170.5±19.7) mL,and the amount of bleeding of the minimally invasive group was (54.7±12.5) mL.The amount of bleeding of the minimally invasive group was significantly less than that of the open reduction group (P<0.001).Between the two groups,there were no significant differences in other evaluation parameter,including operation time (P=0.054),the fluoroscopy times (P=0.053),fracture healing time (P=0.305),postoperative radiographic measurements,such as TAD (P=0.317) and sliding distance of the spiral screw (P=0.206),and hip Harris scores (P=0.459).In regard to morphology character of the fractures,the proximal anterior unstable fractures with separation displacement were more common than the proximal posterior unstable fractures with impaction.The characteristic feature of the proximal anterior unstable fractures was the proximal anterior and medial long oblique fracture,and a V shape cortical defect in the distal fracture fragment on the externally rotation X-ray.Conclusion: Sagittally unstable intertrochanteric fractures can be divided into the proximal anterior unstable fractures with separation displacement,and the proximal posterior unstable fractures with impaction.The two types have their own morphology character individually.The reduction should be performed by minimally invasive techniques.

Objective To investigate the effect of ulinastatin (UTI) on the expression of brainderived neurotrophic factor ( BDNF ) and remyelination in mice with experimental autoimmune encephalomyelitis ( EAE).Methods Twenty-four C57BL/6 mice were randomly divided into UTI group (U),normal saline treated group (S) and normal control group (N,n = 8,respectively).Demyelinations in the spinal cord were observed by solochrome cyanin staining.The expression of BDNF,myelin basic protein (MBP),and 2',3 '-cyclic nucleotide 3'-phosphodiesterase (CNP) in brain tissue of each group were evaluated by Western blot.Results Average clinical scores in group U at the 12,13,14,22,23,31,33,34 and 35 days were 0,0.25,0.38,0.63,0.63,0.40,0.40,0.40 and 0.40 respectively.They were significantly lower than group S at the same time ( U= 16.00,15.00,14.50,7.50,0.00,14.50,14.50,12.00 and 14.50,all P ＜0.05).Solochrome cyanin staining showed that demyelination of spinal cord in group U was also significantly improved than group S.Expressions of BDNF ( 1.96 ± 0.29),MBP (2.67 ± 0.48 ) and CNP ( 1.75 ± 0.20) in group U were all significantly higher than group S ( There were 0.80 ± 0.15,1.36 ± 0.38 and 1.06 ± 0.18 respectively,all P ＜ 0.05).Conclusions UTI has protective effect on EAE.The possible mechanism is that it could promote remyelination,and protect oligodendrocytes and neurons in EAE model by increasing BDNF expression in brain.

Background Lensectomy with anterior capsule preserving is still advisable under specific conditions during vitrectomy.Although lens epithelial cells were polished off during surgery,opacification in varying degrees could be observed.Understanding the composition of proliferative anterior capsule membrane is of an important clinical significance for the prevention and manegement.Objective This study was to investigate the management and pathology of the pupillary area membranous opacity underling preserved anterior capsule after lensectomy in diabetic eyes with silicone oil tamponade.Methods Twenty-three eyes of 21 patients with proliferative diabetic retinopathy (PDR) and cataract received vitrectomy combined with lensectomy preserved anterior capsule in China-Japan Friendship Hospital from January to December 2013,and the proliferative anterior capsular membrane specimens with the opacification grade C or D were obtained.The fibrotic membrane underlying anterior capsules were removed in order to make a clear optical area during the operation of silicone oil removal.The proliferative membrane at pupillary area was cut off by cutter probe for the eyes with the membrane attaching tightly or partial capsule laceration occurred.The available specimens were examined under the optical microscope and polarized microscope respectively after hemotoxylin and eosin staining,Van Gieson collagen staining,Masson collagen staining and Picrosirius staining.Results The proliferative fibrosis membranes were pilled to get a clear pupillary area in 15 eyes,with the successfully rate 65.2％ (15/23).In 14 eyes with degree C opacity,the proliferative fibrosis membranes were pilled in 9 eyes,with the successfully rate 64.3 ％ (9/14),and 5 eyes received anterior capsule cutthrough by cutter in pupillary area,with a diameter of 3-4 mm,and available specimens were obtained in 3 eyes.In 9 eyes with degree D opacity,the proliferative membranes were pilled in 6 eyes,with the successfully rate of 66.7％ (6/9),and 3 eyes underwent cut-through by cutter,and available specimens were obtained in 7 eyes.The best corrected visual acuity was obviously improved in 20 eyes and unchanged in 3 eyes after surgery.The histopathological examination showed fibroblasts,pigment particles and intracellular and extracellular vacuolus formation by hemotoxylin and eosin staining,fibril tissue with the pinke staining by Van Gieson,collage formation with green color by Masson staining in the specimens.Picrosirius staining plus polarization microscopy observation revealed that the collagen consisted of abundant type Ⅰ collagen with stronger reddish yellow color and small amount of type Ⅲ collagen with green color.Conclusions A combination of silicon oil removal with proliferative mambrane pelling is a available way to restore pupillary transparency in the eyes of PDR with cataract and silicone oil tamponade eyes.Proliferative residual lens epithelial cells,pigment epithelial cells and silicon oil granules are the main composition of opacity mambrane.The type Ⅰ collagen is dominant in proliferative collagen tissue.

Metabonomics is a new method to study on the metabolic network and the relationship between body and environment, which conforms to the way of traditional Chinese medicine (TCM) research. In the study process of modernization of traditional Chinese medicine, effectively conjunction with metabonomics method will facilitate the integration of TCM with modern biological science and technology, and promote the modernization of TCM. This paper introduce the application of metabonomics in the research of toxicity mechanism of TCM, compatibility mechanism of TCM formula, pharmacology effect of TCM and processing mechanism of TCM. This paper summarize the problems in the TCM metabonomics research and prospect its bright future.
Animals ; Drug Therapy ; Drugs, Chinese Herbal ; adverse effects ; analysis ; metabolism ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; trends ; Metabolomics ; methods ; trends

OBJECTIVETo investigate the changes in the activity of nuclear factor-kappaB (NF-kappa B) in mice with dextran sulphate sodium (DSS)-induced rat colitis and its modulalorg effect on intercellular adhesion molecule-1 (ICAM-1) expression.

METHODSTwenty normal male mice were randomized into DSS group and normal saline (NS) control group according to a matched-pair design. From days 1 to 7, the mice in DSS group were subjected to oral administration of 5%DSS solution, and from days 8 to 20, NS was given instead, for a total of 3 cycles. In the control group, only NS was administered. The colonic pathology was observed using HE staining and the mucosa 1 damage was scored for each mouse. The DNA-binding activity of NF-kappa B was tested by electrophoretic mobility shift assay, and the expressions of ICAM-1 and NF-kappa B p65 were detected using immunohistochemistry.

RESULTSThe DNA-binding activity of NF-kappa B was significantly increased in DSS group as compared with NS group. ICAM-1 and p65 expressions were detected in the nuclei of the vascular endothelial and inflammatory cells, especially in the mucosa and submucosa, but such positive cells were seldom observed in NS group. A positive correlation was found between the DNA-binding activity of NF-kappa B and ICAM-1 expression.

CONCLUSIONNF-kappa B activation is an important event in the development of DSS-induced colitis in that activated NF-kappa B upregulates ICAM-1 expression during colonic inflammation.

Animals ; Colitis ; chemically induced ; metabolism ; DNA ; metabolism ; Dextran Sulfate ; Electrophoretic Mobility Shift Assay ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; biosynthesis ; Male ; Mice ; Mice, Inbred BALB C ; NF-kappa B ; metabolism ; Protein Binding ; Random Allocation ; Transcription Factor RelA ; metabolism

Objective To explore the effect of endovascular treatment on Stanford type B aortic dissection. Methods The clinical data of 12 cases of Stanford type B aortic dissection were analysed retrospectively. Results All the cases were male, the age ranged from 40-68 years with a mean of 52.1 years. Among the 12cases, 10 patients underwent endoluminal treatment, the instant technique was successfully performed in 10 patients. Endoleak happened in 1 case because of the stent-graft deployment, but automatically stopped 3 days later. In other 9 patients, Angiography after the operation showed that all the rupture areas were sealed completely, and the celiac arteries blood supply were recovered via the true lumen and no blood stream was shown in the false cavity. 2 patients received conservative treatment died, one died of failure of respiration and another died of rupture of the dissection. Conclusions In the treatment of Stanford B type aortic dissection, if the selection of the patient is correct, endoluminal technique is much simple, safe, less trauma, and less complications as compared to the traditional operation, and it can also shorten the hospital stay of the patient. Conservative treatment can not control the development of the diseases, and easily results in death of the patient.

Objective To explore the surgical management for arterial diseases. Methods The clinical data of 86 cases of arterial diseases were analysed retrospectively. These cases included:3 cases of thoracic aortic aneurysm,2 cases of descending aortic dissection with rupture and aneurysm formation,2 cases of abdominal aortic dissection with false aneurysm,1 case of abdominal aortic aneurysm(AAA)with duodenojejunal fistula and GI bleeding,5 cases of ruptured AAA with shock, 3 cases of traumatic rupture of abdominal aorta,21 cases of AAA combined with unilateral or bilateral iliac aneurysms,6 cases of iliac aneurysms,9 cases of popliteal aneurysms,21 cases of false aneurysm of iliac or popliteal artery,1 case of rupture of junction of subclavian and vertebral artery with false aneurysm,3 cases of rupture of subclavian artery with false aneurysm,2 cases of aneurysm of carotid artery and 7 cases of false aneurysm of carotid artery. Prosthetic vascular graft was performed in 71(cases),autologous vein graft in 3 cases and suture(repair) of arterial rupture in 12 cases.Results Operative (mortalty) was 3.5%(3/86)in this series.Seventy-one cases were followed-up for 1 month to 5 years, the results showed that all the patients were alive and well.Conclusions In the(management) of(appropriate) aortic diseases, the use of endoluminal technique is simple, microtraumtic, safe and has few complications. It also can shorten the hospital stay of the patient. Endovascular technique should be the first choice for patients with aortic diseases.

Objective To explore the surgical management for acute cases of aortic diseases. Methods The clinical data of 18 acute cases of thoracoabdominal aortic diseases were analysed retrospectively. Results This study included ruptured thoracoabdominal aortic dissection of 15 cases and open wound of the abdominal aorta of 3 cases. There were 15 males and 3 females, with mean age of 42.7 years. Eight patients were received open emergent operation, and the other 10 cases underwent endovascular procedure. The mortality was 11.1% (2/18). Follow-up from 2 months to 3 years revealed all patients in a good condition. Conclusions In cases of emergent aortic diseases, endoluminal technique is simple, mini-invasive and safe. However, open surgery is still mandatory and effective especially when endovascular procedure is not indicated or failed.

OBJECTIVETo objectively evaluate the clinical efficacy, safety and technical operating standard of percutem clamp fixation (PCCF), an operation designed by imitating bone setting method of TCM, in treating unstable tibiofibular fracture (UTF).

METHODSA prospective controlled multicentre clinical study was carried out on 200 patients with UTF, they were assigned to the treated group (99 cases) treated with PCCF and the control group (101 cases) treated with unilateral multifunctional external fixator (UMFEF).

RESULTSPCCF showed better effects than UMFEF in reducing the time of fixing operation and healing time; and the immediate effect after removing the fixating apparatus and long-term efficacy as well as safety in the treated group were also superior to those in the control group (P < 0.01).

CONCLUSIONIt is convenient, safe and effective to treat UTF by fixation with percutem clamp.

Adolescent ; Adult ; Female ; Fibula ; injuries ; Fracture Fixation ; methods ; Fractures, Bone ; therapy ; Humans ; Male ; Middle Aged ; Multiple Trauma ; therapy ; Prospective Studies ; Tibial Fractures ; therapy ; Treatment Outcome

To control the quality of Maca, the quality standard was established in this study. According to the methods recorded in the Appendix of Chinese Pharmacopoeia (2010 Edition), the water, extract, total ash, acid insoluble substance, and heavy metals inspections in Lepidium meyenii were carried out. N-benzyl-9Z, 12Z-octadecadienamide in L. meyenii was identified by TLC, and it was determined by HPLC. The results showed that the N-benzyl-9Z, 12Z-octadecadienamide identification of TLC was a strong mark and specificity. In content determination experiment, the linearity of N-benzyl-9Z, 12Z-octadecadienamide was in the range of 0.01-2 microg (r = 0.9998), and the average recovery (n=9) was 99.27% (RSD 2.0%). The methods were simple, accurate, with good reproducibility. It is suitable for quality control L. meyenii.
Chromatography, High Pressure Liquid ; methods ; Chromatography, Thin Layer ; methods ; Lepidium ; chemistry ; Plant Extracts ; chemistry