Sixty cases of different types of patellar fractures were treated from December 1986 to October 1990 by a self-designed miniature external fixator. The patients were followed-up for 6 months to 4 years, and there was not a single case of infection, prepatellar bursitis or early degeneration of the knee joint. The structure of the fixator is simple and the operation is easy. It is a versatile tool, because it can be used either for extension or for compression.since the pins are inserted without operation, it gives rise to little pain. Under the present treatment bone healing is rapid and the function of the knee joint is well preserved. The rate of excellent result reaches 98.2 per cent

This study was to investigate the effect of peoniflorin on the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream signal molecules in the hippocampus of Alzheimer's disease (AD) rats for exploring the mechanism of peoniflorin protecting hippocampal neurons. AD model rats were established by bilateral intrahippocampal injection of beta-amyloid(1-42) (Abeta(1-42)) and divided randomly into 3 groups: AD model group, peoniflorin low-dose (15 mg x kg(-1)) group and peoniflorin high-dose (30 mg x kg(-1)) group. The vehicle control rats were given bilateral intrahippocampal injection of solvent with the same volume. After peoniflorin or saline was administered (ip) once daily for 14 days, the hippocampuses of all animals were taken out for measuring the expressions of Nrf2, heme oxygenase-1 (HO-1) and gamma-glutamylcysteine synthethase (gamma-GCS) mRNA by reverse transcription PCR, determining the contents of glutathione (GSH), malondialdehyde (MDA) and carbonyl protein (CP) using colorimetric method, and for assaying the expressions of neuronal apoptosis inhibitory protein (NAIP) and Caspase-3 by immunohistochemical staining method. The results showed that peoniflorin markedly increased the expressions of Nrf2, HO-1 and gamma-GCS mRNA, enhanced the level of GSH and decreased the contents of MDA and CP in the hippocampus, as compared with the model group. Peoniflorin also improved the NAIP expression and reduced the Caspase-3 expression in the hippocampus neurons. In conclusion, peoniflorin protects against the Abeta(1-42)-mediated oxidative stress and hippocampal neuron injury in AD rats by activating the Nrf2/ARE pathway.

A new method to reconstruct a thumb was worked out in the past few years. It was achieved by inverting the skin flap of the amputated thumb stump and suturing it to an island-shaped skin flap with nerves and vessels from the dorsum of the index finger. A piece of artificial bone was inserted between the two skin flaps into the first phalanx. The operative procedure was described in detail and the indications, advantages and disadvantages of this method were discussed. It is suggested that this method be used to reconstruct a thumb since it is simple and effective.

Transverse fracture was inflicted to the tibia of goats and specially designed external fixator was used for fixation to observe the relationship of different intensity of compres-sive force with fracture-healing.It was found in vitro test that the external fixator possessed less effect of stress protection.X-ray examination revealed that the stronger the compressive force was applied,the later the external callus would appear and the less amount of external callus would form.In the 6th week after fracture,the fracture line became oblierated in cases with mild compression while a transparent line in the external callus could be seen on x-ray films in those cases with heavy compression.Though there was no significant difference of the parameters of torsionmetry among different groups,the strength of the healed fracture with mild compression was nearer to the strength of a normal bone than that with heavy compression.Histo-logical examination revealed that all the bone unions belonged to secondary bone healing and bone callus became less matured along with the increase of compressive force.

BACKGROUND: As reported in some literatures, articular dysfunction following limb lengthening is one of the commonest complications, but some scholars believe that the articular dysfunction after lower limb lengthening is avoidable providing appropriate technical operation and effective function prevention.OBJECTIVE: To investigate the changes of articular function of knee during limb lengthening in rabbits so as to provide a experimental basis for clinical tasks.DESIGN: A randomized controlled trial SETTING: Department of Orthopeadics, Affiliated Hospital of Some Military Medical University.PARTICIPANTS: Study was conducted in the Experimental Animal Center of the Third Military Medical University of Chinese PLA from February 2001 to June 2002. Totally 30 healthy adult New Zealand rabbits obtained from the Experimental Animal Center of the Third Military Medical University of Chinese PLA were randomly divided into lengthening group and delayed observation group(observed at 3 months after the stop of lengthening).METHODS: Every group was further divided into three sub-groups according to distraction range: 10%, 20% and 40%. Upper-tibia metaphysis distraction was adopted at the rate of 1 mm per day . Distraction and iconography changes of knee joint were observed with X-ray. The motive range of knee was investigated at the end of distraction and three months later.MAIN OUTCOME MEASURES: Articular motive range of the knee before the distraction, at the end of distraction and three months later, X-ray resutls RESULTS: ① There was no obvious radiographic change in knee at every time point in each group. ② Significant flexion disorder in knee was found in 20% distraction subgroup( P ＜ 0. 05), which was only 44. 7% of normal motive range in 40% distraction subgroup( P ＜ 0. 01) . Motive functions of knee in delayed observation group were significantly improved; thereinto,20% distraction subgroup returned to preoperative level, while 40% distraction subgroup also had significant improvement compared with that of 3 months earlier but still lower than normal level, which was only about 88.5% of normal level( P ＜ 0.05).CONCLUSION: Temporary articular dysfunction might occur during limb lengthening process, and mostly during big range of distraction. Although the dysfunction could be gradually recovered after the stop of lengthening, active prevention is still necessary.

Objective To use external fixator in the treatment of fracture of the olecranon of ulna. Methods Ninety four cases of olecranon fracture were treated with external fixators. The lateral medial displacement was first reduced, followed by the reduction of the proximal fragments. In some difficult cases with comminated fracture, a Kirschner wire was inserted to lever the fracture fragments to proper site. The fragments were held together by two hands, and they were fixed with an external fixator with addition of longitudinal pressure. Results The mean healing time of all the 94 cases was 35 days (5 6 weeks), and the function of the elbow joint were restored to normal. Conculsion The method as described above is an easy, economical and safe method, and can be used in out patientdinic

Objective To investigate the role of large-conductance Ga2+-activated K+ (BKCa) channels and protein kinase G (PKG) in ketamine-induced isolated tracheal smooth muscle relaxation in rats with asthma.Methods Healthy Sprague-Dawley rats,weighing 250-300 g,were used in this study.Asthma was induced with egg albumin.Thirty-six tracheal rings of 15 rats in which asthma model was successfully established were randomly divided into 3 groups (n =12 each):ketamine treatment group (group AK),IBTX (BKCa channel blocker) +ketamine treatment group (group AKI),and KT-58232 (PKG inhibitor) + ketamine treatment group (group AKK).Tracheal rings were suspended in an organ bath filled with oxygenated Kreb's solution at 36.5-37.5 ℃.In group AK,the tracheal rings were precontracted with acetyleholine 0.1 mmol/L,and the rings were then exposed to ketamine 0.4 g/L for 15 min.In group AKI,before acetyleholine and ketamine were added to the solution,the rings were pretreated with IBTX 3μmol/L for 30 min.In group AKK,before acetyleholine and ketamine were added to the solution,the rings were pretreated with KT-5823 2μmol/L for 30 min.The tension of rings was measured by using a force-displacement transducer.Results The amplitude of relaxation of isolated tracheal smooth muscle was significantly decreased in groups AKI and AKK as compared with group AK (P ＜ 0.05).Conclusion Ketamine induces isolated tracheal smooth muscle relaxation through activating BKCa channels and PKG signaling pathway in rats with asthma.

Objective To discuss the application of spiral CT angiography in postoperative re-examination of lower limb artery stent implantation. Methods During the period from March 2012 to March 2014 at the Affiliated Nanjing Hospital of Nanjing Medical University, CT angiography was carried out in 67 patients who had received stent implantation for arteriosclerotic occlusion of lower limb. The diseases involved 78 lower limbs, and a total of 85 stents were employed. The volume rendering (VR), maximum intensity projection (MIP), multi-planar reformation (MPR) and curved surface reconstruction (CSR) were performed to stereoscopically display the lesion’s anatomy as well as the implanted stents, and the imaging manifestations were compared with the clinical symptoms and DSA findings. Results Successful examination was accomplished in 65 patients (81 stents in total), and clear images were obtained. Of the 81 stents, no stenosis was seen in 43, Ⅱ - Ⅳ grade stenosis in 32 and complete occlusion in 6. The results were closely correlated with the clinical symptoms. The CT angiography manifestations in 31 patients (34 stents in total) were compared with their DSA performed in two weeks, and the results showed that the stenotic degrees of three stents judged by CT angiography were not consistent with those judged by DSA. The consistent rate of CT angiography was 91.2% when taking DSA as the standard. Conclusion Lower limb arterial CT angiography examination is a safe and non-invasive technique, it can clearly display the stent inner canal. Therefore, this technique is of great value in postoperative re- examination of lower limb artery stent implantation.

OBJECTIVETo study the mechanisms of Danggui Shaoyao San (DSS) on Alzheimer's diseases (AD) focusing on anti-inflammation.

METHODAD rats were established by intrahippocampal bilateral injection of Abeta1-42 protein. The AD rats were randomly divided into three groups: AD model group, DSS high-dose group, DSS low-dose group. Vehicle group rats were intrahippocampal bilateral injection of solvent with the same dose. The learning ability and memory of rats was investigated in step-down passive avoidance test and Morris water maze test, expression of IL-1beta, IL-6, TNF-alpha mRNA were observed by reverse transcriptase PCR (RT-PCR), levels of NO was measured by colorimetric method and neuron apoptosis in the hippocampus was investigated by tag method of TdT-mediated end-labeling of fragmented DNA (TUNEL).

RESULTDSS significantly reduced the escape latency and increased the time that rats spent in the target quadrant in Morris water maze test, shortened the responsive latency and decreased the error numbers in step-down passive avoidance test, reduced the expression of the IL-1beta, IL-6, TNF-alpha mRNA, and the level of the NO depressed the neuron apoptosis in the hippocampus.

CONCLUSIONDSS improving cognition of the rats might be related to attenuate inflammatory reaction and reduce cell apoptosis in the hippocampus.

Alzheimer Disease ; drug therapy ; Animals ; Anti-Inflammatory Agents ; pharmacology ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hippocampus ; drug effects ; pathology ; Male ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the clinical results of proximal humeral internal locking sys-tem(PHILOS)self-locking plates in treatment of proximal humeral fractures. Methods There were 35 patients including 19 males and 16 females(at mean age of 53.5 years,ranging from 29 to 92 years)with proximal humeral fractures treated with PHILOS plate.According to the Neer's classification sys-tem,there were two-part fractures in 19 patients,three-part fractures in 15 and four-part fractures in 1.Surgery was performed with PHILOS serf-locking plate via dehopectoral approach.All patients were fol-lowed up for mean 18.9 months(6-46 months)and evaluated by using Constant score and X-rays. Re-suits X-rays proved that all fractures got good reduction and complete healing during 8-12 weeks.The latest Constant scores was mean 89.5 points(82-94 points).There were no complications including plate loosing.humenral head necrosis or gleno-humeral ioint osteoarthritis. Conclusion PHILOS plate is a good choice for treatment of proximal humeral fractures because of its advantages including easy operation,stable fixation,good clinical results and few complications.