BACKGROUND:Intercondylar eminence fractures of the tibia are often treated by arthroscopic surgery, but the fixation methods are controversial.
OBJECTIVE:To compare curative effect of hol ow screw and suture fixation in treatment of tibial intercondylar eminence fractures under arthroscopy.
METHODS:A total of 46 patients with tibial intercondylar eminence fractures were recruited from the Third People’s Hospital of Yancheng, China from June 2010 to January 2013. According to the patient’s wil ing and physician’s suggestions, the involved patients were divided into hol ow screw group (n=25) and suture fixation group (n=21), undergoing hol ow screw and suture fixation under arthroscopy, respectively.
RESULTS AND CONCLUSION:According to Ikeuchi grade, the excellent and good rate after fixation showed no significant differences between the two groups (P>0.05), but the functional training time in hol ow screw group was significantly shorter than that in suture fixation group (P<0.05). Hol ow screw treatment under the arthroscopy is better than suture fixation in treatment of intercondylar eminence fractures of the tibia.

Blood transfusion in liver surgery still plays an important role.However,blood transfusions may cause immunosuppression recipients and hinder the body' s immune response against the tumor,promotes tumor metastasis and recurrence.How to resolve this contradiction? We must study and research the effects of allogeneic blood transfusion on liver cancer metastasis and recurrence after hepatic resection,and to find strategies to improve the liver cancer prognosis.

Objective To assess the association of cerebrovascular reserve(CVR) with diabetes(DM)、hypertensive atherosclerotic lacunar infarction(HALI),hypertension(HT) and diabetic lacunar infarction(DLI) by means of transcranial Doppler ultrasonography (TCD) with breath-holding maneuver.Methods The breath-holding index (BHI), which was the percentage increase in middle cerebral artery(MCA) blood flow velocity as index of CVR assessment,was detected during breath-holding by TCD and breath-holding technique in 30 diabetic patients,30 hypertensive atherosclerotic lacunar infarction patients,30 hypertension patients and 30 diabetic lacunar infarction patients. Results There was significant difference in the ascending rates of Vm and BHI between diabetic group and diabetic lacunar infarction group,diabete lacunar infarction group and hypertensive atherosclerotic lacunar infarction group,hypertension group and diabetic group (all P<0.05). Conclusions Diabetes can more significantly impair CVR than hypertension. Diabetic lacunar infarction can more significantly impair CVR than diabetes. Diabetic lacunar infarction can more significantly impair CVR than hypertensive atherosclerotic lacunar infarction .

Background and purpose:Ever since the use of anthracycine and /or taxanes-based regimen for the adjuvant and/or neoadjuvnat chemotherapy of breast cancer,there have few sensitive agents for advanced breast cancer(ABC)when it occurs drug resistance to anthracycine and /or taxanes.The aim of this study is to evaluate the effect of gemcitabine plus cicplatin in advanced breast cancer after the failure of treatment with anthracycines and /or taxanes.Methods:From May,2005 to Jan 2007,34 ABC cases with anthracycine and/or taxanes resistance were treated with GEM(1000 mg/m2.day1,day8)and DDP(30 mg/m2,day 1 to day 3)every 3 weeks.A median of 5 cycles(2-6 cycles)of the treatment was delivered.All cases were followed up more than 6 months.Results:3 cases(8.8%)had complete response(CR),13 cases(38.2%)had partial response(PR),while 12 cases(35.3%)had stable disease(SD)and progressive disease(PD)was 6 cases(17.7%);the overall response rate was 47.0%.The median time to progression(TTP)was 6.5 months,grade 3/4 diarrhoea and thrombocytopenia were main side effects.Conclusions:GEM plus DDP are effective in the treatment of advanced breast cancer with anthracycine and/or taxanes resistance.

[Objective]The best treatment method for cemented acetabular component loosening during revision hip replacement has not been established.The purpose of this study is to determine the initial results obtained with a unique implant the modular porous tantalum cup,designed as an alternative treatment for aseptic prosthesis loosening following total hip arthroplasty.[Method]From Apr. 2006 to Nov.2006,porous tantalum cups were implanted during sixteen revision total hip replacements in nine women and seven men who had an average age of 69.2 years at the time of the procedure.Harris score and UCLA activity score were measured before,at 1,2 years and after arthroplasty.Radiographic follow-up was performed simultaneously.All patients were followed-up clinically and radiographically.[Result]The mean follow-up period was 24 month (range18-25months).The mean preoperative Harris hip score(HHS) was 21-54 (32.6) compared with the postoperative HHS of 56-90 (87.5).The mean preoperative UCLA score was 2-5(3.8) compared with the postoperative score of 6-9 (8.2).Radiographic evaluation of the revised components demonstrated no evidence of loosening or subsidence,and all showed radiographic evidence of bone ingrowth.[Conclusion]At the time of short-term follow-up,the porous tantalum cup effectively provided structural stability for acetabular component failure of cemented primary fixation.The potential for long-term biologic fixation may provide durability for porous tantalum cup.Long-term follow-up and comparison with alternative revision techniques will be required to evaluate the true effectiveness of this treatment approach.

Recently ,metabolic surgery has received much concern for its notable and everlasting effectiveness on glucose control ,weight loss and other metabolic disorders and concomitant diseases. Previous clinical practice and guidelines mostly focused on surgical indications ,especially BM I cut‐off point. In recent years ,BMI cut‐off point in guidelines has shown a downtrend and BMI cut‐off value has tended to become obscure ,which harvested from that clinical staff have realized the importance of comprehensive control for long‐term multiple metabolism and risk factors and overall benefit of the patients through increased clinical evidences and no longer limited to the improvement of obesity and diabetes itself.

Safflower Yellow is the essential component of Chinese traditional medicine Carthamus tinctorius with the effect of promoting blood circulation and removing blood stasis .Clinical studies have found its obvious curative effect in cardiovascular and cere -bral vascular diseases .Clinical treatment of angina , hyperlipidemia , cerebral infraction and arterial type cervical spondylosis in recent years was reviewed , which can provide references for treatment of cardiovascular diseases with Safflower Yellow .

Objective To evaluate the clinical value of endoscopic retrograde cholangiopancreatography(ERCP) in the diagnosis and treatment of biliary complications after orthotroptic liver transplangtation.Methods We retrospectively reviewed the clinical data of 139 patients with biliary complications after orthotropic liver transplangtation,and summarized 10 categories of biliary complications.The location of biliary complications included donor liver,anastomotic stoma,receptor biliary duct,duodenal papilla,and so on.Common complications were biliary duct or anastomotic strictures(102/139,73.4%),cholangitis(94/139,67.6%),common bile duct or intrahepatic cholelithiasis(75/139,54.0%),dysfunction of the duodenal papilla(20/139,14.4%),bile leakage(17/139,12.2%),and complications related to T-tube(4/139,2.9%).Infrequent complications involved duodenal papillary stenosis(1/139,0.7%),complications related to PTC(2/139,1.4%),biliary bleeding(3/139,2.2%),and too long and twisted bile duct(4/139,2.9%).The treatment methods included EST(112/139,80.6%),dilatable bougie or balloon dilatation(157/250,62.8%),plastic stent placement(139/250,55.6%),ENBD and irrigation(87/250,34.8%),and gallstone removal(27/250,10.8%).Results A total of 250 times of ERCP was performed in the 139 patients,the success rate of intubation being 99.2%(248/250).The total cure rate reached 70.5%(98/139) and the improvement rate was 18.7%(26/139),with a total effective rate of 89.2%(124/139).There were 9 patients with conversions to open surgery(9/139,6.5%),4 patients with no improvement(4/139,2.9%),and 2 patients with spontaneous quitting treatment or loss of follow-up.The postoperative complications included cholangitis in 37 patients,the dislodgement of ENBD tube in 26 patients,and biliary sludge or stone in 18 patients.Conclusions ERCP is an effective way to diagnose and treat the biliary complications after orthotroptic liver transplantation.

BACKGROUND: Metal on metal (MoM) hip prosthesis has been used for more than 30 years. With the increasing number of young patients who used it, the metal ions cumulative in the body may cause the biological effects, such as cell toxicity, genetic toxicity, carcinogenicity and metal allergy, etc, which have received attention and concern. OBJECTIVE: To describe what influences the production of metal ions, and how metal ions distribute in human tissue after MoM hip prosthesis implantation. In particular the change of the metal ions serum level and the MoM hip prosthesis biological effects of the pathological manifestations were investigated. This paper also focused on the factors influencing metal ions serum level and the mechanism of metal ions biological effects. RETRIEVAL STRATEGY: A computer-based search of Pubmed database was undertaken to identify the articles between January 2004 and November 2007, with the key items of "metals, total hip replacement" and language was limited to English. Meanwhile the China Journal Full-text Database was retrieved for the related articles published from January 2000 to November 2007, with the words of "joint replacement, metal ions" in Chinese. Totally 267 articles were screened out, and checked primarily. Inclusion criteria: ①prosthesis interface described the articles for MoM;②procedure described in the articles for hip replacement;③ articles focused on biological effects of metal ions. Exclusion criteria: ①non-MoM interface of the prosthesis;②non-hip arthroplasty;③articles described the metallurgy;④reproducibility study. LITERATURE EVALUATION: Both titles and abstracts were screened preliminarily, excluding 194 articles of unrelated objectives, 58 articles of repeated contents and 0 Meta analysis. Finally 30 articles were taken into further analysis, including 6 reviews and other basic or clinical trials. DATA SYNTHESIS: MoM prosthesis releases metal ions in the body through electrochemical process (corrosion) and enhanced machinery plus electrochemical process (wear-corrosion). It spreads to various body tissues by body fluid, and raises a number of biological effects. Human body shows a reaction of metal ions in a dose-dependent manner, and metal ions serum level decides the biological effects. Generally we consider the serum concentration of metal ions is influenced by ①ion excretion factors. ② mechanical factors. ③individual factors. ④others. At present, the biological effects of metal ions include ①inflammatory response, ②oxidative damage, ③apoptosis, ④osteoporosis and extracellular matrix dissolution, ⑤carcinogenesis, ⑥host response. Its mechanism is related with corrosion, macrophage activation, reactive oxygen generation, osteoblast function inhibition, osteoclast activation, metal-protein complex formation, and so on. The consequence is a series of pathological changes: ①foreign body granuloma synovitis, ②draining lymph node lesions, ③chromium calmly disease, ④malignant lesions, ⑤metal allergy. CONCLUSION: There is no better product to replace MoM hip prosthesis. Through the study of their biological effects, people gradually concern about two issues. First: What is a safe wear rate? Second: What is harmful serum level of metal ions?

Objective To explore the diagnosis value of single photon emission computed tomography(SPECT) imaging to supratentorial brain gliomas with technetium 99m sestamibi.Methods In 53 patients with supratentorial brain glioma,31 cases for high grade malignant glioma, 22 cases for low grade glioma were examined by SPECT,(SPECT was performed after injection 740-930 MBq MIBI for 15 min),and the coronal,sagittal and transverse views were reconstructed. MIBI uptake index was computed as the ratio of counts in foci region and the counts in contralateral homologous region.Results In high-grade malignant gliomas,the MIBI uptake index was 1.9～6.6(mean 3.6?1.4),low grade malignant gliomas was 0.8～1.7 (1.1?0.2),there is a comparison between the two groups(P