Objective To assess the clinical value of the mi nimally invasive plate fixation technique in treatment of metaphyseal comminute d fractures of long tubular bones.Methods Sixty-eight patients with metaphyseal comminuted fractures o f femur or tibia were treated with min imally invasive percutaneous plati ng and early recovery movement from April 1999to October 2001.Results All the patients were followed up for a mean time of 10months.The postopera tive radiograph showed that reducti on and internal fixation were satisfactory in sixty-five patients.Lateral angular deformity of 8?occurred in one c ase,and 2cm shortage of the lower lim b in two cases.Sixty-eight patients obt ained bone union and satisfactory clinical function.There were no deep i nfec-tion,nonunion or other complicatio ns.Conclusion For metaphyseal comminuted fractur es of long bones of lower extremities,minimally invasive percutaneous plate fixation is o f significant value due to the advant ages of less iatrogenic trauma,rigid fixation and early movement.[

Objective To discuss our tentative application of the anatomic plate in the treatment of distal tibia fractures in order to develop a new effective fixation technique for this kind of fracture. Methods From November 2000 to September 2001, the authors applied Linkdistal tibia anatomical plates in the treatment of distal tibia fractures, which involved metaphysis in 12 cases, including 8 males and 4 females, aged from 18 years ～66 years, with 38 years on average. All the cases were of high energy injuries and complicated with ipsilateral fibular fracture. According to AO/ASIF classification: three were type A1, five were A2, three were A3, and one was B1; three of them were close fractures, five were type IO1 open fractures, and four were IO2. Results All the cases healed at one stage without infection or exposure of the implant. Bone callus could be found 2 3 weeks after operation. Bone union was achieved within 3～6 months, with 4 months on average. No delayed union or non union occurred. Functions of ankle joints recovered completely. Conclusion The anatomical plate for distal tibia is supperior to the traditional plates in both biomechanical and biological aspects. It is the best choice for the treatment of distal tibia fractures.

[Objective]To discuss a reasonable treatment for unstable intertrochanteric hip fractures in senile patients by comparing the effects of hemiarthroplasty and DHS fixation.[Method]Totally 126 intertrochanteric hip fractures in senile patients with complete clinical data were retrospectively analyzed,who were treated with hemiarthroplasty or DHS fixation from June 2002 to October 2005.Of the 126 patients,53 were treated with hemiarthroplasty,73 were treated with DHS fixation.All of them had multiple medical co-morbidities and were combined with severe osteoporosis.According to modified Even-Jensen classification,all of them belonged to unstable fractures.Comparison was made between the two treated groups in terms of operative time,blood transfusion during or after surgery,time for bed rest postoperatively,postoperative complications and St.Michael hip score one year after surgery.[Result]The average duration of follow-up for hemiarthroplasty and DHS fixation was 16 and 18 months respectively.Compared with the group of DHS fixation,the group of hemiarthroplasty experienced shorter time for bed rest postoperatively,fewer postoperative complications and higher St.Michael score 1 year after surgery,and the differences between two groups had statistical significance(P0.05).[Conclusion]Cemented hemiarthroplasty has the advantages of allowing early full weight bearing after surgery,low complication rate and satisfactory functional recovery.It is a reasonable treatment for unstable intertrochanteric hip fractures in senile patients.

Objective To evaluate biomechanical properties of self-designed polyaxial self-locking anatomical plate so as to offer scientific evidence for clinical application.Methods According to anatomic characteristics of distal tibiae of domestic people,a polyaxial self-locking anatomical plate for distal tibia was designed.Six paired ( left,right) fresh cadaver tibial specimens were used to make fracture fixation models and were divided into groups A and B,six specimens per group.Common anatomical locking plates were assembled in group A and polyaxial self-locking anatomical plates were assembled in group B.The biomechanical tests were performed by using 858 Mini Bionix testing machine.Non-destructive tests were performed in both groups,including axial loading,4-point bending and torsional loading and the stiffness of the two fixation instruments was compared.SPSS 13.0 software was used for statistical analysis.Results Polyaxial self-locking anatomical plate was fit for the morphology of distal tibiae.The self-designed pelyaxial plate could increase angular regulation amplitude for the locking screw up to 30°.Compression stiffness was (557.53 ± 20.72) N/mm in group A and (562.80 ± 28.26 ) N/mm in group B.Four-point bending stiffness was ( 268.02 ± 36.77) N/mm in group A and ( 265.76 ± 27.21 ) N/mm in group B.Torsional stiffness was (0.28 ±0.01) Nm/deg in group A and (0.29 ±0.02) Nm/deg in group B.The three tests in two groups showed no statistical significance ( P ＞ 0.05 ).Conclusions The self-designed polyaxial self-locking anatomical plate of distal tibia is fit for the tibial morphology of domestic people.Its biomechanical properties are equivalent to those of common anatomical locking plate,which can meet the needs for clinical application.

Objective To explore the common bleeding location, disease features, and the management strategies of intractable aged epistaxis. Methods 134 serious epistaxis patients were examined step by step according to nasal anatomic structure and treated by a stepwise way under endoscopy. Results The bleeding location of the intractable aged epistaxis were found as follows:2 cases (1. 49%) in anterosu-perior area, 44 cases (32. 84%) in anteroinferior area, 18 cases (13. 43%) in posterosuperior area, 22 cases (16. 42%) in posteroinferi-or area, 3 cases (2. 24%) in nasopharynx, and the bleeding site of the other 45 cases (33. 58%) were not found. All the patients were healed. The final treatment way were:46 cases (34. 33%) with pharmacotherapy or cauterization (grade Ⅰ~Ⅲ), 88 cases (65. 67%) with anterior nasal packing (grade Ⅳ), 9 cases (6. 72%) with posterior packing(gradeⅤ),1 case (0. 75%) with selective angiographic embolization (grade Ⅵ). There were 82 cases (61. 19%) succeed with the initial hemostasis methods while 52 cases (38. 81%) succeed with the upgrade therapy. Both hemostasis methods and upgrade therapy had statistical significance in different nasal position groups ( hemo-stasis methods:χ2 =16. 35,P=0. 00; upgrade therapy: χ2 =16. 35,P=0. 00). Conclusion Compartmental examination and classified treatment steps by using endoscope may locate and stop nose bleeding promptly while decrease patients' pain and medical cost.

Objective To observe the safety and effectiveness of inductive chemotheray with lobaplatin plus 5-Fu (LF regimen) and concurrent chemoradiotherapy with lobaplatin for local-regionally advanced nasopharyngeal carcinoma (NPC) patients,and investigate the appropriate lobaplatin dose for the concurrent chemoradiotherapy.Methods Newly diagnosed local-regionally advanced NPC patients signed informed consent.The inductive chemotherapy was lobaplatin 30 mg/m2 + 5-Fu 4 g/m2 civ 120 h for 2 cycles every 21 days,then concurrent lobaplatin chemoradiotherapy was conducted.The initial lobaplatin dose for concurrent chemoradiotherapy was 50 mg/m2 with at least 3 cases in every dose level.If 2 of 3 patients presented dose-limiting toxicity (DLT),5 mg/m2 dose decreased for the next level until maximal tolerant dose (MTD) reached.The tumor response was evaluated after inductive chemotherapy,at the end of the chemoradiotherapy,3 months after chemoradiotherapy and 6 months after chemoradiotherapy.Results From Dec 2011 to Apr 2012,11 patients were enrolled in this study.After 2 courses of inductive chemoradiotherapy,CR,PR and SD were observed in 1,8 and 2 patients,respectively.At the end of the chemoradiotherapy and 3 months after chemoradiotherapy,CR and PR were observed in 10 and 1 patients,respectively.Six months after the chemoradiotherapy,all patients were CR.For the patients(3 in each arm) received 50 mg/m2 or 45 mg/m2 lobapaltin concurrent chemoradiotherapy,2 patients in each arm presented DLT.For the 5 patients received 40 mg/m2 lobapaltin concurrent chemoradiotherapy,no patients presented DLT.40 mg/m2 was suggested as the MTD.Inhibition of platelet was the major DLT.Conclusion Inductive chemotherapy with LF regimen and concurrent chemoradiotherapy with lobaplatin is safe and effective for local-regionally advanced NPC patients and the MTD of lobaplatin for the concurrent chemoradiotherapy is 40 mg/m2.Further clinical trial with large sample is expected.

Objective To evaluate the efficacy and safety of management of kidney calculi in non-uronephrosis by percutaneous nephrolithotripsy (PCNL) under ultrasound guidance. Methods From July 2005 to June 2008, 97 cases of kidney calculi in non-uronephrosis were performed by percutaneous nephrolithotripsy. A tube was first inserted into the pelvis through cystoscope, and saline was instilled to dilate collecting system. Antegrade percutaneous access was obtained under ultrasound guidance. A combination of pneumatic and ultrasonic lithotrite was used to disintegrate and remove stone under direct vision. Clinical data including operation time, complications and stone free rate were analyzed retrospectively. Results The perutaneous renal access was successfully established under ultrasound guidance in all patients, immediate phase Ⅰ lithotripsy was performed in 95 cases and delayed phase Ⅱ lithotripsy in 2 cases. Operation time was 70-180 min, average time was (96±23 ) min. The average blood loss was 60 ml (20-500 ml), 4 cases had transfusion during the PCNL and average 400 ml. Minor pyrexia ( < 39℃) was seen in 24 cases,whereas serious pyrexia was noted in 3 cases. Conservatively administered with appropriate antibiotics, the fever disapeared in 27 cases within 5 days postoperatively. Severe complications did not occur during nephrolithotripsy. Stones were cleared completely in 78 out of 97 cases (80.4%)during immediate phase Ⅰ lithotripsy, residual stone fragment was found in 19 cases. Conclusion The management of kidney calculi in non-uronephrosis by PCNL appears to be efficacious and safe under ultrasound guidance.

In traditional biomedical research, a series of mechanism and measures had been taken for identity protection of data subjects, such as data disclosure in aggregated methods, information restricted in public only after identified variables removal and etc. The purpose of such process was aimed to properly keep confidentiality of health information for the target subjects in research. As the protection of subject privacy was viewed as one of the most essential principle of medical ethics in human research, the effects to fulfill and accomplish such process can help to maintain the trust and support among participants and social public. Currently, such traditional modes of privacy safeguard are widely-applied in genetics and genomics study. However, the universal applicability also causes a number of controversies, and the effectiveness remains to be proven. Nowadays, the risk assessments of data subjects’ privacy call for taking the whole“data context” into consideration, not just self-restricted in isolation and confined to quality control of data disclosure. With the soaring increasing of data resources in research involved human subjects, the issues of releasing genetic data have caused more and more public attention, especially for the sensitive domains of privacy protection. Based on the core problem and principles, this article attempted to discuss the controversial bioethical issues such as data context, data-intruder concept, privacy of data subject, identity control of releasing data, potential risk of individual identification, privacy protection of data subject, and etc. We hope these considerations can provide references to the bioethical understanding of biobanks research and decision-making of ethic review.

AIM: To study the effect of S-methylisothiourea(SMT) on adriamycin(ADM)-induced changes of superoxide dismutase and alutathione peroxidase activities in myocardial tissue of rats.METHODS: Rats were treated with ADM by intraperioneal injection (10.0 mg/kg body weight),and then the ADM-treated rats were intervened by SMT at different dosages by intravenous injection(once a day for three days).The contents of malondialdehyde(MDA) and NO_2~-/ NO_3~-,the activities of manganes superoxied dismutase(MnSOD),copper-zinc superoxide dismutase(Cu-Zn SOD),glutathione peroxidase(GPx) and inducible nitric oxide synthase(iNOS) were determined by spectrophotometry in myocardial tissue.The activity of isoenzymic CK-MB of creatine kinase(CK) was determined by enzymic rate method in serum.The expression of MnSOD mRNA,Cu-ZnSOD mRNA,GPx mRNA and iNOS mRNA were detected by reverse transcription-ploymerase chain reaction.RESULTS: The contents of MDA,NO~-_2/ NO~-_3,and iNOS activity of myocardial tissue,the activity of CK-MB in serum in SMT(5.0,10.0,20.0 mg/kg) intervention groups were significantly lower than those in ADM-treated group(P