Objective To investigate surgical outcomes of anterolateral plus posteromedial approaches for treatment of complex tibial plateau fractures.Methods We reviewed 68 patients with tibial plateau fractures of Schatzker types Ⅴ and Ⅵ who had been treated from January 2008 to December 2011 and fully followed up in our department.They were 42 men and 26 women,22 to 64 years of age (average,42.3 years).Fractures occurred at the left side in 24 cases and at the right side in 44 cases.Intervals between injury and operation ranged from 3 to 15 days,7.4 days on average.All of them were operated on through anterolateral plus posteromedial approaches.T-or L-shaped steel plates were used laterally while reconstruction plates or T-shaped plates for distal radius were used medially.Results In this cohort the operation time averaged 3.13 hours,intraoperative blood loss 562.7 mL and hospital stay 20.4 days.All cases were followed up for an average of 18.8 months (range,12 to 38 months).Fractures healed from 4 to 8 months,6.7 months on average.The average tibial plateau angle,posterior slope angle and femorotibial angle immediately postoperation were respectively 87.3°± 1.5°,12.0°± 2.5° and 170.0°± 2.5°,not significantly different from those at one year postoperation (86.8° ± 1.2°,13.0° ± 1.8° and 171.0° ± 1.7°) (P ＞ 0.05).According to The Hospital for Special Surgery Score,the outcomes were excellent in 36 cases,good in 24 cases,fair in 6 cases and poor in 2 cases,with a good to excellent rate of 88.2％.No neural or vascular injury,deep infection,or implant failure was found in this group.Conclusion Anterolateral plus posteromedial approaches are effective for complex tibial plateau fractures,leading to anatomic reduction,stable fixation and early functional rehabilitation.

Objective: To study the effect of hydrogen-containing preservation solution against oxidative stress and inflammatory damage of rat donor heart. Methods: Thirty-two SD rats were evenly randomized into four groups(n = 8) : control group (the hearts were protected by HTK solution), H1 group (hydrogen concentration was about 0.2 mmol/L in the HTK solution), H2 group (hydrogen concentration was about 0.4 mmol/L in the HTK solution) and H3 group (hydrogen concentration was about 0.8 mmol/L in the HTK solution). The rat hearts were harvested in all groups and were mounted on the Langendorff apparatus to estimate baseline hemodynamic values. All the hearts underwent hypothermic (4°C) storage for 6 h in the corresponding cardioprotective solutions. Then, superoxide dismutase (SOD) activities and malondiadehyd (MDA) contents in myocardium tissues were measured after reperfusion by xanthine oxidase method and TBA method, respectively. The levels of 8-hydroxydeoxygunosine, TNF-α, and IL-6 in the myocardium tissues were measured by enzyme-linked immunosorbent assay (ELISA). Results: The MDA levels in H1, H2, and H3 groups were lower than that in the control group 6 h after preservation (P<0.01 or P<0.05), and the SOD activities in H2, H3 groups were higher than that in the control group (P<0.01 or P<0.05). The levels of 8-hydroxydeoxygunosine, TNF-α, and IL-6 in the control group were higher than those in H1, H2, and H3 groups (P<0.01 or P<0.05). Conclusion: Hydrogen-containing preservation solution can relieve the oxidative damage and reduce production of inflammation factors during preservation of rat donor heart.

AIM: To observe effects of shear stress and TNF-? on caveolin-1 expression. METHODS: Cultured human aortic endothelial cells (HAECs) of passage 3-5 were used in the experiment. Cells were exposed to a laminar flow (shear stress 1.0 Pa) by using a parallel rectangular flow chamber for different time. Caveolin-1 mRNA and protein expression were measured by RT-PCR and Western blot, respectively. Caveolin-1 expression of the cells stimulated by TNF-? were also studied to elucidate the influence of this inflammatory factor. RESULTS: After 24 h of exposure to 1.0 Pa shear stress, both of caveolin-1 protein and mRNA expression decreased in HAECs, especially caveolin-1 mRNA expression (P

Objective To investigate the effect of IL-1 7A on lipopolysaccharide (LPS)-induced neuroinflammation and fear conditioning test.Methods Among 70 male SD rats aged 18 months, firstly,thirty rats were randomly divided into five groups:control group(group A),LPS 6 h group (group B),12 h group(group C),24 h group(group D),48 h group(group E).Group A were injected intraperitoneally with normal saline and groups B,C,D and E were injected with LPS 500 μg/kg.Ani-mals of groups A,B,C,D and E were killed respectively after LPS injection and their hippoeampus tis-sue was detected for the concentration of IL-1 7A.Secondly,forty rats were randomly divided into 4 groups:control group(group O),IL-1 7A antibody group(group P),LPS group (group Q),IL-1 7A antibody+LPS group(group R).Group P and group R were injected intracerebroventricularly with IL-1 7A antibodies 3 μl (200 μg/μl),groups O and Q were injected equal volume of normal saline.30 min later,groups Q and R were injected intraperitoneally with LPS 500 μg/kg,groups O and P were in-jected equal volume of normal saline.24 h later,contextual fear conditioning test was performed. Then,all animals were killed and their hippocampus tissue would be detected for the concentration of TNF-αand IL-6,as well as the expression of Iba1-positive cells.Results The concentration of IL-1 7A of groups B,C,D and E increased significantly compared with group A (P <0.01 ),there was no difference between groups E and A.The freezing time of groups Q and R was significantly shortened than that in group O(P <0.01 or P <0.05 ),the freezing time of group R was significantly longer than that in group Q(P <0.01).The concentration of TNF-αand IL-6 of groups Q and R was obvi-ously higher than group O(P <0.01 ),the concentration of TNF-α and IL-6 of group R lower than group Q(P <0.01).The expression of Iba1-positive cells in hippocampal area CA1 of groups Q and R was obviously increased compared with group O(P <0.01).Compared with group Q,the expression of Iba1-positive cells in hippocampal area CA1 of group R were obviously decreased (P < 0.05 ). Conclusion IL-1 7A is implicated in the early stage of LPS-induced neuroinflammation and the chan-ging of freezing time in contextual fear conditioning in aged rats.

OBJECTIVETo investigate the clinical characteristics of Segond fracture combined with injuries, and to explore the operative method and opportunity.

METHODSFrom June 2010 to December 2014, 10 patients with Segond fracture were treated. There were 10 males, ranging in age from 26 to 69 years old, with a mean of 42 years old. Under arthroscopy examination within 7 to 10 days after injury, 6 patients had compete rupture of anterior cruciate ligament and meniscus injury; 2 patients had tibial avulsion fractures of the ACL combined with meniscus injury. At 4 to 8 weeks after injury, 2 patients were performed with arthroscopy examination; 1 patient had complete rupture of anterior and posterior cruciate ligament combined with meniscus injury; and the other patient had complete rupture of anterior cruciate ligament alone. All the patients with cruciate ligament rupture were treated with reconstruction of cruciate ligament; 9 patients had meniscus injuries were treated with menisus plasty or suture; and 2 patients had tibial avulsion fractures of the ACL were treated with non-absorbable Ethicon suture fixation under arthroscopy. After operation, the Lysholm scoring system was used to evaluate clinical effects.

RESULTSEight patients were operated within 10 days after injury, the knee joints swelling was obvious at the 3rd day after operation, and blood oozing was found by joint puncture. These 8 patients did out-of-bed activity with assistance at 1 week postoperatively. Other 2 patients performed operation in 4 to 8 weeks after injury without knee joint obvious swelling at the 3rd day after operation, and no blood oozing was found by joint puncture. These 2 patients did out-of-bed activity with assistance after 3 days postoperatively. All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 18 months. Postoperative Lysholm score of all patients was higher than preoperative scor, and the results were satisfactory.

CONCLUSIONFor Segond fractures, firstly, it is important to gain early diagnosis for treatment. Secondly, it is often associated with the rupture of anterior cruciate ligament and meniscus injuries, and the best time of cruciate ligament rebuilding and meniscus repairing maybe between 4 to 8 weeks after injury. Thirdly, personalized treatment should be chosen according to different complications.

Adult ; Aged ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Humans ; Male ; Middle Aged ; Tibial Fractures ; complications ; diagnosis ; surgery ; Tibial Meniscus Injuries

Objective To investigate the role and molecular mechanism of epithelial‐mesenchymal transition (EM T ) in che‐moresistance to oxaliplatin in colorectal cancer cells .Methods Oxaliplatin resistant LOVO/L‐OHP cells were established by gradu‐ally increasing the concentration of oxaliplatin and intermittent treatment with high‐dose concentration on parental cells (LOVO) . The expression of E‐cadherin and Vimentin was detected by indirect immunofluorescence and Western blot analysis .The expression of Snail and Twist was detected by Western blot analysis .cell proliferation was detected by MTT .Results Compared with LOVO cells ,the epithelial phenotype of LOVO/L‐OHP cell line was lost ,and the expression of E‐cadherin was decreased (22 .63 ± 3 .25)% (P<0 .01) ,an increase in the mesenchymal marker Vimentin (475 .42 ± 58 .36)% (P< 0 .01) .LOVO/L‐OHP cell line Twist expression was slightly increased (116 .42 ± 18 .36)% (P> 0 .05) ,Snail expression was significantly increased (382 .18 ± 41 .33)% (P<0 .01) .The expression of siSnail increased E‐cadherin (246 .82 ± 31 .57)% (P<0 .01) .The expression of Vimentin (28 .75 ± 3 .96)% (P< 0 .01);siSnail significantly enhanced sensitivity to oxaliplatin based chemotherapy in LOVO/L‐OHP cell line ,IC50 control group and siSnail group were 23 .75 μg/mL and 12 .42 μg/mL .Conclusion EM T may play an important role in chemoresistance to oxaliplatin in colorectal cancer cells ,inhibition of EM T can restore chemosensitivity of resistant colorectal cancer cells.

Molecular methods and fluoroscopic techniques suggest that rich microbial diversity exist in the marine environment, but less than 1% of these microbes can be cultured in the laboratory conditions, and that the cultivable dominant species were even less. This limitation has long been a barrier to the development of environmental microbiology and the utilization of marine resources. In the past decade, novel methods for culture and detection of these uncultured marine microbes have successfully applied to obtain several conventionally-uncultured microbes including those from extreme environments. Those progresses have inspired researchers greatly. Developments in the research of marine microbial resources are an important basis for the study of the micro-world and deserve increasing scientific attention.

Objective To explore the feasibility,advantages and disadvantages of combined trans- gastric and transcolonic routes for NOTES.Methods A female swine was used in this study.Transgastric entrance was the first,followed by transeolonie entrance.A dual-channel endoscope was inserted through the porcine mouth into the gastric cavity and penetrated into the peritoneal cavity through the puncture and bal- loon dilatation of the gastric wall.Then under direct visualization through the transgastric approach,the other endoseope was advanced into the peritoneum.Using the two endoscopes inside the peritoneal cavity,collabo- rative peritoneoseopy was performed by the two endoscopists.After the examination the incisions in the stom- ach and the colon wall were closed with Endoclips.The animal was sacrificed for post-mortem examination with particular attention to the entrance sites and presence of any complications related to the access or to ma- nipulations inside the peritoneal cavity.Results No hemorrhage oecurred during the puneture and balloon dilatation or bow-knife cutting of the gastric wall or the eolonic wall.The liver was damaged while a needle knife penetrated the gastric wall.On the contrary,no organs were damaged during the needle knife penetra- ted the eolonic wall under direet visualization through the transgastric approach.It was difficult to find the gallbladder or the oviduct with a"single arm",but it was easy to see them with the double routes.It was easier to close the colonic incision than to close the gastrie wall with Endoclips.Conclusion Combined transgastric and transcolonic route for NOTES is feasible and it seems to be easier to show a target compared with a single route.

Fluid therapy has been the focus of attention and dispute. In this paper, there are three aspects including postoperative bowel function, surgical prognosis, and acute diffuse peritonitis. Colloidal supplement and appropriate crystal/colloid ratio should be noted in low perfusion conditions. The different types of fluid in recent studies did not show a significant difference in the long term. The new evidence will be noted in fluid therapy among 2012 SSC Severe Sepsis and Septic Shock Guideline update (unpublished).
Digestive System Surgical Procedures ; Fluid Therapy ; Humans ; Perioperative Care ; Peritonitis ; therapy ; Prognosis ; Shock, Septic ; therapy

more coincidence with ultrasound than SPECT. ConclusionsUltrasonography is a noninvasive method for assessing the effect of multiple burr-hole operation in patients with moyamoya disease.