Objective To study the curative effect of MMP-9 changes on left ventricular hypertrophy patients with hypertension heart disease by carvedilol and metoprolol.Methods 168 cases were divided into two groups.The control group(84 cases)applied metoprolol.The observation group applied carvedilol.The changes of IVST,LVPWT, LVMI and LVGI,expression of MMP-9 were observed in two groups after treatment.Results The values of IVST, LVPWT,LVMI and LVGI,expression of MMP-9 were decreased after treatment.But the decreased values of IVST [(1.72 ±0.35 )mm vs (0.36 ±0.11 )mm,t =5.75,P <0.05 ],LVPWT[(0.66 ±0.25 )mm vs (0.24 ± 0.18)mm,t =4.32,P <0.05],LVMI[(16.23 ±3.35)g/m2 vs (7.44 ±2.24)g/m2 ,t =9.86,P <0.05 ],LVGI [(0.52 ±0.12)g/m2 vs (0.40 ±0.11)g/m2 ,t =4.24,P <0.05],MMP-9[(76.23 ±20.87)vs(42.55 ±10.87),t =6.54,P <0.05]were higher in the observation group than in the control group.Conclusion The treatment of carvedilol is satisfied,can improve ventricular remodeling,decreased the expression of MMP-9,and is worthy of being recommended in left ventricular hypertrophy patients with hypertension heart disease.

[Objective]To provide Chinese morphological data for anterior C1、2 transarticular screw fixation.[Method]With a digital vernier and a goniometer made in China,the anatomic parameters related to anterior C1、2 transarticular screw fixation were measured from 50 pairs of dried Chinese adult human C1 and C2 vertebrae.[Result]In the anterior transarticular screw fixation,the lateral angulation of the screw tract to the sagittal plane ranged from(10.8?2.10)? to(25.13?3.12)?,the posterior anguation to the coronal plane from(8.85?2.12)? to(26.96?3.09)?,the screw tract length was from(17.48?2.1) mm to(25.4?2.59)mm,the distance from medial part of C2 foramen to the middle of C2 body was(14.12?1.28)mm.[Conclusion]It is optimal for the anterior C1、2 transarticular screw fixation to place the anterior C1、2 transarticular screw with the length of 17 mm to 25 mm in lateral angulation ranged from 10? to 25? and the posterior angulation ranged from 9? to 27?.During the procedure,the dissecting distance from the middle of C2 to lateral should not exceed 14 mm.

Objective To study method and timing of internal fixation for long bone fractures in polytraumatized patients with fat embolism syndrome (FES). Methods Twenty-eight cases of polytraumatized patients with FES received internal fixation for their long bone fractures in our hospital from January 1990 to August 2004. The method and timing of internal fixation were analyzed retrospectively. The long bone fractures in 27 cases were treated 5 to 7 days after their clinic FES symptoms disappeared, while one fracture was treated five days after the FES symptoms were relieved and the vital signs became stable. Eleven cases of long bone fracture were treated with open fixation by unreamed or slightly reamed intramedullary nailing while 27 cases were fixated with plate internally. Results Of the 27 patients who received open reduction and internal fixation for their fractures 5 to 7 days after disappearance of FES symptoms, 22 cases experienced no postoperative complications but fever and quickened pulse reoccurred in five cases after the first osteosynthesis. However, FES-like symptoms reoccurred in the one case who received the first operation when FES did not disappear. Conclusions Internal fixation by plate and intramedullary nailing without reaming are safe for polytraumatized patients with FES and long bone fractures. Proper timing of the first surgery for this kind of patient should be 5 to 7 days after the disappearance of FES.

Objective To describe postmedial approach to the knee and discuss the main technique using it to repair and reconstruct posterior cruciate ligament (PCL). Methods 24 patients with PCL injury were operated on with the postmedial approach. 13 cases were repaired directly using the technique of pulling out steel wire and 11 cases were reconstructed by semitendinosus. Prone position was adopted in 16 cases and supine position in 8 cases (21 cases had been followed up over six months). Applied anatomy, main techniques and clinical results were evaluated. Results The postmedial approach saved 30～60 minutes compared with the posteior approach, and was not restricted by body posture. Neurovascular structure did not need to be dissected, PCL repair and reconstruction could be finished in one incision.By a six month follow up evaluation, no symptoms of instability occured and they were completely stable on physical examination. Conclusion The postmedial approach is simple, safe, and yields excellent exposure. It's an ideal approach for repair and reconstruction of the PCL.The technique of pulling and steel wire and semitendinosas drawn out "U" shaped pins fixation are essential methods to repair and reconstruct the PCL.

As locking plate is widely used in periarticular and comminuted fractures as well as in fixation of osteoporotic bone,the events involving difficulty in removal of a locking plate increase gradually.Little research addresses the difficulty in implant removal.Stripping of the recess of the screw head,cross-threading between threads in the screw head and screw hole and cold welding are the main causes for difficulty in removing screws from a locking plate.Skills for implant removal include simple ones that require no use of special devices and complex ones that require use of special devices.Difficult implant removal will result in lengthened operation time,increased risk of secondary invasive surgery,residues of metallic shavings and so on.Prevention is the most effective countermeasure.This review summarizes the cause for difficult removal of locking plate and screws as well as the removing skills to help orthopedic surgeons prevent and respond to the difficulties intraoperatively.

24 hours. Results There were totally 192 patients met the criteria for the investigation. Group A consisted of 76 patients, group B 116 patients. No significant differences between the two groups were found in terms of associated injury, ISS, ICU length of hospital stay,complication or mortality, while significant difference existed between two groups in terms of associated shock (?2=6.078,P

Purpose:To look for an ideal screening method in vitro for establishing osteosarcoma cell sublines with different metastat ic potential. Methods:20 osteosarcoma cell sublines were isolated preliminari ly by clone technique in vitro. They were screened by electrophores migratio n rate assay and cell migration assay in vitro and obtained respectively a h igh and low metastatic potential osteosarcoma cell sublines (A1、A2、B1 and B2). The advantages of the two methods were compared and confirmed by using cell pro liferation, agarose clony-formation and transplantation in nude mice. Results:The cell proliferation rate , agarose clony-formation ability and spontaneous metastatic ability to lung of A1 and B1 were obviously h igher than that of A2 and B2 and the difference was statistically significant( P

0.05). JOA scores of group A is higher than those of group B on 1, 2, 4 weeks postoperatively and the difference is of statistical significance (P

[Objective]To study the surgical technique for the treatment of acetabular fractures.[Method]Retrospective analysis on consecutive acetabular fractures operatively treated at our hospital from January 1995 to March 2005 was made to find out the correlation factors influenced on the operative approaches.[Result]A total of 107 cases had surgery for an acetabular fracture in the meamtime.Of them,44 were exposed through a Kocher-Langenbeck approach,5 through an extended iliofemoral route,30 through an ilioinguinal or an anterior extensile approach,and 28 through a combined anterior and posterior incisions.After operation,anatomic reduction was obtained in 66 cases,good reduction in 36,incomplete reduction in 5.According to AAOS score,the satisfactory rate was 89.72% after following-up 1 to 11 years.[Conclusion]To determine reasonable surgical exposure of an acetabular fracture,the key factors are fracture type and its displacement direction,and the important reference factors include associated injuries with the fracture,operative time and complications related to different operative routes.

[Objective]To investigate the injury characteristics and treatment of the Hoffa facture associated with extensor mechanism injury.[Method]Four patients with Hoffa facture associated with extensor mechanism injury treated in author's hospital in recent 6 years were enrolled in this study.All the patients were multiple-injured,and associated with the ipsilateral limb fracture and retinacular and capsule laceration.The site of the extensor mechanism injury included 1 distal patellar tendon disruption,2 proximal patellar tendon disruption,and 1 distal quadriceps tendon disruption.No cruciate ligament injury was found in 3 ipsilateral bicondylar fractures.One unicondylar fracture was associated with anterior and posterior cruciate ligament and medial collateral ligament injury simultaneously.Emergency operation was performed along with the debridement in the three open fractures.In another patient with closed fracture,operation was performed one week after injury.Fractures were reduced and fixed with lag screws.Extensor apparatus were repaired and strengthened with a tension band wire through both patella and tibia.Ipsilateral limb fractures were reduced and internal fixed with hardware simultaneously. The knees were immobilized in extension with cast after operation,and flexion exercise was commenced four to six weeks later.[Result]Four patients wounds reached the first rate healing.There was no infection and necrosis of skin.All patients were followed-up for six months to three years.All 7 condyles of the 4 patients reached bone union.Healing time was about six to twelve weeks.According to Letenneur’s functional assessment system,excellent and good results were in 1 cases,fine in 3 cases.[Conclusion]Hoffa facture associated with extensor mechanism injury are usually accompanied with injuries in other part of the body.In open fracture,emergency operation is mandatory,and fracture reduction and internal fixation and extensor apparatus repair should be performed along with debridement.Tension band wire may strengthen the stability of the extensor mechanism and facilitated early mobilization.