OBJECTIVE: To summarize the current situation and progress of treating transverse acetabular fractures using different types of internal fixations. DATA SOURCES: The databases including PubMed were retrieved using key words of "acetabular/acetabulum, fracture, plate/plates, screw/screws, cable" both in English and Chinese. DATA SELECTION: The basic research, clinical research, review articles, as well as case reports concerning operation opportunity, and internal fixation methods were included. And repeated papers or articles with incomplete data were excluded. MAIN OUTCOME MEASURES: Totally 35 papers were selected, including 3 review articles, 8 basic research and 24 clinical research. RESULTS: Open reduction and internal fixation has been a preferred treatment for transverse acetabular fractures. The goals of treatment are anatomical reconstruction of articular surfaces and rigid internal fixation of the fragments of the fracture, so that to get early active motion. Reconstruction plate was characterized by great strength, good toughness, stable fixation, as well as excellent histocompatibility, which has accepted as standard internal fixation materials. However, the application of newly developed system, such as locking plate, absorbable screws, shape memory alloy staple, and acetabular memory internal fixation system, has received a better clinical results. CONCLUSIONS: There are plenty of internal fixations can be used in treating transverse acetabular fractures, and the reconstruction plate is the most accepted one. Actually, the internal fixations should be combined together to obtain a good result if necessary.

From January 2006 to December 2007,44 cases of humeral shaft fractures were admitted to Department of Orthopaedics,Sixth People's Hospital of Shanghai Jiao Tong University,including 29 males and 15 females,with an average age of 40.7 years old(ranging 19-89 years).Of them,13 cases of fracture involved upper segment,24 involved middle segment and 7 lower segment.All fractures were close fractures.According to AO/ASIF classification,there were 5 cases of type A1,11 of A2,6 of A3,6 of B1,12 of B2,and 4 of B3.All patients were treated by expendable intramedullary nailing system.Time of operation,hospitalization and healing,blood loss,intra-or postoperative complications and range of shoulder and elbow motion were recorded and analyzed statistically.X-ray was shot to observe the union of fractures.The expendable intramedullary nailing was successfully performed in all patients for 86 minutes(ranging 30-150 minutes).The blood loss ranged from 30 to 200 mL with a mean of 70 mL.Except primary injury-caused radial paralysis,no iatrogenic radial paralysis occurred.All 44 patients were follow-up with an average of 18 months.Of them,41 patients had fracture union,and 3 nonunion.The average healing time was 15.8 weeks.There were 15 patients complained of pain in the shoulder joint,which did not affect daily life.According to UCLA shoulder scoring system,an excellent result was found in 18 patients,good in 23 patients,and fair in 3 patients with an excellent/good rate of 93.2%.All the patients had the excellent results according to Mayo elbow performance score system.No infection,iatrogenic fracture,limb shortening,nail breakage,fat embolism syndrome or peripheral nerve injury was found.The expandable nail offers the advantages of little blood loss,reduced operation time and exposure to radiation.However,nail antegrade insertion may lead to shoulder pain,and it should be paid more attention for cases of rotational instability in inferior segment of the humerus.

Objective To explore the expression of glutathione-S-transferase-π(GST-π),P-glycoprotein (P-gp),topoisomerase Ⅱ (Topo Ⅱ) and thymidylate synthase (TS) in gastric adenocarcinoma tissues and the clinical significance.Methods Envision method of immunohistochemistry was used to detect the expression of GST-π,P-gp,Topo Ⅱ and TS in sample of 64 gastric adenocarcinoma tissues and 12 normal gastric mucosas,and their corresponding clinical data were comprehensive analyzed.Results The expression positive rates of GST-π,P-gp,Topo Ⅱand TS were respectively 76.6 ％(49/64),64.1％ (41/64),84.4 ％ (50/64) and 53.1％ (34/64),that were all higher than in gastric mucosa [8.3 ％ (1/12),8.3 ％(1/12),16.7 ％ (2/12),0],the differences were statistically significant respectively (P ＜ 0.01).Their positive expression rates were closely relevant to the degree of differentiation (P ＜ 0.05),but not to the patients' gender,age,tumour size,clinical staging,invasive depth and lymph node metastasis (P ＞ 0.05).The expressions of GST-π,P-gp and TS in high and middle differentiation adenocarcinoma were high.er than in low differentiation,but the expression of Topo Ⅱ in high and middle differentiation adenocarcinoma was lower than in low differentiation (P ＜ 0.05).Conclusion GST-π,P-gp,Topo Ⅱ and TS are over-expressed in gastric adenocarcinoma,which is related to the multidrug resistance of gastric adenocarcinoma.The joint detection of the expression of GST-π,P-gp,Topo Ⅱ and TS in gastric adenocarcinoma can be looked as an important symbol for guiding its chemotherapy drug and prognosis.

AIM To study hypoxia reoxygenation induced apoptosis of neonatal rat cardiomyocytes and the roles of nitric oxide in this process. METHODS Cultured neonatal rat cardiomyocytes were divided into two groups. Cells of one group were cultured in an incubator of 950 mL?L -1 N 2 and 50 mL?L -1 CO 2 for 16 h, 32 h and 48 h followed by normal incubation for 6h to form the cell model of hypoxia reoxygenation injury.Cells of another group were cultured in the same hypoxia condition for 16 h, 32 h and 48 h. Before they were put in normal condition for 6 h, NO donor SNAP was added to the media to form the final concentration of 100 ?mol?L -1 . Apoptosis was detected by TUNEL and flow cytometer. RESULTS Apoptotic cells were detected by TUNEL after hypoxia of 16 h, 32 h and 48 h followed by 6 h reoxygenation and the apoptotic rates of cardiomyocytes were (5 5?0 7)%, (11 0?1 1)% and (14 2?1 6)% respectively detectedby flow cytometer. The apoptotic rates of myocardiums with SNAP were (3 2?0 7)%, (7 8?0 7)% and (10 9?1 0)% respsctively. CONCLUSION The apoptotic rates of cardiomyocytes undergoing hypoxia reoxygenation injury increase with time of hypoxia; NO can inhibit apoptotic rates of cardiomyocytes in this pathological process and thus may have a protective effect on cardiomyocytes.

Objective To discuss and analyze the imaging features of extramedullary hematopoiesis (EMH).Methods Imaging data of EMH in 7 patients with 85 lesions confirmed by clinical and pathological results were retrospectively analyzed.Results CT or MRI showed thoracic paravertebral multiple tumor-like soft tissue masses in 6 patients accompanied with pleural mass in 1,with liv-er mass in 1 and spleen mass in 1,and the masses in the distal ileum and in front of the inferior vena cava in 1.Thoracic paraverte-bral and pleural masses presented isodensity on plain CT and moderate enhancement on post-contrast CT.Among the 6 liver mas-ses,CT showed uniform density in 5 and small area of necrosis in 1.The only one spleen mass also appeared inner necrosis and mul-tiple small calcifications.The mass in the ileum presented thickened bowel wall with moderate enhancement,meanwhile the mass in front of vena cava presented obvious edge enhancement.MRI in 2 patients showed the masses with low signal on T1 WI and high sig-nal on T2 WI.Conclusion EMH has certain specific imaging characteristics,which may be helpful for correct diagnosis of EMH when combined with the clinical data.

Objective To explore the effect of long-term enhanced external counterpulsation(EECP)on endothelium-dependent and endothelium-independent vasorelaxation in the carotid arteries of atherosclerotic piss. Method Totally 18 20-day-old male infant pigs were randomly divided into 3 groups according to feeding given: the normal[control group(n=6),the hypercholesterolemic control group(n=6)and the hypereholesterolemic +EECP group(n=6).Porcine model of hypercholesterolemia was made by feeding high-cholesterol diet.After EECP for 36 hours in the hypercholesterolemic+EECP group(n=6),carotid arterial rings were harvested from all animals and their vaso-relaxation response to different dose of Acetylchofine(Ach)and Sodium nitroprusside (SNP)were detected,respectively.Results As the dose of Ach varying between 10-8 mol/L and 10-5mol/L, endothelium-dependent vasorelaxation ratio of hypereholesterolemic piss with or without EECP treatment was significantly lower than that of the normal control group(P＜0.05),however,endothehum-dependent vasorelax- ation ratio in pigs with EECP treatment was obviously higher compared with hypereholesterolemic pigs without EECP treatment(P＜0.05)as the Ach ranged from 10-7 mol/L to 10-5mol/L.Similarly,as the concentration of SNP ranged fiun 10-8 mol/L to 10-5 mol/L.endothelium-independent vasorelaxafion ratio of both the hypercholesterolemic control group and the hypercholesterolemic+EECP group were significantly lower than that of the normal control group(P＜0.05),and end othelium-independent vasorelaxation ratio of the hypercholesterolemic+EECP group was significantly higher than that of the hypercholesterolemic control group (P＜0.05).Condusions Long-term EECP improves the impaired endothelium-dependent and endothelium independent vasorelaxalion function resulting from atherosclerosis.

Objective To investigate the influence of comprehensive nursing intervention in elderly diabetic patients with acute cerebral infarction .Methods 84 elderly cerebral infarction patients were randomly divided into observation group (n =42)and control group (n =42),the control group was gave conventional nursing method,and the observation group was given the comprehensive nursing intervention.Symptoms of the patients was improved and healthy levels were observed.Results The overall effective rate of the observation group was much higher than the control group,the difference in the overall effective rate of two groups was statistically signifi-cant (P <0.05).The NIHSS score of observation group after nursing was significantly lower than in the control group,the difference was statistically significant(P <0.05).The ADL score of ob-servation group after nursing was significantly higher than the in the control group,the result re-vealed that the difference was statistically significant (P <0.05).Conclusion The systematic nursing intervention can help to improve the prognosis of patients with cerebral infarction and the life quality.

Objective To investigate the influence of comprehensive nursing intervention in elderly diabetic patients with acute cerebral infarction .Methods 84 elderly cerebral infarction patients were randomly divided into observation group (n =42)and control group (n =42),the control group was gave conventional nursing method,and the observation group was given the comprehensive nursing intervention.Symptoms of the patients was improved and healthy levels were observed.Results The overall effective rate of the observation group was much higher than the control group,the difference in the overall effective rate of two groups was statistically signifi-cant (P <0.05).The NIHSS score of observation group after nursing was significantly lower than in the control group,the difference was statistically significant(P <0.05).The ADL score of ob-servation group after nursing was significantly higher than the in the control group,the result re-vealed that the difference was statistically significant (P <0.05).Conclusion The systematic nursing intervention can help to improve the prognosis of patients with cerebral infarction and the life quality.

Objective To expore the effects of international resident assessment instruments (InterRAI) comprehensive evaluation and intervention on nutritional status of aged inpatients.Methods Totally 235 aged inpatients of a tertiary hospital from February to December 2015 were selected,and 126 cases of them had nutritional risk after the test of NRS 2002. Patients with nutritional risk were randomly divided into the intervention group and the control group,with 63 cases in each group. Patients in two groups were all given dietary estimation,nutritional education,and enteral or parenteral nutrition;besides,patients in the intervention group also received InterRAI comprehensive evaluation and intervention. At the first day and three months after intervention,Inbody 720 body composition analyzer was used to test the protein,body fat, skeletal muscle and BMI,and the second nutritional evaluation was conducted through blood nutrition indicators (plasma total protein concentration,serum albumin,prealbumin and transferrin). SPSS 17.0 software was used to analyze the data,and measurement data adopted two independent samples to design thet test.Results At the first day after admission,there were no differences in body composition index and blood nutrition indicators between two groups (P>0.05). Reexamination after three months showed that,the protein (8.5±0.7) kg,body fat (16.5± 4.8) kg,skeletal muscle (24.2±4.0) kg and BMI (17.2±5.6) kg/m2 in the intervention group,were all higher than the protein (6.6±0.9) kg,body fat (20.2±5.6) kg,skeletal muscle (18.5±3.1) kg and BMI (16.5±6.1) kg/m2 in the control group (t=9.595,8.055,11.331,2.015;P<0.05). and blood nutrition indicators in the intervention group, were better than that in the control group (P<0.05). The plasma total protein concentration (67.1±6.9) g/L, serum albumin (44.3±7.4) g/L, prealbumin (245.1±15.4) mg/L and transferrin (2 530.3±190.5) mg/L in the intervention group,were all higher than the plasma total protein concentration (55.6±7.2) g/L,serum albumin (32.5±6.3)g/L, prealbumin (210.1±16.8) mg/L and transferrin (2 001.1±169.8) mg/L in the control group (t=12.805,7.890, 9.421,14.427;P<0.05).Conclusions The InterRAI comprehensive evaluation and intervention can effectively improve the nutritional status and the quality of life in the elderly,and reduce the nutritional risk.