Objective To evaluate the outcome of posterolateral approach to the fibula for trimalleolar fractures,especially the fracture in posterior malleolus.Methods Thirty-two patients with trimalleolar fractures treated via posterolateral transmalleolar approach from July 2006 to July 2011 were analyzed retrospectively.All underwent open reduction and internal fixation,including 22 Lauge-Hansen grade Ⅳ supination-external rotation ankle fractures and 10 Lauge-Hansen grade Ⅳ pronation-extemal rotation ankle fractures.Results All fractures had bone union after the follow-up of average 15.5 months (range,12-18 months).Average American Orthopedic Foot & Ankle Society (AOFAS) score was 90.75points,suggesting an excellent result.Kellgren grading system for posttraumatic arthritis severity was grade 0 in eight patients,grade Ⅰ in 18,grade Ⅱ in five,and grade Ⅲ in one,which turned out to be satisfactory.Conclusions Posterolateral approach to the fibula for trimalleolar fractures allows direct reduction and fixation of posterior malleolus fragment in treatment of trimalleolar factures and the clinical outcome is satisfactory.Moreover,the approach deserves clinical practice.

Objective To compare the clinical effect of simple volar or dorsal plate fixation of intra-articular distal radius fracture.Methods This retrospective study included 42 patients with closed intra-articular distal radius fracture treated surgically using the dorsal or volar plate.Out of the 15 patients in dorsal plating group 5 were males and 10 females at age of (55 ± 7)years (range, 48-62 years), 13 were injured from falls and 2 traffic accidents, 10 were classified as AO type C3 and 5 AO type C2.Out of the 27 patients in volar plating group 8 were males and 19 females at age of (56 ± 6)years (range, 50-62 years), 24 were injured from falls and 3 traffic accidents, 17 were classified as AO type C3 and 10 AO type C2.Between-group differences were compared with respect to wrist range of motion, postoperative radiographic parameters, postoperative complications, disabilities of the ann, shoulder and hand (DASH) score and Gartland-Werley score.Results All the patients were followed up for 11-25 months.There were no significant differences in the wrist range of motion and radiographic parameters between the two groups (P ＞ 0.05).Volar plating group resulted in a significantly better Gartland-Werley score compared to dorsal plating group [1 vs 4 points, P ＜ 0.05], but no significant difference was noted in DASH score (P ＞ 0.05).Four patients (27％) in dorsal plating group developed tendon adhesions and tenolysis was in demand, but one patients (4％) in volar plating group was complicated by median nerve symptoms (P ＜ 0.05).Conclusions Although the DASH score of the two methods was similar, volar plating yields better results in Gartland-Werley score and complication incidence.Thus the volar plating is recommended for intra-articular distal radius fracture.

Objective To investigate the postoperative joint not?reset therapeutic effects in the commi?nuted double ankle fracture. Methods From August 2012 to February 2015 in Dongfeng Hospital Affiliated to Hubei Medical College,72 comminuted double ankle fracture postoperative joint not?reset patients were selected as the study subjects,and according to the order of admission were equally divided into the treatment group and the control group,36 patients of each group. The treatment group were treated with closed reduction internal fixa?tion,the control group were given the open reduction and internal fixation. The intraoperative and postoperative recovery of both groups were observed. Results All the operation were completed successfully, the operative time,blood loss and postoperative hospital stay in the treatment group were ( 89. 24 ± 10. 34 ) min, ( 67. 24 ±14. 87) ml and (11. 45±2. 34) d respectively,significantly less than the control group((123. 45±11. 98) min,(82. 14±13. 45) ml and (14. 98±2. 47) d),the differences were significant(t=6. 498,4. 988,5. 278,P<0. 05) . The postoperative 3 months ankle function excellent in the treatment group and the control group were 94. 4%(34/36) and 77. 8%(28/36) respectively,the differences was significant(χ2=5. 966,P<0. 05). The postoperative 3 months pain scores in the treatment group and control group were 1. 78 ± 0. 45 points and 2. 60 ±0. 44 points,the differences was significant(t=8. 355,P<0. 05),and significantly lower than the preoperative ((6. 44±0. 67) points, (6. 49±0. 40) points),the differences were significant(t=25. 983,17. 332,P<0. 05) . Conclusion The closed reduction internal fixation for the postoperative joint not?reset therapeutic in the com?minuted double ankle fracture has better minimally invasive,it can promote double ankle function recovery and relieve pain,it is a reliable way of clinical applications.

Cells, Cultured ; Coal ; toxicity ; Dust ; Humans ; In Vitro Techniques ; Mutagenicity Tests ; Mutagens ; toxicity ; Mutation ; drug effects ; Salmonella typhimurium ; drug effects ; genetics ; Sister Chromatid Exchange ; drug effects

Animals ; Guanylate Cyclase ; metabolism ; Hypercapnia ; metabolism ; Hypoxia ; metabolism ; Lung ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Cytoplasmic and Nuclear ; metabolism ; Soluble Guanylyl Cyclase

Two parental strains BY-14 and BY-6,with high leavening ability in lean and sweet dough respectively,were selected.Through spore production and separation,two haploids with opposition types were selected for cross-breeding.At last one hybridization strain was obtained,with good fermentation ability as BY-14 in lean dough and better than BY-6 by 25%in sweet dough.

Objective To discuss methods and clinical efficacy of patients treated with arthrolysis for posttraumatic elbow stiffness with heterotopic ossification.Methods The study involved 16 patients with posttraumatic elbow stiffness combined with heterotopic ossification treated by arthrolysis between June 2007 and June 2011.There were 11 males and 5 females,at average age of 29.6 years (range,18-53 years).Time from injury to surgery averaged 10.7 months (range,8-14 months).Other than medial approach for only one patient,the rest adopted medial to lateral approaches to have a complete clearance of periarticular heterotopic ossification tissue and hyperplastic tissue as well as partial resection of articular capsules and ligaments.Besides,seven patients were fixed using hinged external fixators.After surgery,three weeks of oral celecoxib was given for the patients.Rehabilitation was started immediately after operation.Range of motion (ROM) of the elbow and Mayo elbow pcrformance score (MEPS) were used to determine clinical results.Results All patients were followed up for 8-17 months (mean 13.4 months).ROM of the elbow (extension lag,flexion,pronation and supination)showed an improvement from (45.2-3.5)° to (27.2 ±8.4)°,(68.1-11.8)° to (106.8 ± 16.4)°,(55.8 ± 8.2) ° to (80.5 ± 3.3) °,and (53.7 ± 6.3) ° to (83.1 ± 5.3) ° respectively (P ＜ 0.01).MEPS increased from (46.8 ±7.0) points to (83.2 ±9.4) points after operation (P ＜0.01).According to MEPS criterion,the results were excellent in seven patients,good in five and fair in four.Conclusion With respect to posttraumatic elbow stiffness with heterotopic ossification,satisfactory therapeutic results can be achieved by thorough preoperative evaluation,strict control of surgical indications,appropriate selection of intraoperative techniques and early systematic rehabilitation.

Objective To investigate the clinical features of primary retroperitoneal fibrosis (RPF), and to find out better method for diagnosis and therapy. Methods Nine patients with primary RPF in Peking Union Medical College Hospital since 1990 to 2003 were analyzed retrospectively. Results All patients had abnormal findings in CT or MRI, and 8 of them had chronic non-specific inflammation of the retroperitoneum in pathology. Six patients had renal involvement and 2 of them had severe renal failure. Eight of the patients had received therapy with corticosteroid or tamoxifene. Conclusions RPF is an uncommon collagen vascular disease characterized by a chronic non-specific inflammation of the retroperitoneum.Because of the atypical manifestations of RPF, awareness of the disease is important.CT and (or) open biopsy remains the gold standard for diagnosis.Management typically includes surgery and drug treatment.Corticosteroid therapy or more recently,tamoxifen has been used successfully. The clinical and radiographic improvement with drug treatment has been seen in several patients and confirmed the diagnosis,thereby early diagnosis and treatment can bring the patient more excellent renal and general outcome.

0.05).Conclusion Multi-disciplinary techniques combined with 125Ⅰ seeds implantation is effective in the management of the malignant obstructive jaundice.No significant difference for relief and liver function were found between CT-guided and during operation interstitial 125Ⅰ seeds implantations,but it seems more quickly relief or recovery was achieved in the latter.

AIM:To investigate the effects of N-acetylcysteine (NAC) on acute lung injury induced by H9N2 swine influenza virus ( SIV) in mice.METHODS: BALB/c mice were used to establish the animal model of acute lung injury by nasal inoculation of H9N2 SIV.The mice were divided into control group (without SIV infection), H9N2 SIV group (inoculation of H9N2 SIV) and NAC group (inoculation of H9N2 SIV plus pretreatment with NAC).The pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio.The pathological changes of the lung tis-sues were observed .The concontrations of TNF-α, IL-1βand IL-6 in bronchoalveolar lavage fluid ( BALF) were meas-ured.The virus titer, T-SOD activity, MPO activity and MDA content in the homogenate of the lung tissues were detected . RESULTS:Treatment with NAC decreased the morality of infected mice , and significantly prolonged the survival time of infected mice .The pathological changes of the lung tissues , the lung W/D ratio and the lung index were relieved when SIV infected the mice treated with NAC .Treatment with NAC significantly decreased the infiltration of inflammatory cells inclu-ding macrophages, lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased.Treatment with NAC also significantly increased the T-SOD activity.CONCLUSION: The protective effect of NAC on the acute lung injury mouse model is related to suppression of the oxidative stress and inflamma -tory responses .