Objective To summarize the clinical effects of retrograde intramedullary nail in treating distal femora| fracture. Methods Retrospectively analysed 52 cases of intereondyiar and supracondylar fracture of femur treated with retrograde intrameduUary nail. Results All cases were followed up for 6 to 24 months. All fracture were union except 2 reoperations cases had delay union. Conclusion Retrograde intrameduUary nail has supreme biological stability and allowed early exercise. It also can shorten operation time, reduce damage of periosteum and reduce delay union rate.

Objective To investigate the operative indications and the therapeutic effect of the pedide screw fixation used for treating multiple fractures of the thoracolumbar spine. Methods 16 cases of multiple fractures of the thoracolumbar spine were chosen to be treated by open reduction through posterior approach and pedicle screw fixation. 10 cases were the fractures involved adjacent segments,4 cases were the fractures with one intact vertebral segment between them,2 cases were the fractures with two intact vertebral segments between them. Results The patients were followed up for 12～36 months,with an average of 21.5 months. After the operations,function of moat of the injured nerves had beeu improved or restored. The vertebral height of the fractured segment showed no signifi-cant loss. The materials of internal fixation found no loosening or fracturing at the end of follow-up. Conclusion Fractures of multi-segment of thoraeolumhar vertebrae can cause serious instability and are required for timely treat- ment. The method of the internal fixation with pedicle screw-rod fixation system through posterior approach, fol- lowed by limited decompression, can reconstruct the stability of the vertebrae and promote the recovery of the im- paired neurological functions.

Objective Summarize the clinical experience on the improved intramedullary nail therapy for the fraction of femurand tibia,to improve the skill. Methods The modified intramedullary nail has been used for frac-tion-cure on 64 cases of which 29 are femur fraction and 35 tibin fraction through the period. Results All the pa-tients were recovered within 4 months without any joint malfunction or syndromes. Conclusion The far-end aiming of the modified intrameduUary nail could maintain a 100 % precision, which out down the surgery operation time and reduce bleeding. Remain the advantage of previous intrarnedullary nail is beneficial to bone fraction concrescence and function recovery.

Objective To investigate the clinical effect of interbody cages combined with pedicle screw system in treatment of spondylolisthesis. Methods Of 20 patients with spondylolisthesis, interbody cages combined with 10pedicle screw system was performed in 10 patients and spinal decompression combined with intervertebral bone grafting in another 10. Results All the patients were followed up for 8-12 months (average 10 months), which showed significant improvement in the syndrome. Of 10 patients treated with interbody cages combined with pedicle screw system, seven patients were evaluated excellent, two good and one fair. Of 10 patients treated with spinal decompression combined with intervertebral bone grafting, five patients were evaluated excellent, two good and three fair. Conclusion Interbody cages combined with pedicle screw system is an safe and effective surgery for spondylolisthesis.

Objective To investigate the severity of allogenic rejection after partial liver transplantation (PLTx) with different graft weight to recipient liver weight (GW/RLW).Methods The full-size liver transplantation (group A),GW/RLW ＞33％ PLTx (group B) and GW/RLW ＜ 30％ PLTx (group C) were set up using BN rats and Lewis rats as donors and recipients,respectively.All recipients were observed for 28 days.The Banff RAI grading,survival rate,jaundice and body weight recovery were evaluated to determine the severity of acute allogeneic rejection.Two PLTx groups,group B1 (GW/RLW＞33％) and group C1 (GW/RLW＜30％),were established to assess the mRNA level of IL-2,GranzymeB,Perforin and CD3 48 h and 7 days postoperatively.Additionally,the mRNA level of B7-H1,the ratio of Ki67 + hepatocytes and the liver enzymes were also assessed 7 days postoperatively.Results All recipients in group C died within 22 days postoperatively,presenting with severe lymphocytic infiltration and vascular endothelialitis.All recipients in group A and group B survived until the end of observation time.All recipients in group A survived and presented with a mild lymphocytic infiltration and rare vascular endothelialitis.Group B presented with moderate lymphocytic infiltration and moderate vascular endothelialitis.The Banff RAI grading in group C was significantly higher than that in group A and group B (P ＜ 0.05).In accordance with the result of histology and survival rate,group B and group C presented with earlier jaundice and lower body weight recovery than that of group A (P＜0.05).As compared with group B1,group C1 presented with higher mRNA levels of Perforin,GranzymeB,IL-2 and CD3,higher level of liver enzymes and heavier liver graft weights.Besides,the mRNA level of immunosuppresive molecule B7-H1 in group C1 was lower than that of group B1.However,there was no significant difference in the ratio of Ki67 + hepatocytes between group B1 and group C1.Conclusion The allogenic liver rejection may be enhanced by reducing the GW/RLW.

Increased microglial activation and neuroinflammation within autonomic brain regions such as the rostral ventrolateral medulla (RVLM) have been implicated in stress-induced hypertension (SIH). Prorenin, a member of the brain renin-angiotensin system (RAS), can directly activate microglia. The present study aimed to investigate the effects of prorenin on microglial activation in the RVLM of SIH rats. Rats were subjected to intermittent electric foot-shocks plus noise, this stress was administered for 2 h twice daily for 15 consecutive days, and mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) were monitored. The results showed that MAP and RSNA were augmented, and this paralleled increased pro-inflammatory phenotype (M1) switching. Prorenin and its receptor (PRR) expression and the NLR family pyrin domain containing 3 (NLRP3) activation were increased in RVLM of SIH rats. In addition, PLX5622 (a microglial depletion agent), MCC950 (a NLRP3 inhibitor), and/or PRO20 (a (Pro)renin receptor antagonist) had antihypertensive effects in the rats. The NLRP3 expression in the RVLM was decreased in SIH rats treated with PLX5622. Mito-tracker staining showed translocation of NLRP3 from mitochondria to the cytoplasm in prorenin-stimulated microglia. Prorenin increased the ROS-triggering M1 phenotype-switching and NLRP3 activation, while MCC950 decreased the M1 polarization. In conclusion, upregulated prorenin in the RVLM may be involved in the pathogenesis of SIH, mediated by activation of the microglia-derived NLRP3 inflammasome. The link between prorenin and NLRP3 in microglia provides insights for the treatment of stress-related hypertension.