Objective To investigate clinical characteristics and treatment of Hoffa fractures.Methods Twenty patients with Hoffa fracture (24 condyles) were treated from January 2002 to April 2009.They were 14 men (18 condyles) and 6 women (6 condyles), aged from 20 to 70 years (average, 43. 3 years).There were 15 fractures of medial femoral condyle and 9 ones of lateral femoral condyle. Two rare cases were fractures of unilateral bi-condyles and one rare case fractures of unilateral bi-condyles plus contralateral single condyle. Four fractured condyles were old due to implant failure and 20 were fresh. According to the modified Letenneur's classification, there were 6 condyles of type Ⅰ, 4 condyles of type Ⅱ and 14 condyles of type Ⅲ.Fifteen condyles were fixed anteroposteriorly with 2 to 4 cancellous or canulated screws, 8 condyles were fixed posteroanteriorly with 2 to 4 screws, and one condyle was fixed with K wires. Five condyles were fixed with screws plus lateral supporting plates, and 3 condyles with screws plus posterior anti-sliding plates. Results All the patients were followed up for an average of 14. 4 months (6 to 84 months) . All the 24 condyles obtained bony union after an average of 18. 6 weeks (from 12 to 44 weeks). There was no infection, implant failure, nonunion or bone necrosis. According to Letenneur's functional assessment system, 16 condyles were excellent, 6 good and 2 poor, with a good-to-excellent rate of 91. 7%. Conclusions All Hoffa fractures should be treated with screws. Screw diameter, fixation direction and surgical incision should depend on facture type and size of fracture block. Unstable Hoffa fractures should be treated with screws combined with lateral supporting plates or posterior anti-sliding plates.

Objective To explore the anti-sliding plating for Hoffa fractures by comparing the me-chanical properties of anti-sliding plates and cancellous bone screws. Methods Twenty cases of the same type of Hoffa fracture in the model femur were randomly divided into 4 even groups. Group A used 2 antegrade cancellous bone screws; Group B used 2 retrograde cancellous bone screws forwards; Group C used anti-sliding plate and locking screw fixation; Group D used anti-sliding plate and cancellous bone screw fixation. All the samples were subjected to the cycle fatigue and the maximum failure load tests. Results The fatigue test revealed no significant difference in the mean maximum displacements at the 10, 100, 1000, 10 000 cycles between the 4 groups. In the maximum failure load test, there were significant differences between Group A [(1224±72) N] and Groups C and D [(2183±227) N and (2124±235) N], as well as between Groups B [(1405±235) N] and Groups C and D; there was no significant difference between Group A and Group B, neither between Group C and Group D, Conclusions In the initial period after secure fixation for Hoffa fractures, anti-sliding plates and cancellous bone screws can all provide satisfactory mechanical stability and strength. But anti-sliding plating is recommended for cases of long healing expected, patients with great body mass index, and patients with poor compliance.

Objective To investigate the effect of Xuesetong Dripping Pills combined with alprostadil intervention on serum brain natriuretic peptide in elderly patients with chronic congestive heart failure.Methods In 74 patients with chronic congestive heart failure, were randomly divided into observation group and control group, 37 cases in each group.Control group received conventional method.The observation group received Xuesetong Dripping Pills combined with alprostadil on the basis of conventional therapy.Compared the efficacy, the heart function level, walking test and level of serum brain natriuretic peptide between two groups after 15 days’ treatment.Results The total efficiency of observation group was 94.59%, which was higher than 75.68% in the control group, the difference was statistically significant(P<0.05).After treatment, the heart function level improvement in the observation group was better than the control group, the difference was statistically significant(P<0.05).After treatment, 6 min walking test in the observation group(316.4 ±20.7) m, was better than the control group(303.5 ±28.1) m, the difference was statistically significant(P<0.05).The level of serum brain natriuretic peptide in the observation group(608.9 ±158.1)ng/L, was lower than that of the control group(792.7 ±179.4) ng/L, the difference was statistically significant ( P <0.05 ) .Conclusion Xuesetong Dripping Pills combined with alprostadil has good curative effect in the treatment of chronic congestive heart failure,can relieve the abnormal increase of serum brain natriuretic peptide, improve blood circulation and heart function.

Objective To introduce a new CT classification system we designed for Hoffa fractures and compare the interrater reliability between the CT and X-ray classification systems.Methods A total of 20 isolated Hoffa fractures from January 2008 to December 2011 were randomly selected for the present analysis of their imaging data (anteroposterior and lateral X-ray films of the knee joint and three-dimensional CT reconstruction of the femoral condyle).At the same time,a total of 20 independent observers (clinicians with junior,intermediate and senior professional qualifications) were selected for classification of the Hoffa fractures in the same manner respectively according to the Letenneur's X-ray system and our self-designed CT system.We used Kappa statistics to evaluate the interrater reliability among the clinicians between the 2 classification systems for Hoffa fractures.Results According to the CT classification of the 20 Hoffa fractures by the 20 clinicians,type Ⅰ,Ⅱ and Ⅲ fractures accounted for 66.0％,30.5％ and 3.5％ respectively.In type Ⅰ fractures,type Ⅰb involving zone b accounted for the most (50.0％),next by type Ⅰc(31.0％) and type Ⅰa (19.0％).In type Ⅱ comminuted fractures,fracture fragments were mostly seen in zone b.The overall incidence of fractures involving zone b by CT classification was 67％.According to the X-ray classification,type Ⅰ,Ⅱ,Ⅲ and Ⅳ fractures accounted for 31.4％,14.3％,28.0％ and 26.3％,respectively.The interrater reliability for CT classification agreement (Kappa =0.681) among clinicians was higher than that for X-ray agreement (Kappa =0.261).Conclusion For Hoffa fractures,communicated ones in particular,our CT classification system may be better than the X-ray classification system.

Objective To understand the fluorescence pattern of antinuclear antibody(ANA)and the distribution of target anti-gen and ANA′s impact on rheumatoid arthritis(RA)RA.Methods The data of rheumatoid factor(RF)and anti-cyclic citrullinated peptide antibodies(anti-CCP antibodies)and ANA of 860 RA patients during 2014-2015 were collected and divided into 2 groups according to the ANA levels.The differences of RF and anti-CCP antibodies level between 2 groups were analyzed.Analyzed the fluorescence pattern of RA merger ANA and the distribution of target antigen by statistical.Results Of the 860 RA patients,the positive rate of ANA was 37.6%,the major fluorescence pattern of RA merger ANA was speckled pattern,anti SSA positive rate was 21.7%.The RF and anti-CCP antibodies level had statistical difference between ANA positive group and ANA negative group (P <0.05).Conclusion RA merger ANA positive can show different fluorescence patterns and target antigen,the speckled pattern and anti-SSA positive are the main pattern.The severity of arthritis symptoms and the degree of bone destruction between ANA positive group and ANA negative group were difference.Anti-ANA positive has a certain promoting effect on the progression of RA disease.

Objective To explore the relationship between the expression of human telomerase RNA component (TERC) gene , human papilloma virus (HPV) infection and mutation of chromosome 3 number with cervical lesions .Methods 81 women received the treatment in the Gynecology Department of the Second Affiliated Hospital of Kunming Medical University from June 2008 to February 2009 ,including the healthy group(normal pathological examination ,20 cases) ,CIN1 group(28 cases) ,CIN2 group(12 ca‐ses) ,CIN3 group(9 cases) and cervical cancer group(12 cases) .The TERC gene expression in uterine epithelial exfoliated cells was detected by using the fluorescence in situ hybridization (FISH) method ,meanwhile the HPV infection was detected by using the real time fluorescence quantitative polymerase chain reaction (FQPCR) technology .The correlation between cervical cancer with TERC gene and HPV was analyzed .At the same time the number of chromosome 3 mutations in 81 cases was recorded .Results In the cervical lesion detection ,the detection positive rate had no statistical difference between the TERC gene detection and HPV detec ‐tion (P> 0 .05) ,their positive rates in the CIN 1 ,CIN2 ,CIN3 and cervical cancer groups were significantly higher than that in the healthy group (P< 0 .05) ,the difference between the CIN1 group and the CIN2 group had no statistical significance (P > 0 .05) , while between the CIN3 group and the cervical cancer group had statistical significance (P< 0 .05) ,the higher the malignant degree , the higher the positive rate .The abnormal mutation rate of chromosome 3 number was 0% in the healthy group and the CIN1 group ,16 .7% in the CIN2 group ,66 .7% in the CIN3 group and 100 .0% in the cervical cancer group ,the positive rate in the CIN3 group and the cervical cancer group was significantly higher than that in the healthy group ,CIN1 group and CIN2 group ,the differ‐ences were statistically significant (P< 0 .05) .Conclusion The TERC abnormal gene expression ,high risk HPV infection and mutation of chromosome 3 number could play an important synergistic effect during the process of occurrence and progression of cervical cancer .

Objective To study the prevalence and genotypes of rotavirus (RV) among children,< 5 years old hospitalized with viral diarrhea in Tianjin. Methods Stool specimens were collected from hospitalized diarrhea children in Tianjin children's hospital between May 2008 and April 2009. Detection of rotavirus was employed by Colloidal Gold Device. The detected positives were inoculated to MA-104 cells. The total RNA of virus was extracted after CPE which was caused by rotavirus were observed, The VP7 serotypes were determined by using RT-PCR to amplify the VP7 gene and sequencing the RT-PCR products.The clinical data for each patient were also collected. Results Among 837 specimens, the RV antigen positive rate was 26. 3% (220/837). Among all the children with rotavirus diarrhea, 90. 5% (199/220)were < 2 years old. The prevalence of rotavirus diarrhea in children peaked during Oct. 2008 through Apr.2009. Of the 208 rotavirus positive specimens, 95 were successfully identified by RT-PCR Thirty-five positive strains of RV were sequenced, and the sequencing results showed that 32 positive strains were belonged to rotavirus G1 type, 2 positive strains were belonged to rotavirus G3 type and 1 positive strain were belonged to rotavirus C9 type. Conclusion RV was the dominant etiological agent for infantile diarrhea infection in Tianjin, and the predominant serotype was G1.

Objective To study the pathogenic prevalence and genotypes of astrovirus among children under 5 years old hospitalized with diarrhea in Tianjin. Methods A total 837 stool specimens were collected from children with diarrhea hospitalized in Tianjin children's hospital from May 2008 to April 2009. Astrovirus antigens were detected using ELISA and the postive specimens were inoculated in CaCo-2cells. After the CPE caused by virus were observed, the total RNA of virus was extracted, then the genomc fragments of the strains were amplified by using RT-PCR and confirmed by sequencing of the RT-PCR products. Detection of rotavirus was employed by Colloidal Gold Device. Results Astrovirus antigen was found positive in 3.0% of the patients. The coinfection rate of astrovirus and rotavirus was 0. 7% (6/837).Ninety-six persent of children with astrovirus diarrhea were younger than 2 years of age, Forty-eight persent of children with astrovirus diarrhea were younger than 6 months. The astrovirus infections occurred mainly between August 2008 and April 2009. Of the 21 astrovirus positive specimens, 11 cases were successfully identified by RT-PCR and they were all serotype 1. Conclusion Astrovirus is a major cause of nonbacterical diarrhea between 2008 and 2009 in Tianjin, and the predominant serotype is type 1.

In order to provide more practicable and convenient continuing medical education for orthopedic surgeons in primary hospitals and expand the academic influence of expert lecturers and host hospitals in the region, our department hosted nine short-term training courses of orthopedic surgery jointly with primary hospitals, which lasted for 1 to 1.5 days on weekends from June 2001 to October 2017, with expert lectures as the main form. Traumatic orthopedics was the main topic, and most expert lecturers were orthopedic experts from famous hospitals within the province and the whole country, as well as the experts from the host hospital. More than 1200 orthopedic and surgical physicians in local districts and counties participated in the training, and excellent social effect has been achieved. For short-term orthopedic training jointly held with hospitals in prefecture-level cities, the topic of training should be carefully selected, and duration of the training and number of lecturers should be controlled, so as to achieve satisfactory social effects under the premise of low cost of administrative resources.

Objective To investigate the treatment of radi us head fracture through internal fi xation.Methods 42cases of radius head fracture trea ted with internal fixation were foll owed up.Mason classification and Broberg and Morrey criteria were use d to analyze the correlation between the results and the factors of fractu re type and method of fixation.Results42cases were followed up for a mean time of 25months.Evaluation was done according to Broberg and Morrey score systems.The function recovered we ll in 76%of the cases.The results of minor plate group were better than th ose of the screw(P=0.01)or K wire group(P=0.04).The results of Mason typeⅡwere better than those of the typeⅣ(P=0.03).Conclusion Treatment of radius head fracture with internal fixation will improve the elbow function and has better result for Mason typeⅡ.Fixation with minor plate is better than with screw or K wi re.[