Objective To explore the management alternatives to tr aumatic periprosthetic femoral fractures after hip replacement. Metho ds A retrospective analysis was done on five cases of traumatic perip rosthetic femoral fractures posterior to hip replacement admitted in from June 1 998 to June 2003. There were two males and three females, with age range of 52- 71 years (average 59 years). One case suffered from traffic accident and the oth er four from slipping. Three cases had received hip replacement for femoral head aseptic necrosis, the other two for femoral neck non-union. Total hip replacem ent was carried out in four cases (five hips) and femoral head replacement in on e. These traumatic periprosthetic fractures occurred from one month to 17 years after hip replacement. According to classification to periprosthetic fracture of Vancouver (1995), there were 3 cases of type B and 2 type C. Two cases (one cas e of type B and one type C) were treated with traction and conservative treatmen ts, two (type B) with long shaft prosthesis revision combined with shape memory saw tooth embracing fixator or wires and one (type C) with anatomical plate inte rnal fixation. Results All 5 cases were followed up for f rom two months to five years and attained fracture union with no complications s uch as infection, nonunion or fixation breakage. Conclusions Traumatic periprosthetic femoral fractures after hip replacement are hard to deal with. The management alternatives differ according to fracture site, prost hesis loosening, bone quality and general status of patients. Classification cri teria and corresponding managements of periprosthetic fractures of Vancouver are proved to be suitable guidelines.

Object To study the physiological changes of Taxus chinensis var. mairei (Lemee et L?vl.) Cheng et L. K. Fu in the case of methyl jasmonate (MJ). Methods TTC assay, soluble protein measurement and enzyme analysis were used. Results It was observed that MJ inhibited Taxus cell growth in the view of primary metabolism. MJ induced phenylalanine ammonia lyase(PAL) activity while it inhibited polyphenoloxidase (PPO) activity. Extracellular phenolic content after addition of MJ increased to the maximum at the three days than that of the control group. Conclusion It was demonstrated that MJ induced the transition of Taxus cell from primary metabolism to secondary metabolism. This is favorable for secondary metabolism of Taxus cells. It is important to study the physiology of Taxus cells for revealing the mechanism of MJ.

Objective To analyze, treatment of ipsilateral Pilon and calcaneal fractures (IPCF). Methods Injury causes included fallings in seven patients, traffic injury in two and impact injury in one, with ISS score of 5-22 points. There were seven patients with open injuries and 3 with close ones. Nine pa-tients had Ⅱ-Ⅲ degree of Pilon fractures according to the AO/OTA classification and six comminuted com-pression calcaneal fractures according to the Essex-Loprest classification. The Pilon fractures were fixed by cannulated nail, screw or Kirschner wire through open reduction in six patients including four fixed with ex-ternal fixators (the calcaneal fractures were fixed with percutaneous eannulated nail or Kirschner wire by poking reduction). The calcaneal fractures were fixed with only Kirschner wire through poking reduction in two patients and double fractures treated conservatively in two. Results The reduction of Pilon and cal-caneal fractures treated by operation were markedly improved in six patients, while there occurred angular deformity and joint surface introeession in the patients treated conservatively. The wound healing of soft tis-sue was sound in seven patients but unsatisfactory in the other three. The ankle-hind foot score was 82-94 points in four patients who were followed up. Conclusions IPCF is caused by the high energy force and characterized by severe injures of the soft tissues and the bone tissues at the distal tibia and calcaneua, for which limited internal fixation plus external fixation are suitable treatment choice.

OBJECTIVE:To get to know the preoperative and postoperative medication of patients with cataract.METHODS:The preoperative and postoperative medication of 564 cases with cataract extraction in our hospital from September 2004 to October 2004 was analyzed statistically.RESULTS:Antibacterial eye gutta was mainly used before cataract extraction while compound eye gutta containing antiseptic drugs and glucocorticosteroid were chiefly used after cataract operation.CONCLUSION:The preoperative and postoperative medication for patients with cataract in our hospital was reasonable.

Objective To optimize the prescription ofBaichanting Tablets by the central composite design-response surface methodology.Methods The doses of MCC, cCMC-Na, SiO2, and magnesium stearate were set as investigation factors; disintegration time and moisture rate were set as indexes. Linear equation quadratic polynomial described mathematic relationship of disintegration time and moisture rate with other four influence factors. Response surface was described according to the optimal mathematic models; the optimal prescription was chosen; predictive analysis was conducted.ResultsThe relationship of disintegration time and moisture rate with other four influence factors could not be described by linear equation. When quadratic polynomial matching was used, correlation coefficients were 0.837 9 and 0.923 1, with relatively high reliability. Optimal prescription contained 30.6%MCC, 10%cCMC-Na, 0.30%SiO2, and 0.10% magnesium stearate. The theoretical value and predicted value deviations of the disintegration time limit and moisture absorption rate were within 5%.Conclusion The predictability of the established model is good. Application of central composite design-response surface methodology can precisely optimize the prescription ofBaichanting Tablets.

ObjectiveTo study the neuron protection mechanism of Uncariae Ramulus Cum Uncis extract for the MPTP-induced PD mice.MethodsC57BL/6 mice were randomly divided into control group, model group, Uncariae Ramulus Cum Uncis extract group and madopar group, and injected with MPTP in abdominal cavity. Behavior test was used to detect grabbing capacity and body movement coordination capacity: three biochemical indexes (SOD, MDA, GSH-Px) were detected by biochemical process and the activity of two immune enzyme-linked indexes (IL-1β, IL-6) were detected by enzymelinked immunosorbent assay.ResultsCompared with the control group, the autonomic activity numbers of mice increased and climbing pole time decreased in the model group (P<0.05), enzymatic activity of SOD and GSH-Px decreased significantly and the contents of MDA, IL-1β and IL-6 increased obviously (P<0.01). Compared with model group, the autonomic activity numbers of mice increased and climbing pole time decreased in the Uncariae Ramulus Cum Uncis extract group and madopar group (P<0.05). Enzymatic activity of SOD and GSH-Px increased and the contents of MDA and IL-1β and IL-6 decreased (P<0.05,P<0.01).ConclusionUncariae Ramulus Cum Uncis extract can reduce neuronic apoptosis PD mice, whose therapeutic action may be realized through eliminating oxygen free radicals, improving oxidation resistance and reducing inflammatory reactions.

BACKGROUND:Tibial plateau fractures involving the posterolateral articular surface present a great challenge due to its complex anatomy.The posterolateral corner complex and the proximity of the common peroneal nerve restrict both the exposure of the joint surface and the ability to distract across the joint using a varus force.OBJECTIVE:To analyze the anatomy,morphology and classifications of the posterolateral fractures of the tibial plateau,and compare different surgical approaches and fixation materials.METHODS:A computer-based research of PubMed and CNKI databases was performed for the relative literatures published from 1990 to 2016 using the keywords of tibial plateau,posterolateral fragment,fixation in English and Chinese,respectively.The anatomy,morphology and typing of posterolateral fractures of the tibial plateau were analyzed and different surgical approaches and fixation materials were compared.RESULTS AND CONCLUSION:Posterolateral fractures of the tibial plateau should be treated in accordance with the intra-articular fracture principle,such as repairing joint surface to normal morphology,restoring the lower limb alignment,and maintaining joint mobility painlessly.Fractures are clarified according to Schatzker,AO,and three-column classification systems,but still need to be improved.To choose a proper surgical approach mainly depends on the fracture pattern.Biomechanics tests suggest that posterolateral locked plate exhibits excellent biomechanics characters,and can avoid the reduction loss caused by the shear force of fracture fragments.

AIM:To explore the preliminary mechanism of senegenin ( Sen) on inhibiting hypoxia/reoxygenation ( H/R)-induced apoptosis of primary cortical neurons .METHODS:The cultured cortical neurons were randomly divided in-to normal group (control group), model group (H/R group), Sen+H/R group and Sen group.Flow cytometry was used to evaluate the effect of Sen on H/R-induced cell apoptosis .The protein levels of JNK , p-JNK, c-Jun, p-c-Jun, Bcl-2 and Bax were assessed by Western blotting .RESULTS:The apoptotic rate in H/R group was obviously higher than that in control group (P<0.05), while the apoptotic rate in Sen +H/R group was obviously lower than that in H/R group (P<0.05), suggesting that the model of apoptosis was established successfully .The results of Western blotting showed that Sen increased the expression of JNK and c-Jun, inhibited the phosphorylation of JNK and c-Jun (P<0.05), increased the protein level of Bcl-2 and inhibited the protein level of Bax in H/R treated primary cortical neurons (P<0.05).CONCLUSION:Sen has a protective effect against H/R-induced neuronal apoptosis by increasing the expression of JNK and c-Jun, inhibiting the phosphorylation of JNK and c-Jun, increasing the protein level of Bcl-2 and decreasing the protein level of Bax .

Objective To explore the clinical effect of periarticular knee fractures combined with anterolateral ligament (ALL) avulsion fracture.Methods From June 2014 to November 2015,13 patients with ALL avulsion fracture in periarticular knee fractures were fixed by the star plate,cannulated or screws suture anchor,including 9 male and 3 female with the mean age of 39.5 years (range from 28 to 51 years).6 patients were diagnosed distal femoral fracture,4 tibial plateau fracture,and 3 tibial intercondylar eminence avulsion fracture which all combined with ALL avulsion fracture.Postoperatively,all patients were treated with the adjustable knee brace for 3 months.Results All patients were followed up for 4-20 months,the mean follow-up time was 13.5 months.The average surgical time was 130 min (range from 90 to 210 min).In all 13 patients,ALL was found and identified.Bone union was obtained in all patients,and the bone union time was 11.4 weeks (10-12 weeks).7 cases were fixed with star plate,5 cases were fixed with hollow screw,and 1 case was fixed with anchor.All follow-up patients underwent anteroposterior and lateral X-rays.Pain,swelling and functional recovery of the knee joint were observed.Patients were assessed postoperatively with International Knee Documentation Committee (IKDC) score,Lysholm score,and Tegner activity scale to evaluate the clinical effect.At the last follow-up,all patients had full range of motion of the knee joint which from 0° to approximate 120°.The Lysholm,objective IKDC were 86.5 and 84.6 respectively.Among the 13 patients evaluated,9 patients were graded A,and 4 patients were graded B by subjective IKDC.The Tegner activity scale at the last follow-up was 6.7.Incision of poor healing in 1 case,and got healed after 32 d cleaning dressing.Conclusion This study confirmed the presence of the ALL.The fixation of ALL avulsion fracture in periarticular knee fractures can be an effective procedure at a minimum follow-up of 13.5 months.

Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods From March 2005 to March 2010,26 patients with Hawkins Ⅲ talus neck fracture were treated and 21 of them were followed,including 13 males and 8 females,with an average age of 37.6 years.The fractures occurred on the left side in 11 patients and on the right side in 10patients.The mechanism of injury included high falling injury in 13 patients,traffic accident injury in 7 patients and rolling down injury in 1 patient.Five cases were closed fractures and 6 cases were open fractures.A bilateral approach,the medial and lateral approaches,was used to perform the operation with cannulated screw fixation in emergency.After external fixation in functional position for 6 weeks without loading,ankle joints were allowed to take exercise with hinge brace and to bear partially basing on plain radiograph 12-16weeks later.The weight-bearing should be adjusted with follow-up.Functional results were assessed according to AOFAS (American Orthupaedic Foot and Ankle Society,AOFAS)score.Results The average duration of follow-up was 36.6 months (range,6-60 months).All fractures gained union and the average union time was 4.5 months.The average AOFAS score was 78.6.There were 4 cases in excellent results,10 in good,5 in fair and 2 in poor.The overall excellent and good rate was 67.8％.Traumatic arthritis occurred in 13 cases and avascular necrosis in 5 cases.Conclusion The effect of surgical treatment for Hawkins Ⅲtalus neck fracture via a bilateral approach is satisfactory.