AIM: To analyze the characteristics of internal fixation implantation therapy for comminuted patella fracture. METHODS: A computer-based search of Pubmed database and Chinese Journal Full-text Database was undertaken, and the quotations of each literature were checked after the primary screening. Inclusion criteria: the papers about the application of internal fixation materials in comminuted patella fracture, those published in authority journals within recent five years were preferred. Exclusion criteria: repeated study or Meta analysis. RESULTS: Internal fixation approach differs as the fracture type. Tension band fixation is generally accepted to treat transverse patella fracture. Kirschner wire plus tension band fixation are inferior to transverse fixation, but in comminuted fracture it can induce more complications; despite of wide application, nickel titanium patella fixator is unsuitable for comminuted fractures due to its hypersensibility and carcinogenicity; silk or steel wire loop fixation fits various comminuted fractures, but metal cerclage is predisposed to induce infection and breakage because of insufficient fixation force. CONCLUSION: There is no common way for comminuted patella fracture therapy. Further researches on material and method which can cure all kinds of comminuted patella fracture are still needed.

Objective To compare the analgesia effect of lidocaine carbonate combined with intravenous flurbiprofen axetil with intravenous flurbiprofen axetil on intrapelvic irrigation and incision infiltration after gynecological laparoscopy.Methods Seventy-five patients scheduled for gynecological laparoscopy under general anesthesia were divided into 3 groups by random number table method with 25 cases each.Patients in control group 1 receivcd intravenous flurbiprofen axetil 100 mg after surgery;patients in control group 2 received intrapelvic irrigation with 0.35％ lidocaine carbonate 100 ml,and incision infiltration with 0.87％ lidocaine carbonate 10 ml respectively after surgery;patients in observation group received the combination of control group 1 and control group 2.The visual analogue scores (VAS) at 1,4,8,12 and 24 h after surgery,time of passage of gas by anus and untoward reaction were recorded.Results One case in control group 1 and 1 case in observation group withdrew from the study.The VAS at 1,4,8,12 and 24 h in observation group were (9.5 ± 7.9),(14.9 ± 8.7),(17.2 ± 10.3),(12.2 ± 7.7),(5.3 ± 3.8) mm,in control group 1 were (39.2 ± 15.0),(33.4 ± 13.0),(36.2 ± 12.8),(35.8 ± 12.7),(10.6 ± 4.2) mm,and in control group 2 were (26.6 ± 13.0),(30.2 ± 12.0),(33.3 ± 13.1),(30.4 ±9.8),(9.8 ±4.7) mm.And there were statistical differences between observation group and control group 1,2 (P ＜ 0.05).There were no statistical differences in time of passage of gas by anus and untoward reaction incidence in the 3 groups (P ＞ 0.05).Conclusion Intrapelvic irrigation and incision infiltration with lidocaine carbonate and intravenous flurbiprofen axetil compared with intravenous flurbiprofen axetil alone after gynecological laparoscopy can significantly reduce the pain intensity and analgesia requirement,without increasing the untoward reaction incidence.

Objective To analyze the independent factors affecting the prognosis of gastrointestinal stromal tumor(GIST) patients undergoing radical operation.Methods The clinical characteristics and follow up data of the 97 patients with GIST underwent radical opsration from January,2001 to January,2003 in our hospital were retrospectively analyzed by univariate and multivariate methods.Results In the univariate analysis of the 97 cases,gender,tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were found to be related to the prognosis of GIST.Multivariate Cox model analysis showed that tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were independent prognostic factors for patients with GIST.Conclusions Tumor location,tumor size,tumor cell type,necrosis,mitotic count are important prognostic factors for patients with GIST undergoing radical operation.

Six new oleanane-type saponins, arilloside A-F (Ⅰ～Ⅵ), along with a known saponin, polygalasaponin ⅩⅩⅩⅤ(Ⅶ), were isolated from the root of Polygala arillata Buch.-Ham.. The structures of these new compounds were elucidated as 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3, 4-di-O-acetyl)-β-D-fucopyranoside(Ⅰ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-β-D-fucopyranoside(Ⅱ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3,4-di-O-acetyl)-β-D-fucopyranoside(Ⅲ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-[β-D-galactopyranosyl (1→4)]-β-D-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-β-D-fucopyranoside(Ⅳ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-[β-D-galactopyranosyl (1→4)]-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3-O-acetyl)-β-D-fucopyranoside(Ⅴ) and 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-[β-D-galactopyranosyl (1→4)]-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3,4-di-O-acetyl)-β-D-fucopyranoside(Ⅵ) on the basis of spectroscopic and chemical methods.

[Objective]To study the effects of titanium cable system used as a treatment alternative for comminuted patella fractures.[Method]Fifty-seven cases of comminuted patella fractures were treated from November 2004 to August 2007.The patients were divided into three groups:the group of titanium cables,AO modified tension band and nickel titanium-patella catcher respectively,according to the choice of internal fixation.The operation time,the amount of blood loss,the first knee exercise time after operation,length of hospitalisation,medical expenses,time off for employees,complication and long-term knee function were studied.All the data were analyzed and compared by statistical ways.[Result]The 57 patients were followed up for 11 to 48months(means,22.4 m).Patients who were fixed with titanium cables could start most early extending and flexing the knee(5.6 d after operation),but most expense in medical usages(9500 RMB).The good or excellence rate was 95.1% in patients treated with titanium cables cerclage,which was better than that of the other two groups.[Conclusion]Titanium cables cerclage can cure comminuted patella fractures.The method had advantage of better long-term curative effect and less complication,and so on.It's worthy to be recommended for the therapy of comminuted patella fracture.

Postpartum inferior vena cava (IVC) thrombosis is a rare, but potentially life-threatening disorder. Here we reported one case of the youngest woman to date who presented with massive IVC thrombus extending from deep veins of the right leg to the level of the 11th thoracic vertebra, associated with asymptomatic pulmonary embolism.

The medical records of 108 inpatients treated with vancomycin and norvancomycinin were collected and analyzed retrospectively.And 78.7% of all cases were used for therapy and 21.3% for prevention.The pathologic examination submission rate was 88.9% ( n=96 ).The drug utilization index ( DUI) of norvancomycin was 0.95 and vancomycin 0.92.The proportion of combination use was 86.1%and a maximum of 3 antibiotics were used.There were 6.5% cases of doubtful adverse drug reaction.The inpatient uses of vancomycin and norvancomycin are basically rational.Indications should be mastered strictly.Empirical and prophylactic uses should be minimized to prevent and delay drug resistance strain from spreading and prolong effectiveness.Necessary therapeutic drug monitoring is required.

Objective To evaluate the efffects of leukocyte-depleted blood transfusion the protection of cardio pulmonary tissue and the reduction of postoperative bacterial infection.Methods Three hundred and forty-four pediatric patients were allocated to one of 3 groups based on transfusing different components of blood during open heart surgery:control group(n=109),routing blood transfusion group(RBT,n=113),leukocyte depleted blood transfusion group (LDBT,n=122). Blood samples were taken before operation,at 6h,and 24h after operation fir determination of creatininee kinase MB( CK MB),aspartate transaminase(AST),lactate dehydrogenase(LDH)and MDA. At the same time,we monitored changes of TPR and RI,and recorded changes of body temperature and days of utilizing antibiotics after operation.Results After operation serum concentrations of CK MB,AST, LDH and MDA significantly increased in all groups as compared to the values before operation,but the values of those in group LDBT were significantly loert than those in group RBT(P0.05).Conclusions Leukocyte depleted blood transfusion can effectively prevent the patients from cardion pulmonary ischemia-reperfusion injury and reduce postoperative bacterial infection in pediatric open heart surgery.

Objective To investigate the effects of tumor necrosis factor-alpha (TNF-?) on insulin sensitivity and glucose-lipid metabolism in TNF-?-induced IR mice. Methods Male C57BL/6J mice were given an intraperitoneal injection of TNF-? (H group,6?g/kg; M group,3?g/kg; L group,1?g/kg;twice daily) and saline (NC group) for 7 days. The plasma glucose and insulin were assayed during intravenous glucose tolerance test (IVGTT) and hyperinsulinemic-euglycemic clamp combined with 3-[3H] glucose as a tracer was carried out. Results After TNF-? treatment,fasting blood glucose (FBG),plasma insulin and free fatty acids (FFA) were significantly elevated in H group compared with NC,L and M groups (P