Objective To evaluate the effects of induction chemotherapy plus radiotherapy (ICRT) and concurrent chemotherapy plus radiotherapy (CCRT) for Stage Ⅱ -Ⅲ non-small cell lung carcinoma (NSCLC) . Methods From July 19% to July 1999, 64 patients with Stage Ⅱ -Ⅲ NSCLC were randomized into two groups: ICRT group (32 patients) induction chemotherapy with DDP( 100mg/m2,dl) and VP-16 (100mg/m2,dl-d3) per week, one cycle per 4 weeks was given. Radiation was given after 2-3 cycles. CCRT group (32 patients) received radiotherapy plus concurrent chemotherapy with DDP(20 mg/m2,dl-d5) and VP-16 (50 mg/m2,dl-d5) per week for 8 weeks. In either group, radiation was given with a total dose of 60-70 Gy/6-7 weeks. Results One patient was excluded from ICRT group for development of distant metastasis, and 3 from CCRT group for their acute complications or other diseases. The overall response rates ( CR + PR) of ICRT and CCRT groups were 81.3% and 84.4%, respectively . NR + PD rates of both groups were 18.7% and 15.6% . The median survival periods were 13.4 months in ICRT group and 21.6 months in CCRT group (t = 2.58, P

BACKGROUND:Many studies have confirmed that recombinant human bone morphogenetic protein 2 plays a very important role in bone formation and fracture healing, but recombinant human bone morphogenetic protein 2 alone implanted is prone to diffusion and degradation, which is unable to play a persistent role in new bone formation. OBJECTIVE:To explore the effect of recombinant human bone morphogenetic protein 2 composite bone in the rabbit lumbar fusion. METHODS:Thirty New Zealand white rabbits were selected to make posterior lumbar intertransverse fusion models, and then were randomly divided into three groups, in which, L5-6 intertransverse implantation of autologous iliac bone, al ogeneic bone and recombinant human bone morphogenetic protein 2 composite bone (recombinant human bone morphogenetic protein 2 and al ogeneic bone complex) was done respectively. At 6 weeks after implantation, gross observation, X-ray examination and histological observation were performed. RESULTS AND CONCLUSION:Fusion rate and percentage of new bone area were higher in the composite bone group than the autologous iliac bone and al ogeneic bone groups (P<0.05);the tensile strength was lower in the al ogeneic bone group than the other two groups (P<0.05), but there was no difference between these two groups except the al ogeneic bone group. X-ray films showed cal us formation in the implanted region of the three groups. In the autologous iliac bone group, a large amount of cartilage tissues formed along with a smal amount of bone trabeculae and a certain amount of woven bones. In the al ogeneic bone group, the implant was covered with a large amount of fibrous tissues, bone island was seen and there was also a smal amount of bone trabeculae and cartilage tissues. In the composite bone group, a great amount of bone trabeculae and cartilage tissues were visible to form woven bone and cortical bone. These findings indicate that the recombinant human bone morphogenetic protein 2 composite bone can obtain good effect in the rabbit lumbar fusion.

Objective To analyse the effectiveness of the preoperative 3-dimensional conformal radiotherapy for large nephroblastoma up to 10 centimeters in diameter,and to investigate more effective preoperative therapies for intermediate and advanced nephroblastoma.Methods 32 cases of nephroblastoma were treated with preoperative radiotherapy with a dose fractionation as follows:150-200 cGy/fraction,5 fraction/week,the total dose of 1 000-2 000cGy,the mean dose of 1 600 cGy.During the radiotherapy,the B ultrasonic examination and CT were performed weekly to measure the variation of tumor volumes.The time of operation were determined based on the overall health status of patients,the shrinkage of tumor,and adhesions between tumor and adjacent vital organs.Radiontherapy was terminated one week before operation.4 patients who were found tumor adhered to normal tissues around kidney during operation were placed silver clip,and were given postoperative radiotherapy with additional dose of 1 000-2 000 cGy and the mean dose of 1 200 cGy.Results The median tumor reduction rate was 37 ％.The effective rate of preoperative radiotherapy was 100 ％.The complete resection rate was 87.5 ％.2-years tumor-free survival rates was 84.4 ％ and 5-years was 78.1％.There was no surgery-related death.Conclusion Preoperative 3-dimensional conformal radiotherapy reduces tumor volume,and raises resection and survival rate.

A derivatization method for the determination of oligosaccharides with high sensitivity by matrix-assisted laser desorption/ionization-time of flight-mass spectrometry(MALDI-TOF-MS) based on a labeling regent 1-(4-Cyanophenyl)-4-piperidinecarbohydrazide(CPH) was proposed. The hydrazones were generated by the reaction of the reducing ends of oligosaccharides and the hydrazide of CPH. The derivatives were directly analyzed by MALDI-TOF-MS. Reaction conditions such as reaction temperature, concentration of acetic acid and excess ratio of CPH regent were optimized. When the oligosaccharides reacted with 100 time excess of CPH at 100 ℃ and in 0.125% acetic acid (V/V), the yield was highest. The results showed the derivatization with CPH increased the sensitivity of MS detection and this method was suitable for the analysis of oligosaccharides′ compositions.

Alzheimer’s disease (AD) has become one of the worldwide critical diseases which seriously threaten the health of the elderly. Exploring and developing medicine with high efficiency and low toxicity for AD patients is one of the vital medicine issues. Traditional Chinese medicine has high research and development value in the prevention and treatment of AD. Currently, increasing researches have proved that Ginseng Radix et Rhizoma, as a kind of traditional and valuable Chinese herbal medicine, shows effects on improving learning and memorizing ability and prevention and treatment of AD. This article reviewed Ginseng Radix et Rhizoma extract improving symptoms of AD and its mechanism of action in detail, with a purpose to provide references for Ginseng Radix et Rhizoma extract improving learning and memorizing ability and prevention and treatment of AD in clinic.

The coronal process of ulna is an important stable structure in front of the elbow joint, which is composed of the tip of the coronal process, towering tubercle and anterior medial face. The fracture of the coronal process is often accompanied by the fracture and dislocation of the elbow joint, which leads to the instability of the elbow joint. The coronoid process has the advantages of small size, special shape, complex surrounding soft tissue structure, and plays an important role in the stability of the elbow joint. The selection of safe, minimally invasive and well exposed surgical approach is a necessary condition for safe and effective internal fixation. The choice of surgical approach must comprehensively consider the concomitant injury and choose the best surgical approach. This article mainly describes the normal anatomical structure of the coronal process and around the elbow joint, analyzes the biomechanics and stability of the coronal process in the elbow joint, and reviews the latest progress in surgical treatment.

Objective:To investigate the differences in incidence of deep vein thrombosis (DVT) after closed fracture of lower extremity between patients with different blood types ABO.Methods:A retrospective study was conducted in the 1, 951 patients who had been admitted to Department of Orthopaedics Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University for lower extremity fractures from August 2014 to June 2018. They were 924 males and 1,027 females with a mean age of 63 (46, 78) years (range, from 16 to 102 years). Of them, 572 were type O, 564 type A, 609 type B and 206 type AB. Venous ultrasonography was performed on both lower extremities within 12 hours after admission. The incidences of DVT after fracture were compared between different blood types in all the patients, patients with proximal fracture of the knee, peri-knee fracture and distal fracture of the knee, and patients<60 years old and ≥60 years old.Results:The incidences of DVT were, respectively, 26.75% (153/572), 28.72% (162/564), 34.32% (209/609) and 29.61% (61/206) for patients with blood type O, type A, type B and type AB. The DVT incidence for type B was significantly higher than that for type O ( P< 0.008). The incidences of DVT were, respectively, 28.74% (98/341), 28.99% (100/345), 39.45% (144/365) and 30.97% (35/113) for blood type O, type A, type B and type AB in the patients with proximal fracture of the knee. The DVT incidence for blood type B was significantly higher than those for blood type O and blood type A ( P< 0.008). There were no significant differences in the DVT incidence between different blood types ABO in the patients with peri-knee fracture, distal fracture of the knee,<60 years old or ≥60 years old( P>0.05). The incidences of DVT were, respectively, 30.99% (97/313), 33.33% (108/324), 45.22% (156/345), 34.74% (33/95) for blood type O, type A, type B and type AB in the patients ≥60 years old. The DVT incidence for blood type B was significantly higher than those for blood type O and blood type A ( P< 0.008). Conclusions:The incidence of DVT varied with different blood types ABO after lower extremity fracture. The highest DVT incidence was found in patients with blood type B. The impact of blood type on the DVT incidence after lower extremity fracture was mainly observed in the patients with proximal fracture of the knee or an age of ≥ 60 years old.

Objective:To compare the minimally invasive plate osteosynthesis (MIPPO) with versus without B-ultrasound surface localization of the upper arm nerves in the treatment of fractures of the middle and upper humeral shaft.Methods:A retrospective analysis was conducted of the 105 patients who had been admitted to Department of Orthopaedic Trauma, Honghui Hospital for fractures of the middle and upper humeral shaft from August 2015 to May 2017. They were divided into 2 groups according to whether or not B-ultrasound surface localization of the upper arm nerves had been used in MIPPO. There were 52 cases in the B-ultrasound localization group and 53 cases in the simple MIPPO group. The 2 groups were compared in terms of operation time, intraoperative blood loss, fracture union time and complications. The shoulder joint functions were assessed at the last follow-up using the Neer shoulder joint function scoring.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between groups ( P>0.05). There were significant differences between the B-ultrasound localization group and the simple MIPPO group in operation time [(62.8±8.6) min versus (96.8±7.5) min], or intraoperative blood loss [(107.4±5.6) mL versus (215.4±7.2) mL]. Neer shoulder function scoring showed that the excellent and good rate in the B-ultrasound localization group [94.2% (49/52)] was significantly higher than that in the simple MIPPO group [81.1% (43/53)] ( P<0.05). Conclusions:In the MIPPO of fractures of the upper and middle humeral shaft, B-ultrasound surface localization of the upper arm nerves should be used as preoperative routines to reduce operation time and intraoperative blood loss to improve prognostic functions of the shoulder.

Objective: To determine the role of acromioclavicular ligament in maintaining the stability of acromioclavicular joint. Methods: In 12 cadaveric specimens of normal shoulder joint which had been routinely treated by formalin, the coracoclavicular ligaments (trapezium and conical ligaments) were dissected and exposed after soft tissue was removed from the surface. The distribution of the insertion and starting points, appearance and attachment area of the trapezium and conical ligaments were observed. The lengths of the 2 ligaments, the coronal and sagittal lengths of the clavicular attachment area, the distances from the most lateral point to the distal end of the clavicle, and the angles at the coronal and sagittal positions of the 2 ligaments were measured. Subsequently, the 12 cadaveric specimens were randomly divided into 4 groups (n=3). Group A retained the intact acromioclavicular ligament, group B the intact coracoclavicular ligament, group C the intact trapezium ligament and group D the intact conical ligament. In an electronic machine for versatile mechanical tests, a 100 mm/min load speed was applied for destructive static stretching of the ligament specimens in the vertical direction. The load-displacement curves were recorded and drawn by a computer in connection with the biomechanical testing machine. The rupture strengths of the 4 ligaments were recorded. Results: The average lengths of the conical and trapezium ligaments were 10.6 mm and 12.5 mm, respectively. The coronal and sagittal lengths of the clavicular attachment area of the conical ligament averaged 13.4 mm and 5.8 mm, respectively. The coronal and sagittal lengths of the clavicular attachment area of the trapezium ligament averaged 14.2 mm and 8.7 mm, respectively. The distances from the most lateral points of the conical and trapezium ligaments to the distal clavicle averaged 35.5 mm and 23.6 mm, respectively. The average angles at the coronal and sagittal positions were 6.2° and 11.3° for the conical ligament and 38.7°and 6.9° for the trapezium ligament, respectively. The average tensile force was 201.3±1.9 N for the acromioclavicular ligament rupture, 374.6±1.4 N for the coracoclavicular ligament rupture, 192.3±4.3 N for the trapezium ligament rupture, and 345.7±1.1 N for the conical ligament rupture. Conclusions The roles and contributions of the conical, trapezium and acromioclavicular ligaments are different in maintaining the stability of the acromioclavicular joint. In anatomical reconstruction of the acromioclavicular joint, it is more important to reconstruct the conical ligament and to repair the acromioclavicular ligament simultaneously as much as possible.

Objective:To explore the biomechanical stability of a novel anchor-loop internal fixation system in the treatment of acromioclavicular joint dislocation using cadaveric specimens.Methods:The acromioclavicular ligaments were severed in 12 complete shoulder joint specimens, in which the quasi-static non-destructive cycle experiment was performed until the coracoclavicular ligaments failed. The failure intensities of the coracoclavicular ligaments were recorded. Next, the 12 specimens were randomly divided into groups A, B, C and D ( n=3), in which 4 different internal fixation materials were used respectively to reduce and fix the acromioclavicular joint. Group A was subjected to 3.5 mm clavicular hook locking compression plate, group B to 5 mm soft tissue with wire anchor, group C to 10 mm Endobutton steel plate, and group D to the novel anchor-loop internal fixation system (5 mm soft tissue with wire anchor + 10 mm Endobutton steel plate). An X-ray machine was used to evaluate the reduction and internal fixation of the acromioclavicular joint. After the shoulder specimens were securely fastened by a homemade fixation jig to a 100 KN electronic universal mechanical testing machine, each experimental specimen was subjected to a destructive static tensile mechanic determination in the vertical direction at a loading speed of 100 mm/min. The load-displacement curves were recorded and drawn by a computer connected with the biomechanical testing machine. The failure strength and failure causes were recorded for each internal fixation. Results:The fracture strength of the coracoclavicular ligament in 12 cadaver specimens was (374.6±0.8) N. The mechanical load of internal fixation failure was (409.5±2.6) N in group A, (297.8±3.4) N in group B, (375.2±3.1) N in group C and (376.2±3.1) N in group D. The internal fixation failure was due to clavicular fracture in 2 specimens and to acromial fracture in 1 specimen in group A, to anchor protrusion in all the 3 specimens in group B, to coracoid base fracture in all the 3 specimens in group C, and to anchor protrusion in all the 3 specimens in group D. The mechanical loads of internal fixation failure were significantly different among the 4 experimental groups ( P<0.05). The mechanical load of internal fixation failure in group D was significantly different from that in groups A and B ( P<0.05). Conclusions:Our self-developed novel anchor-loop internal fixation system can effectively reposit the acromioclavicular joint to treat acromioclavicular joint dislocation, because it conforms to the biomechanical characteristics of the acromioclavicular joint, and is easy to handle. Therefore, its feasibility is high.