OBJECTIVETo explore clinical outcomes of talus neck fracture treated with mini-plate internal fixation through dual-incision approaches.

METHODSFrom August 2010 to February 2013,18 patients with closed talus neck fractures were treated (10 males and 8 females, aged from 31 to 66 years old with an average of 38.2 years old) with mini-plate internal fixation through dual-incision approaches. According to Hawkins classification, 12 cases were type II and 6 cases were type III. All cases were evaluated with X-ray and 3D CT scan preoperatively to define type and comminuted degree of fractures. Mini-plate fixation with dual-incision approaches was performed after swelling was resolved. X-ray films were taken during following up regularly. Functional evaluation was carried out according to Visual Analogue Scale (VAS), the ankle and hind-foot score of American Orthopedic Foot and Ankle Society (AOFAS). Complications were also recorded.

RESULTSSixteen patients were followed up with an average time of 22.6 months (ranged, 17 to 46 months). No wound infection, skin and flap necrosis or implant failure were found. Traumatic arthritis in subtalarjoint was found in 1 patient. Preoperative VAS (5.94±1.12) was decreased to postoperative (1.06±1.06) (t=27.13, P<0.05). The average AOFAS score was 88.7510.19 at the latest following up; and 11 cases obtained excellent results, 3 good and 2 moderate.

CONCLUSIONMini-plate fixation with dual-incision approaches for talus neck fracture especially for talus neck comminuted fracture, an effective method, could obtain stable fixation, decrease complications.

Adult ; Aged ; Ankle Fractures ; surgery ; Bone Nails ; Female ; Follow-Up Studies ; Foot Injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Talus ; injuries ; surgery

OBJECTIVETo explore the clinical effect of interference screw and flexor hallucis longus tendon as augmentation material in repair of chronic Achilles tendon rupture.

METHODSFrom September 2010 to June 2012,26 patients with chronic Achilles tendon rupture were treated, including 18 males and 8 females with an average age of 44.2 years old (20 to 66 years old). All patients were unilateral damage. MRI showed the Achilles tendon.ends' distance was 6.0 to 9.0 cm. The postoperative complications were observed. The curative effect was assessed by American Orthopedic Foot and Ankle Society and Leppilahti score.

RESULTSAll the 26 patients were followed up for 18 to 68 months (means 30.4 months). No neurological injury and infection of incision occurred, all patients were stage I incision healing. The shape and function of the ankle were recovered well. The average AOFAS score increased from 52.27±12.30 preoperatively to 90.92±6.36 postoperatively. Leppilahti Achilles Tendon Repair score increased from 34.23±12.86 preoperatively to 90.00±5.10 postoperatively.

CONCLUSIONThe flexor hallucis tendon transfer with an interference screw technique for repairing the chronic Achilles tendon rupture of type IV of Kuwada had advantages of simple operation, quick recovery, firm tendon fixation, and less complications.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Rupture ; physiopathology ; surgery ; Tendon Injuries ; physiopathology ; surgery ; Tendon Transfer ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore a drug supply system to meet radiation accident.METHODS: According to the characteristics of drug utilization for radiation disease,a retrospective analysis was conducted on the drug demand and supply in the course of treating two patients with severe radiation disease.RESULTS: The characteristics of drug supply to meet demand of remedy of acute radiation sickness manifested as a great variety and wide scope of drugs involved and purchase without scheme because of uncertainties of dosages and course of treatment,and the time is urgent,and the drug supply is more difficult.Great importance should be attached to the reserving of drugs,information,capability,and pre-draft in building and operating the drug supply system to meet radiation accident.CONCLUSION: To build a drug supply system to meet radiation accident,reasonable organization and utilization of drugs resources is quite necessary.

Objective To explore the variation of the main chemical constituents of Herb Epimedii in decocting Herb Epimedii and Radix Astragali separately and compatibly. Methods Herb Epimedii combined with Radix Astragali were decocted with water in which the proportion of them were 1∶0, 2∶1, 1∶1, 1∶2 and 0∶1, respectively. RP-HPLC was used to compare the content of icariin and the fingerprints in separate and compatible decoction. Results Afeter combination, the number of chromatographic peaks were added and no new peaks were detected. The contents of some chemical constituents such as icariin in Herb Epimedii were increased, especially in the compatible decoction at the proportion was 1∶1. Some constituents were not changed obviously. Conclusion Herb Epimedii decocted together with Radix Astragali especially at a ratio of 1∶1 can increase the solubility of the chemical constituents in Herb Epimedii. This provides a scientific basis for more effective use of the compatible decoction of the two herbs.

Objective To evaluate the diagnostic and differential diagnotic values of DSA features for inflammatory pseudotumor of the liver(IPL). Methods An retrospectively comparative analysis of 12 hepatic inflammatory pseudotumors confirmed surgicopathologically from May 2002 to March 2007 with DSA features and correlative imaging data were carried out. Results 10 cases consisted of only 1 lesion and other 2 cases with multiple lesions were opacified initially at the late arterial phase,with prominent peripheral ring-like staining at portovenous and parenchymal phases and less dense opacification in the central region; furthermore heterogenous staining occurred in 5 cases. Conclusions DSA is probable the most appropriate method for the diagnosis and differential diagnosis of hepatic inflammatory pesudotumor.

Taxus canadensis distributed mainly in North America, such as northern Minnesota, Newfoundland, south to Wisconsin and Pennsylvania. Its composition has been shown to be very different from other species, and in recent years, some new skeletons also have been found in Canada yew. Through analysis of the taxanes content on various Taxus plants containing taxanes, the results showed a higher content of taxol in T. canadensis. Based on the current research on T. canadensis (from the research results of the author in recent years, as well as from studies of scholars in the field), the paper outlined the research progress in recent years on the chemical constituents of taxane of T. canadensis and the spectral characteristics of various types of compounds. Besides, this paper analyzed the present research about solutions for the taxol drug source crisis.
Animals ; Bridged-Ring Compounds ; chemical synthesis ; chemistry ; pharmacology ; Humans ; Molecular Structure ; Plant Extracts ; chemical synthesis ; chemistry ; pharmacology ; Plants, Medicinal ; chemistry ; Taxoids ; chemical synthesis ; chemistry ; pharmacology ; Taxus ; chemistry

Objective:To label monoclonal anti-GPⅢa antibody (SZ21) with 99 Tcm and evaluate the value of 99 Tcm-SZ-21 for detecting thrombi in vivo.Methods:SZ-21 was modified with 2-iminotholane and labeled with 99 Tcm-GH and radiochemical purity was determined by ITLC-SG.99Tcm-SZ-21 was injected via ear edge vein in 5 rabbits in which thrombi were induced in the right femoral arteries.As control,99 Tcm-GH was administered in 1 rabbit.Static images were acquired and irregularly shaped ROIs were drawn on the images to calculate the ratios of T/M and T/B.Vein blood was drawn at 2 min,5 min,10 min,30 min and 1 h-3 h after injection in 2 rabbits so as to observe the blood clearance of 99 Tcm-SZ-21.Rabbits were sacrificed after 3 h of imaging.The vessels including clots were harvested and imaged.Cardiac muscle,liver,spleen,lung,kidney,etc.were excised and weighed.Radioactivity counts were measured to calculate % ID/g.Results:The radiochemical purity of 99 Tcm-SZ21 was beyond 90% and stable in vitro.Thrombi could be visualized at 30 min after injection,and at 2 h image of thrombi was clearly visualized,T/M (2.55?0.72) and T/B (1.94?0.51) ratios were high.In vitro imaging showed that T/B was 4.43?1.5.Conclusion:99Tcm-SZ-21 could be a potential agent for imaging diagnosis of thrombotic disease.

Objective To study the diagnostic value of calcification in differentiating benign and malignant thyroid lesions. Methods CT images of 318 consecutive patients with pathologically proven thyroid lesions were retrospectively reviewed by two radiologists. The following characteristics of calcification on CT images were evaluated: (1) size (≤2 mm indicating microcalcification and > 2 mm or shelly and irregular shape indicating macrocalcification, and both features indicating mixed calcification), (2) number (single or multiple) and (3)location (internal or edge). χ~2 test was used for statistical analysis. Results Oft he 318 cases, 48 were diagnosed as malignant (papillary carcinoma 26, follicular carcinoma 7, medullary carcinoma 3 and microcarcinoma 12) and 270 were benign (nodular goiter 36, adenoma 170, nodular goiter with adenoma 38 and adenoma with Hashimoto's thyroiditis 26). Calcification was found in 60 cases (18.9%). Among them 21 (papillary carcinoma 12,microcarcinoma 6,follicular carcinoma 2 and medullary carcinoma 1) were malignant(43.8%) and 39(nodular goiter 6, adenoma 13,nodular goiter with adenoma 19 and adenoma with Hashimoto's thyroiditis 1) were benign (14.4%) (P < 0.01). Sensitivity and specificity for diagnosing thyroid carcinoma were 43.8% (21/48) and 85.6% (231/270), respectively. Microcalcification was found in 37 cases (malignant 8, benign 29) and macrocalcification was found in 23 cases(malignant 13, benign 10) (P < 0.01) . Sensitivity and specificity of macrecalcification for diagnosing thyroid carcinoma were 61.9% (13/21) and 74.4% (29/39), respectively. Single calcification was found in 31 cases (malignant 13, benign 18) and multiple calcification was found in 29 cases(malignant 8, benign 21) (P >0.05). Internal calcification was found in 15 cases of malignant lesions(71.4%) and 12 of benign lesions(30.8%); Edge calcification was found in 6 cases of malignant and 27 of benign, (P <0.01). Sensitivity and specificity of internal calcification for diagnosing thyroid carcinoma were 71.4% (15/21) and 69.2% (27/39), respectively. Conclusion Internal calcification or(and) macrocalcification of the thyroid lesions may strongly suspect thyroid carcinoma and fine-needle aspiration or surgery should be further performed.

Since Hosobuchi first found that spinal cord stimulation had the effect of significantly increasing cerebral blood flow (CBF) more than two decades ago, spinal cord stimulation had attracted wide attention in the field of treating cerebral ischemia. A large number of animal and clinical studies have been performed in this field, which make it another research focus following thrombolysis and interventional therapy. This article reviews the research history, mechanisms, and current status of clinical applications of spinal cord stimulation in cerebral ischemia protection.

Objective To study the effects of sodium bicarbonate (SB) on resuscitation in swine model of asphyxiation cardiac arrest (CA).Methods Thirty-two healthy miniature pigs were randomized (ramdom number) into two groups,the SB group (n =16) and the control group (n =16).Animals in both groups underwent endotracheal tube clamping to induce CA.Once induced,CA left untreated for a period of 8 minutes.At the beginning of initiation of cardiopulmonary resuscitation (CPR),SB (1.0 mEq/kg,diluted to 40 mL) was injected in central venous in SB group and isopyknic normal saline solution was injected in control group.Two minutes following initiation of CPR,defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died.To assess the SB effects on myocardial metabolism,positron emission tomography (PET) was performed at baseline and 6 after ROSC.To analyze 18F-FDG myocardial uptake identified in PET,the maximum standardized uptake value (SUV) was measured.Results ROSC was 10/16 successful in SB group and only 8/16 successful in control group.The average survival time of SB group was (3.63 ± 0.76) h and that of control group was (2.45 0.70) h.Myocardial metabolism imaging using PET demonstrated that myocardial metabolism injuries in control group were more severe than in SB group at 6 h after ROSC and SUVmax was more higher in SB group than in control group (6 hrs after ROSC:1.32 ± 0.20 vs.1.10 ± 0.14,P =0.035).Conclusions In swine model of asphyxiation CA,SB improve the myocardial metabolism and might raise the possibility of ROSC and have no hypernatronemia.