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.

Objective: To investigate the effect of interleukin-8 (IL-8) on survival and apoptosis of hypoxic human umbilical vein endothelial cells (HUVECs) with its mechanisms.
Methods: Hypoxic HUVECs were induced by CoCl2. HUVECs were cultured with different concentrations of CoCl2 or IL-8 and the survival rates of HUVECs were examined. Normal or hypoxic HUVECs were incubated with IL-8 or simultaneously incubated with anti-IL-8 or Akt inhibitor LY294002 for 48h. The HUVECs survival rate was detected by MTT method, apoptosis rate was measured by Annexin V-FITC/PI method, the protein expressions of Caspase-3, phosphorylated Akt (pAkt) and GSK-3βser9 (pGSK-3βser9) were evaluated by Western blot analysis.
Results: By 12 h incubation with low concentration of CoCl2 (50, 100 μmol/L), HUVECs proliferation were improved, P<0.01; while by 24h and 48 h incubation with high concentration of CoCl2 (200, 400 μmol/L) HUVECs survival were decreased. By 48h and 72h incubation with IL-8 at (10, 50, 100 ng/ml), the hypoxia induced cell apoptosis was decreased and the survival was increased,P<0.01. IL-8 at 10 ng/ml may obviously inhibit the normal and hypoxic HUVECs apoptosis, down-regulate caspase-3 and up-regulate pAkt and pGSK-3βser9 expressions in HUVECs,P<0.01, while the above effects could be reversed by LY294002 and anti-IL-8,P<0.01.
Conclusion: IL-8 could down-regulate caspase-3 and up-regulate pAkt and pGSK-3βser9 expressions in HUVECs and therefore, inhibit the apoptosis and improve the survival of hypoxic HUVECs.

Objective To evaluate the effectiveness of several methods in eliminating Mycoplasma contamination in cell culture of human hepatoma-derived cell line C3A. Methods PCR was performed to detect the Mycoplasmas contamination in cell cultures. The contaminated samples were treated by ciprofloxa-cin, heating, Plasmocure or co-culturing with macrophages. Transmission electron microscope ( TEM) and Q-PCR were used to comparatively analyze the cell morphology and gene expression before and after Plas-mocure treatment. Results Plasmocure succeeded in eliminating Mycoplasma contamination, while cipro-floxacin showed temporary efficacy. Heating and co-culturing with macrophages failed to eliminate Mycoplas-ma contamination. No Mycoplasma contamination in the Plasmocure-treated group was observed under TEM and the expression of ALB, TF and CYP3A4 genes were higher than the genes expressed in the contaminated group (P<0. 01). Conclusion Plasmocure treatment was effective in eliminating Mycoplasma contamina-tion in cell culture. Moreover, the cell morphology and gene expression in Plasmocure-treated group were re-stored to normal.

Objective To explore the clinical effect of early cognitive rehabilitation on cognitive,physical function and quality of life in the patients transferred from intensive care unit (ICU).Methods A total of 120 cases of patients who were transferred from ICU to general wards was randomly divided into the control group and the observation group with 60 cases in each group.The control group was given symptomatic treatment according to their original disease,without cognitive intervention.On the basis of the control group,the observation group was treated with cognitive rehabilitation training,2 times / week,2 h/ times,12 weeks of treatment.The cognitive function,physical function and quality of life of two groups were compared with the memory and executive screening scale (MES),the daily activity scale (ADL),and the concise Health Survey (SF-36) before and after treatment.Results Compared to before treatment,after treatment,MES,SF-36 (in addition to bodily pain) and ADL scale project score in the observation group was significantly higher,SF-36 bodily pain scores decreased significantly,all the differences were statistically significant (P ＜ 0.05);Compared to the control group,after treatment,the MES,SF-36 (in addition to bodily pain) and ADL scale scores in the observation group of were significantly increased,the bodily pain score of SF-36 in the observation group compared with the control group decreased significantly,all the differences were statistically significant (P ＜ 0.05).Conclusions Early cognitive rehabilitation can significantly improve the cognitive,physical function and quality of life in the patients transferred from ICU,and it is worthy of clinical reference.

Objective To investigate the effect of depression on the incidence of osteoporosis in patients with maintenance peritoneal dialysis (MPD).Methods We enrolled 80 MPD patients,who underwent peritoneal dialysis in our dialysis center.The clinical data and biochemical parameters of all patients were collected,bone mineral density was detected and the Self-rating depression scale was used to evaluate depression state.Results Among the 80 enrolled MPD patients,34 patients had osteoporosis (42.5％),48 patients had the presence of depression (60％).Logistic regression analysis showed that age,dialysis age,gender,diabetes history and depression state were the risk factors for osteoporosis in MPD patients,the depression state was negatively correlated with BMD of lumbar and femoral neck (r=-0.347,r=0.426,P＜0.05).Conclusion Depression state may be a risk factor for osteoporosis in clinic,it is of great significance to focus on the psychological state of MPD patients in the prevention and treatment of osteoporosis.

Objective To explore the clinical application value of multi-slice spiral CT angiography.Methods 28 patients who were suspected cerebrovascular disease were taken cerebrovascular enhanced scan by 16-slice spiral CT,and VR,MIP and MPR post -processing were uset to reconstmct the cerebrovascular image.Results In 28 patients,11 cases were normal,17 cases were abnormal,and among these patients there were 8 cases of abnormal blood vessels,4 cases of aneurysms,1 case of cerebral arteriovenous malformation,4 cases of cerebral artery stenosis.Conclusion The multi-slice CT compared with ordinary spiral CT had the advantage of faster and more secure.It had an important role in guiding the screening and clinical treatment programs in cerebral infarction patients with suspected cerebral artery stenosis.It had a lot of advantages in diagnosis vascular disease and clinical observation after treatment.