OBJECTIVETo investigate the clinical effects of double-plating internal fixation for the treatment of medial tibial plateau fractures with fracture-dislocation type through combined anterior and inverted "L" posteromedial knee approaches.

METHODSFrom February 2010 to September 2013, 17 patients with medial tibial plateau fractures with fracture-dislocation type were treated by double-plating internal fixation at our department. Anterior knee approach was adopted for medial mass reduction and fixation,while the inverted "L" posteromedial approach was used for posteromedial mass. There were 11 males and 6 females, with an average age of 42 years old (ranged, 21 to 65 years old). The efficacy were investigated by comparing pre- and post-operative radiographic data, and by evaluating clinical symptoms using the HSS score system.

RESULTSAll the patients were followed with a mean time of 18 months (ranged, 11 to 25 months). The tibial-plateau varus angle immediately after operation and at the latest follow-up were respectively (87.8 ± 4.2)° and (88.2 ± 4.6)°, and there was no statistical difference (P = 0.458). The posterior slope angle immediately after operation and at the latest follow-up were respectively (10.1 ± 3.7)° and (10.3 ± 4.1)°, and there was no statistical difference (P = 0.512). The knee joint HSS score was 86.7 ± 6.1. No patient had complications such as infection, skin necrosis, internal fixation loosening or loss of fracture reduction.

CONCLUSIONDoubl-plating internal fixation through combined approaches is an ideal operation method for medial tibial plateau fractures with fracture-dislocation type, because it can provide clear surgical field, satisfactory reduction, reliable fixation, and chance for early functional exercise.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Tibial Fractures ; surgery

Adult ; Carcinoma, Small Cell ; pathology ; Female ; Humans ; Male ; Melanosis ; pathology ; Uterine Cervical Neoplasms ; pathology

OBJECTIVETo analyze the imaging features of osteopoikilosis and its diagnosis knowledge.

METHODSThe imaging data of 9 patients with osteopoikilosis were analyzed retrospectively, including 6 familial cases and 3 sporadic cases. In 6 familial cases,there were 4 males and 2 females with an average age of 28 years old ranging from 10 to 63 years. Clinical manifestations of 1 familial case were left knee pain and limitation of activity for 3 years, and other 5 cases without clinical manifestation. In 3 sporadic cases, there were 2 males and 1 female with an average age of 33.7 years old ranging from 25 to 44 years. Three sporadic cases had obvious injury history with following up from 6 to 12 months. All imaging results of 9 cases were observed.

RESULTSThe imaging data of 6 familial osteopoikilosis showed the multiple round or oval nodes within bone with clear margins, uniform density, different size. The occurrence of the hyperostotic spots preferentially localized in the epiphyses and metaphyses of the long bones, and carpus and tarus. X-ray features of 3 sporadic osteopoikilosis were similar to that of 6 familial cases and for 6 to 12 months follow-up X-ray features were unchanged.

CONCLUSIONThe imaging features of osteopoikilosis are relatively specific such as the multiple mottling dense focal within bone with clear border and bilateral symmetry, and the focus located on cancellous bone and the diaphyses usually is unaffected. The imaging is a valuable examination for the accurate diagnosis of osteopoikilosis.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Osteopoikilosis ; diagnosis ; diagnostic imaging ; Pedigree ; Radiography ; Young Adult

OBJECTIVETo explore the curative effect and safety of acupuncture for mild cognitive disorders after stroke.

METHODSRandomized controlled trial was adopted and one hundred cases conforming to criteria were divided into a combined acupuncture and medication group (group A) and a medication group (group B), 50 cases in each group. The basic treatment of cerebrovascular disease was applied in two groups. The group A treated was with acupuncture at Baihui (GV 20), Shenting (GV 24) and Qucha (BL 4) etc. and oral administration of Nimodipine. In group B, Nimodipine was taken orally. The treatment lasted for 3 months, the scores of Mini-Mental State Examination (MMSE), modified Hasegawa Dementia Scale (HDS-R) and Barthel Index (BI) were observed before and after treatment in two groups.

RESULTSThe total effective rate in group A was 66.7% (32/48), which was superior to 30.4% (14/46) in group B (P < 0.05). The scores of MMSE, HDS-R and BI after treatment were apparently improved as compared with those before treatment in two groups (all P < 0.01). The improvements in group A were superior to those in group B (all P < 0.05). There was no adverse event reported during the treatment in two groups.

CONCLUSIONAcupuncture can improve activity of daily living and has significant effect in treating mild cognition disorders after stroke without adverse reactions.

Acupuncture Therapy ; Aged ; Cognition ; Cognition Disorders ; etiology ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

Objective To investigate the effect of hydrogen sulfide postconditioning on the systolic function of left ventricle during myocardial ischemia-reperfusion (IR) in rats. Methods Part Ⅰ Adult male SD rats weighing 200-250 g were anesthetized with pentobarbital 40 mg/kg and heparin 250 U/kg. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95% O2-5% CO2 at 37 ℃. Forty isolated rat hearts were randomly divided into 5 groups ( n = 8 each) after 20 min of equilibration: control group (group C); IR group; sodium hydrosulfide 1,10, 100 μmol/L postconditioning group (group SP1, SP10, SP100 ).In group Cthe hearts were perfused continuously for another 100 min. In group IR, the hearts were reperfused for 60 min after 40 min ischemia induced by 10 ml/kg ST. Thomas solution. In group SP1 , SP10 and SP100 the hearts were perfused with K-H solution containing sodium hydrosulfide 1, 10, 100 μmol/L for 2 min before reperfusion.LVDP and ± dp/dtmax were recorded at the end of equilibration and reperfusion. Part Ⅱ Cardiomyocytes were isolated from the male SD rats (weighing 200-250 g) and then cultured in CO2 incubator for 4 h. Sixty-four dishes of cultured myocytes were randomly divided into 4 groups( n = 16 each): control group (group C), hypoxia/reoxygenation group (group HR), hydrogen sulfide postconditioning group (group SP) and hypoxia postconditioning group (group HP). Group C were cultured continuously for 2 h. Group HR, SP and HP were exposed to 1 h hypoxia (95%N2-5%CO2 ) followed by 1 h reoxygenation. In group SP 10 μmol/L sodium hydrosulfide was added and the myocytes were then incubated for 2 min before reoxygenation. In group HP the cultured myocytes were expased to 3 min reoxygenation followed by 3 min hypoxia for 3 times before the 1 h reoxygenation. Mitochondrial membrane potential and F-actin expression were determined. Results Part Ⅰ Compared with group C, LVDP and ± dp/dtmax were significantly decreased at the end of reperfusion in group IR (P ＜ 0.05), while no significant difference was found in group SP1 , SP10 and SP100(P ＞0.05). Compared with group IR, LVDP and ± dp/dtmax were significantly increased in group SP ( P ＜ 0.05). There was no significant difference in LVDP and ± dp/dtmax among group SP1, SP10 and SP100(P ＞0.05). Part H Compared with group C, the mitochondrial membrane potential was significantly decreased in group HR and HP, and the expression of F-actin was significantly up-regulated in group HR, SP and HP ( P ＜ 0.05). Compared with group HR, the mitochondrial membrane potential was significantly increased and the expression of F-actin up-regulated in group SP and HP ( P ＜ 0.05 ). There were no significant difference in the mitochondrial membrane potential and expression of F-actin between group SP and HP ( P ＞0.05).Conclusion Hydrogen sulfide postconditioning can improve left ventricular systolic function during IR in rats by stabilizing mitochondrial membrane potential and promoting aggregation of F-actin.

At present,the doctor-patient relationship in China is a little tense,communication between doctors and patients is not smooth,and the doctor-patient communication skills of the young doctor is obviously insufficient and need to be improved.In this paper,we analyze the factors that affect the communication between doctors and patients in the Department of Neurology through the complexity of professional knowledge,the current background and so on.In addition,we discuss multiple methods of improving communication capability among this group doctors,hoping to strengthen young physicians' clinical basic skills training,and impart doctor-patient communication skills from the linguistic modifiers,oral expression,words and deeds,use of metaphor,simulation training and other aspects,and establish dynamic assessment system of doctor-patient communication ability.

Objective To investigate the effect and mechanism of hydrogen saline on oxidative stress damage in rats brain tissues after cardiopulmonary resuscitation (CPR). Methods Eighteen adult male pathogen-free Sprague-Dawley (SD) rats were randomly divided into control group (Con group), conventional resuscitation group (ROSC group) and hydrogen saline treatment group (ROSC+HRS group), with 6 rats in each group. All rats were asphyxiated by tracheal clip method to establish cardiac arrest (CA) model, and received first aid with CPR, electric defibrillation and adrenaline until return of spontaneous circulation (ROSC). The rats in ROSC+HRS group were intraperitoneally injected with 2% hydrogen saline (5 mL/kg for the first time and 3 mL/kg every 2 hours). The rats in Con group were only tracheal intubated and mechanical ventilated. The rats were sacrificed after ROSC for 12 hours, and the brain tissue was harvested to determine the contents of malonaldehyde (MDA), superoxide dismutase (SOD), and catalase (CAT). The protein expression of heme oxygenase-1 (HO-1) was determined with Western Blot, and the mRNA expression of HO-1 was determined with reverse transcription-polymerase chain reaction (RT-PCR). Results Compared with the Con group, the MDA was significantly elevated in ROSC group (nmol/mg: 8.15±0.11 vs. 3.68±0.16, P < 0.05), the SOD and CAT were significantly decreased [SOD (U/mg): 69.30±2.39 vs. 94.65±2.75, CAT (U/mg): 74.38±1.65 vs. 95.68±1.88, both P < 0.05], HO-1 mRNA expression was significantly elevated (gray value: 1.383±0.194 vs. 1.117±0.083, P < 0.05), and HO-1 protein expression showed no significant change (gray value: 0.350±0.049 vs. 0.175±0.026, P > 0.05). Compared with the ROSC group, the MDA was significantly decreased in ROSC+HRS group (nmol/mg: 4.72±0.28 vs. 8.15±0.11, P < 0.05), the SOD and CAT were significantly elevated [SOD (U/mg): 83.02±1.10 vs. 69.30±2.39, CAT (U/mg): 85.07±1.94 vs. 74.38±1.65, both P < 0.05], HO-1 mRNA expression was significantly elevated (gray value: 3.200±0.200 vs. 1.383±0.194, P < 0.05), and the HO-1 protein expression was significantly elevated (gray value: 0.788±0.059 vs. 0.350±0.049, P < 0.05). Conclusions Oxidative stress damage is an important mechanism of CPR brain damage. Hydrogen saline can increase the expression of HO-1 in brain tissue, and decrease oxidative stress damage of brain after CPR.

The expression of Attractin mRNA and protein in testis and semen of human and male mice was investigated. Human testis and semen samples were all collected from Reproductive Center of Renmin Hospital, Wuhan University in December, 2012. Testis samples were collected from 7 cases of obstructive azoospermias when they were subjected to diagnosed testis biopsy, and 30 normal human semen samples were obtained from those cases of semen analysis. Adult mice testis tissues were obtained from 10 2-month-old male BALB/c mice, and 60 male mice at different ages were classified into 10 groups (day 1, 5, 10, 15, 21, 28, 35, 42, 56, and 120 respectively, n=6 each). The expression of Attractin mRNA and protein in testis was detected by RT-PCR and Western blotting respectively. Human semen samples were centrifuged into sperm plasma (SP) and sperm extract (SE), and mice sperm samples were collected from the epididymis of 10 adult male BALB/c mice. Western blotting was used to determine the Attractin protein expression level. Attractin mRNA and protein were expressed in the testis of both patients with obstructive azoospermias and adult Bcl/B mice. Quantitative RT-PCR revealed that no Attractin mRNA was detectable in day 1 male BALB/c mice group. The Attractin mRNA and protein levels were low on the day 10, and increased with age until day 56. On the day 120, the expression levels of Attractin were decreased. As for human semen samples, Attractin protein was expressed in both SP and SE, but didn't exist in samples from the epididymis of male BALB/c mice. It was suggested that Attractin acted as a novel active substance and was involved in male reproduction in both human and BALB/c mice, but it exerted a different expression profile in different mammal species.

Adolescent ; Adult ; Child ; Child, Preschool ; Choristoma ; metabolism ; pathology ; surgery ; Encephalocele ; metabolism ; pathology ; surgery ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Infant ; Male ; Meningocele ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neuroglia ; metabolism ; pathology ; Nose Diseases ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Vimentin ; metabolism ; Young Adult

We developed and designed a new type of artificial trachea. The basic structure of the artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings on both sides. Dualmesh was sutured on titanium rings. This experimentation follows the replacement of trachea in dogs with a combined artificial trachea to investigate the feasibility of this type of prosthesis. Sixteen dogs were implanted with the combined artificial trachea after resection of 5 cm of cervical trachea. The 5 cm-long trachea of dogs on the necks were resected and the reconstruction of the defect of the trachea was performed with trachea prosthesis. According to the method of trachea reconstruction, the models were divided into 2 groups, artificial trachea implantation group (the control group, n = 8) and group of artificial trachea implantation with growth factor (the experimental group, n = 8). Then computer tomography scan (CT), bronchoscope and pathologic examination were conducted periodically to observe the healing state of the hybrid artificial trachea. None of the dogs died during operation of cervical segmental trachea construction. But four dogs in the control group died of apnea in succession because artificial trachea was displaced and the lumen was obstructed, while 2 dogs died in the experimental group. In the first month there was granulation around anastomosis with slight stenosis. The rest of dogs were well alive until they were sacrificed 14 months later. The mean survival time of the experimental group was longer than that of the control group. The rate of infection, anastomotic dehiscence, severe stenosis and accidental death in the experimental group were lower than the control group (P < 0.05). Artificial trachea was encapsulated by fibrous tissue and no mucous membrane was seen in the lumen of the artificial trachea. The artificial trachea can be used to reconstruction of the defect of the trachea with long-term survival of the animals. The unique design of artificial trachea reduces stenosis around anastomosis effectively but infections and split or displacement of the artificial trachea are still major problems affecting long-term survival of the animals. Application of growth factors to a certain extent promotes tissue healing by changing the local environment.
Animals ; Artificial Organs ; Dogs ; Prostheses and Implants ; Prosthesis Design ; Prosthesis Implantation ; Reconstructive Surgical Procedures ; Titanium ; Trachea ; surgery