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

Objective To investigate the changes of nuclear factor-κB (NF-κB),tumor necrosis factor-α(TNF-α),and cell apoptosis of cerebral ischemia-reperfusion injury and the influence of brain-derived neutrophic factor(BDNF) on these parameters in rats.Methods Eighty-four male Sprague-Dawley (SD) rats were randomly divided into two groups:BDNF (n =42) and control (n =42) groups.The BDNF group was induced using the improved Zea-longa method and were received abdominal injections of BDNF (0.5 μg/μl) immediately after injury.The control group was received abdominal injections with the same dose sodium chloride injection immediately after injury and repeated one time everyday until the rats was killed.Each group was divided into seven subgroups by sacrificed time after injury,including subgroups 1 h,3 h,6 h,12 h,24 h,3 d,and 7 d; each subgroup got 6 rats.Each subgroup were randomly selected three rats after being killed.The expressions of NF-κB and TNF-α of rats contusion peri tissues brain tissue were detected by immunohistochemical methods.Terminal deoxynucleotidyl transferase (TUNEL) method was used to observe the peri cell apoptosis after brain contusion.Results The expressions of NF-κB and TNF-α in BDNF group was significantly decreased relative to the control group (P ＜ 0.05),with a significant positive correlation between two parameters in two groups (P ＜ 0.001).The number of apoptotic cells was significantly decreased in the BDNF group relative to control group (P ＜ 0.05).Conclusions Brain-derived neutrophic factor probably relieves inflammation response,reduces the change of secondary brain injury after traumatic brain injury,and decreases neural cell apoptosis,and finally provides protection of neurocytes.

The PDB culture medium was selected to ferment the endophyte strain, and the secondary metabolites of endophytic fungi Penicillium polonicum were studied. Combined application of Sephadex LH-20, ODS and HPLC chromatographies over the ethyl acetate extract of the fermented culture led to the isolation of 6 compounds. By spectral methods, the structures were elucidated as [3, 5-dihydroxy-2-(7-hydroxy-octanoyl)]-ethylphenylacetate (1), (3, 5-dihydroxy-2- octanoyl)-ethyl phenylacetate (2), (5, 7-di- hydroxy-9-heptyl)-isobenzo pyran-3-one (3), 3-(hydroxymethyl) 4-(1E)-1- propen-1-yl-(1R, 2S, 5R, 6S)-7-oxabicyclo [4.1.0] hept-3-ene-2, 5-diol (4), (E)-2-methoxy-3-(prop-1-enyl) phenol (5) and p-hydroxylphenylethanol (6).
Biological Factors ; chemistry ; metabolism ; Endophytes ; chemistry ; isolation & purification ; metabolism ; Fabaceae ; microbiology ; Fermentation ; Penicillium ; chemistry ; isolation & purification ; metabolism ; Secondary Metabolism

Adult ; Aged ; Aged, 80 and over ; Humans ; Middle Aged ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; methods ; Tomography, X-Ray Computed ; X-Ray Film

Animals ; Macrophages, Alveolar ; drug effects ; enzymology ; Male ; Muramidase ; biosynthesis ; Quartz ; toxicity ; Rats ; Rats, Sprague-Dawley

To observe the morphology of corneal endothelial cells after femtosecond laser in situ keratomileusis ( Femto-LASlK) .METHODS:From May to September in 2013, 88 eyes of 45 patients with myopia who accepted Femto-LASlK were enrolled in this study. The morphology of central corneal endothelial cells was measured by a non-contact corneal endothelial cell analyzer before, 1mo and 1a after surgery. The number, density, average size, size standard deviation, size coefficient of variation and hexagonality of the corneal endothelial cells were observed. All the measurements were analyzed by statistical analysis.RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery;One month after surgery, the endothelial cell density (ECD) was 2815. 34±297. 07/mm2, which had a 2. 64% decrease compared with preparative ECD (t=4. 60, P= 0. 00), there was no statistical significance between ECD measurements of 1mo and 1a after surgery ( P>0. 05 ); One month after surgery, the size standard deviation ( SSD ) was 118. 47 ± 31. 58μm2 , which increased significantly compared with the preoperative SSD(t=-3. 87, P=0. 03), there was no statistical significance between SSD measurements of 1mo and 1a after surgery ( P>0. 05 );After surgery, the number, hexagonality, average size and size coefficient of variation of the corneal endothelial cells didn't change statistically(P>0. 05).CONCLUSlON: ln the early period after Femto-LASlK, the ECD decreased slightly, however this kind of surgery did not have significant harm to the function of corneal endothelial cells, and the surgery didn't cause the progressive loss of corneal endothelial cells.

Objective To explore the dynamic change of serum leptin interleukin-6(IL-6),and interleukin-8(IL-8)during cerebral infarction,and to analyze the possible relationship between these factors and the severity of the disease.Method The levels of serum leptin,IL-6 and IL-8 were measured by radioimmunoassay in 60 patients with acute cerebral infarction,who were admitted to the hospital within 24 hours after stroke.Patients' neurologic impairment were evaluated by European Stroke Scale(ESS)at 1,3 and 7 days respectively after hospitalization.At the same time,another 30 normal adults were enrolled set as control group. Results The levels of serum Leptin,IL-8 in patients group after at 1 days,3 and 7 days were higher than those in the controls(P0.05).The ESS of these patients were 76.77?26.42,70.02?29.17,74.65?28.42 respectively,after 1,3 and 7 days.It shown that ESS simply correlated to the level of IL-8(P0.05).Statistic analysis was carried,but by using t test and linear correlation.(SPSS11.5 statistical package).Conclusion Leptin,IL-6 and IL-8 probably play a role in the inflammatory,reaction during acute cerebral infarction.The IL-8 may reflect the severity of the disease.

Objective To explore the extent of lung injury induced by hyperoxia,and the activity of ubiquitin-proteasome pathway(UPP) in pathophysiological progress of lung tissue in early stages.Methods Adopted completely random design,20 SD rats were divided into hyperoxia group and air control group.For the air control group,the oxygen concentration exiting the cages was analyzed with oxygen monitor and oxygen concentration remained at 210 mL/L for 72 hours;while in the hyperoxia group,the condition changed into high-density oxygen(950 mL/L) for 72 hours to estimate the hyperoxia lung injury in rats model.The contents linked morphology as pathological classification in gross finding,pathological score of lung injury and the index of pneumonedema-the ratio of moist to dry weight of lungs were mea-sured.The expressions of ubiquitin protein and the activity of proteasome 20 S and the active statement of ubiquitin-proteasome pathway were detected by immunohistochemistry and Western blot methods.Results 1.The hyperoxia lung injury rat model was successfully duplicated.2.In hyperoxia group,pulmonary edema with increased ratio of moist to dry weight of lungs could be found(P=0).3.Macroscopic observation: bright red and full-stacked lung tissue,foliated or local hemorrhage on the surface,but little pleural effusion was observed in hyperoxia group.There was statistical significance of pathological classification in gross finding between hyperoxia group and air control group(P=0.005).Light microscope observation:swelled alveolar epithelium,widened alveoli wall,capillary engorgement and telangiectasis,obvious edema in interstitial tissue of pulmonary aveolus and alveolar space,increased inflammatory cells were observed in hyperoxia group.The findings of pathological score of lung injury indicated more serious injure than control group(P=0).4.The increased expression of ubiquitin protein in lung tissue was discoved by using immunohistochemistry and Western blot findings after hyperoxia exposure 72 hours.(P=0).5.The acti-vity of proteasomes 20 S in hyperoxia group was higher than that in control group(P=0).Conclusions The mainly pathological changes of lung are generated through hyperoxic exposure for 72 hours,including alveolar epithelial cell and vascular endothelial cell injury diffusely,inflammatory cell infiltration and pulmonary edema.Active the ubiquitin-proteasome pathway is connected with the pathophysiological process of lung injury in the initial stages of hyperoxia-exposure.

Objective To investigate the protective effects of the ubiquitin proteasome inhibitor MG-132 on p38 signaling pathway and apoptosis in lung injury induced by hyperoxia. Methods Twenty-six SD rats were randomly divided into 4 groups: normal control group(n=5),MG-132 control group(n=5),hyperoxia group(n=8) and MG-132 hyperoxia group(n=8).Hyperoxia lung injury rat models were established,and proteasome inhibitor(0.5 mg/kg) was intraperitoneally injected in control group and MG-132 hyperoxia group once daily.The resected lungs were histopathologically examined,and cell apoptosis and expression of ubiquitin and p38 were detected by TUNEL and immunohistochemistry,respectively.Results After hyperoxia exposure,there were edema and inflammatory cell infiltration in the lung tissues of SD rats.The apoptosis index and expression of p38MAPK of hyperoxia group were higher than those of normal control group and MG-132 hyperoxia group(P

OBJECTIVETo retrospectivly compare the clinical efficacy of dynamic hip screw (DHS) with proximal femoral nail anti-rotation (PFNA) for the treatment of unstable intertrochanteric fractures in the elderly.

METHODSTotally 92 elderly patients with unstable intertrochanteric fractures were treated with DHS [including 27 males and 23 females with a mean age of (72.5 +/- 5.3) years old] and PFNA [including 22 males and 20 females with a mean age of (72.8 +/- 5.8) years old] from August 2008 to August 2012. The data of operation time,blood loss (obvious and hidden blood loss), bedridden time, down load time, postoperative complications and Harris hip function score were recorded and compared.

RESULTSBoth of two groups were followed-up for 10 to 18 months with an average of 13.5 months. PFNA was implanted with a significantly smaller incision and shorter clinical healing time, less blood loss,while hidden blood loss were more. Postoperative complications, therapeutic effects and Harris score in PFNA group were better than that of DHS group.

CONCLUSIONFor treatment of senile patients with unstable intertrochanteric fractures, PFNA was superior to DHS in reducing complication rates, recovering hip joint, while DHS could reduce perioperative blood loss in treating type II a, II b and III fracture.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Case-Control Studies ; Female ; Femur ; surgery ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Internal Fixators ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome