BACKGROUND: The separation injury of pubic symphysis is most commonly associated with severe pelvic fracture injuries. Because the anatomical position of the pubic symphysis is deep, and the curative effect is often unsatisfactory. Anatomical and biomechanical studies are necessary to better guide clinical diagnosis and treatment. OBJECTIVE: To summarize and analyze the anatomical characteristics and biomechanical research status of pubic symphysis, and to provide some benefits for the clinical treatment of pubic symphysis separation. METHODS: The authors retrieved CNKI, VIP, and PubMed with the key words of “separation of pubic symphysis” and “biomechanics” for articles published from April 1984 to February 2020. Relevant literature was selected by title and abstract, and the titles and abstracts of the references were read. The related literatures were selected again and the duplicate literatures were eliminated. RESULTS AND CONCLUSION: There were 57 eligible literatures, and 33 were finally included. (1) The present anatomical study mainly focuses on the structure of pubic symphysis and its adjacent ligaments. (2) Because of the position of pubic symphysis, no further study was carried out. The precise distribution of the starting and ending points of the peripheral ligaments and muscles, and the precise nerve and blood distribution need further study. (3) There have been relatively few studies of pubic symphysis biomechanics, and they vary widely. It needs to be deeply studied and agreed upon. (4) With the development of finite element, the biomechanics focus on the treatment of pubic symphysis. (5) Due to good mechanical stability, the reconstructed plate and the hollow screw are used as common fixation for pubic symphysis separation. However, percutaneous hollow screw fixation has become the trend in the future because of its minimal invasion.

Objective The paper is an attentative effort to evaluate the reaction and mechanism of estrogen on pregnant rabbits with acute lung injury caused by hemorrhagic shock. Methods Sixty pregnant New Zealand white rabbits were randomly divided into 6 groups, with 10 rabbits in each group, namely normal control group (NG group, with anesthesia only), estrogen group (E2G group, with additional estrogen injection at 60 min) and the other four hemorrhagic shock groups underwent hemorrhagic shock (i.e. E2SG, FSG, SBSG, E2SBSG group;mean blood pressure-40 mmHg(1 mmHg=0.133 kPa)by phlebotomy for 15 min. After maintenance of the pressure for 45 min, the rabbits were treated with E2(0.37 mg/kg), fructose injection(5%,2 ml/kg), the p38 mitogen-activated protein kinases(p38MAPK) inhibitor SB-203580 (2 mg/kg) or E2 plus SB-203580. Tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) were measured at different time points(0 min, 60 min, 80 min and 260 min), lung tissue methane dicarboxylic aldehyde(MDA) level, lung tissue myeloperoxidase(MOP), superoxide dismutase(SOD) activity, lung tissue dry weight/wet weight (DW/WW) value were measured after the experiment was finished, pulmonary pathology of the rabbits was observed. Result (1) Serum TNF-α level of NG group and E2SG group were not significantly different compared with the other four groups at the 0 min and 60 min. At 80 min and 260 min of experiment, serum TNF-αlevel of all the four shock groups were increased, E2SG group [(172.4±16.0) and (216.7±18.6) ng/L], FSG group [(171.6 ± 9.1) and (263.9 ± 7.8) ng/L], SBSG group [(172.8 ± 7.2) and (300.6 ± 4.8) ng/L], E2SBSG group [(167.9±4.8 )and (261.8±9.6) ng/L], and significantly higher than NG group and E2G group, separately (P<0.05). (2) Serum IL-6 level of NG group and E2SG group were not significantly different compared with the other four groups at the 0 min, 60 min and 80 min. At 260 min, the serum IL-6 level[(98.3 ± 0.9) and (110.4 ± 1.8) ng/L;(120.9 ± 2.3)and (109.8 ± 2.6) ng/L] of the four shock groups (E2SG, FSG, SBSG, E2SBSG group) were significantly higher than NG group and E2G group (P<0.05). (3) Lung tissue MDA level [(2.20± 0.12),(2.57±0.11),(3.17±0.08), (2.75±1.09) nmol/mg] and MPO activity [(4.45±0.25),(6.65±0.56),(9.55±0.30), (6.78 ± 0.11) U/mg] of the four shock groups (E2SG, FSG, SBSG, E2SBSG group) were higher than NG group and E2G group (P<0.05). (4) Lung tissue SOD activity [(51.8 ± 1.8),(40.2 ± 1.5), (30.0 ± 1.7),(41.2 ± 2.0) U/mg] was significantly higher in the four shock groups(E2SG, FSG, SBSG, E2SBSG group) compared with NG group and E2G group (P<0.05). (5) Lung tissue DW/WW value(0.143 ± 0.008, 0.127 ± 0.008, 0.109 ± 0.006, 0.125 ± 0.008) was significantly lower in the four shock groups(E2SG, FSG, SBSG, E2SBSG group) compared with NG group and E2G group (P<0.05). (6) Lung tissue of the rabbits in NG group and E2G group is basically normal without obvious pathology changes. Lung tissue pathological damage of rabbits was observed in the four shock groups, and the pathological damage of rabbits in SBSG group was most serious. Conclusion Estrogen can reduce acute lung injury of pregnant rabbits with hemorrhagic shock, the p38MAPK pathway plays a critical role in mediating the salutary effects of E2 on shock-induced acute lung injury.

Objective To study the clinical characteristics and to summarize our experience in the diagnosis and treatment of ectopic splenic autotransplantation (ESAP) many years after splenic rupture and splenectomy.Methods The clinical data of 15 patients with ESAP who were treated in the People's Hospital of Zhengzhou from January 1998 to January 2013 were retrospectively analyzed.Results Of the 15 patients,2 patients presented with intestinal obstruction due to the ectopic splenic tissues and required partial resection of small intestine.In 5 patients,the ectopic splenic tissues were in the greater omentum which required resection of part or the whole of the greater omentum.In 4 patients,the ectopic splenic tissues were in the mesentery which required partial or total resection of the tissues.The ectopic tissues were in the pelvis in 3 patients and resection of the left fallopian tube was carried out in 2 patients and resection of the pelvic tissues in 1 patient.In 1 patient the diagnosis was made under laparoscopic biopsy,thus avoiding open surgery.Three patients had multiple implanted sites for these ectopic splenic tissues.Conclusions ESAP is an uncommon disease and it has no clinical characteristics.It is easy to confuse the condition with metastatic deposits.A diagnosis could be made only by combining the history with magnetic resonance imaging,or 99mTc study of red blood cells,or laparoscopic exploration and biopsy.

OBJECTIVETo investigate clinical efficacy and significance of gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis.

METHODSFrom January 2008 to June 2010,52 patients with gluteal muscle contracture induced knee osteoarthritis were reviewed. Among the patients,15 patients were male and 37 patients were female, ranging in age from 15 to 45 years, with an average of 35 years. Eighteen patients had left knee osteoarthritis, 30 patients had right osteoarthritis, and 4 patients had double knee osteoarthritis. All the patients were treated with gluteal muscle contracture release. Lysholm knee score was used to evaluate therapeutic effects before and after operation.

RESULTSAll the patients were followed up,and the duration ranged from 12 to 37 years,with a mean of 15 months. The Lysholm knee score improved from preoperative (68.12 +/- 0.78) points to postoperative (91.23 +/- 0.47) points at the last follow-up, the difference had statistical difference (t=31.269, P<0.01).

CONCLUSIONGluteal muscle contracture release is effective to relieve symptoms of gluteal muscles contracture and knee osteoarthritis. The patients with gluteal muscle contracture should be treated early so as to prevent effects of gluteal muscle contracture on knee joint, slow down degeneration of knee joint at early stage, and prevent occurrence of knee osteoarthritis.

Adolescent ; Adult ; Buttocks ; Contracture ; complications ; diagnostic imaging ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; etiology ; therapy ; Tomography, X-Ray Computed ; Young Adult