OBJECTIVETo evaluate the clinical effect of a new surgical approaches for repairing the acute Achilles tendon rupture.

METHODSFrom January 2009 to January 2014, 21 patients with Achilles tendon rupture were treated by 2 minimally invasive incisions and remaining skin bridge of achilles tendon end including 16 males and 5 females with an average age of 44.3 years old ranging from 21 to 57 years old. Postoperative complications, the range of movement of affected ankle joint, the circumference calf and ankle on both side, time of reture to work and sports activity were observed and recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate the functional recovery.

RESULTSAll patients were followed up for 6 to 36 months with an average of 13.5 months. No skin necrosis, wound infection, deep vein thrombosis,re-rupture and sensory disturbance with the ankle or foot in the sural nerve distribution were found. At 1 year after operation, there was no significant difference in the range of movement between affected foot (55.4 ± 6.5)° and unaffected foot (56.3 ± 3.7)° (t = 0.872, P = 0.325). There was significant difference in AOFAS between preoperative (65.1 ± 6.9) and postoperative (94.3 ± 5.5) (t = 7.672, P = 0.013). All patients returned to work and study at an average of 10 weeks (ranged from 6 to 15 weeks) and 15 patients returned to normal sports activities at 21 weeks (ranged from 18 to 24 weeks). Calf and ankle circumferences decreased by 0.45 cm (0.3 to 0.8 cm) and increased by 0.4 cm (0.2 to 0.7 cm), respectively in the injured leg as compared with the contralateral leg.

CONCLUSIONThe simplicity of the technique of minimally invasive incision and skin bridge for acute closed Achilles tendon reconstruction is an effective and reliable method with low complication.

Achilles Tendon ; surgery ; Acute Disease ; Adult ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Rupture

Child ; Epidermal Cyst ; Humans ; Keratoderma, Palmoplantar ; Nails, Malformed ; Skin Diseases ; Syndrome

Amino Acid Metabolism, Inborn Errors ; pathology ; Child, Preschool ; Humans ; Male ; Twins

Child ; Humans ; Hyperhomocysteinemia ; genetics ; Male

OBJECTIVETo discuss the treatment strategy of acetabular fractures and unstable pelvic fracture of the hip and to evaluate its outcome.

METHODSRetrospective analysis of clinical data in 32 patients with unstable pelvic fracture and acetabular fractures from January 2007 to June 2013 were collected. There were 18 males and 14 females aged from 18 to 62 years old (means 38 years old). According to Tile classification of pelvic fracture, 11 cases were type B1, 8 were type B2.1, 7 were type B2.2, 3 were type C1.1, 2 were type C1.2, 1 was type C3. According to Judet-Letournel classification, anterior column fracture was in 1 case, transverse fracture in 8, transverse plus posterior wall fracture in 6, T-type fracture in 1, anterior column plus half transverse fractures in 5, double column fracture in 11. Other combined injuries were treated early, the surgical operation were performed after stable condition. The hip joint function and the fracture reduction were assessed during follow-up.

RESULTSThe operative time was from 1.8 to 6.5 hours (averaged 3 hours). Two fat patients' incision occurred in fat liquefaction and healed after dressing, no incision infection happened. Only 1 case was lost to follow-up, 31 patients were followed up with a mean time of 23 months (6 to 42 months). The healing time of pelvic fracture was from 8 to 18 weeks (averaged in 10.6 weeks). The hip function was evaluated according to the Matta and Tornetta standard postoperatively, the result was excellent in 15 cases, good in 14 cases, fair and poor in 1 case respectively. The Majeed score of the hip function was 83.65? 7.67, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The healing time of acetabular fractures was from 8 to 16 weeks (averaged in 10.2 weeks). The fracture reduction was assessed by Matta standard, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The heterotopic ossification was evaluated by Brooker standard, 4 cases were grade I, 1 case was grade II . There were no infection, nonunion and necrosis of the femoral head in all patients. The nerve damage symptoms in 5 patients disappeared during 4 to 6 months after operation.

CONCLUSIONPatients with unstable pelvic fractures and acetabulum fractures were in a critical condition early, using the concept of damage control to save lives in a timely manner. Grasp the operation time in the late treatment, acetabulum fractures reach anatomical reduction as far as possible, pelvic fractures are given priority to stable reconstruction. The operation order was fixed pelvic ring first, according to the condition to choose the appropriate surgical approach and fixed mode.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Aldehyde Oxidoreductases ; deficiency ; Child, Preschool ; Female ; Humans ; Metabolism, Inborn Errors ; diagnosis ; enzymology ; metabolism ; Succinate-Semialdehyde Dehydrogenase ; gamma-Aminobutyric Acid ; metabolism

of Streptomyces regensis was isolated from soil to produce a novel antibiotic AGPM of a strong biological activity of antitumor The strain was irradiated by UV after treatment with LiCl to give a AGPM yield of 1 87?10 2 mg mL 1 , 2 2 times higher than that of the original strain The optimum UV irradiation time was 30～60 s and the best LiCl concentration was 0 05～0 09 mol/L The fermentation of AGPM was conducted in a 30 L stirred tank, the maximum yield of AGPM using the mutants reached 1 85?10 2 mg mL 1 , while that using the original strain was only 0 85?10 2 mg mL 1

Purpose:To evaluate the effects of intraoperative radiotherapy for adenocarcinoma gastric cardia.Meth- ods:From Jan.1992 to Dec.2000 a trial on intraoperative radiotherapy for AGC was carried out in 38 patients.Whose age was younger than 75 years,at least on semiliquid diet and no contraindication of surgery.6MV or 9MV-E photon was used for the intraoperative radiation therapy to the cardia,lower segment of the esophagus,fundus,lesser curvature and hepato- gastric ligament.Results:Average follow up 65 months.The 5 year survival rates were 39.4%.Conclusions:Intraoperative radiation therapy is able to improve the results of surgery for adenocarcinoma of the gastric cardia.

Objective:To evaluate the feasibility of implanting a new self-expanding valved stent for aortic valve implantation and its influence on coronary blood flow. Methods:We designed a self-expanding valved stent made from super-elastic memory nitinol alloy,with a tubular shape and a wide mesh in the cavate middle part. A valvular ring made of nitinol wire was sutured on the lower part. Fresh porcine pericardium was decellularized,treated with 0. 6% glutaraldehyde solution for 36 h,trimmed into leaflets,and sutured by hand into the valvular ring. The valved stent was pulled into a 14-French sheath by a silk and positioned in the left ventricle of isolated pig heart via the ascending aorta,and then deployed over the native aortic valves by pulling back the outer sheath. Water was injected into the ascending aorta by a silicon tube to evaluate the competence of the prosthetic heart valves and its effect on coronary flow. Results:The prepared valved aortic stent could be stably positioned over the native valves and could be removed after deployment. The prosthetic heart valves showed a satisfactory function and had no influence on coronary flow and mitral valve motion. Conclusion:This self-expanding valved stent is well-designed and allows for aortic valve implantation over the native valves without interfering the coronary flow; it can be evaluated further in vivo.