Objective To investigate indications and surgical methods of laparoscopic cholecystectomy (LC) in the management of acute cholecystitis. Methods Clinical data of 78 cases of acute cholecystitis treated by LC were retrospectively analyzed. Stones were impacted in the neck of the gallbladder in 65 cases. An anterograde cholecystectomy was performed in 47 cases, a retrograde cholecystectomy in 19 cases, and a subtotal cholecystectomy, in 12 cases. Results The laparoscopic operation was successfully accomplished in 74 cases, whereas a conversion to open surgery was required in 4. An abdominal drainage was used in 61 cases and was removed 24~48 hours after the surgery. The mean length of postoperative hospital stay was 4.8 days. Postoperative biliary leakage occurred in 1 case because of an injury of the common hepatic duct by electrocauterization, which was cured by open surgery with T-tube drainage for 6 months. No other severe complications happened. Conclusions With the exception of a small number of cases (such as Mirrizi's syndrome type Ⅲ or Ⅳ, the gallbladder totally or partially embedded in the liver, or suspected carcinoma of gallbladder), anterograde, retrograde or subtotal laparoscopic cholecystectomy can be safely applied to these with acute cholecystitis within 48 hours after the onset.

Objective To investigate the effect of laser‐doppler flowmetry (LDF) in the evaluation of established canine spi‐nal cord injury(SCI) model .Methods Totally 15 beagle dogs were randomly divided into the group A ,B and C .Through the im‐proved numerical control SCI apparatus ,different impacts and compression time were adopted to establish the different acute SCI models .The group A was 1 .2 m/s+5 mm+5 mm+15 mns ,the group B was 1 .2 m/s+5 mm+5 mm+10 mns ,while the group C wastakenasthecontrolgroup.LDFwasusedtomeasurethespinalcordbloodflow(SCBF)chart,thepathologicchangewasevalu‐ated by measuring the spinal cord necrosis area .Results The SCBF chart in 3 groups measured by LDF showed that the decrease of SCBF in the group A was most obvious ,the injury degree in the group A was more severe than those in the group B and C ,the difference was statistically significant(P<0 .05) .The motor evoked potential displayed that the decrease degree of SCBF was close‐ly related with the prognosis and motion function .Conclusion LDF could effectively judge the degree of spinal injury and SCBF sit‐uation ,which has a good application prospect in animal experiments and clinical field .

We review the literature about Heterotopic Ossification (HO) and introduce its pathophysiology, classification, incidence, clinical presentation, diagnosis, prophylaxis and treatment in this article. HO is the presence of bone in soft tissue where bone normally does not exist. Mature HO has the same morphology as callus. It is considered that 3 conditions are necessary for HO: osteogenic precursor cells, inducing agents, and a permissive environment. Fever, swelling, erythema, and occasional joint tenderness appear in the early stage of HO. The most sensitive imaging modality for early detection of HO is three-phase bone scintigraphy which can also monitor the metabolic activity and degree of maturity of HO. Non-steroidal antiinflammatory drugs (NSAIDs) are the most effective for the prophylaxis of HO after the operation of hip replacement or acetabulum fracture. Surgical resection is the only treatment for patients with severe joint tenderness following HO.

Objective To evaluate the secondary internal fixation plus bone grafting for salvage of failed internal fixation for intertrochanteric hip fractures. Methods Between January 2001 and March 2008, 25 patients with intertrochanteric fractures who had suffered from failed initial internal fixation were treated with secondary open reduction and internal fixation and bone auto grafting. They were 15 men and 10 women, with a mean age of 50 (17 to 72) years. The mean interval between the initial operation and the revision was 12 (4 to 27) months. The failure of original internal implants involved the dynamic hip screw (DHS) in 12 patients, the dynamic condylar screw (DCS) in 3, the angular blade plate (ABP) in 1, the cephalomedullary nail in 3 and the cannulated screw in 6. The replacement of internal implants included PFN in 12 eases, DCS in 7, DHS in 4 and ABP (95°) in 2. Results The mean follow-up was 24 (6 to 84) months. The revisions were uneventful. Of the 25 nonunions, 24 healed (96.0%). The postoperative mean hip rating (Harris score) for the hip joint was 87(35 to 100) points. The X-ray films at the last follow-up revealed the coLlodiaphyseal angle averaged 120° ( 110° to 140°). No avascular necrosis of the femoral head or hip degeneration was found. Conclusion In properly selected patients, secondary internal fixation with bone grafting for failed open reduction and internal fixation of intertrochanteric hip fractures can provide a high rate of union and good clinical results with a low rate of complications.

Objective To classify tibial plateau fractures based on the analysis of the morphology and injury mechanisms of 200 cases of tibial plateau feature.Methods We collected the X-ray and CT images of 200 consecutive cases of tibial plateau fracture in i99 patients who had been treated at our department from January 2010 to April 2011.They were 134 males and 65 females,from 15 to 77 years of age (average,45.7 years).According to the Schatzker classification,9 cases were type Ⅰ (4.5％),105 type Ⅱ (52.5％),19type Ⅳ (9.5％),37type Ⅴ (18.5％),30type Ⅵ (15.0％),and none type m.The fracture morphology and injury mechanism of each case were analyzed to propose a new classification system.Results Fractures of tibial plateau can be classified into the following five types:(a) Lateral condylar fracture and valgus injury (100 cases,50％).The injury mechanism is the axial force on the valgus and extended knee joint.(b) Fracture-dislocation injury (24 cases,12.0％).This type includes typical Schatzker type Ⅳ,and some cases of Schatzker type Ⅵ associated with lateral subluxation.Its mechanism is a compound force of valgus,varus,rotational and axial stresses.The rotational force is the key factor leading to subluxation of the knee joint.(c) Double-condylar fracture (40 cases,20.0％).This type is caused by an axial force on the extended knee,including Schatzker type Ⅴ and some cases of Schatzker type Ⅵ not associated with knee subluxation.(d) Posterior condylar fracture and flexion injury (32 cases,16.0％).This type only involves the posterior condylar plateau,and is caused by an axial force on the flexed knee.Based on the morphology,posterior condylar fractures can be further divided into three subtypes:simple split of posteromedial condyle,simple collapse of posterolateral condyle,and a combination of the two.(e) Frontal plateau compression fracture and hyperextension injury (4 cases,2.0％).This type is caused by an axial force on the hyper-extended knee.It is characterized by significant compression of the anterior plateau and intact posterior plateau.Conclusion Based on the morphological features and injury mechanisms,tibial plateau fractures can be classified into 5 types:lateral condylar fracture,fracture-dislocation injury,double-condylar fracture,posterior condylar fracture,and frontal plateau compression fracture.

Objective To discuss the influence factors on the quality of Potassium dehydroandrograpolide succinate for injection,and to optimize its production process.Methods The related substances were taken as the estimated standards and the orthogonal experimental method for determining the best production process was adopted.Results The water temperature and pH value had a significant effect on the related substances.The best production process was:dispensing water temperature at 40℃,pH at 6.4 and filling time being 2 h.Conclusion The optimized production process was quality control and reasonable,which can be used in industrial production.

BACKGROUND:Studies have shown that neural stem cel transplantation combined with exercise training can promote the recovery of hindlimb motor function from spinal cord injury in rats, but its mechanism of action has not been fuly elucidated. OBJECTIVE:To investigate the effects of early exercise training combined with neural stem cel transplantation on the recovery of hindlimb motor function in rats with spinal cord injury. METHODS:Sixty Sprague-Dawley rats with spinal cord injury were randomly divided into three groups: control group (n=20, given conventional treatment after injury), cel transplantation group (n=20, given neural stem cel transplantation after injury), experimental group, (n=20, given neural stem cel transplantation combined with early exercise training after injury). Recovery of the hindlimb motor function was assessed by Basso, Beattie and Bresnahan scale and inclined plane test before and at 1, 7, 14, 21 days after injury. Western blot assay was used to detect caspase-3 and myeloperoxidase expression. Hematoxylin-eosin staining was done at 21 days after injury to observe the structure changes of the injured spinal cord. RESULTS AND CONCLUSION:(1) Scores of Basso, Beattie and Bresnahan scale and inclined plane test were significantly better in the experimental group than the cel transplantation group folowed by the control group (P < 0.05). (2) In the control group, the expression of caspase-3 and myeloperoxidase was significantly increased at 14 days after injury. In the cel transplantation, the expression of caspase-3 and myeloperoxidase was significantly higher than the experimental group (P < 0.05). (3) Pathological inflammation was reduced most in the experimental group folowed by the cel transplantation group. In the experimental group, the structure of injured spinal cord was improved and became relatively clear and intact. These findings indicate that neural stem cell transplantation combined with early exercise training can effectively promote the recovery of hindlimb motor function from spinal cord injury in rats, by reducing the expression of caspase-3 and myeloperoxidase and alleviating secondary lesion of the spinal cord.

Objective To study the effects of lifestyle quantilization based-weight management on overweight or obesity police officers.Methods One hundred and seven overweight or obesity police officers received lifestyle quantilization based-weight management (i.e.Jinbi weight management) and were then assigned to the excellent performance group (group A,n =50),good performance group (group B,n =42)and loss to follow-up group (group C,n =15).Dietary habits,body weight,height,waist circumference (WC),blood pressure (BP),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were measured before and after the intervention.After 8 weeks' intervention,the changes of above parameters were recored.Student's t test was used for data analysis.Results Of group A and B,83 reported weight loss (group A t =13.31,group B t =5.04 ; both P ＜ 0.05).In group A,body weight,body mass index (BMI),WC,body fat and visceral fat index were significantly decreased,in contrast to body water (t values were 13.31,13.72,10.8,8.59,6.83 and-6.62,respectively; all P ＜ 0.05).However,there were no significant changes of BP,FPG,TC,TG,LDL-C and HDL-C in group A.Following intervention,daily dietary energy intake of group A was reduced by 74.1 k J,fat intake was decreased by 11.6 g,energy ratio of dietary fat was decreased by 1.8％,energy ratio of cereal was increased by 4.2％,and sodium chloride and cooking oil was decreased by 1.3 g and 10 g,respectively.Conclusion Lifestyle quantilization based-weight management shows effectiveness among overweight or obese police officers,and thus may be recommended for other functional communities.

Objective:To investigate the med- to long-term clinical outcomes of open reduction and cannulated screw fixation via the modified Smith-Petersen approach for irreducible femoral neck fractures in young adults.Methods:The clinical data of 16 young adults were retrospectively studied who had been treated for irreducible femoral neck fractures by open reduction and cannulated screw fixation via the modified Smith-Petersen approach by the same surgeon from December 2009 to February 2015 at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital. There were 11 males and 5 females aged from 19 to 59 years (average, 42.9 years). All their fractures were closed Garden type Ⅳ, with high energy injury in 8 cases and low energy injury in the other 8 ones. The time from injury to surgery averaged 5.4 d (from 1 to 11 d). In all the patients, open reduction and cannulated screw fixation via the modified Smith-Petersen approach was conducted after ideal reduction had not been achieved by 3 continuous attempts in primary closed reduction in a traction bed. Recorded were the postoperative full weight-bearing time, return to work time, fracture union time, function of the affected hip and complications at the last follow-up in the patients.Results:The 16 patients were followed up for 6 to 12 years (average, 8.8 years). The postoperative full weight-bearing time averaged 12.7 weeks (from 2 to 16 weeks) in 16 patients; the return to work time averaged 15.0 weeks (from 3 to 20 weeks) and the fracture union time 3.5 months (from 3 to 6 months) in 15 patients while fracture nonunion happened in the other one. The HSS hip scores at the last follow-up averaged 90.3 points (from 62 to 98 points), yielding 12 excellent, 2 good, one fair and one poor cases. The one case with fracture nonunion underwent total hip arthroplasty (THA); of the 4 cases with avascular necrosis of the femoral head, 2 underwent THA; limited range of hip motion due to heterotopic ossification was noted in one case.Conclusion:Open reduction and cannulated screw fixation via the modified Smith-Petersen approach may lead to fine med- to long-term clinical outcomes in young adults whose femoral neck fracture cannot be reduced by closed reduction, because the modified Smith-Petersen approach allows fracture reduction under direct vision.

Schistosomiasis is one of the major infectious diseases that seriously endanger the health of people, and social and economic development. Before the year of 1949, Yujiang County of Jiangxi Province was one of hyper-endemic regions for schistosomiasis. After the founding of the People’s Republic of China, under the leadership and high attention of the Chinese Communist Party and the government, after the arduous struggle with schistosomiasis, Yujiang County became the first county that reached the standard of eradication of schistosomiasis in 1958. Moreover, Chairman Mao Zedong gladly wrote the famous poem of "Farewell to the God of Plague". Since then, the work of schistosomiasis control has been greatly inspired by the poem. In 2016, Yujiang County became the first county of schistosomiasis elimination in Jiangxi Province. In this paper, the experience and process of eradication and elimination of schistosomiasis in Yujiang County are systematically reviewed and summarized by analyzing the endemic situation of schistosomiasis before and after the eradication and elimination in Yujiang County, to expound the significance and enlightenment of the schistosomiasis control in Yujiang County. This paper commemorates the 60th anniversary of the publication of Mao Zedong’s poem.