Objective To discuss the feasibility,indications,surgical techniques,and outcome con- cerning the application of less invasive stabilization system (LISS) for complex proximal femoral fractures.Methods We treated 12 complex proximal femoral fractures using femoral LISS reversely from June 2005 to May 2006. They were five complex intertrochanteric fractures and seven subtrochanteric ones.By AO classification,two were type 31-A2.2,two type 31-A2.3,one type 31-A3.3,one type 32-A3.1,three type 32-B1.1,one type 32-B2.1, and two type 32-B3.I.The patients were treated with closed or indirect reduction and fixation with percutaneous LISS plate reversely.Results There were no major postoperative complications in this study.The mean operation time was 65 minutes (range,50 to 90 minutes),the mean intra-operative blood loss was 142 milliliters (range,50 to 400 milliliters),and the mean postoperative hospital stay was 9.3 days (range,6 to 15 days).All patients had a clinical follow-up;the mean follow-up time was 7.2 months (range,3 to 14 months).Ten cases healed clinically three months postoperatively,one periprosthetic fracture healed four months and one pathological fracture healed six months after operation.At the final radiographic follow-up,no collapse,varus deformity,cutting-out,hardware failure,or avascular necrosis was found.Conclusions Femoral LISS used reversely can provide secure fixation for proximal femoral fractures biomechanically and anatomically.It is also easy and safe.It is particularly suitable for old patients with intertrochanteric fractures complicated with disorders of internal organs and severe osteoporosis or patients with complex proximal femoral fractures.It is important to be skillful in indirect reduction and positioning of guide wire into hole A,and to avoid immediate weight-bearing postoperatively.

ObjectiveTo enrich and quantitatively analyze peripheral circulative carcinoma cells by magnetic activated cell sorting (MACS) in colorectal cancer patients.MethodsBlood samples, preoperatively collected from 21 patients with colorectal cancer and 9 healthy volunteers, were labeled by anti-cytokeratin (CK) with magnetic microbeads, and passed through magnetic columns; CK +carcinoma cells were separated from the samples, and quantified by flow cytometry.ResultsCK +CD45 -cells could not be detected from the samples without MACS; in the sample undergoing MACS, the concentrations of CK +CD45 -cells were significantly higher in patient group than in control group(P

ObjectiveTo investigate the disruption of blood-brain barrier (BBB) after brain trauma in rats using IgG immunohistochemical staining.MethodsAn impact-acceleration head injury model was established with rats. Histological changes of rats' brains were observed by HE staining and light and electron microscopes at 1 h, 6 h, 24 h and 7 d after injury, and BBB permeability was analyzed semi-quantitatively by IgG immunohistochemical staining at the same time points.ResultsThe spot bleeding and brain edema was present in the damage region after brain trauma and endothelial cell damage and astrocyte swelling could be found under electron microscope. The extravasations of IgG was detected in the injured hemisphere of rats at 1 h, and achieved the peak at 6 h, remained a high level up to 24 h, and decreased at 7th d.ConclusionThe disruption of BBB function occurs after brain trauma in rats, and detection of IgG extravasations tested by immunohistochemical staining is a simple and sensitive way to investigate BBB permeability.

Objective To study the changes of diastolic function of left ventricle by tissue Doppler imaging (TDI) and the serum level of endocrine factors,and analyse the relations between these factors and mass or diastolic function of left ventricle in patients with essential hypertension.Methods Sixty one patients with essential hypertension were divided into left ventricular hypertrophy(LVH) group and no left ventricular hypertrophy(NLVH) group.Twenty healthy subjects were considered as control group.The early(e) and late(a) diastolic maximal myocardial velocity and e/a of lateral wall motion of mitral valve annulus were recorded by TDI.The levels of atrial natritic peptide(ANP),brain natriuretic peptide(BNP),endothelium(ET),calcitonic gene related peptide(CGRP) and insulin like growth factor 1(IGF 1) were measured by radio immunology analysis.Results The e wave maximal velocity in LVH group was lower than that of NLVH group and control group [( 14.56 ? 7.83 ) cm/s,( 16.40 ? 0.66 ) cm/s,( 18.68 ? 3.78 ) cm/s,respectively],and a wave maximal velocity in LVH group was higher than that of NLVH group and control group [( 18.28 ? 9.60 ) cm/s,( 16.03 ? 5.88 ) cm/s ,( 14.53 ? 1.28 ) cm/s,respectively]; The e and a maximal velocity velocities in both LVH and NLVH groups had statistic differences with those of control group(P

Objective To investigate the impact of overweight and obesity on left atrial (LA) function in healthy subjects with excess body weight.Methods Conventional echocardiography and tissue Doppler imaging were performed in 30 obese subjects (BMI≥28 kg/m2),30 overweight subjects (BMI,24to 28 kg/m2) and 30 age-matched normal subjects (BMI＜24kg/m2).Strain (S),peak systolic strain rate (SSR),peak early diastolic strain rate (ESR) and peak late diastolic strain rate (ASR) values were used to evaluating LA function.Results Compared with controls,mean S,SSR and ESR were decreased in obese subjects,while mean SSR,ESR and ASR were decreased in overweight subjects.Compared with overweight subjects,mean ESR was decreased in obese subjects.Conclusions An impaired LA function is found in overweight and obese subjects who has no other clinically appreciable cause of heart disease by using strain and SR imaging.

Objective To discuss the selections of surgical treatment for lower cervical spine fracture and dislocation and the treatment outcome.Methods Clinical data of 50 cases of lower cervical spine fracture and dislocation were analyzed retrospectively.There were 37 males and 13 females at mean age of 41 years (range,20-80 years).Forty-four cases underwent anterior fusion,but 4 with ankylosing spondylitis and 2 with extremely unstable cervical spine were treated with combined posterior fusion.Two cases sustaining ankylosing spondylitis and being unable to be operated via the anterior approach due to the maximum neck flexion limits were treated with posterior decompression and fusion.Two cases developed delayed fracture and underwent posterior release prior to the anterior fixation and fusion.Two cases underwent a second surgery with the posterior release,anterior fusion and posterior fusion performed successively.Neurological performance was evaluated using the American Spinal Injury Association (ASIA)scale.Results All the patients were followed up for mean 28 months (range,12-48 months).Implant loosening and redislocation occurred in one ankylosing spondylitis case 2 months after anterior fusion.Other 49 cases achieved bony fusion in 6 months.Neurological function showed no recovery in complete spinal cord injury cases,but improved for average ASIA 1-2 grades for incomplete spinal cord injury cases.Conclusions Anterior surgery provides good reduction and neurological improvement in treatment of lower cervical spine fracture and dislocation.For extremely unstable cases or difficult anterior reduction cases,posterior surgery or combined anterior/posterior surgery should be considered.

Objective To compare the efficacy of reversed less invasive stabilization system (LISS) and intramedullary fixation devices for treatment of femoral trochanteric fractures.Methods Data of 362 consecutive patients with femoral trochanteric fractures who were treated with reversed LISS or intramedullary fixation devices at our institution between March 2004 and May 2011 were retrospectively analyzed.There were 32 males and 38 females treated with reversed LISS.The mean age at injury was 73.4 years.There were 125 males and 167 females treated with intramedullary fixation.The mean age at injury was 74.7 years.The operation time,intraoperation blood loss and length of hospitalization were compared.The patients were asked to fill in a questionnaire of Harris hip score,and radiographs were used to evaluate the bone healing situation.Results The mean operation time was 120 min in reversed LISS group and 80 min in intramedullary group.The length of hospitalization was 12 days in reversed LISS group and 10 days in intramedullary group.More operation time and longer length of hospitalization were needed in reversed LISS group.The intraoperation blood loss was 100 ml in reversed LISS group and 100 ml in intramedullary group.There were 3 DVT in reversed LISS group,10 DVT and 3 PE in intramedullary group.No difference was found in the aspect of intraoperation blood loss,postoperative deep venous thrombosis and pulmonary embolism rate.A total of 320 patients were successfully followed-up,including 63 in LISS group and 257 in intramedullary group.The median Harris score was 75 in LISS group and 77 in intramedullary fixation group respectively.There was no difference of hip function score between two groups.The implant-related complication rate was 11.1％ in reversed LISS group,including 7 implant breakages.In intramedullary fixation group,there were neck screw exiting in 2 patients and cutout in 9 patients.So the implant-related complication rate was 4.3％ in intramedullary fixation group,which is statistically lower.Conclusion Both reversed LISS and intramedullary are effective for the treatment of proximal femoral fractures.There were no major difference in functional outcome between LISS and intramedullary nail.Intramedullary nail is still the choice of priority in most unstable proximal femoral fractures.The implants related complications in reversed LISS group are higher than Intramedullary nail group.However,for the unstable fractures proximal femoral fractures with lateral wall fracture,in which nailing may be difficult,reversely using LISS may be a good alternative.

Objective To carry out the clinical validation of a domestic HBsAg kit to evaluate its application value. Methods 543 serum samples with HBsAg ELISA values of S/CO ≥ 0. 7 were tested by HBsAg confirmatory test. Specific anti-HBs reagent and control reagent were added separately into duplicate wells of HBsAg ELISA plate, in which test sample was also added. After incubation at 37℃, HBsAg was detected by routine ELISA, and the inhibition rate was calculated using absorbanee (A) result of anti-HBs reagent well and control reagent well according to the provided formula. The sample was confirmed as HBsAg positive when the inhibition rate was≥50%. For HBsAg weakly positive samples, "prolonged confirmatory test" (conjugate reaction time was prolonged to 120 rain) was applied to increase the sensitivity. 39 samples were randomized selected for testing and comparison with Abbott Murex confirmatory test. Results 543 serum samples in total were tested by the confirmatory test. Among the 504 cases which showed positive reaction in screening HBsAg ELISA, 89 ( 17. 7% ) were confirmed as negative. According to their S/CO value of the screening HBsAg test, the ratio of negative cases / tested eases in the group were:S/CO≤<5.0, 87/143 (60. 8% ) ;5.0 < S/CO ≤ 10. 0,0/25 (0) ;10. 0 < S/CO ≤ 15.0, 1/21 (4. 8% ) ;15.0 < S/CO ≤ 20. 0, 1/23 (4. 4% ) ;S/CO 20. 0, 0/292(0). Among 39 cases with negative HBsAg (0. ≤