Cerebral dura mater substitutes for dural repair are essential to maintain anatomical integrity and cerebral protection. Currently, there are three substitutes of cerebral dura mater including xenograft (bovine pericardium), allograft (cadaver cerebral dura mater) and synthesized material (expended polytetrafluoroethylene). Each material has their specific advantages, accompanied by some drawbacks. For example, autologous membrane material has limited sources and worse intensity than natural dura mater, and may induce secondary trauma; allogenous membrane can cause viral infection; xenogenous membrane has residual toxicity after glutaral processing; gelatin sponge has rapid degradation, but its intensity is bad and unable to suture. The synthesized material based on allogenous and xenogenous materials may be developed by the combination of their specific advantages.

0.05). Radiographic analysis showed quite good results in 77 cases. Complications included delayed union in six cases, severe stiffness in one and neuropraxia in two. Conclusions Open reduction and internal fixation of intracondylar humeral fractures is a safe and effective technique. Meanwhile, triceps-split approach and olecranon osteotomy can obtain same clinical outcome for intracondylar humeral fractures.

Objective To investigate clinical results of shoulder hemiarthroplasty in treating comminuted proximal humeral fractures. Methods Shoulder hemiarthroplasty was performed from May 1997 to June 2004 in 28 cases with comminuted proximal humeral fractures who were followed up for mean 2.1 years. American Shoulder & Elbow Surgeon (ASES) score was adopted for evaluating pain after operation, range of active movement and function of daily work. Results Mean ASES score was 87.9(67-96 scores), with mean forward flexion of 132?, external rotation of 40?, mean VAS score of 2.6 and internal rotation at T_ 10 level. Strength and function of 23 cases reached 80% of the normal side six months postoperatively and 90% of the normal side one year postoperatively. Of all cases, 82% were satisfied with the treatment. Conclusion Only reconstruction of normal humeral length, tuberosity fixation and persevering rehabilitation can contribute to a successful result of hemiarthroplasty for the comminuted proximal humeral fractures.

Objective To study the effect of TBTCl on the immunity of mice. Methods The mice were randomly divided into 5 groups, namely groups of negative control, low dose (0.8 mg/kg), moderate dose (4 mg/kg), high dose (20 mg/kg) and positive control. Gavage was employed to administrate TBTCl to mice for two consecutive weeks, the number of T-lymphocyte in blood and invert ability of T-lymphocytes in spleen, hemolysin in serum, clearance exponent and viscera quotiety were determined to study the effect of TBTCl on immunity of rats. Results Compared with the control, no significantly increased T-lymphocytes were seen in low dose group, in moderate dose group the number of T-lmphocyte and the production of hemolysin increased, no obvious changes in the clearance exponent and viscera quotiety were seen. In high dose group, a significantly decreased T-lymphocytes, the clearance exponent and viscera quotiety were observed. Conclusion Low level TBTCl exposure may stimulate the immune system of mice, high exposed to TBTCl may intensively inhibit the immune system.

Objective To evaluate the effect of lightweight polypropylene mesh in tension-free repair of inguinal hernia.Methods A total of 60 patients were divided into 2 groups to receive lightweight polypropylene mesh(experimental group)or standard polypropylene mesh(control group)repair procedures.Data collected included:operation time,postoperative highest temperature and the length of hospital stay;leucocyte count and differential count,CRP,AST,ALT,BUN,Cr at the first day preoperatively and postoperatively.Postoperative complications including wound infection,hernia recurrence,testicular swelling or atrophy,scrotal hydrocele,chronic pain and foreign body feeling were compared with each other.Data were analyzed by statistical method.Results No significant differences were found between the two groups in the operation time,postoperative highest temperature,postoperative hospital stay,and cases of elevated postoperative CRP(c-reactive protein)level.No significant differences were found in the leucocyte count,differential count,and AST,ALT,BUN,Cr level perioperatively between the two groups.During the follow up period of 12～16 months,there was no wound infection,hernia recurrence,testicular swelling or atrophy in the two groups;There were 2 cases of scrotal hydrocele and 1 case of postoperative chronic pain in experimental group,there were 3 cases of scrotal hydrocele and 3 cases of postoperative chronic pain in control group;Six patients complained of foreign body feeling in control group,but no one in experiment group,the difference was statistically significant(P＜0.05).Conclusions Lightweight polypropylene mesh in tension-free herniorrhaphy is safe and effective.It ameliorates postoperative foreign body feeling thanks to the feature of light weight,high porosity and excellent flexibility.

BACKGROUND: Hypogonadism happens gradually with body aging. Traditional Chinese medicine views that deficiency of essential qi is the chief reason for body aging. OBJECTIVE: To observe the influence of tiannianyin, the Chinese herb , on serum testosterone, superoxide dismutase (SOD) activity in testicular tissue and expression of proliferating cell nuclear antigen of spermatogenic cells in testes in subacute senile rats induced by D-galactose. DESIGN: Randomized controlled experiment. SETTING: Basic Medicine Institute of Chengde Medical College. MATERIALS: The experiment was perlormed in Basic Medicine Institute of Chengde Medical College from April to July 2003, in which, 40 adult male SD rats were employed and randomized into 4 groups, 10 rats in each .In normal group, no any management was done. In model group, medication group and negative control, D-galactosie was used for abdominal injection continuously at 200 mg (kg·d), once a day, totally for 40 days to prepare the model of subacute senile animal. In model group, no any management was done after modeling success. In medication group, gastric infusion with tiannianyin. Tiannianyin was administrated everyday after modeling success, once a day, totally for 30 days. In negative control, gastric infusion with physiological saline of same dosage was administrated after modeling success for same days. METHODS: Enzyme linked immunosorbent assay (ELISA) was used for determination of serum testosterone content, xanthine oxidase assay was used for determination of SOD activity in testicular tissue and immunohistochemical method was used to observe expression of proliferating cell nuclear antigen in rats of every group. MAIN OUTCOME MEASURES: ① serum testosterone content; ② SOD activity in testicular tissue; ③ expression of proliferating cell nuclear antigen of spermatogenic cells. RESULTS: Forty rats all entered result analysis. ① Serum testosterone content: That in model group was lower than normal group(P ＜ 0.05), and that in medication group was higher than model group(P ＜ 0.05). ② SOD activity in testicular tissue: That in model group was lower remarkably than normal group(P ＜ 0.01), and that in medication group was higher remarkably than model group(P ＜ 0.01). ③ Expression of proliferating cell nuclear antigen of spermatogenic cells: That in model group was lower than normal group(P ＜ 0.05), and that in medication group was higher remarkably than model group(P ＜ 0.05). CONCLUSION: Tiannianyin delays degeneration of reproductive function and aging of certain degree.

Objective To study the application of extended tibia tubercle osteotomy in revision of total knee arthroplasty. Methods Retrospective study was carried out in 12 cases that had received extended tibia tubercle osteotomy in Zhongshan Hospital from May 1998 to October 2002. Results After osteotomy, all knees were healed clinically and radiologically at 6th month postoperatively. Average range of joint motion increased from 79 degrees to 95 degrees. Average knee score improved from 60 to 85. Conclusion Extended tibia tubercle osteotomy can improve the exposure of operation and knee joint function.

Objective To observe the efficacy of telmisartan in treatment of congestive heart failure.Methods 87 patients with chronic congestive heart failure(CHF),who had unsatisfactory results under conventional digitals,diuretics and vasodilators therapy,were given telmisartan 40～80mg orally once a day for 4 week.The changes of clinical effects and cardiac function were observed.Results 4 weeks after treatment,the clinical total effective rate were 99%.Left ventricular end-systolic dimension(LVDs),left ventricular end diastolic dimension(LVDd) improved,stroke volume(SV),left ventricular ejection fraction(LVEF),cardiac output(CO) and cardiac index(CI) increased significantly.Aldosterone decreased obviously(P

Objective To evaluate the clinical use of delayed open reduction and internal fixation technique in the treatment of Rud?i Ⅲ Pilon fractures. Methods From May 1997 to June 2003, 38 patients with Rud?i Ⅲ Pilon fractures underwent immediate calcaneal traction as well as treatment with methylprednisolone and mannitol. After 5-8 days, all patients underwent regular open reduction and internal fixation with cloverleaf buttress plates. One week after the operation, ankle joint began to exercise with no weight bearing. Results All patients were followed up for average 18 months and evaluated subjectively and objectively by using systems of Teeny and Wiss, which showed good results for 74 %, mild for 21% and poor for 5%. All fractures healed within an average of 5.7 months except for two cases of infections and one soft tissue complication. Conclusion Delayed open reduction and internal fixation offers acceptable way for treatment of severe Pilon fractures.

Objective To study the application of Polypropylene-Prolene Hernia System ( PHS) in tension-free herniorrhaphy of femoral hernia. Methods A total of 36 patients with femoral hernia were randomly divided into 2 groups to receive respectively PHS or Plug repair procedure. Data collected included; operative time, hospital stay, postoperative complications and recurrence rate. Results In PHS and Plug groups, the operative time were (42?7) min and (41?4) min respectively, the hospital stay was (4. 1?1. 0) d and (4.4?1. 2) d respectively. During the follow up period from 6 to 30 months,there was no recurrence, one case of scrotal hydrocele in PHS group, and there were two cases of recurrence and one case of ecchymoma in Plug group. Five patients complained of foreign body feeling in Plug group, and no patient in PHS group ( P