Objective To introduce the experience and analyze the clinical outcome of applica- tion of reinforced bar-ring hybrid external fixator combined with limited internal fixation for complex frac- turcs of tibia plateau in patients.Methods From Aug.2002 to Feb.2005,21 patients with complex fractures of tibial plateau were treated with reinforced bar-ring hybrid external fixatar combined with lim- ited internal fixation.According to Schatzker classification,there were 13 patients with typeⅤfracture and 8 with typeⅥfracture.Voluntary and non-weight beating knee joint motion to partially weight bear- ing was taken one week after operation.Progressive loading was taken continuously until there was clinical evidence of fracture stability and then full weight bearing was done.Results The mean follow-up peri- od was 15.9 months (10-24 months).All the fractures got united and the mean union time was 4.2 months(3-8 months).All the injured knees could extend to less than 5 degrees and flex to more than 90 degrees after rehabilitation.Evaluated by Merchant score system for knee joint,81% of patients achieved excellent healing (7 cases) and good healing (10 cases).Conclusion Operation by using reinforced bar-ring hybrid external fixator combined with limited internal fixation can reduce complications and avoid stiffness of the knee joint.It is an effective method for complex fractures of tibial plateau.

OBJECTIVETo compare laparoscopic Nissen fundoplication (LNF)and Toupet laparoscopic fundoplication (LTF) with respect to treatment outcomes and postoperative complications.

METHODSPubMed, Medline, Embase and the Cochrane Library were searched. Only randomized controlled trials (RCTs) comparing laparoscopic Nissen and Toupet fundoplication were included. Outcomes evaluation included occurrences of heartburn, reflux, difficulty swallowing, chest pain, abdominal distention, failure to hiccup, diarrhea, and early complications and degree of patient satisfaction at early (three to six months) and later (one to three years) post-operative periods.

RESULTSOf 939 patients in seven RCTs, 478 received LNF and 461 received LTF. For both groups, control of reflux was good and occurrence of heartburn was similar (P>0.05). A lower incidence of postoperative dysphagia for both early and later post-operative periods, but a higher overall complication rate in early post-operative period were observed in the LTF group (P<0.05). Patient satisfaction was similar (P>0.05).

CONCLUSIONSLNF and LTF are both safe and effective. The adoption of procedure should be based on the patient status and surgeon experience.

Fundoplication ; methods ; Gastroesophageal Reflux ; surgery ; Humans ; Laparoscopy ; methods ; Randomized Controlled Trials as Topic ; Treatment Outcome

OBJECTIVETo investigate the treatment of acute and chronic osteomyelitis with negative pressure wound therapy.

METHODThirty cases of acute and chronic osteomyelitis were treated with negative pressure wound therapy, assisted with debridement, autodermoplasty and myo-cutaneous flap surgery.

RESULTSNo evidence of relapse was found in all cases treated with negative pressure wound therapy. All the patients were followed up, range from 6 to 23 months, the average was 13.6 months.

CONCLUSIONThe negative pressure wound therapy maybe a simple, effective and inexpensive method, and could be one of the favorable therapy in the treatment of acute and chronic osteomyelitis.

Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Diseases, Infectious ; etiology ; surgery ; Chronic Disease ; Debridement ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Osteomyelitis ; surgery ; Surgical Wound Infection ; surgery

BACKGROUNDThe coagulation function in patients with pancreatic carcinoma is abnormal and the reason is not very clear. In this study, we retrospectively analyzed the coagulation function in patients with pancreatic carcinoma.

METHODSFrom June 2004 to December 2007, 132 patients received diagnosis and treatment in our hospital. The coagulative parameters including the prothrombin time, activated partial thromboplastin time, and fibrinogen levels were collected and studied retrospectively.

RESULTSThe average fibrinogen levels in patients with pancreatic carcinoma, (476.21 +/- 142.05) mg/dl, were significantly higher than in patients with cholangiolithiasis, (403.28 +/- 126.41) mg/dl (P < 0.05). In patients with pancreatic carcinoma, the levels of fibrinogen in the group with jaundice were significantly higher than in patients without jaundice (P < 0.05). In patients who received Pancreaticoduodenectomy, Whipple's operation, the level of fibrinogen in the group with local invasiveness was significantly higher than in the group without invasiveness. The group with lymphatic metastasis had higher levels than the group without lymphatic metastasis (P < 0.05). There was no significant difference of intraoperative blood loss between patients with vitamin K, (748.27 +/- 448.51) ml, and those without vitamin K, (767.31 +/- 547.89) ml (P > 0.05).

CONCLUSIONSThe level of fibrinogen in patients with pancreatic carcinoma was elevated. The elevated fibrinogen level may be associated with invasiveness and lymphatic metastasis. Using vitamin K in perioperation management did not reduce intraoperative blood loss.

Adult ; Aged ; Aged, 80 and over ; Blood Coagulation ; physiology ; Cholelithiasis ; drug therapy ; metabolism ; surgery ; Female ; Fibrinogen ; metabolism ; Humans ; Jaundice ; metabolism ; physiopathology ; Lymphatic Metastasis ; physiopathology ; Male ; Middle Aged ; Pancreatic Neoplasms ; drug therapy ; metabolism ; physiopathology ; surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Vitamin K ; therapeutic use ; Young Adult

BACKGROUNDPeroxisome proliferator-activated receptor (PPAR) alpha is one of the subtypes of PPARs. It regulates metabolism of lipid and lipoprotein, as well as glucose homeostasis. In addition, PPARalpha influences cellular proliferation, inflammation, differentiation and apoptosis, which plays a vital role in cardiovascular diseases. The purpose of this study was to investigate the role and mechanisms of PPARa activation in relation to acute myocardial damage induced by isoproterenol in rats.

METHODSThirty male Wister rats were randomly divided into control group, isoproterenol (Iso) injured group and fenofibrate (FF) treatment group. Acute myocardial damage caused by isoproterenol intraperitoneal injection induced ischemia was established. We determined the levels of creatine kinase (CK) and lactic dehydrogenase (LDH) in serum as well as the concentrations of free fatty acids (FFA) in serum and myocardium. The mRNA expressions of PPARa, muscular type carnitine palmitransferase (M-CPT-I) and medium chain lipid acetyl coenzyme A dehydrogenase (MCAD) were analyzed by reverse transcription-polymerase chain reaction (RT-PCR).

RESULTSCompared with the control group, the levels of serum CK and LDH were significantly increased after FF and Iso treatments. Moreover, the concentrations of FFA in both serum and myocardium were obviously increased in the Iso group and FF group, while the mRNA expressions of PPARalpha, M-CPT-I and MCAD declined, respectively (P < 0.01). When compared with the Iso group, significant decreases in serum CK and LDH were observed in the FF group. The concentrations of FFA both in serum and myocardial tissue were markedly decreased in the FF group, while the expressions of PPARalpha, M-CPT-I and MCAD mRNA were increased (vs. Iso, P < or = 0.01).

CONCLUSIONSThe utilization of FFA was reduced in isoproterenol induced acute myocardial damage. PPARalpha activation by its activator fenofibrate may play a key role in energy metabolism in acute myocardial damage induced by isoproterenol in rats.

Animals ; Creatine Kinase ; blood ; Energy Metabolism ; Fatty Acids, Nonesterified ; metabolism ; Fenofibrate ; pharmacology ; Heart ; drug effects ; Isoproterenol ; toxicity ; L-Lactate Dehydrogenase ; blood ; Male ; PPAR alpha ; physiology ; Rats ; Rats, Wistar

Adult ; Cell Adhesion Molecules ; genetics ; Genetic Predisposition to Disease ; Genotype ; HIV Infections ; etiology ; genetics ; Humans ; Lectins, C-Type ; genetics ; Middle Aged ; Receptors, Cell Surface ; genetics

OBJECTIVETo observe osteoclasts on the resorbing surface of human deciduous teeth.

METHODSAfter fixing the collected deciduous teeth, we prepared the tooth slices without decalcification, treated them with HE and TRAP dyestuff, and observed the osteoclasts under light and scanning electron microscope.

RESULTSThere were large quantity of various forms of overlapping and huge osteoclasts with many nuclei and silk-like protuberances on the resorbing surface of deciduous teeth. The multinucleated osteoclasts align on the surface of coarse dentin.

CONCLUSIONOn the resorbing surface of human deciduous teeth there are large amount of osteoclasts which can be used as a source of studying human osteoclast.

Humans ; In Vitro Techniques ; Osteoclasts ; cytology ; Tooth Resorption ; Tooth Root ; cytology ; Tooth, Deciduous ; cytology

Objective To analyze the therapeutic effects of microvaseular decompression on primary trigeminal neuralgia. Methods The general clinical data,culprit vessels and therapeutic effects of the surgical interventions were analyzed in 181 patients(aged from 24 to 79 years with a mean of54.9 years,including 78 male and 103 female patients)with established diagnosis of primary trigeminal neuralgia admitted from January,2000 to Deceber,2007. Results Blood type O was present in 43.65%of the 181 patients with trigeminal neuralgia,which had an increasing tendency compared to the national norm(33.8%).The morbidity ratio between the right and left side was 1.8:l in these patients.Forty-five patients(24.86%)were identified to have more than 2 culprit vessels.The culprit vessels included the superior cerebellar artery(96 cases),posterior inferior cerebellar artery(7 cases),anterior inferior cerebellar artery(25 cases),arteries communicated with veins(25 cases),internal auditory artery (13 cases),basilar artery(15 cases),vertical artery(9 cases),exclusive veins(15 cases,mainly vena pelrosa and bridging vein)and unknown vessels(9 cases).of the 181 cases,171(94.48%)were cured within one month,9(4.97%)showed relieved symptoms but required drug therapy,and 1 was in vegetative state(0.55%). Conclusions Patients with blood type O may have greater chance of developing primary trigeminal neuralgia.Microvascular decompression is an ideal treatment for primary trigeminal neuralgia,and clear identification of the culprit vessels can be crucial for decreasing the postoperative recurrence.

OBJECTIVETo investigate the effect of the different immunosuppression therapy on CD4(+)Foxp3(+)regulatory T cells (CD4(+)Foxp3(+)Treg cells) in the peripheral blood monocytes of kidney transplantation recipients.

METHODSA Closed Cohort study was conducted in 50 primary living kidney transplant recipients between January 2006 and January 2008, who had been followed up for 1 year. The recipients divided into calcineurin inhibitors group (CNI + MMF + Pred) (19 recipients, including cyclosporin group 10 recipients and tacrolimus group 9 recipients), rapamycin group (RAPA + MMF + Pred) (31 recipients). Twenty end-stage renal disease patients were in control group. The frequency of CD4(+)Foxp3(+)Treg cells in total CD4(+)T cells was analyzed by flow cytometry in peripheral blood from three groups, results were compared.

RESULTSThe clinical variables of recipients such as age, sex, cold ischemia time, human leucocyte antigen mismatch, panel reaction antibody, rejection episode were no significant difference. The percentage of CD4(+)Foxp3(+)Treg cells in total CD4(+) cells was significantly higher in rapamycin group and end-stage renal disease group than calcineurin inhibitors group (P < 0.01). The level of CD4(+)Foxp3(+)Treg cells between cyclosporin group and tacrolimus group was no significant difference (P > 0.05).

CONCLUSIONThe level of CD4(+)Foxp3(+)Treg was significantly higher in patients receiving RAPA + MMF + Pred than the patients receiving CNI + MMF + Pred, which suggested that RAPA may be play a more important role in immune tolerance induction.

Adult ; Female ; Follow-Up Studies ; Forkhead Transcription Factors ; Humans ; Immunosuppression ; methods ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; immunology ; Male ; Middle Aged ; Sirolimus ; therapeutic use ; T-Lymphocytes, Regulatory ; drug effects ; immunology

OBJECTIVETo develop a system for quick screening of efficient siRNA targeted HBx mRNA.

METHODSUsing recombination DNA technique, the fusion expression plasmid of HBx and EGFP was constructed, and siRNA expression cassettes (SECs) containing U6+1, H1 or tRNA(Val )promoter were prepared via one-step overlapping extension PCR. By co-transfection with recombinant plasmid and SECs into AD293 cell, the inhibition effects on the transient expression of HBx-EGFP fusion protein were analyzed by FACS and semi-quantitated RT-PCR analysis.

RESULT(1)HBx-EGFP fusion protein expression plasmid pHBx-EGFP was constructed successfully, which expressed green fluorescence in cell mainly located at plasma or the periphery of nucleus in granules. (2) Co-transfection with recombinant plasmid and SECs into AD293 cells resulted in inhibition of HBx-EGFP expression. SEC-siHBx388 showed significant inhibition effect on HBx-EGFP expression compared with SEC-siHBx271, indicating that siHBx388 is effective siRNA site and could be screened out with our screening system. In addition,the results of that U6+1-, tRNA(Val) and H1-siHBx388 reduced HBx-EGFP expression by 21.7%, 12.9% and 12.4% of control respectively indicated that both tRNAVal and H1 promoter was high efficient in driving effect of siHBx388.

CONCLUSIONCombination of the HBx expression carrying reporter gene and PCR-based multi promoter SECs may develop a useful system to be applied in identification of optimal HBx- siRNA and its matching promoter.

Base Sequence ; Cells, Cultured ; Genetic Therapy ; Green Fluorescent Proteins ; Humans ; Luminescent Proteins ; genetics ; Molecular Sequence Data ; Plasmids ; RNA, Small Interfering ; analysis ; Recombinant Fusion Proteins ; biosynthesis ; Trans-Activators ; antagonists & inhibitors ; genetics ; Transfection