Docetaxel and vinorelbine, which were plant alkaloids, had showed the good activities as chemotherapy of breast cancer. Combination chemotherapy with docetaxel and vinorelbine had drawn more and more attention. This papers reviewed the docetaxel/vinorelbine combination treatment of breast cancer.

Objective To explore an effective prevention and management of nonunion and malunion due to insidious infection after fracture internal fixation. Methods From January 2001 to January 2006,we treated 26 patients with nonunion and malunion due to insidious infection after fracture internal fixation.They were 15 cases of femoral fractures, 2 cases of ulna fractures, 3 cases of radial fracturos, 3 cases of humerus fractures, and 3 cases of tibial fractures. The patients were treated with irrigation after debridement.In 23 fractures, the internal fixation was dislodged and changed into external fixation. In the 3 cases whose internal fixation remained, instillation and drainage were conducted after debridement. Bone grafting was performed for 20 cases after replacement of internal fixation, and for 3 cases after removal of external fixation.Three patients received no bone graft. Results The preoperative X-ray findings confirmed the diagnosis of insidious infection in 21 cases, while the other 5 cases were diagnosed by bacterial culture or pathological examination of the pus and inflammatory granulation tissue found during surgery. The bacterial culture was positive in 17 cases, including 6 cases of Staphylococcus epidermidis, 8 cases of Staphylococcus aureus, and 3 cases of Escherichia coli. All the patients were followed up for 8 to 48 months, with an average of 23.5 months. Of the 26 cases, 22 obtained bony union, 2 partial union and 2 nonunion. Complications included fistula in 2 patients and infection relapse in 3 patients. Conclusions Insidious infection may be related to the bacterial toxicity, anatomical sites and surgical methods. X-ray changes may help the diagnosis of insidious infection. Surgery is necessary for management of nonunion and malunion due to insidious infection after fracture internal fixation.

Objective To investigate the multi-slice spiral computed tomography (MSCT) features of crush maxillofacial frac-tures in the massive Wenchuan earthquake. Methods MSCT data of 85 patients with crush maxillofacial fractures caused by earth-quake were retrospectively analyzed. The anatomic distribution of fractures was evaluated. Results In 85 patients, single bone frac-tures (59 patients) were more common than multiple bone fractures (26 patients) (P<0.05). The fractures involved isolated mid-face, isolated mandible, and both were found in 49 patients (57.6%), 24(28.2%), and 12(14.2%), respectively. Midface frac-tures were most frequent (P<0.05). The fractures of condyle, posterolateral and anterior wall of maxillary sinus, zygomatic arch and lateral orbital wall accounted for 47.1%(24/51) ,41.5%(22/53) , 37.7%(20/53),71.9% (23/32) and 63.2%(24/38) of the total fractures of the corresponding maxillofacial bones. Conclusion Isolated bone fracture and midface factures are the main fea-tures of crush maxillofacial fractures resulted from the massive earthquake. MSCT and three-dimensional reconstruction images can demonstrate maxillofacial fractures well.

BACKGROUND: Autologous bone marrow transplantation (ABMT) has been widely used in treatment of the malunion of fracture, but this treatment to cure malunion of fracture induced by infection is still not consistent.OBJECTIVE: To observe the application and clinical outcome of ABUT for the malunion of fracture induced by infection.DESIGN, TIME AND SETTING: A retrospective analysis. The patients were all enrolled at Department of Orthopaedics in the Third Affiliated Hospital of Hebei Medical University from January 2001 to January 2006. PARTICIPANTS: A total of 19 patients with malunion of fracture induced by infection, including 13 males and 6 females aged from 18 to 50 years, with an average of 36. The lesioned site contained fracture of tibia 10, fracture of femur 5, fracture of ulna 2 and fracture of humerus 2. Among them, there were 6 cases with bone defect, 9 cases with bone fracture delayed union and 4 cases with bone fracture disunion.METHODS: Nineteen patients treated with percutaneous ABUT. Among the 19 cases, 12 patients received the transplant 3 weeks after infection was under controlled, and other 8 patients received the transplant following autologous bone transplantation.MAIN OUTCOME MEASURES: After ABMT, all patients were checked using X-ray regularly, the pacing of bone union was traced through observing the growth of callus, and the side reaction was also detected.RESULTS: Totally 19 patients were included in the follow-up visit, and 15 cases of them achieved bony union. Clinical healing time was 7-20 weeks. The patients had no obvious discomforts except local gas pains when injecting and at pristine time after injection. Five patients had a small quantity of exudation. No infection relapse or soft tissue ossification were observed at the injection position. Four patients had not achieved bony union, the reason was that bone defect in 2 patients exceed 2 cm; fracture disunion with pseudoarticulation formatted in one patient, the sclerous broken ends of fractured bone was more than 2 cm; another patient's external fixation displaced, we adjusted it and the bone healed after 12 weeks. Three patients received autoallergic ilium bone transplantation in the second time of operation, the fractured bone got bony union. CONCLUSION: ABMT by percutaneous injection into malunion site can induce ossification, repair bone fracture and bone defects. The clinical application is simple and exhibits small wounds without complications. Especially ABMT is effective for the patient with the malunion of fracture induced by infection.

Objective To observe the branches and distribution of the tibial nerve and analyze the compressed position of it.Methods Twenty sides of adult cadavers were anatomized and the tibial nerve branches in ankle,foot,the internal and external plantar tunnel were observed.Correlated data was measured and recorded.Results ① The tendinous part of abductor hallucis muscle that was located under the muscle and consisted the surface of the internal and external plantar tunnel was(8.62?0.79)cm in length,(3.01?0.30)cm in width,and the thickness of it was about(0.24?0.02)cm.The internal and external nerves were located in the internal and external tunnel.The length of the internal tunnel was about(4.58?0.41)cm,and the diameter was(1.11?0.10)cm.The length of the external tunnel was about(2.58?0.23)cm,the diameter was about(0.96?0.08)cm.② Internal hell nerve was in an isolated tunnel interior the hell,which was the hell tunnel.The length of the hell tunnel was about(3.03?0.21)cm,the diameter was(1.07?0.09)cm.Conclusion The tibial nerve branches can be compressed at internal,external plantar tunnel or the heel tunnel.When making neurolysis of the tibial nerve for tarsal tunnel syndrome patients,except for the flexor retinaculum,the internal and external plantar tunnel and the hell tunnel should also be decompressed especially for the patients with the symptom of compressed single branch.

Diverticulitis of colon,the inflammation of colonic diverticulars,is connected with dietary,age and disorder of colonic environment.Due to the different cultures between western contries and orient nations,the morbidity,predilection site,clinical manifestation and management are different in diverticulitis of colons.Computed tomography(CT)has been the key diagnosic method,and it is able to guide transfixion pins to treat diverticulitis of colon.After medical treatment,most of patients can be relaxed,and only someone need operations.

With the age increasing,the lobules in women's breasts undergo progressive involution or regression,which is called age-related lobular involution.It's a physiologic and irreversible process,while the rate and extent of involution vary considerably among individual women.It has been hypothesized that the extent of age-related lobular involution is strongly associated with a reduced risk of breast cancer,and there are some associations between lobular involution and risk factors of breast cancer.

Objective To explore the diagnosis and treatment of thyroid malignant tumor (TMT) arising on basis of Hashimoto′s disease (HD).Methods 150 pathology proved HD patients admitted between 1976 and 1999 were retrospectively analyzed for the incidence of TMT.Results 15 HD patients were found suffering from thyroid carcinoma with a concurrent rate of 10%, and 3 with thyroid malignant lymphoma (TML) (2%). All postoperative TMT patients were followed up for an average period of 6 years, 15 TC patients were all alive without recurrence, and all TML patients died within 2 years.[WT5”HZ] Conclusion Surgical treatment of HD patient associated with TMT is indicated. The key to diagnosis and rational treatment are a detailed understanding its clinical feature, routine examination of serum antibodies and FNAC or frozen section in operation.

[Objective]To study diagnosis and treatment of insidious infection after the internal fixation of long bone fracture.[Method]Thirteen patients with insidious infection after internal fixation of long bone fracture were treated with irrigation after debridment. Among the 13 cases 8 fractures were dislodged internal fixation and then were fixed with the external fixation. 5 fractures were remained the internal fixation and were instilled after debridment. All of the patients were given with antibiotics for 2～3 weeks after operation.[Result]All the 13 patients were followed up. The follow-ranged from 8 to 48 months with an average of 23.5 months. Among the thirteen patients 11 fractured-bone had bony union, one nonunion and one case had fistula, Infection relapsed in two patients.[Conclusion]Bone defects, fracture nonunion often occur on patients who have insidious infection after internal fixation of long bone fracture. These patients need to be operated. In slight infections fracture can be remained after debridement. Fractures with seriously infectious have to dislodge internal fixation and to be fixed with made according to its radiographic changes.

Objective To explore the influence of Al2O3 nanoparticle (20nm in average) on RP4-mediated conjugation and its mechanism was explored further. Methods Mating was conducted between E.coli HB101(RP4) and Salmonella aberdeen Kauffmann 50312(strR) in saline at 25 ℃ without stirring for 8 h,the concentrations of Al2O3 nanoparticle were 0.005,0.05,0.5,5,50 mmol/L respectively. The initial concentration of donor and recipient were both about 109 cfu/ml(donor per recipient ratio was 1∶3).Later transmission electron microscope(TEM) and laser scan confocal microscope (LSCM) were exploited to investigate cell morphology and structure. Results 5 mmol/L and 50 mmol/L Al2O3 nanoparticle could increase the conjugal transfer frequency by 150-fold and 40-fold respectively. TEM observation on thin section indicated several bacterial were prone to form conjugational junction together in 5 mmol/L and 50 mmol/L Al2O3 nanoparticle treated group,which was rarely seen in control group. Meanwhile the cell envelope of bacterial was significantly damaged upon the treatment by 50 mmol/L Al2O3,which might be the reason why transfer frequency of 50 mmol/L Al2O3 group was less than 5 mmol/L Al2O3 group. LSCM result indicated that Al2O3 nanoparticle might damage cell envelope and the damage was positively related to the accumulation of Al2O3 in bacterial. Conclusion Al2O3 nanoparticle can stimulate RP4 conjugal transfer. Conjugative gene is highly regulated. Al2O3 nanoparticle might modulate conjugative gene expression directly or influence cell membrane permeability and thus modulate the process of conjugation indirectly .