In Pro.Fan Yongsheng’s view,the causa morbi and mechanism of systemic lupus erythematosus(SLE) is based on kidney deficiency,showing heat toxin and blood stasis; on the basis of differentiating disease and syndromes,to treat it with combination of TCM and western medicine,as well as by removing toxin,stasis and nourishing kidney,has good curative effect.

By means of introducing four medical records to elucidate Pro.Fan Yongsheng' experience that is actively applied in cooling blood to remove apthogenic heat and acting blood to remove stasis to treat stagnated heat stagnation syndrome in systemic lupus erythematosus.

[Objective]To investigate the clinical effect of saddle-shaped condylar plate in treating the fracture of the femoral intercondylar and supracondylar.[Method]Thirty-two cases with the fracture of the femoral intercondylar and sapracondylar,who were selected randomly were fixed by saddle-shaped condylar plates after reduction,of which 8 cases of patellar fractures accompanied with ipsilateral fracture of the femoral condylar.[Result]All cases were completely healed during the follow-up study of 4 months to 2 years,all cases achieved bone union in 5～9 months.[Conclusion]The design of the plate conforms to the principle of biomechanics and is good for the heal of the fracture.The saddle-shaped structure makes the plate and the cannular bone tangent as fixing so it can reduce the putrescence of the bone which is caused by pressure;The arch-bridge-shaped juncture and the mechanical bolts which are fixed across can strengthen the power of anti-bending and anti-rotation of the broken ends of the fractured bone.The stability of the fixation enables the patient do the functional exercise after the operation as soon as possible.It has definite clinical value and is worth of popularization.

Objective To develop an anatomically based method of accurate pedicle screw insertion for cervical spine fixation. Methods Forty adult cervical spine were mounted onto a specially designed jig. Parameters including height, width, length, and axis angulation of pedicles,depth of lateral fovea, height of superior posterior border of arcus vertebrae and angles of posterior articular prominance as well were mea sured with vernier calibre or goniometer either directly or radiographically. Results Lateral fovea did exist in all C2-C7 vertebrea. The pedicles of the cervical spine were wide and long enough to accept 28 mm long 3.5 mm screws. The abduction angle of the screw was 20? at the C1 level, 25? superiorly and 44? inferiorly at the C2 level, 45? to 47? from level C3 to C5, and 40? from level C6 to C7. The angle of posterior plane of articular mass was minus 2.30? at C3,it was 2.32? to 2.42? from level C4 to C6, and it was 15.22? at C7. The stability of cervical spine fixation and neurological improvement were satisfactory. Conclusion Transpedic ular screw fixation for the cervical spine is practicable. Anatomical symbol of the superior posterior border of the arcus vertebrae and the posterior plane of articular mass and the lateral fovea is easy to be exposed and identified in the operation. Transpedicular screw can be precisely inserted easily and safely for the cervical spine fixation with limited exposure and without using fluoroscopic guidance.

Objective To detect the frequency of peripheral blood CD4+ CD25high Tr and CD4+CD25lowT cells and expression of programmed death-1 ( PD-1 ) on their surface in the patients with systemic lupus erythematosus(SLE) and their clinical signifcance is analyzed.Methods The expression of PD-1 on the CD4+ CD25highTr and CD4+CD25lowT cells was examined in patients with 33 active SLE,18 inactive SLE and 38 healthy controls(HC) by flow cytometry.Clinical manifestations and laboratory findings of SLE were collected.Patients were divided into two groups according to their disease activity.SLE disease activity index(SLEDAI) score≥10 was defined as high disease activity and ＜10 as inactivity.The percentage of CD4+ CD25highTr and CD4+CD25lowT cells and proportions of expression of PD-1 on their surface were compared between not only inactive or active SLE patients and healthy controls (HC),but also between patients with lupus nephritis and without lupus nephritis.Correlation with clincal manifestations and laboratory findings was analyzed.Results (1)The proportions of CD4+CD25highTr and CD4+CD25low T cells were significantly decreased in active and inactive SLE patients as compared with HC.(2)The percentage of CD4+ CD25lowPD-1 +Tr and in active and inactive SLE patients were higher than HC.The proportions of CD4+CD25lowPD-1+ T cells were significantly increased in HC and inactive SLE patients as compared with inactive SLE patients.(3) The proportions of CD4+CD25highPD-1+Tr in SLE patients with nephritis were higher than those in patients without nephritis.But the percentage of CD4+ CD25 lowPD-1 + T cells was significantly decreased in SLE patients with nephritis as compared those without nephritis.(4)A positive correlation was observed for proportions of CD4+CD25highPD-1 + T cells with SLEDAI score.Proportions of CD4+ CD25high Tr,CD4+ CD25low PD-1 + T cells was inversely correlated with SLEDAI score.Conclusion The aberrations of proportions of CD4+CD25highpD-1+,CD4+CD25lowPD-1+,CD4+CD25high and CD4+CD25low T cells were observed in patients with SLE.The abnormality of PD-1 and PD-L1 pathway may play an important role in the function and number of Tr.

Objective To evaluate the risk factors associated with operative death after pancreatoduodenectomy(PD) and thus be able to decrease mortality. Methods The data of 123 consecutive patients undergoing PD during 9 years were reviewed. The variables analyzed were clinical data, laboratory data, operative factors , pathological diagnosis, and complications. Results The 30-day postoperative mortality rate was 7.3 percent. Postoperative intra-abdominal hemorrhage(OR=17.954), diabetes(OR=7.097), gastrointestinal hemorrhage (OR=7.789), preoperative serum albumin concentration(OR=10.689) and amount of operative blood loss(OR=5.473) were independent risk factors. Conclusions The chief risk factors associated with operative death after PD are low concentration of preoperative serum albumin, diabetes, large amount of operative blood loss, and postoperative intra-abdominal and gastrointestinal hemorrhage. These risk factors should be specifically considered in the perioperative management of the patients.

This study was aimed to investigate the effects of Chai-Hu Shu-Gan Tang (CHSGT) on levels of TNF-α and 5-HT in lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model, in order to discuss the intervention effect of CHSGT on TNF-α and 5-HT in epilepsy–depression comorbidity. The lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model was established. After 6 weeks of animal establishment, rats were randomly divided into 5 groups, which were citalopram group (A), physiological saline group (B), CHSGT high dose group (C), medium dose group (D), and low dose group (E). Intragastric administration was given for 4 weeks, twice a day. Before and after the treatment, RT-PCR was performed to detect hippocampal TNF-αlevels. Liquid chromatography-mass spectrometry was performed to detect hippocampal 5-HT levels. Both forced swimming test (FST) and saccharin preference test were carried out to monitor the depressive behaviors of rats. In the meantime, 24 hours a day video camera surveillance were performed to record the number of seizures of rats. The results showed that after treatment, the number of seizures of rats were significantly reduced, the accumulative immobility time in FST was shortened, and the consumption of sucrose increased significantly (P < 0.01) in group A, C and D. Compared with group B, after the treatment, the expressions of hippocampal TNF-α mRNA of rats in group A, C, D were distinctly downregulated, with the level of 5-HT significantly increased (P < 0.05,P < 0.01). Compared with group A, group C and D showed no significant changes. It was concluded that TNF-α played a role in the pathogenesis of epilepsy–depression comorbidity through mediating the level of 5-HT. High and medium doses of CHSGT can downregulate the expression of TNF-α mRNA in depression comorbidity of chronic temporal lobe epilepsy, increase 5-HT level, reduce the number of seizures of rats, and improve depressive behaviors.

Purpose: To explore the therapeutic method for lameness caused by lumbar spinal stenosis. Methods: 28 cases of the patients with lameness were treated by puncturing Dachangshu (BL 25), Weizhong (BL 40), Chengshan (BL 57) and Kunlun (BL 60) and simultaneously another 26 cases were treated with routine method for control study. Results:After the treatments for four weeks, the scores of the symptoms in the two groups were remarkably elevated. In the acupuncture treatment, the results showed remarkable effect in 4 cases, effect in 21 cases. In the routine treatment, the results showed remarkable effect in 4 cases and effect in 8 cases. Conclusion: acupuncture treatment is better than the routine conventional treatment for lameness caused by lumbar spinal stenosis.

Objective To explore the effects of Jiedu Quyu Ziyin Recipe (JQZR) on the apoptosis and expressions of bcl-2 and bax mRNA of peripheral-blood lymphocyte in MRL/lpr mice. Methods 80 MRL/lpr mice were randomly divided into model group,TCM group, Western medicine group and TCM and Western medicine group,20 mice in each group, meanwhile,20 Kunming mice were selected as normal group, then intragastrically administered normal sodium, JQZR apozem, prednisone suspension and JQZR apozem and prednisone suspension, 0. 5ml every time,once daily for 12 weeks respectively. At the end of the 12th week, peripheral-blood lymphocytes of every mice purified by gradient centrifugation were cultivated for 48 hours ,then the apoptosis was detected by flow cytometry. Furthermore,the expressions of bcl-2 and bax mRNA of peripheral-blood lymphocyte were detected by RT-PCR. Results At Oh or 48h,the apoptosis ratios of PBLC in normal group, TCM group,Western medicine group and TCM and Western medicine group are higher than model group and the differences are significant(P <0. 05 ,P <0. 01 ) ,while,at Oh,which are not significant within Western medicine group, normal group and TCM and Western medicine group ( P > 0. 05) ,even if which are significant between TCM group and TCM and Western medicine group or between model group and TCM and Western medicine group( P < 0. 05 ). At 48h, the differences of apoptosis ratios of PBLC are significant between Western medicine group and TCM and Western medicine group( P < 0. 05 ), and between TCM group and TCM and Western medicine group or between model group and TCM and Western medicine group which are significant, too( P < 0. 01 ). The ratios of bcl-2/bax mRNA of normal group,TCM group and TCM and Western medicine group are significantly lower than which of model group or Western medicine group ( P < 0. 05, P < 0. 05, P <0. 01 ,respectively) ,but there is no significant difference between which of model group and Western medicine group.Conclusion JQZR has adjustable effects on the apoptosis and expressions of bcl-2 and bax mRNA of peripheralblood lymphocyte in MRL/lpr Mice.

BACKGROUND:Primary dislocation after total hip arthroplasty is a major complication, besides prosthesis loosening. It is controversial whether joint capsule and external rotators should be repaired during total hip arthroplasty through posterolateral approach.
OBJECTIVE:To explore the clinical significance of joint capsule and external rotator repair on preventing hip dislocation after primary total hip arthroplasty through posterolateral approach.
METHODClinical data of patients with primary or secondary hip osteoarthritis after primary total hip arthroplasty through posterolateral approach were retrospectively analyzed. They were assigned to two groups according to different strategies of soft tissue repair. Control group did not receive posterior soft tissue repair. Combined repair group received the repair of joint capsule and short external rotators. Al patients were fol owed up for more than 1 year. Early dislocation was defined as the dislocation occurred within 1 year after operation. The effects of different repair methods on early dislocation rate were compared.
RESULTS AND CONCLUSION:There were 362 patients. Total y 390 case-times of primary total hip arthroplasty were included. Early dislocation occurred in 7 cases, of which 6 case-times in the control group (2.2%, 6/268), and 1 case-time in the repair group (0.8%, 1/122). There were significant differences in the incidence rate of early dislocation between the repair group and control group (P=0.012). These findings confirmed that the combined repair of posterior joint capsule and short external rotators could decrease the rate of early dislocation after primary total hip arthroplasty through posterolateral approach.