Objective To analyze and discuss the causes of late dysfunction following the mismanagement of acute Lisfranc fracture- dislocations in light of the latest advancement in this field. Methods From March 2000 to February 2005, we treated 34 cases of old Lisfranc fracture- dislocation. 24 cases were treated with open reduction and internal fixation, and 10 with arthrodesis. Results According to the AOFAS for midfoot, 2 cases scored 50 to 60, 4 cases scored 60 to 70, 5 cases scored 70 to 80, 18 cases scored 80 to 90 and 5 cases scored 90 to 100. Conclusions Since the incidence of Lisfranc fracture- dislocation tends to increase, clinic orthopedists must take great care to examine the midfoot strain lest a case should be overlooked. The late complications are related to poor reduction, inadequate fixation, or inadequate postoperative immobilization. For most patients, open reduction and internal fixation within 6 weeks after injure is preferred. The cannulated screws are simple and stable for fixation of lateral and medial columns, and screw removal should be done 3 to 4 months after surgery to prevent recurrent diastasis and screw breakage.

Purpose: To evaluate the efficacy and the side effects of 3 D-conformal radiotherapy for malignant thoracic tumor. Methods: Between September 1999 and August 2002, 36 patients with malignant thoracic tumor were treated with 3D-conformal radiotherapy. Twenty-two patients had primary lung cancer, 12 patients had metastatic lung cancer, and 2 patients had malignant mediastinal tumor. All 36 patients were pathologically confirmed. Squamous cell carcinoma 16 cases, adenocarcinoma 15 cases, small cell carcinoma 2 cases, embryonal carcinoma 1 case, malignant thymoma 1 case and sarcoma 1 case. For the primary tumor, conventional radiotherapy was first used to 50Gy/25F/5W, followed by 3D-conformal radiotherapy 16-20Gy(4Gy per fraction, 3 fractions per week) with MLC or cone from 5 ~6 non coplanar or coplanar static ports. For metastatic tumor, using arc therapy to only 28-40Gy(4Gy per fraction, 3 fractions per week, 7-10 fractions) with cone from 1 ~ 4 arcs. Tumor volumes from 1. 85 cm3 to 104. 61 cm3 with a median of 24. 96 cm3 in 3D-CRT. Results: To evaluate the effects, thoracic CT scan was taken two months after completion of 3D-conformal radiotherapy. In 34 evaluated patients, 13 cases obtained CR, 14 PR, 5 NC, and 2PD. The overall 1 and 2-year survival rates were 74. 1% and 38.4%. Toxicity consisted of grade 1 acute radiation pneumonitis in 17 patients, grade 2 in 10 patients, grade 3 in 1 patients, and 2 patients dead of radiation pneumonitis ( with non coplanar technique), late complication was radiation pulmonary fibrosis, grade 1 in 20 cases, grade 2 in 8 cases. Conclusions: 3D-conformal radiotherapy as complement of conventional external beam radiotherapy for malignant thoracic tumor can obtain better short-term effects, although the survival is yet to be investigated. But attention must be given to the irradiation technique, the irradiation volume should not be too large and beams angles appropriately adjusted to avoid excessive irradiated volume in normal lung.

Unilateral enlargement of the vestibular aqueduct (EVA)is a relatively rare disease. Bilateral EVA was found to be more common than unilateral EVA. There are significant differences in clinical features and molecular etiology between unilateral EVA and bilateral one. This article reviewed related researches of the unilateral EVA in clinical characteristics, molecular etiology and pathogenic mechanism.
Vestibular Aqueduct ; pathology

Objective To evaluate the clinical diagnosis,treatment and prognostic factors of kidney clear cell renal carcinoma(KIRC)in international sample database.Methods From 1998 to 2012,consecutive patients with KIRC who diagnosed and treated in TCGA organizations were enrolled.Clinical characteristics,objective response and survival time were evaluated,and correlation analysis with lncRNA urothelial cancer associated 1 (UCA1)gene was performed.Results 512 patients with KIRC were enrolled.35.4% of patients were female,59.6% of stage Ⅰ -Ⅱ, 90.0% of white and 45.1% of grade 1 -2.Comprehensive treatment was consistent with the clinical guidelines. Significant correlation was found between UCA1 expression and 4 mRNA subtype,30 genes mRNA expression, mir -101 -1 expression and PBRM1 mutation.And patients with UCA1 overexpression could achieve poor prognosis. Conclusion Diagnosis and treatment of the international TCGA -KIRC research meets clinical guidelines.UCA1 overexpression is an important poor prognostic factor.Combined with the clinical relevance of other important driver genes,UCA1 may be significantly valuable for further study.

Aim To prepare for psoriasis transgenic animals, psoriasis susceptible gene was constructed. Methods Extract gDNA from blood preparations of psoriasis patients, screen positive gDNA owns HLA-Cw*0602 gene, then copy the whole sequence and link it to pMD-19T Simple Vector. Results The identification showed the construction of psoriasis susceptible gene was sucessful. Conclusion The successful construction of HLA-Cw*0602 gene will lay the foundation for development of transgenic animal models of psoriasis.

Based on entire literature retrieval about low back pain treated with acupuncture and moxibustion, Clinical Practice Guideline for Low Back Pain Treated with Acupuncture and Moxibustion was drafted according to method of evidence quality and recommended intensity grading system(GRADE). This article specificly introduces the aim and available diseases of the guideline. The principle and recommended plans are also detailedly explained.
Acupuncture Therapy ; methods ; standards ; China ; Humans ; Low Back Pain ; therapy ; Moxibustion ; methods ; standards ; Practice Guidelines as Topic

Adult ; Child ; Endoscopy ; Fibrous Dysplasia of Bone ; pathology ; surgery ; Humans ; Male ; Nose ; surgery ; Orbit ; pathology

Objective To retrospectively analyze management of chronic lateral ankle instability and evaluate its clinical results. Methods There were 74 patients including 43 males and 31 females at age range of 15-63 years (mean 39 years). All patients had at least half year of disease history, more than twice repeated strains and over six weeks of conservative management. Of all, 41 patients were trea-ted with surgical operations including modified Brostrom in 12 patients, Myerson in eight and Chrisman-Snook in 21. The aasoeiated pathological problems should be treated at the same time, ie, tenedesis for the peroneal tendon subluxations in six patients, Achilles tendon lengthening in nine, lateral shift of cal-caneal osteotomies in eight and clearance and holes-making for the osteochondral lesions in 13. Results Of all, functional instability was alleviated in 21 patients through conservative treatment before surgery. Of 53 patients with either functional or mechanical instability, 10 patients showed symptomatic relief, two refused surgical operation and the remained 41 patients were treated surgically. Thirty-nine patients trea-ted surgically and 28 treated conservatively were followed up for 6-91 months. The Roos Functional Out-come Score was used for validating the results. The average value of the ankle functional outcome was 86.24 and 97.34 respectively following operation and conservative management. Conclusions The full examination is needed to remove any possible pathological factors for the patients with chronic lateral ankle instability. The surgical operation can obtain satisfactory functional recovery of the ankle if the conserva-tive management is failed.