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.

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

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.

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.

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.

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

BACKGROUND: The bone marrow stem cell (MSC) transplant treatment have the obvious superiority to tradition graft treatment for bone nonunion, but how to obtain the concentrated and highly effective bone marrow mesenchymal stem cell, as well as the dose-effect relations to fracture healing need further discussions. OBJECTIVE: To observe the curative effect of bone nonunion by using autologous MSC transplant treatment, and to compare with autologous iliac bone graft.DESIGN, TIME AND SETTING: Randomized controlled analysis was performed from January 1999 to June 2005 in the Affiliated Second Hospital of Hebei Northern College.PARTICIPANTS: The admitting 140 patients with humerus and tibia fracture were divided into 2 groups at random, autologous iliac bone graft group and autologous MSC transplant group, with 70 patients in each group. METHODS: Under aseptic condition, autologous MSC transplant group received puncture through posterior superior iliac spine, extracting bone marrow 10-20 mL from different spots, separating MSC using the density gradient centrifugation method, and counting as 4×10~9 nucleated cells/mL under the microscope for later use. In the autologous iliac bone graft group, bone fracture end was implanted with the suitable amount of iliac bone, while autologous MSC transplant group with the mixture of decalcified bone matrix and MSC, followed by suture. After the transplantation, external fixation may assist for 4-6 weeks according to the fixed degree of internal fixation.MAIN OUTCOME MEASURES: ① Bone callus formation and pain conditions in 2 groups at different time points after transplantation. ② Comparison of bone healing time between 2 groups. ③ Adverse events and side effects.RESULTS: According to intention-treatment analysis, experimental adopted 140 patients of humerus and tibia fractures, who all entered the final analysis. ① Bone callus formation and pain at different time points post-surgery: At 1 month after transplantation, bone callus formation in the fracture end was not obvious in autogenous iliac bone graft group, and could be seen in autologous MSC transplant group, both groups of fractures exhibited tenderness. At 2 months after transplantation, bone callus formation was observed in autogenous iliac bone graft group, fracture tenderness was relieved compared with the previous condition; in autologous MSC transplant group, a large number of bone callus formed, fracture tenderness was not obvious. At 3 months after transplantation, there were a large number of bone callus formations in autogenous iliac bone graft group, with slight fracture tenderness; in the autologous MSC transplant group, continuous bone callus formation appeared, without fracture tenderness. ② Bone healing time: The average healing time of autologous MSC transplant group was significantly shorter than autogenous iliac bone graft group [(5.5±1.5), (8.0±2.0) months, P < 0.05]. ③ Adverse events and side effects: Except 4 patients had iliac bone pain, all patients during the treatment had no infection and other complications, there were no re-fracture occurred at the follow-up of 8 months.CONCLUSION: The autologous MSC transplant treatment of exhibits a short duration and good effect for bone non-union, has obvious advantages over traditional bone graft.

BACKGROUND:Poly-D,L-lactic-co-glycolic acid (PLGA) that was characterized as absorbable,weak cytotoxicity,and adjustable hardness was ideal to be synthetized artificial spinal dura mater.Because of lacking of functional group at the surface of PLGA,it should be modified to fit the demand of satisfied biocompatibility.OBJECTIVE:To study the biocompatibility of PLGA membrane modified by type-Ⅰ collagen and chitosan.DESIGN,TIME AND SETTING:Contrast observation study,which was carded out in the Biochemistry and Molecular Biology Laboratory Shanghai University of Traditional Chinese Medicine from May to December 2007.MATERIALS:Porous PLGA membrane was provided by Jinan Banzheng Biology-Technology Co.,Ltd.,type-Ⅰ collagen by Sigma Company,USA,chitosan by Shanghai Qisheng Biological Agent Medical Apparatus and Instrument Company,and L929 L cell by Cellular Institute of Shanghai Academy of Life Science,Chinese Academy of Science.METHODS:PLGA membrane (P membrane),PLGA/type-Ⅰ collagen composite membrane (PG membrane),PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane (PGC 9:1 membrane) and PLGA/type-Ⅰ collagen/chitosan (5:5) composite membrane (PGC 5:5 membrane) were produced through a certain process.MAIN OUTCOME MEASURES:Contact angle,absorption rate and cytotoxicity were tested.Morphological changes of L929 L cell cultured for 1,3,and 7 days were observed under fiberscope.RESULTS:Contact angle was shown as PG membrane＜PGC 9:1 membrane＜PGC 5:5 membrane＜P membrane (P＜0.01 );absorption rate was shown as P membrane＜PGC 5:5 membrane＜PGC 9:1 membrane＜PG membrane (P＜0.01).L929 L cell was characterized as well distribution,expansion and appearance after inoculation of PG membrane,PGC 9:1 membrane and PGC 5:5 membrane.Cytotoxic experiment (MTT methods) showed that,on the 1st day,there was no significant difference in absorbency among groups (P＞0.05).On the 3rd and 7th days,there were significant differences between P membrane and PG membrane or PGC 9:1 membrane,and between PGC 9:1 membrane and PCK2 5:5 membrane (P＜0.05).PGC 9:1 membrane could further improve cell adhesion and proliferation,and PGC 5:5 membrane could inhibit cell proliferation and differentiation.CONCLUSION:Type-Ⅰ collagen and chitosan appended to the exterior of PLGA can enhance the biocompatibility of membrane.In terms of biocompatibility,PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane can be fit to the qualification as a type of material of artificial spinal dura mater.