OBJECTIVETo discuss the treatment strategy of acetabular fractures and unstable pelvic fracture of the hip and to evaluate its outcome.

METHODSRetrospective analysis of clinical data in 32 patients with unstable pelvic fracture and acetabular fractures from January 2007 to June 2013 were collected. There were 18 males and 14 females aged from 18 to 62 years old (means 38 years old). According to Tile classification of pelvic fracture, 11 cases were type B1, 8 were type B2.1, 7 were type B2.2, 3 were type C1.1, 2 were type C1.2, 1 was type C3. According to Judet-Letournel classification, anterior column fracture was in 1 case, transverse fracture in 8, transverse plus posterior wall fracture in 6, T-type fracture in 1, anterior column plus half transverse fractures in 5, double column fracture in 11. Other combined injuries were treated early, the surgical operation were performed after stable condition. The hip joint function and the fracture reduction were assessed during follow-up.

RESULTSThe operative time was from 1.8 to 6.5 hours (averaged 3 hours). Two fat patients' incision occurred in fat liquefaction and healed after dressing, no incision infection happened. Only 1 case was lost to follow-up, 31 patients were followed up with a mean time of 23 months (6 to 42 months). The healing time of pelvic fracture was from 8 to 18 weeks (averaged in 10.6 weeks). The hip function was evaluated according to the Matta and Tornetta standard postoperatively, the result was excellent in 15 cases, good in 14 cases, fair and poor in 1 case respectively. The Majeed score of the hip function was 83.65? 7.67, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The healing time of acetabular fractures was from 8 to 16 weeks (averaged in 10.2 weeks). The fracture reduction was assessed by Matta standard, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The heterotopic ossification was evaluated by Brooker standard, 4 cases were grade I, 1 case was grade II . There were no infection, nonunion and necrosis of the femoral head in all patients. The nerve damage symptoms in 5 patients disappeared during 4 to 6 months after operation.

CONCLUSIONPatients with unstable pelvic fractures and acetabulum fractures were in a critical condition early, using the concept of damage control to save lives in a timely manner. Grasp the operation time in the late treatment, acetabulum fractures reach anatomical reduction as far as possible, pelvic fractures are given priority to stable reconstruction. The operation order was fixed pelvic ring first, according to the condition to choose the appropriate surgical approach and fixed mode.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the difference of vacuum sealing drainage (VSD) on the effect of one-stage skin graft and second-stage sugery after scar release.Methods A total of 42 patients who wanted to undergo scar release and skin graft was randomly divided to control group (n =21) and VSD treatment group (n =21).The control group implemented skin graft immdiately after scar release while VSD treatment group were treated with VSD for 3 days after scar release and then implemented skin graft.The rate of subcutaneous blood stasis and the survival rate of skin graft were observed at 7 days after skin graft.The condition of grafted skin contracture and hyperplasia after half a year was also observed.Results The incidcnce of subcutaneous blood stasis was significantly lower in the VSD group than that in the control group (P ＜ 0.05).The survival rate of skin grafts was significantly higher in the VSD group than that of the control group (P ＜ 0.05).The score of Vancouver scar was significantly lower in the VSD group than that in the control group (P ＜ 0.05).Conclusions VSD treatment of second-stage sugery after scar release can reduce the occurrence of subcutaneous blood stasis,promotc skin graft survival,reduce postoperative skin graft contracture and improve the prognosis of patients compared to one-stage skin graft.

Objective To observe the influence of taurine supplementation during early postnatal life on body weight and ultrastructure of islet ? cells in neonatal rats with low birth weight(LBW).Methods LBW neonatal rats were made by feeding 20%(C group) or 10%(R group) protein diet to fetal rats during gestation and lactation.Half of femal rats in group R were given a supplementation with 2.5% taurine drinking water(RT group) only during lactation,while other femal rats freely drunk.At postnatal day 1 and 21,the neonatal rats were weighted and their pancreas were removed.The ultrastructural changes of ? cells were observed by electron microscopy.Results At postnatal 21 days,the body weight of offsprings in group RT was significantly highter than that in group R(P=0.003);and the ultrastructure of ? cells in group RT got more improvement than that in group R.Conclusion Taurine supplementation can improve the growth-catch-up and the ultrastructure of islet ? cells of neonateal rats with LBW.

ObjectiveTo determine the cerebral protection effect and mechanism of propofol on global cerebral ischemia and reperfusion damage in rats.Methods19 adult male Wistar rats were randomly divided into 3 groups, ischemia group (n=7), propofol group (n=7), and sham injury group (n=5). Global cerebral ischemia and reperfusion model were made by means of Pulsinelli's method. Rats in propofol group were anesthesia with propofol at the dosage of 1.5 ml/h for 30 min at the beginning of reperfusion. Apoptosis and necrosis rate were detected by cytometry. In the same time, bcl-2, Bax and p53 protein expression in hippocampus neurons were detected. ResultsThe apoptosis and necrosis rate in propofol group were significantly decreased as compared with ischemia group ( P<0.05). Bax and p53 protein expression in hippocampus neurons were also significantly decreased as compared with ischemia group (P<0.05), however, no significant findings in bcl-2 protein expression (P>0.05).ConclusionPropofol can decrease apoptosis and necrosis rate in cerebral ischemia reperfusion injured neuron, and the mechanism maybe related to decreasing the expression of Bax, p53 protein.

Objective:To investigate the correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome in the elderly population.Methods:This was a cross-sectional study.A total of 114 212 subjects aged 65 years and over in Wujin District receiving health examination in 2019 were enrolled, including 40 388(35.4%)patients with metabolic syndrome.The survey contents included a questionnaire, physical examination and laboratory tests.Logistic regression and restricted cubic splines were used to analyze the correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome.Results:With increases in pulse pressure levels and pulse pressure index, the prevalence of metabolic syndrome and its components increased accordingly( P<0.01). After adjusting for confounding factors, the ORvalue of metabolic syndrome gradually increased along with increases in pulse pressure and pulse pressure index.Compared with the first quartile, pulse pressure and pulse pressure index in the second, third and fourth quartiles were correlated with metabolic syndrome(pulse pressure: OR=1.52, 95% CI: 1.47~1.58, OR=1.89, 95% CI: 1.82~1.96 and OR=2.15, 95% CI: 2.07~2.23, respectively; pulse pressure index: OR=1.22, 95% CI: 1.18~1.26, OR=1.36, 95% CI: 1.31~1.41 and OR=1.47, 95% CI: 1.42~1.53, respectively). Restricted cubic spline analysis showed that pulse pressure and pulse pressure index had non-linear dose-response relationships with metabolic syndrome( χ2=309.23 and 57.14, P<0.01). Conclusions:Pulse pressure and pulse pressure index are correlated and show non-linear dose-response relationships with metabolic syndrome and its components in the elderly.

The paper aims to explore the studying method for the pharmacokinetics of drugs in target organs, the pharmacokinetic process of tramadol hydrochloride in the extracellular fluid of frontal cortex (FrCx) of mice was investigated. Six male mice (Kunming strain) were anaesthetized (urethane, 1.8 g x kg(-1), ip) and secured on a stereotaxic frame. A microdialysis probe was implanted into the FrCx and perfused with artificial cerebrospinal fluid at a flow rate of 2 microL x min(-1). One hour later, mice were administrated (ip) with tramadol hydrochloride (50 mg x kg(-1)) and dialysates were collected continuously at 12-min intervals (24 microL each) for 6 h. The tramadol concentration in dialysates was determined by HPLC-Ultraviolet detection method, and the concentration-time curve and pharmacokinetic parameters of tramadol were calculated with DAS software. The results showed that the pharmacokinetic process of tramadol in the FrCx extracellular fluid of mice was fitted to a two-compartment open model, and the main pharmacokinetic parameters t1/2alpha, t1/2beta, t(max), C(max) and AUC(0-infinity) were (0.27 +/- 0.05) h, (2.72 +/- 0.24) h, (0.50 +/- 0.10) h, (2 110.37 +/- 291.22) microg x L(-1) and (4 474.51 +/- 441.79) microg x L(-1) x h, respectively. In conclusion, a studying method for pharmacokinetics of drugs in the target organ is established, which is simple and feasible. Tramadol hydrochloride shows a two-compartment model in the extracellular fluid of the mouse FrCx, and the distribution- and elimination half-life are 0.5 h and 2.7 h, respectively.
Animals ; Area Under Curve ; Chromatography, High Pressure Liquid ; Extracellular Fluid ; metabolism ; Frontal Lobe ; metabolism ; Half-Life ; Male ; Mice ; Microdialysis ; Tramadol ; pharmacokinetics ; Ultraviolet Rays

Aged ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Bone ; complications ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUNDOnabotulinumtoxinA is widely used in treating neurogenic detrusor overactivity (NDO). We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating NDO.

METHODSWe searched the following databases: Medline, EMBASE, and the Cochrane Controlled Trials Register. All published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of NDO were identified in the analysis. The reference lists of the retrieved studies were also investigated.

RESULTSFour publications involving a total of 807 patients were identified in the analysis, which compared onabotulinumtoxinA with placebo. The changes of the mean number of urinary incontinence per week (the standardized mean difference [SMD] = -10.91, 95% confidence intervals [CIs] = -14.18--7.63, P < 0.0001); maximum cystometric capacity (SMD = 146.09, 95% CI = 126.19-165.99, P < 0.0001) and maximum detrusor pressure (SMD = -32.65, 95% CI = -37.83--27.48, P < 0.0001) indicated that onabotulinumtoxinA was more effective than the placebo, despite the doses of onabotulinumtoxinA. Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with more complications. Urinary tract infections (relative risk [RR] =1.48, 95% CI = 1.20-1.81, P = 0.0002); hematuria (RR = 1.81, 95% CI = 1.00-3.24, P = 0.05) and urinary retention (RR = 5.87, 95% CI = 3.61-9.56, P < 0.0001).

CONCLUSIONSThis meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for NDO with side effects primarily localized to urinary tract.

Botulinum Toxins, Type A ; adverse effects ; therapeutic use ; Humans ; Urinary Bladder, Overactive ; drug therapy

OBJECTIVETo investigate the startup detail of circulation dysfunction and its role in the progress of delayed neuropsychologic sequelae (DNS) after carbon monoxide (CO) poisoning with comparison with the model of ischemia-reperfusion.

METHODSThe ischemia-reperfusion rat model was established by Pulsinelli-Brierley method, and the CO poisoning rats model by i.p. injected with CO repeatedly respectively, and the rats were identified with DNS following the experiment of pathology and the ethnology.

RESULTSThe whole blood viscosity, plasma viscosity, hematocrit and fibrinogen increased significantly immediately after reperfusion, and recovered gradually with the ischemia-reperfusion rat model. The whole blood viscosity decreased significantly immediately after CO treated i.p. Especially at low shear rate, the hematocrit also declined remarkably in the early stage after CO treatment. But 1day later, these parameters turned to the trend of the ischemia-reperfusion rats. There was a prominent elevation of both indexes until the 14th day following CO injection i.p.

CONCLUSIONThere are significantly sustained hyper-coagulation and hyper-viscosity with circulation in rats after CO poisoning compared with ischemia-reperfusion model during the period of DNS, which might contribute to increase cerebral circulation resistance, blocked blood flow, and deteriorate hypoxemia in progression of DNS.

Animals ; Blood Circulation ; Carbon Monoxide Poisoning ; physiopathology ; Disease Models, Animal ; Hemorheology ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; physiopathology

OBJECTIVETo study the correlation of tenascin-c (TN-C) degradation with relapse and/or metastasis in stage-I non-small cell lung cancer (NSCLC) in order to search for a potential biomarker for predicting recurrence, and also to investigate the molecular mechanism of TN-C degradation. Methods The fragment of TN-C in 63 surgically treated stage-I NSCLC was detected by Western blotting, and the activity of matrix metalloproteinases (MMPs) was also examined by gelatin zymography.

RESULTSTN-C degradation fragment was positively detected in 12 of 63 patients, and 9 of these 12 patients (75.0%) were found to develope recurrence during follow-up. The recurrence-free survival at 4 years was 28.1% in patients with positive TN-C degradation versus 82.1% in those without (P < 0.001), and which was 76.6% at 10 years in the patients without TN-C degradation. The activity of MMP-2 in the patients with positive TN-C degradation was also found to be significantly higher than that in the patients without (P < 0.001).

CONCLUSIONTenascin-c degradation fragment may be a reliable biomarker for predicting recurrence and/or metastasis in the early NSCLC, and matrix metalloproteinase-2 may be a responsible proteinase for degradation of tenascin-c.

Aged ; Aged, 80 and over ; Biomarkers, Tumor ; Bone Neoplasms ; metabolism ; secondary ; Brain Neoplasms ; metabolism ; secondary ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Pneumonectomy ; Tenascin ; metabolism