Objective To investigate the epidemiological characteristics of multiple-injuries of bone and joint in the belief that a better knowledge of such injuries may help their prevention and treatment. Methods A retrospective study was done on the data of 346 patients with multiple-injuries of bone and joint who had been ad- mitted to our department from January 2001 to December 2004. On the basis of CAI's classification, the following data were statistically analyzed: gender, age, cause of injury, injured part, number of injured parts, associated injuries and mortality. Results Of the 346 injured patients, there were 278 males and 68 females, with an av- erage age of 32.8 years (9months to 89 years). Two hundred and twenty-six cases resulted from traffic accidents, 65 from crush by a heavy object, and 52 from falling. There were 159 fractures of shaft of tibia and fibula, 96 fractures of femoral shaft, 87 fractures of shaft of ulna and radius, 58 fractures of ankle and foot, 57 chest injuries, 50 knee injuries, 50 hip injuries, 49 injuries at the pelvis region, 46 wrist and hand injuries, 36 injuries of shoulder, 36 skull fractures, 33 fractures of humeral shaft, 23 spinal fractures, and 17 elbow injuries. Two hundred and forty-two patients had two parts injured, 83 had three parts, 20 had four parts, and one had six parts. The average number of injured parts was 2.3. Two hundred and five patients suffered from close injuries, and 141 from open ones. The associated injuries included skull and brain injury in 51 cases, chest injury in 23, abdomen injury in five, urine system injury in three, nerve and vessel injury in 21, shock in 78, and fat embolism in six. Five patients died. Conclusions Male young people tend to be the majority of victims of multiple-injuries of bone and joint. Traffic accidents result in most of such injuries. Since multiple-injuries mostly involve lower limbs, they are easy to diagnose while the associated close injuries involving brain, chest, abdomen and pelvic are likely to be overlooked or misdiagnosed. Strengthening safety education and technical training of first aid is important to im- provement of treatment and to decrease of disability rate and mortality.

Objective To build a Monte Carlo dose verification tool for IMRT Plan by implanting an irradiation source model into DPM code and to extend the ability of DPM to calculate any incident angles and irregular-inhomogeneous fields.Methods The virtual source and the energy spectrum unfolded from the accelerator measurement data were used,in combination with optimized intensity maps,to calculate the dose distribution of the irradiation irregular-inhomogeneous field.The irradiation source model of accelerator was substituted by a grid-based surface source.The contour and the intensity distribution of the surface source were optimized by IMRT.The dose calculation was realized by combining the position of the emitter with the fluence map from the IMRT plan.The weight of the emitter was decided by the grid intensity.The direction of the emitter was decided by the combination of the virtual source and the emitting position.The weighted fraction of the emitter was also combined with the flux grid intensity based on the particle transport model of DPM code.Results The accuracy of calculation was verified by comparing with the measured data.It was illustrated that the differences were acceptable (＜ 2％ inside the field,2-3 mm in the penumbra).The dose calculation of irregular field by DPM simulation was also compared with that of FSPB (Finite Size Pencil Beam).The passing rate of gamma analysis was 95.1％ for peripheral lung cancer.The regular field and the irregular rotational field were all within permissible range of error.The calculation time of regular fields were less than 2 h,and that of the test of peripheral lung cancer was 160 min.Conclusions The adapted DPM code with its simple irradiation source model is faster than that with classical Monte Carlo procedure.Its computational accuracy and speed satisfy the clinical requiremcnt,and it can be useful as a Monte Carlo dose verification tool for IMRT Plan.

Endoscopy ; methods ; Humans ; Intestinal Diseases ; diagnosis ; diagnostic imaging ; Intestine, Small ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods

Objective To study the expression and phosphorylation of focal adhesion kinase(FAK) in rat's au- tologous vein graft and the olmesartan modulating effect.Methods Autologous external jugular veins were grafted to common carotid arteries in 40 male Sprague Dawley rats.After surgery,rats were randomly assigned to the fol- lowing groups:sham;control;olmesartan treatment(10mg/kg.d by gavage);or physiological saline.The intimal thickness,the I/M in vein grafts was quantitated by HE stain.The expression and phosphorylation of focal adhe- sion kinase were assessed by Western-blotting,PCNA and ?-smooth muscle actin were measured by immunohisto- chemistry.Results Neointimal hyperplasia in control group was characterized by significantly increased intimal thickeness I/M(P

BACKGROUND: The surface electromyography can evaluate the effect of exercise by recording the parameters of muscle activities, and vibration exercise is the best supplement to traditional weight training. More research focuses on the effect of simple vibration training on the surface electromyography of lower limbs, but the influence of vibration combined with weight-bearing training is poorly understood.OBJECTIVE: To study the effect of vibration combined with load on the surface electromyography of lower limbs at the micro level of muscle working principle.METHODS: Eight healthy college students were recruited, and subjected to four different stimulations: vibration (45 Hz) combined with load (45% one repetition maximum (IRM)); vibration (45 Hz) combined with load (60% 1RM); vibration (50 Hz) combined with load (45% 1RM); vibration (50 Hz) combined with load (60% 1RM), followed by semi-squat exercise with the heel lifting, 10 times/minute, for 3 courses with more than 2 hours in between.RESULTS AND CONCLUSION: Different vibrations combined with loads made significant difference on the root mean square amplitude of the surface electromyography (P < 0.01), and there was a significantly increased root mean square amplitude in the vibration (50 Hz) combined with load (45% 1RM), especially at the medial gastrocnemius. The four kinds of stimulations made significant different effects on the surface electromyography of rectus femoris, tibialis anterior, and medial gastrocnemius, except semitendinosus (P ≤ 0.05). Moreover, the effect showed significant difference among different stimulations except vibration (50 Hz) combined with load (45% 1RM) (P ≤ 0.05). Compared with the other three stimulations, vibration (50 Hz) combined with load (45% 1RM) exerted better effect on the muscular activation. To conclude, different vibrations combined with loads exert different effects on the motor unit of same neuromuscular activity, and a suitable stimulation may produce better effect. Besides, the same stimulus for the motor unit of different neuromuscular activities produces different effects, which may match to the muscle nature.

OBJECTIVETo discuss the clinical effects of open reduction and internal fixation (ORIF) for treatment of patients with Lisfranc injury combined the second metatarsal base comminuted fracture.

METHODSFrom March 2007 to June 2012, 7 patients with Lisfranc injury combined the second metatarsal base comminuted fracture were treated including 5 males and 2 female aged from 22 to 51 years old (means 42 years), 4 of sprain and 3 of traffic injury. According Myerson classification, there was 1 case of type A, 3 of type B and 3 of type C. Kirschner wire was used to fix Lisfranc ligament placing from the medial cuneiform bone to the second metatarsal base during the operation. After the operation American Orthopaedic Foot and Ankle Society (AOFAS) criteria system were applied to evaluate the foot and ankle function. Preoperative and postoperative AP, lateral and oblique X-ray and CT scan were collected for radiographic evaluation.

RESULTSAll patients were followed up from 12 to 20 months (16.8 months in average). According to AOFAS criteria system, 3 cases were excellent result,3 good, 1 fair. All the wounds were primary healing without skin necrosis, infection, Kirschner loose,broken, or other complications.

CONCLUSIONKirschner wire had good clinical efficacy for fixing Lisfranc ligament injury with the second metatarsal base comminuted fracture, and could avoid arthrodesis.

Adult ; Bone Wires ; Female ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged ; Tarsal Joints ; injuries ; surgery ; Wound Healing

AIMTo investigate the effect of 5-hydroxytryptamine (5-HT) on spontaneous unit discharges of primary somatosensory cortex (SI-SUD) and the role of 5-HT1A receptor in 5-HT inhibitory effect on SI-SUD in rat.

METHODSThe SI-SUD was recorded before and during microiontophoresis of 5-HT and 8-OH-DPAT (the selective agonist for 5-HT1A receptor. The changes of mean of interspike interval (MISI) of SI-SUD were analysed and handled with the statistics.

RESULTS(1) Effects of 5-HT on SI-SUD may be inhibitory (48/96), excitatory (26/96) or non-responsive (22/96), and the major effect is inhibitory. (2) In 20 of 5-HT inhibited units, 17 are also inhibited with microiontophoresis of 8-OH-DPAT, but 3 have no obvious response to 8-OH-DPAT.

CONCLUSIONThe major effect of 5-HT on SI-SUD is inhibitory. In majority of 5-HT inhibited units, 5-HT1A receptor may be existence, which may involve in the inhibition of 5-HT on SI-SUD.

8-Hydroxy-2-(di-n-propylamino)tetralin ; pharmacology ; Animals ; Female ; Male ; Rats ; Rats, Wistar ; Receptors, Serotonin ; drug effects ; physiology ; Serotonin ; physiology ; Somatosensory Cortex ; drug effects ; physiology

Although the essential oil of Xiangfu Siwu decoction (XFSWD) has strong pharmacological activity, its special physical and chemical properties restrict the clinical application and curative effect. In this paper, Xiangfu Siwu decoction essential oil (XFS-WO) was prepared by forming inclusion complex with β-cyclodextrin (β-CD). The present study is to investigate the effect of β-CD inclusion complex on the transport of major components of XFSWO using Caco-2 cell monolayer model, thus to research the effect of this formation on the absorption of drugs with low solubility and high permeability, which belong to class 2 in biopharmaceutics classification system. A sensitive and rapid UPLC-MS/MS method was developed for simultaneous quantification of senkyunolide A, 3-n-butylphthalide, Z-ligustilide, dehydrocostus lactone and α-cyperone, which are active compounds in XFSWO. The transport parameters were analyzed and compared in free oil and its β-CD inclusion complex. The result revealed that the formation of XFSWO/β-CD inclusion complex has significantly increased the transportation and absorption of major active ingredients than free oil. Accordingly, it can be speculated that cyclodextrin inclusion complex can improve bioavailability of poorly water-soluble drugs. Above all these mentioned researches, it provided foundation and basis for physiological disposition and pharmaceutical study of XFSWD.
Biological Transport ; Caco-2 Cells ; Drugs, Chinese Herbal ; analysis ; Humans ; Oils, Volatile ; analysis ; beta-Cyclodextrins ; pharmacology

OBJECTIVETo explore the molecular biological mechanism of Arnebia Root oil (AO) in promoting the recovery of surface of wound by observing basic fibroblast growth factor (bFGF) mRNA expression in the wound tissue and healing rate of the wound.

METHODSPatients in the observed group with their wound treated by AO and those in the control group treated by petrolatum gauze. The wound surface healing rate was estimated and bFGF mRNA expression was observed by RT-PCR.

RESULTSEndogenous bFGF mRNA expression existed in the wound surface of both groups, but its level in the observed group at any time point was obviously higher than that in the control group respectively, with significant difference in comparison of the gray density between the two groups (P < 0.05). The wound surface healing rate kept abreast with bFGF mRNA expression in wound tissues, so it was significantly higher in the observed group than that in the control group (P < 0.05). GAPDH gene, which was taken as a parameter for internal reference, expressed with a certain amount unchanged in different periods of healing (P > 0.05 ).

CONCLUSIONAO shows obviously promotive action on bFGF, an important regulatory factor on wound healing, it might complete the recovery process by stimulating the increase of bFGF.

Adolescent ; Adult ; Boraginaceae ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fibroblast Growth Factor 2 ; biosynthesis ; genetics ; Humans ; Male ; Middle Aged ; Phytotherapy ; Plant Oils ; administration & dosage ; isolation & purification ; Plant Roots ; chemistry ; RNA, Messenger ; biosynthesis ; genetics ; Wound Healing ; drug effects ; Wounds and Injuries ; drug therapy ; metabolism

Objective: To investigate the survival rate, function outcomes, and complications after using unicondylar osteoarticular allografts with or without prosthesis to reconstruct the knee joint for tumors located in distal femoral or proximal tibial uni-condyle. Methods: Twenty-two patients who underwent unicondylar osteoarticular allografts with or without prosthesis composite reconstructions from January 2007 to December 2015 in Department of Orthopaedic Surgery of Xi Jing Hospital, the Fourth Military Medical University were retrospectively reviewed. There were 14 males and 8 females and the mean age was 35 years(8-65 years). There were 12 malignent tumors and 10 aggressive benign tumors. The tumors were located in distal femur in 14 cases and proximal tibia in 8 cases. After tumor excision, the distal femur was reconstructed with unicondylar osteoallograft-prosthesis composite, and proximal tibial plate was reconstructed with unicondylar osteoarticular allograft with the help of computer-assisted navigation system. Function and radiograph were documented according to the Musculoskeletal Tumor Society (MSTS) functional scoring system and the International Society of Limb Salvage (ISOLS) radiographic scoring system. The median follow-up time was 60 months (5-116 months). Results: At the latest follow-up, 2 patients had amputation owing to local recurrence in 12 malignant tumors. Three patients had pulmonary metastasis and 1 patient died another 2 alive with disease. Kaplan-Meier analysis indicated that the disease-free survival rate was 73%. There was no recurrence and metastasis in 10 patients with giant cell tumor. The average MSTS score was 26 points and the radiographic score was 78%-94%(average 90%). The complications included superficial infection in 1 patient and screw broken in 1 patient. There was no broken or collapse allograft in all composite reconstruction patients but 6 cases in allograft reconstruction. Conclusions Unicondylar osteoarticular allografts or prosthesis composite was feasible reconstruction for tumors in distal femoral uni-condyle. It could provide good functional outcomes and also prevent joint degeneration. Similarly, allograft reconstruction was also a reliable technique for proximal tibial defect.