OBJECTIVE: To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. METHODS: Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operation time, intraoperative blood loss, hospital stay duration, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. RESULTS: All operations were successfully completed. The operation time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complication such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month after operation. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140° (mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complication, including implant failure, occurred during follow-up. CONCLUSION For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operation time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.
Humans ; Male ; Tibial Fractures/surgery* ; Female ; Middle Aged ; Adult ; Arthroscopy/methods* ; Minimally Invasive Surgical Procedures/methods* ; Fracture Fixation, Internal/methods* ; Aged ; Treatment Outcome ; Robotic Surgical Procedures/methods* ; Operative Time ; Range of Motion, Articular ; Fracture Healing ; Length of Stay ; Tibial Plateau Fractures

[ABSTRACT]OBJECTIVETo study the expressions of 34βE12, Galectin-3 and HBME-1 in thyroid nodules, and to explore its diagnostic value for papillary thyroid carcinoma (PTC).METHODSEn VisionTM immunohistochemical technique was used to detect the expression of 34βE12, Galectin-3 and HBME-1 in 352 thyroid lesions. The correlation between the expressions of the 3 protein markers and clinicopathological characteristics was evaluated. The receiver operating characteristic area under the curve (ROC-AUC) and their index for diagnosis evaluation were also calculated.RESULTSThe positive rates of 34βE12, Galectin-3 and HBME-1 in 246 PTC lesions were significantly higher than those in benign nodules (P<0.001). There was no relationship between the expression of the 3 protein markers and clinicopathological characteristics (eg. gender, age, numbers of lesions, tumor size, capsular invasion, lymph node metastasis, TNM staging). The ROC-AUC of 34βE12, Galectin-3 and HBME-1 for diagnosis of PTC was 0.936, 0.915 and 0.898 respectively. The sensitivity of 34βE12, Galectin-3 and HBME-1 for diagnosis of PTC was 94.3%, 95.5% and 91.1% respectively, while the specificity was 81.1%, 71.7% and 83.0% respectively, and the diagnostic accuracy rate was 90.3%, 88.4% and 88.6% respectively.CONCLUSION The expressions of 34βE12, Galectin-3 and HBME-1 are statistically different between PTC and benign lesions, but no associations are found with clinicopathological characteristics, indicating the three protein markers have important diagnostic value for PTC.

Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.

Background The enhance of differentiation of orbital preadipocyte is a main factor for pathogenesis of thyroid associated ophthalmopathy(TAO).Experiment has proved that orbital preadipocyte can differentiate into mature adipocyte expressing resistin,and resistin is a adipocyte factor with biological activity.Objective The present study is to investigate the effects of recombinant human resistin on differentiation of orbital preadipocytes derived from TAO patients orbital tissues.Methods Orbital adipose tissue was obtained from 10 eyes with TAO during the orbital decompression surgery.Orbital adipose tissue of the normal group was obtained from 5 removed eyes during the surgery due to different reasons.Preadipocytes were isolated and cultured using expand culture method.The 2-5 generations of preadipocytes were identified by oil red O staining under the light microscope.0,10,25,50,100ng/mL of recombinant human resistin were added into medium in the first day after differentiation of cells.The expression of PPARγ mRNA in differentiated adipocytes were detected by reverse trancripaton PCR(RT PCR).Results The differentiation of preadipocyte presented the similar procedure and outcome between the TAO group and normal group.Differentiated adipocyte was stained into the jacinth by oil red O.The expression of PPARγ mRNA in differentiated cells was gradually declined with the increase of concentration of recombinant human resistin (F=241.341,P＜0.01).A dose dependent inhibitory effect was detected in the expression of PPARγ mRNA.The weakest expression of PPARγ mRNA in differentiated cells was 100ng/mL resistin group.Conclusion The recombinant human resistin has an inhibitory effect on the differentiation of orbital preadipocytes by reducing the expression of adipose related genes.Resistin is probably a new research approach to treatment of TAO.

Objective To discuss the diagnosis and surgical management of acute gangrenous cholecystitis (AGC) early after EST and ERCP. Methods Clinical and pathological data of 1468 cases receiving EST and ERCP in our hospital from 2005 to 2007 were retrospectively analyzed. Results AGC occurredin 16 cases and the incidence was 1.09%. Its main manifestations were pain in the right upper abdomen with local pertonitis and fever 1 to 3 d after operation, blood WBC exceeding 15.0× 109/L in 15 cases (93.8%), gallbladder tumefaction and double layer structure by B mode ultrasound, the diagnostic accuracy before operations was 81.3 %. We performed cholecystectomy in 10 cases, cholecystectomy and choledochotomy for common bile duct exploration and stone removal and T-tube drainage in 2, partial cholecystectomy in 3, cholecystostomy in 1. Pathological examination showedthat it was AGC in all the patients. Conclusion Latency in 1 to 3 d, local pertonitis, high blood WBC and B mode ultrasound are main managements in diagnosis of AGC and it should be diagnosed carefully distinguished from perforation and severe acute pencreatitis. It is suggested to undergoing early surgi-cal management once diagnosed definitely.

The genus Rhodococcus is of considerable interest in recent years, stemming from their diverse applications in biodegradation, bioremediation, biotransformation and biosurfactant. Using Nocardia/Rhodococcus-Escherichia coli shuttle plasmid pNV18.1 as the backbone vector, we tested the driven efficiency of promoters Ptac and PlacZ of E. coli and Pami-1/Pami-2 of R. ruber in host R. rhodochrous ATCC 33278 by overexpression of nitrile hydratase. Results showed that the specific activity of nitrile hydratase per dry cell weight in engineered Rhodococcus strains driven by Ptac, Pami-1, Pami-2 and PlacZ was 7.5, 6.3, 5.3 and 1.8 times of that in the wild, respectively. It indicated that these promoters could be well recognized by RNA polymerase of Rhodococcus. We further expressed the beta-galactosidase reporter gene (lacZ) in R. ruber driven by promoter PlacZ. Results indicated that lacZ was an appropriate reporter gene for genetic or metabolic engineering research of Rhodococcus.
Escherichia coli ; genetics ; Gene Expression Regulation, Bacterial ; Genes, Reporter ; genetics ; Lac Operon ; genetics ; Promoter Regions, Genetic ; genetics ; Rhodococcus ; enzymology ; genetics ; beta-Galactosidase ; genetics

D-amino acid oxidase (DAAO) is one of important industrial enzymes. To increase the solubility and activity of the TvDAAO from Trignoposis variabilis expressed in recombinant Escherichia coli (E. coli), a maltose binding protein (MBP) and Vitreoscilla hemoglobin (VHb) was introduced to fuse with N-terminal of the TvDAAO, respectively. Fusion protein of MBP-TvDAAO was constitutively expressed in JM105/pMKC-DAAO and inductively expressed in JM105/pMKL-DAAO. With respect to the control strain of BL21 (DE3)/pET-DAAO without MBP fusion, the constitutive fusion expression obtained 28% of soluble protein with 3.7 folds of solubility improvement. As for the inductive fusion expression, corresponding results changed to 17% and 1.8 folds, respectively. However, the DAAO activity significantly decreased in the MBP-fusing expression. Fusion protein of VHb-TvDAAO was constructed and inductively expressed in BL21 (DE3)/pET-VDAAO. Its DAAO activity highly reached 3.24 u/mL in flask culture, about 90% increase in contrast to the control without VHb.
Bacterial Proteins ; biosynthesis ; genetics ; Carrier Proteins ; biosynthesis ; genetics ; D-Amino-Acid Oxidase ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Maltose-Binding Proteins ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Truncated Hemoglobins ; biosynthesis ; genetics ; Yeasts ; enzymology ; genetics

Objective To investigate the causes and measurement of the colonic fistulas after severe acute pancreatitis(SAP),so as to increase its cure rate.Method A retrospective study was made on 19 SAP cases complicated with colonic fistulas after drainage operation in order to find out the risk factors,the location and the time of complicated colonic fistulas,and to sum up the experiences of earlier diagnosis and comprehensive treatment.Results Most patients occurred colonic fistulas within 4~6 weeks postoperation.Seventeen patients recovered,the cure rate being 89.5%(17/19),and two case died of serious systemtic infection and multiple organ systemtic failure.Conclusions Colonic fistulas complicated by SAP is related to anatomic factors,the degree of local inflammation,the way of draingic tube putted away,and improper surgical therapy.Comprehensive therapy including taking double cannula to drainage in active,earlier jejunostomy nutrition support or colostomy,supplementing with recombinant human growth hormone can lead to better results.

Objective To analyze incidence of thyroid carcinoma and to explore and conclude the principle of its diagnosis and treatment.Methods One hundred and forty six patients of thyroid carcinoma in our hospital were analyzed and discussed with literature.Results 101 cases were diagnosed as thyroid carcinoma by pathological diagnosis of fast frozen sections,the positive ratio is approximately 93.5%.totle resection of affected lobe and isthmus was performed on 35 cases,total resection of affected lobe and isthmus and majority of opposite lobe was done on 37 cases.The lymph node metastasis was found by postoperative pathological diagnosis with a rate of 32.5%.Conclusions Preoperative diagnose of thyroid carcinoma is rarely available,diagnosis of thyroid carcinoma by fast frozen sections is optimal.total resection of affected lobe and isthmus or total resection of affected lobe and isthmus and majority of opposite lobe are the main operation patterns.

Objective To sum up the therapeutic experience for pancreatic abscess complicated with severe acute pancretitis (SAP) and to compared the methods of drainage according to its classification , so as to guide the clinical work. Methods Altogether clinical datas of 58 patients with pancreatic abscess were collected in the latest 20 years, pancreatic abscess were divided into 3 groupes according to its size,locationa and figure.Four methods of drainage including open operation drainaging,percutaneous puncture drainaging, small incision drainaging at lower location but not into peritoneal cavity and “F” tube drainaging were adopted.Results 29 cases drainaged by open operation ,among them 10 adopted second look operation and 4 cases third look operation 5 died of the severious complications such as overwelming blooding and intestinal fistula;10 cases through percutaneous puncture drainage ,6 cases cured and the rest converting to open operation and then cured ; 12 cases by small incision through lower location but not into peritoneal cavity ,all cured.Conclusions The results sugggest the effects of drainge related directly to the choose of methods of drainage for pancreatic abscess complicated with SAP,pancreatic classification and to choose an appropriate way according the aforementioned standard will benefit clincial work.