Objective:To report the surgical techniques and clinical outcomes of multi-dimensional fixation of patellar multi-fragmentary fractures with locking plates.Methods:A retrospective study was performed in the 26 patients with patellar multi-fragmentary fracture who had undergone open reduction and 3-D internal fixation with locking plates from November 2016 to July 2020 at Department of Orthopaedic Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University. There were 17 males and 9 females, with an average age of 62.6 years (from 31 to 90 years). The patellar fractures were exposed and reduced via the longitudinal anterior midline incision of the knee. After the reduction was initially maintained with a cerclage wire, a trimmed and pre-contoured 3.5 mm locking plate was applied onto the patellar surface. After-wards, locking screws were inserted from the lower pole to the upper pole of the patella, from the anterior to the posterior and from the lateral to the medial, respectively, to complete the multi-planar fixation. Follow-ups assessed the B?stman score, knee pain visual analogue scale (VAS), radiographic image and fracture healing, range of motion of the knee, and complications.Results:All the 26 patients were followed up for 12 to 56 months (average, 28 months). Crutches were used while walking until an average of 1.6 months (from 1 to 3 months) after operation in all patients. At the last follow-up, the B?stman score averaged 27.5 points (from 17 to 30 points), yielding 12 excellent, 13 good and 1 poor case with an excellent to good rate of 96.2% (25/26); the knee pain VAS averaged 1.2 points (from 0 to 5 points); the active knee flexion averaged 125° (from 100° to 150°). No breakage, loosening or displacement of the patellar plates or screws was observed during follow-up, but cerclage wire breakage occurred without any symptom in 11 cases. Four patients complained of hardware irritation, and 4 patients underwent hardware removal after fracture union.Conclusion:Multi-dimensional fixation with locking plates is a viable and safe surgical option for patellar multi-fragmentary fractures, due to its satisfactory therapeutic outcomes.

Renal cell carcinoma is a common malignant tumor of the urinary system. The immune microenvironment to which neutrophils belong has a dual role of suppressing and promoting the development of renal cell carcinoma. The cancer-promoting effects through mechanisms such as mediating inflammation, expressing chemokines, and generating neutrophil extracelluar traps have become research hotspots. Targeted drugs and immune checkpoint inhibitors are used as systemic treatments for patients with advanced renal cell carcinoma. Their efficacy and prognosis are related to neutrophil activity. The neutrophil infiltration in tumor and peripheral blood neutrophil level increase suggest the poor prognosis of patients with renal cell carcinoma. The phenotype and function of neutrophils can be affected by inflammation associated with renal cell carcinoma, and the high expression of CXC chemokines leads to poor prognosis. In addition, the neutrophil extracellular traps can capture tumour cells in the peripheral blood and assist their survival and migration.

OBJECTIVETo evaluate the clinical therapeutic effects and safety of chronic fatigue syndrome treated with transcutaneous electrical acupoint stimulation (TEAS) on the conception vessel and the governor vessel.

METHODSEighty-nine patients of chronic fatigue syndrome were randomized into an observation group (46 cases) and a control group (43 cases). In the observation group, TEAS was applied at Dazhui (GV 14) and Mingmen (GV 4), Shenque (CV 8) and Guanyuan (CV 4) [the current intensity: (14±2) mA]. In the control group, the simulated TEAS was applied at the same acupoints as the observation group (the current intensity: 1 mA). The treatment was given for 30 min, once a day, 5 times a week and the treatment of 4 weeks was as 1 session in the two groups. One session of treatment was required. Before treatment and at the end of 1 session of treatment, the fatigue severity scale (FSS) was adopted to evaluate the fatigue symptoms and the somatic and psychological health report (SPHERE) was adopted to evaluate the potential symptoms and observe the safety of TEAS therapy.

RESULTSAt the end of treatment, FSS score and SPHERE score in the control group were not different significantly as compared with those before treatment (both>0.05). FSS score and SPHERE score in the observation group were reduced significantly as compared with those before treatment (both<0.01). FSS score and SPHERE score in the observation group were reduced apparently as compared with those in the control group (both<0.001). In the entire process of treatment with TEAS, no any adverse reaction occurred.

CONCLUSIONTEAS on the conception vessel and the governor vessel relieves fatigue symptoms and the potential symptoms in the patients of chronic fatigue syndrome. It is a safe therapy.

A rapid and sensitive method for the determination of trace carbaryl in water by using diallyl phthalate-europium ( Eu3+) as fluorescent probes was developed. The interaction between Eu3+ and diallyl phthalate and carbaryl was studied by high resolution mass spectrum, and the fluorescence spectra change of complexes before/after binding with carbaryl was also investigated. The influence factors of fluorescence intensity including solution pH and interferent were studied. The results showed that two diallyl phthalate molecules were complexed with one Eu3+to form stable complexes. Carbaryl could also interact with the probe to form multiple complexes, which significantly increased the fluorescent efficiency of the probe. At pH 9. 0 of solution and by using 245/615 nm as excitation/emission wavelength, the fluorescence intensity showed good linear relationship with the carbaryl concentration ranged from 6. 25í10-8 mol/L to 2. 50í10-6 mol/L, and the linear correlation coefficient was 0. 9968. The detection limit of the method was 9. 6í10-9 mol/L. Water samples were extracted by acetonitrile, and then detected by europium ( Eu3+)-diallyl phthalate fluorescent probe. The recovery of the method was 91. 8%-94. 5%, while RSD was within 6. 1%. The method is suitable for the rapid determination of carbaryl in water samples.

Objective To explore the influence of Shenqifuzheng injection on efficacy of chemotherapy and immune function in patients with gastric cancer after surgery.Methods 60 postoperative patients with gastric cancer were selected as the research subjects,and were randomly divided into the control group and observation group by the digital table,30 cases in each group.The control group was given FOLFOX regimen chemotherapy.The observation group received FOLFOX regimen combined with the treatment of Shenqifuzheng injection.The recurrence and metasta-sis,survival,immune function and adverse reactions of the patients were observed and the patients were observed before and after chemotherapy.Results The chemotherapy cycle of the observation group was (3.95 ±0.40),which was significantly higher than (3.40 ±0.30)of the control group,the difference was statistically significant (t =6.025,P <0.01).The progression free survival in the observation group was (9 ±2.4)months,which was significant-ly longer than (6.6 ±3.2)months in the control group,the difference was statistically significant (t =3.286,P <0.01).The reduction rate in the observation group was 6.67%,which was lower than 26.67% in the control group, the difference was statistically significant (χ2 =4.320,P <0.05).The incidence rate of nausea and vomiting in the observation group was 6.67%,which was lower than 26.67% in the control group,the difference was statistically sig-nificant (χ2 =4.320,P <0.05).KPS[(83.51 ±15.37)points]and QLQ -C30[(82.01 ±9.45)points]of the observation group were significantly higher than those in the control group [KPS (74.62 ±13.22)points and QLQ -C30 (74.62 ±13.22)points],the differences were statistically significant (t =2.298,2.491,all P <0.05).After chemotherapy,gastric cancer patients ratio of CD +3 ,CD +4 ,CD +4 /CD +8 in the observation group were higher than those of the control group and the ratio of CD +4 /CD +25 in the observation group was lower than control group,the differences were statistically significant (all P <0.05).Conclusion Shenqifuzheng injection combined with FOLFOX chemo-therapy for gastric cancer patients has low adverse reaction rate,and can effectively improve the immune function.