ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical therapeutic effects of posterior medial approach inverted L-shaped incision combined with reconstruction plate fixation in treating posterior tibial plateau condylar fracture.</p><p><b>METHODS</b>From February 2011 to February 2015, 19 patients that were clearly diagnosed with combined posterior tibial plateau condylar fracture were treated with internal fixation of reconstruction plate through the posterior medial approach L-shaped incision under direct vision, involved 14 males and 5 females with an average age of 45.5 years ranging from 28 to 71 years. The intervals between injury and operation ranged from 6 to 15 days with a mean of 9.2 days. According to Schatzker Classification, there were 6 cases in type II, 2 in type IV, 7 in type V, 4 in type VI In accordance with the three-column theory proposed by Luo Congfeng, 2 cases were medial column combined with posterior column fracture, 6 were lateral column combined with posterior column fracture, and 11 were three-column fracture. The major clinical symptoms before treatment were swelling and deformity of the knee, as well as limitation of motion. X-ray and CT examination were completed. The American Hospital for Special Surgery score(HSS) was used to evaluate clinical effect.</p><p><b>RESULTS</b>One case developed skin infection in the posteromedial incision postoperatively, but other complications, such as neurovascular injury, deep venous thrombosis of lower limb, cracking and failure of internal fixation, and fracture re-displacement were not seen. The patients were followed up for an average of 12.5 months (10 to 24 months). The fracture healing time ranged from 5 to 11 months with a mean of 8.2 months. According to HSS, the total score was 82.1±7.3, 9 patients got an excellent result, 7 good, 2 poor and 1 bad. Regular postoperative re-check X-ray indicated that all fracture showed stage I healing. The difference was not significant on varus angle, post-dip angle and femorotibial angle between 3 days and 1 year after operaiton.</p><p><b>CONCLUSIONS</b>Treating the posterior tibial plateau condylar fracture through the posterior medial approach L-shaped incision of the knee rendered sufficient exposure, little injury, as well as convenient and effective installation of internal fixation. Reconstruction plate possessed the advantages of good plasticity, strong supportability, small implant volume, together with low cost;and the structural and functional recovery of the knee could achieve satisfying clinical therapeutic effects as combined with appropriate postoperative rehabilitation training.</p>
ABSTRACT
When adult developmental dysplasia of hip (DDH) patients have developed secondary os- teoarthritis of hip (OAH) with serious clinical symptoms,total hip replacement (THR) is their first choice of treatment.The anatomic structures of the acetabulum and femur in these patients are ahnormal and special,such as small and shallow cup,small femoral head,and narrow medullary cavity at proximal femoral shaft.As a result,the THR for DDH patients is quite different from the conventional ones and is thus highly difficult.We review in this paper the clinical classification of DDH,which is important for its treatment,the difficulties we will have in THR, especially in acetabular reconstruction and femoral prosthesis placement,and also strategies to resolve them.
ABSTRACT
Parkinson's disease(PD) is the most common neurodegenerative movement disorder and ?-synuclein plays an important role in its development.Using the genetically tractable Saccharomyces cere-visiae as a model system,the phenotypic repercussions and potential mechanisms of ?-synuclein-induced cytotoxicity are characterized through modulating its expression level and other cellular factors.Aggrega-tion-induced toxicity is more dramatic upon elevated expression of ?-synuclein than that induced at moder-ate levels of expression.The induced toxicity is also enhanced by reagents such as dimethyl sulfoxide,which increase intracellular levels of phospholipid and membrane,as well as ferrous ions and hydrogen peroxide,both of which cause oxidative stresses in yeast cells.In contrast,over-expression of yeast homologue of hu-man chaperone DJ-1,YDR533C,markedly alleviate the inhibition of growth afflicted by exogenous expres-sion of ?-synuclein.Taken together,the data presented suggest a role for protein folding machinery together with quality control system in dealing with the aggregation of ?-synuclein.