Pilon fractures: a new classification and therapeutic strategies / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Operative decision-making of Pilon fractures are of great challenges until now. The aim of this study was to investigate the guidance of the four-column theory in decision-making therapeutic strategies for Pilon fractures and its result.</p><p><b>METHODS</b>One hundred and ten cases (107 patients) of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. According to the four-column classification scheme, lateral column of 85 cases, posterior column of 66 cases, medial column of 77 cases, and anterior column of 61 cases are involved. Among all the 110 cases, single column of 14 cases, two columns of 46 cases, three columns of 17 cases, and all of four columns of 33 cases are involved.</p><p><b>RESULTS</b>One hundred and eight cases have been followed up. The average follow up time is 14.7 months, varying between 7 and 52 months. The average healing time is 3.6 months, ranging from 2.5 to 8.0 months. Reduction of 86.1% reviewed Pilon cases are good or acceptable according to Burwell and Charley's Radiology Evaluation System. Ankle function of 87.1% cases are excellent or good according to the AOFAS evaluation system.</p><p><b>CONCLUSION</b>As a simple and comprehensive classification, the four-column classification can contribute to reasonable operation decision-making and good prognosis of Pilon fracture.</p>

New strategy for decision making of Pilon fracture / 中华外科杂志

<p><b>OBJECTIVE</b>To study the guidance of four column theory in decision making of Pilon fractures and its result.</p><p><b>METHODS</b>Ninety-one cases of Pilon fractures classified by four column method and treated by open reduction internal fixation (ORIF) were reviewed from March 2005 to June 2009. Four column classification:lateral column of 67 cases were involved, posterior column of 34 cases were involved, medial column of 34 cases were involved and anterior column of 34 cases were involved. Among all the 94 fractures, single column of 20 fractures were involved, 2 columns of 49 fractures were involved, 3 columns of 15 fractures were involved and all of 4 columns of 10 fractures were involved.</p><p><b>RESULTS</b>Eighty-nine cases had been followed up. The average follow-up time was 16.2 months ranging between 6.0 and 39.0 months. The average healing time was 3.7 months ranging from 3.0 to 5.0 months. Reduction of 91% reviewed Pilon cases were good or acceptable according to Burwell and Charley's radiology evaluation system. Ankle function of 87.6% cases were excellent or good according to AOFAS evaluation system.</p><p><b>CONCLUSION</b>As a simple and comprehensive classification, four column classification can contribute to reasonable operating decision making and good prognosis of Pilon fracture.</p>

Arthroscopic assisted diagnosis and treatment of knee extension limitation / 中华外科杂志

<p><b>OBJECTIVE</b>To figure out the incidence and etiology of knee extension limitation and then to find out the proper methods of arthroscopic assisted diagnosis and treatment.</p><p><b>METHODS</b>We reviewed 303 cases of arthroscopic assisted operation from January to October 2003, 95 cases of which suffered from knee extension limitation before operation, including 54 male and 41female and the mean age was 36.2 years old. The direct reasons of knee extension limitation were identified by routine arthroscopic examination and operations were carried out according to results of the examination.</p><p><b>RESULTS</b>Incidence of knee extension limitation in this group of patients was 31.4%. Trauma, mainly meniscus and ligament injury accounted for 67.4%, which was the most common reason of knee extension limitation. Acute or chronic arthritis like degenerative arthritis, non-specific synovitis, synovial chondromatosis, rheumatoid arthritis, pigmented villonodular synovitis, gouty arthritis and acute pyogenic arthritis formed another common reason. The follow-up period ranged from 3 to 20 months, average 13.3 months. 82 cases gained full extension immediately after operation, 9 cases gained full extension after 3 weeks rehabilitation post-operation, 4 cases did not gain full extension 1 year after operation, recurrence was observed in 4 cases.</p><p><b>CONCLUSIONS</b>Arthroscopy is the best method for diagnosis of knee extension limitation at present. Satisfactory results can be expected after early arthroscopic assisted treatment.</p>

An experimental study of the neuroprotective effect of FK506 on acute spinal cord injury in dogs / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the neuroprotective effect of FK506 on acute spinal cord injury in dogs.</p><p><b>METHODS</b>Acute spinal cord injury model was made with the Allen technique. Animals were randomly divided into 3 groups. Group A (n = 8) was the control group and received operation but no therapy, while group B and C (n = 8) received a single dose of FK506 (0.18 mg/kg and 0.3 mg/kg, respectively) administered with an arterial duct 2 h after spinal cord injury (SCI). Spine MRI, neurological function, histopathological examination of injured spinal cord and immunohistochemical examination of expression of NF(200) in neurons and GFAP in astrocytes were assessed at certain time after injury.</p><p><b>RESULTS</b>Neurological function score of group C and B was better than that of group A (P < 0.05), with significance between group C and A, while no significance between group B and A statistically. The signal scope of spinal cord injury on MRI in group C was the smallest among all the groups, and the signal scope in group B was smaller than that in group A, which was directively associated with the neurological outcome. The expression of NF and GFAP was significantly higher in group C than in group A (P < 0.05), but without statistical significance between group B and A.</p><p><b>CONCLUSION</b>Local administration of FK506 (0.3 mg/kg) possesses neuroprotective effect on acute spinal cord injury, which can improve neurological function recovery and attenuate secondary spinal cord injury. Local administration of FK506 possesses a dosage-effect relation.</p>

Expressions and significance of human telomerase reverse transcriptase mRNA and protein in pheochromocytoma / 中华内分泌代谢杂志

Objective To investigate the expressions of human telomerase reverse transcriptase(hTERT) mRNA and protein in pheochromocytoma and paraganglioma and their significance as diagnostic markers in predicting the biological behaviour of these tumours.Methods Expression of hTERT mRNA was determined by in situ hybridization in 45 pheochromocytomas/paragangliomas(31 benign,7 suspected malignant and 7 malignant) and 9 normal adrenal medulla samples,hTERT protein was determined by immunohistoebemistry.Results hTERT mRNA was expressed in 5/7 malignant turnouts and 5/7 suspected malignant tumours as compared with 3/31 benign tumours(P