ABSTRACT
BACKGROUND: Posterolateral tibial plateau fracture is a special type of tibial plateau fracture. Because of its special anatomical location, there are many kinds of surgical approaches and implants used in the treatment in and outside China, but no consensus has been reached. OBJECTIVE: To summarize various surgical approaches and implants by analyzing the local anatomical structure and fracture types of the posterolateral tibial plateau. METHODS: The databases of Wanfang Medical Network, China National Knowledge Infrastructure and PubMed were searched by computer. Using the keywords of “tibial plateau fracture; posterolateral tibial plateau fracture; internal fixation; surgical approach” in Chinese and English. According to the inclusion and exclusion criteria, 54 related articles were finally included and summarized. RESULTS AND CONCLUSION: There are local structures of common peroneal nerve, anterior tibial artery and fibular head on the posterolateral tibial plateau, which will affect the operation. The commonly used fracture types are Schatzker, AO/ATO, three-column classification systems and posterior column 4 zone. Posterior column 4 zone has a more definite guiding effect on posterolateral tibial plateau fractures. There are many kinds of surgical approaches and internal plants for the treatment of posterolateral tibial plateau fractures, and the optimal selection should be made according to the fracture characteristics. For simple posterolateral tibial plateau fractures, the posterolateral approach has a certain advantage over other approaches. Posterolateral supporting plate has a better supporting effect on posterolateral shear fracture of tibial plateau.
ABSTRACT
Based on previous report that the Chinese herb Ligustrum lucidum (LL) extract directly inhibited hepatitis C virus (HCV) replicase (NS5B) activity, the active components of LL extract to inhibit HCV NS5B activity and their inhibition mode were investigated in this study. LL extract was separated using ethyl acetate and thin layer chromatography (TLC). The inhibitory activity of separated fractions on HCV NS5B was analyzed by the inhibitory assay of NS5B activity. The results showed that only fractions 1 and 2 inhibited NS5B activity, and fraction 2 possessed higher inhibitory activity than fraction 1. HPLC analysis combined with inhibitory assays indicated that ursolic acid and oleanolic acid are the active components within fractions 1 and 2 to inhibit NS5B activity, separately. Moreover, oleanolic acid possessed higher inhibitory activity than ursolic acid. Further inhibition mode analysis found that both oleanolic acid and ursolic acid suppressed NS5B activity as noncompetitive inhibitors. The Ki values of ursolic acid and oleanolic acid were about 4.7 microg x mL(-1) (10 micromol x kg(-1)) and 2.5 microg x mL(-1) (5.5 micromol x kg(-1)), respectively. Taken together, these results demonstrated that oleanolic acid and ursolic acid suppressed NS5B activity as noncompetitive inhibitors, implying that the two natural products have potential value for HCV therapy.