Preoperative intravitreal injection of Conbercept combined with pars plana vitrectomy in the treatment of proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy of pars plana vitrectomy(PPV)combined with preoperative intravitreal injection of conbercept in the treatment of proliferative diabetic retinopathy(PDR)and its effect on aqueous humor inflammatory factors.METHODS: A non-randomized controlled clinical trial was designed. The clinical data of 100 patients(100 eyes)with PDR who were admitted to the hospital from March 2019 to January 2022 were collected(the heavier eye was selected when both eyes had PDR, while the right eye was selected when the PDR degree was the same)and divided into control group and combined group according to their treatment wishes. The 48 eyes in the control group received PPV alone, and 52 eyes in the combined group received intravitreal injection of conbercept combined with PPV. Follow-up period was 12mo. The operative time, pre-and post-operative best corrected visual acuity(BCVA LogMAR), central retinal thickness(CRT)and postoperative complications in the two groups were statistically analyzed. And the levels of inflammatory factors(IL-6, IL-10, IFN-γ and TNF-α)in aqueous humor were compared between the two groups.RESULTS: Compared with the control group, the levels of inflammatory factors IL-6, IL-10, IFN-γ and TNF-α in aqueous humor in combination group were significantly decreased. The operation time of the combined group was significantly shorter than that of the control group, and the number of electrocoagulation, iatrogenic retinal hole and silicone oil filling were less in the combined group than those in the control group(all P<0.05). There was no significant difference in preoperative BCVA and CRT between the two groups(all P>0.05). The BCVA and CRT improved at 1, 6 and 12mo after surgery in both groups, but the improvement was more significant in the combined group(all P<0.05). The postoperative incidence of complications in the combined group were lower than that in the control group(11.5% vs. 35.4%, P<0.05). There was no significant difference in the recurrence rate of PDR between the two groups(P>0.05).CONCLUSIONS: Intravitreal injection of conbercept combined with PPV in the treatment of PDR has a significant effect, which can shorten the operation time, inhibit the inflammatory effect, reduce postoperative complications, and contribute to the improvement of patients' vision.

Efficacy and safety of VRD regimen of autologous hematopoietic stem cell transplantation in patients with newly diagnosed multiple myeloma / 中华内科杂志

Objective: To explore the stem cell collection rate and efficacy and safety of patients aged 70 and below with newly diagnosed multiple myeloma (MM) treated with the VRD (bortezomib, lenalidomide and dexamethasone) regimen followed by autologous stem cell transplantation (ASCT). Methods: Retrospective case series study. The clinical data of 123 patients with newly diagnosed MM from August 1, 2018, to June 30, 2020, at the First Affiliated Hospital of Soochow University and Suzhou Hopes Hematology Hospital, who were eligible for VRD regimen sequential ASCT, were collected. The clinical characteristics, efficacy after induction therapy, mobilization regimen of autologous stem cells, autologous stem cell collection rate, and side effects and efficacy of ASCT were retrospectively analyzed. Results: Of the 123 patients, 67 were males. The median patient age was 56 (range: 31-70) years. Patients with IgG, IgA, IgD, and light-chain types accounted for 47.2% (58/123), 23.6% (29/123), 3.2% (4/123), and 26.0% (32/123) of patients, respectively. In addition, 25.2% (31/123) of patients had renal insufficiency (creatinine clearance rate<40 ml/min). Patients with Revised-International Staging System (R-ISS) Ⅲ accounted for 18.2% (22/121) of patients. After induction therapy, the rates of partial response and above, very-good partial response (VGPR) and above, and complete response (CR)+stringent CR were 82.1% (101/123), 75.6% (93/123), and 45.5% (56/123), respectively. Overall, 90.3% (84/93) of patients were mobilized with cyclophosphamide+granulocyte colony-stimulating factor (G-CSF) and 8 patients with G-CSF or G-CSF+plerixafor due to creatinine clearance rate<30 ml/min and one of them was mobilized with DECP (cisplatin, etoposide, cyclophosphamide and dexamethasone)+G-CSF for progressive disease. The rate of autologous stem cell collection (CD34+cells≥2×106/kg) after four courses of VRD regimen was 89.1% (82/92), and the rate of collection (CD34+cells≥5×106/kg) was 56.5% (52/92). Seventy-seven patients treated with the VRD regimen sequential ASCT. All patients had grade 4 neutropenia and thrombocytopenia. Among the nonhematologic adverse events during ASCT, the highest incidence was observed for gastrointestinal reactions (76.6%, 59/77), followed by oral mucositis (46.8%, 36/77), elevated aminotransferases (44.2%, 34/77), fever (37.7%, 29/77), infection (16.9%, 13/77) and heart-related adverse events (11.7%, 9/77). Among the adverse events, grade 3 adverse events included nausea (6.5%, 5/77), oral mucositis (5.2%, 4/77), vomiting (3.9%, 3/77), infection (2.6%, 2/77), elevated blood pressure after infusion (2.6%, 2/77), elevated alanine transaminase (1.3%, 1/77), and perianal mucositis (1.3%, 1/77); there were no grade 4 or above nonhematologic adverse events. The proportion of patients who achieved VGPR and above after VRD sequential ASCT was 100% (75/75), and the proportion of patients who were minimal residual disease-negative (<10-4 level) was 82.7% (62/75). Conclusion: In patients aged 70 and below with newly diagnosed MM treated with VRD induction therapy, the collection rate of autologous stem cells was good, and good efficacy and tolerability were noted after follow-up ASCT.

Prevention of knee injuries using team sports in the aged population / Prevenção de lesões no joelho por esportes de equipe em idosos / Prevención de lesiones de la rodilla por deportes de equipo en personas mayores

ABSTRACT Introduction: The aging population in the growing national industrialization and urbanization supports an unhealthy lifestyle where the prevention and control of chronic diseases are difficult. Approximately 68% of the elderly have some type of chronic disease, mostly musculoskeletal, especially in the knee joint, compromising their autonomy and affecting their social life, with psychological impacts in the long term. Team sports suggest great therapeutic potential in this group, but there are few studies. Objective: Analyze the situation of team sports among the elderly, propose methods to prevent knee joint injuries, and test these implements' preventive effects. Methods: 92 elderly volunteers who participated in community sports were selected. To understand the causes and main types of knee joint injuries, the elderly were analyzed during community sports, including using the FMS method for health testing. Results: After the tests, it can be seen that the mean FMS score of all the community elderly is 14.23 points, and the total score is 12.00-17.00; the mean score of the overall knee joint injury is increased by 2.65, and the mean FMS score of the female knee joint injury is greatly benefited. Conclusion: After the proposed preventive measures focused on the knee joint, the AFF examinations of the community elderly were significantly improved, indicating that the proposed actions are effective and deserve to be replicated. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O envelhecimento populacional na crescente industrialização e urbanização nacional lastreia um estilo de vida insalubre onde a prevenção e o controle de doenças crônicas são dificultosos. Aproximadamente 68% dos idosos possuem algum tipo de doença crônica, majoritariamente de cunho musculoesquelético com destaque para a articulação do joelho, comprometendo a autonomia e prejudicando seu convívio social, com impactos psicológicos à longo prazo. Os esportes de equipe sugerem grande potencial terapêutico nesse grupo, porém há poucos estudos nesse sentido. Objetivo: Analisar a situação do esporte de equipe entre os idosos, propondo métodos para prevenir lesões articulares no joelho e testar o efeito preventivo dessas implementações. Métodos: Foram selecionados 92 voluntários idosos que participaram de esportes comunitários. Para entender as causas e os principais tipos de lesões articulares do joelho, os idosos foram analisados durante os esportes comunitários, incluindo a utilização do método FMS para a realização de testes de saúde. Resultados: Após os testes, pode-se ver que a pontuação média da FMS de todos os idosos da comunidade é de 14,23 pontos, e a pontuação total é de 12,00-17,00; a pontuação média da lesão geral da articulação do joelho é aumentada em 2,65, e o escore médio de FMS da lesão articular feminina do joelho é muito beneficiado. Conclusão: Após a proposta de medidas preventivas focadas na articulação do joelho, os resultados dos exames de AFF dos idosos da comunidade foram significativamente aprimorados, indicando que as ações propostas são eficazes e merecem ser replicadas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El envejecimiento de la población en la creciente industrialización y urbanización nacional favorece un estilo de vida poco saludable donde la prevención y el control de las enfermedades crónicas son difíciles. Aproximadamente el 68% de los ancianos tienen algún tipo de enfermedad crónica, en su mayoría de naturaleza musculoesquelética con énfasis en la articulación de la rodilla, comprometiendo la autonomía y perjudicando su vida social, con impactos psicológicos a largo plazo. Los deportes de equipo sugieren un gran potencial terapéutico en este grupo, pero hay pocos estudios en este sentido. Objetivo: Analizar la situación de los deportes de equipo entre las personas mayores, proponiendo métodos para prevenir las lesiones de la articulación de la rodilla y comprobar el efecto preventivo de estas implementaciones. Métodos: Se seleccionaron 92 voluntarios de edad avanzada que participaban en deportes comunitarios. Para comprender las causas y los principales tipos de lesiones de la articulación de la rodilla, se analizó a los ancianos durante la práctica de deportes comunitarios, incluso utilizando el método FMS para las pruebas de salud. Resultados: Después de las pruebas, se puede observar que la puntuación media de FMS de todos los ancianos de la comunidad es de 14,23 puntos, y la puntuación total es de 12,00-17,00; la puntuación media de la lesión general de la articulación de la rodilla se incrementa en 2,65, y la puntuación media de FMS de la lesión de la articulación de la rodilla femenina se ve muy beneficiada. Conclusión: Tras las medidas preventivas propuestas centradas en la articulación de la rodilla, los resultados de los exámenes de AFF de los ancianos de la comunidad mejoraron significativamente, lo que indica que las acciones propuestas son eficaces y merecen ser replicadas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

A Bibliometrics Analysis on Academic Influence of Chinese Journal of Integrated Traditional and Western Medicine / 中国结合医学杂志

OBJECTIVE@#To illustrate the academic influence of Chinese Journal of Integrated Traditional and Western medicine, and provide suggestions for further development of the Journal.@*METHODS@#Taking the China National Knowledge Infrastructure (CNKI) database as main source and the Chinese Science Citation Database (CSCD) as reference, the researchers retrieved the related data of the Journal such as its publication quantity, citations, fund projects, authors, institutions and regions from 1981 to 2018, analyzed these data by means of bibliometrics and information visualization with EXCEL, SPSS, VISIO, MATLAB and other softwares.@*RESULTS@#Through the analysis of the main indicators, the relevant indicators of the Journal's academic influence revealed the developing trend of the Journal. Cardiovascular and cerebrovascular diseases, endocrine, digestive system, pharmacological research of Chinese medicine and gynecology, as the hot topics in the discipline and academic, were clarified.@*CONCLUSIONS@#All indicators show that the Journal is a high-quality journal reflecting the excellent achievements in the field of integrated Chinese and Western medicine in China. Through further analysis of relevant indicators, the authors put forward some specific suggestions on how to run the Journal well.

A case-control study of two internal fixation methods in the treatment of comminuted fracture of inferior pole of patella / 中国骨伤

OBJECTIVE@#To compare the effects of tension band combined with patellar cerclage and memory alloy patellar concentrator fixation in the treatment of comminuted fracture of the lower pole of patella.@*METHODS@#From July 2015 to July 2019, 60 patients with distal patellar fracture were treated and were divided into two groups according to different operation methods. In group A, 30 patients were fixed with memory alloy patellar concentrator (NiTi PC), 17 males and 13 females, aged 20 to 71 (39.4±9.9) years, including 19 cases of falling injury, 9 cases of traffic injury and 2 cases of sports injury. The time from injury to operation was 10 to 75 (33.1±7.8) hours; 30 cases in group B were fixed with tension band andcerclage, 15 males and 15 females, aged 21 to 76 (38.6±10.2) years, including 17 cases of falling injury, 12 cases of traffic injury and 1 case of smashing injury. The time from injury to operation was 10 to 91 (34.5±9.1) hours. The curative effects of two groups were observed and compared.@*RESULTS@#All 60 patients were followed up for 9 to 30 months. There was no significant difference in intraoperative bleeding, operation time, follow-up time and fracture healing time between the two groups. Six months after operation, according to the Bostman function score of knee joint:30 cases in group A, the total score was 28.6±4.7, of which 26 cases were excellent and 4 cases were good. The total score of 30 cases in group B was 25.5±4.4, of which 20 cases were excellent, 8 cases were good and 2 cases were poor. There were significant differences in Bostman total score and curative effect evaluation between two groups (@*CONCLUSION@#Memory alloy patellar concentrator is strong and reliable in the treatment of inferior patellar fracture. It can take early rehabilitation exercise after operation, with good recovery of joint function and range of motion and less complications.

Salvianolic acid B decreases interleukin-1β-induced colitis recurrence in mice / 中华医学杂志(英文版)

BACKGROUND@#Degree of mucosal recovery is an important indicator for evaluating the therapeutic effects of drugs in treatment of inflammatory bowel disease (IBD). Increasing evidences has proved that tight junction (TJ) barrier dysfunction is one of the pathological mechanisms of IBD. The aim of this study was to observe whether enhancement of TJ can decrease colitis recurrence.@*METHODS@#Eighty C57BL/6 mice were randomly divided into four groups including normal group, colitis group, sulfasalazine (SASP) treated group, and traditional Chinese drug salvianolic acid B (Sal B) treated group. Colitis was established in mice by free drinking water containing dextran sulfate sodium, after treatments by SASP and Sal B, recombinant human interleukin-1β (IL-1β) was injected intraperitoneally to induce colitis recurrence.@*RESULTS@#Compared with sham control, cell apoptosis in colitis group was increased from 100.85 ± 3.46% to 162.89 ± 11.45% (P = 0.0038), and TJ dysfunction marker myosin light chain kinase (MLCK) was also significantly increased from 99.70 ± 9.29% to 296.23 ± 30.78% (P = 0.0025). The increased cell apoptosis was reversed by both SASP (125.99 ± 8.45% vs. 162.89 ± 11.45%, P = 0.0059) and Sal B (104.27 ± 6.09% vs. 162.89 ± 11.45%, P = 0.0044). High MLCK expression in colitis group was reversed by Sal B (182.44 ± 89.42% vs. 296.23 ± 30.78%, P = 0.0028) but not influenced by SASP (285.23 ± 41.04% vs. 296.23 ± 30.78%, P > 0.05). The recurrence rate induced by recombinant human IL-1β in Sal B-treated group was significantly lower than that in SASP-treated group.@*CONCLUSIONS@#These results suggested a link between intestinal mucosal barrier dysfunction, especially TJ barrier dysfunction, and colitis recurrence. The TJ barrier dysfunction in remission stage of colitis increased the colitis recurrence. This study might provide potential treatment strategies for IBD recurrence.

Cardiac safety evaluation of berberine combining with berberine-derived medicine / 药学学报

Drug-induced cardiotoxicity is a serious concern in recent years, and acquired long QT syndrome (LQTS) is an important manifestation of cardiotoxicity. hERG gene encodes the α subunit of the rapidly activated delayed rectifier potassium channel (Ikr), which plays an important role in action potential phase 3 repolarization. Drug inhibition of Ikr/hERG channel leads to prolonged QT interval, accompanied by Tdp malignant arrhythmia, which can cause sudden death. We studied the effect of berberines on the hERG K+ channels after combination with rosuvastatin and glibenclamide, and evaluated the cardiac safety of these drugs in combination. Whole cell patch clamp technique was used to detect the effect of the combinations of these drugs on hERG current on HEK293 cells stably expressing hERG gene. The results showed that the inhibitory effects of berberine or dihydroberberberine combined with rosuvastatin on hERG current were higher than single drug (P<0.05), but the combination had no effect on the kinetics of hERG channel. Berberine or dihydroberberberine combined with glibenclamide had higher inhibitory effects on hERG current than the application of single drug (P<0.05) while the time constant of hERG channel inactivation was shortened after the combination (P<0.05). In addition, the combination of berberine and glibenclamide inhibited hERG channel activation (P<0.05). In conclusion, our results demonstrated that the combination of berberine with rosuvastatin or glibenclamide significantly inhibited hERG current and the inhibition effects were higher than the application alone. Therefore, when the two drugs that have inhibitory effects on the hERG channel are combined, the risk of inducing prolonged QT interval is significantly increased, and therefore reducing cardiac safety.

Roles and Implications of Paper Media in Early Stage of Integration of Traditional Chinese Medicine and Western Medicine in China / 中国结合医学杂志

Paper media including the People's Daily, Guangming Daily, Health News and Journal of Traditional Chinese Medicine were the main media that spread the thought and policy of integrative medicine (IM) in the early stage of the integration of traditional Chinese medicine (TCM) and Western medicine (WM) in China. Issues including paper media and its roles for spreading IM, from "TCM learning from WM" to "WM learning from TCM", advocating integration of TCM and WM, promoting IM through multiple channels were analyzed in this article, so as to show the propagation process of IM in China and the roles of the paper media. It was shown that strengthening the propaganda of IM through mainstream media, strengthening media convergence and the role of new media are important in spreading the thought of IM.

Endophytic fungus strain 28 isolated from Houttuynia cordata possesses wide-spectrum antifungal activity

Abstract The aim of this paper is to identify and investigate an endophytic fungus (strain 28) that was isolated from Houttuynia cordata Thunb, a famous and widely-used Traditional Chinese Medicine. Based on morphological methods and a phylogenetic analysis of ITS sequences, this strain was identified as Chaetomium globosum. An antifungal activity bioassay demonstrated that the crude ethyl acetate (EtOAc) extracts of strain 28 had a wide antifungal spectrum and strong antimicrobial activity, particularly against Exserohilum turcicum (Pass.) Leonard et Suggs, Botrytis cinerea persoon and Botrytis cinerea Pers. ex Fr. Furthermore, the fermentation conditions, extraction method and the heat stability of antifungal substances from strain 28 were also studied. The results showed that optimal antifungal activity can be obtained with the following parameters: using potato dextrose broth (PDB) as the base culture medium, fermentation for 4–8 d (initial pH: 7.5), followed by extraction with EtOAc. The extract was stable at temperatures up to 80 °C. This is the first report on the isolation of endophytic C. globosum from H. cordata to identify potential alternative biocontrol agents that could provide new opportunities for practical applications involving H. cordata.

Discussions on the development of biomechanics based on applications and grants of NSFC / 医用生物力学

Biomechanics, one important sub-discipline of mechanics, is an interdisciplinary subject involved in mechanics, biology and medical science, and it is closely associated with life health and clinic medicine. In this paper, applications and grants of normal projects and youth science foundation projects of National Natural Science Foundation of China (NSFC) on biomechanics from year 2012 to 2016 are introduced. Research directions and research teams of biomechanics are mainly discussed, and some suggestions are given for the development of biomechanics in China.

CD20 Expression in Adult Patients with B-lineage Acute Lymphoblastic Leukemia and Its Prognostic Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the relationship between the expression of CD20 antigen and clinical characteristics in adult patients with B-acute lymphoblastic leukemia(B-ALL).</p><p><b>METHODS</b>The CD20 expression of 126 acute lympho-blastic leukemia patients in our hospital from July 2009 to July 2012 were determined by flow cytometry. The characteristics, examination results and outcome were analyzed retrospectively. The complete remission rate (CR rate), relape rate, 2-year survival rate and 2-year event-free survival (EFS) of patients with CD20 positive and negative after the first cycle of chemstherapy were compared.</p><p><b>RESULTS</b>Positive rate of CD20 antigen expression in 126 patients was 24.4% (31 cases), negative rate of CD20 antigen expression in 126 patients was 75.6% (95 cases). No significant relationship was found between CD20 antigen expression and sex, age, peripheral blood leucocytes count and chromosomal changes. The relapse rate, 2-year survival rate (OS) and 2-year event-free survival (EFS) of adult patients with B-ALL in CD20 positive and negative groups were 53.3% and 38.0%, 52.1% and 92.3%, 33.7% and 70.8% respectively.</p><p><b>CONCLUSION</b>Expression of CD20 in adult patients with B-ALL did not related with clinical features, but related with poor prognosis.</p>

Busulfan Combined with Cyclophosphamide as the Conditioning Regimen in Patients with Multiple Myeloma Treated by Autolo-gous Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the safety and efficacy of busulfan (BU) combined with cyclophosphamide (CY) as the conditioning regimen of autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with multiple myeloma (MM).</p><p><b>METHODS</b>The safety and efficacy of the BUCY regimen were evaluated through observing the adverse reactions, recovery of hematopoietic reconstitution, response and survival in 20 patients after auto-HSCT.</p><p><b>RESULTS</b>In 20 MM patients with median age 52.5 (38-66), the neutrophil and platelet counts recovered at 10(8-18) d and 10 (8-17) d after auto-HSCT respectively, the treatment related mortality during 100 days after auto-HSCT was 0, the partial remission (PR) rate decreased from 31.58% to 0 (P < 0.05) after auto-HSCT, only 1 patient was in progression of disease, all patients were alived.</p><p><b>CONCLUSION</b>For patients with MM treated with Auto-HSCT, the BUCY regimen is ideal in safety and response, but the long-term effect still should be observed.</p>

Single center comparative analysis of hematopoietic cell transplantation from alternated donor in patients with hematologic malignancies / 中国实验血液学杂志

<p><b>OBJECTIVE</b>One of the truly revolutionary advances in hematopoietic cell transplantation (HCT) is the increasingly successful use of alternative donors, as only 1/4 of patients who require an allogeneic hematopoietic cell transplant will have a HLA-matched sibling donor. Thereby, three alternative graft sources: umbilical cord blood (UCB), haploidentical (hi) related donor and mismatched unrelated donor hematopoietic cell transplantation (MMUDT) are available. This study was purposed to compare the characteristics of umbilical cord blood transplantation(UCBT), haplaidentical (hi) related donor hematopoieetic cell transplantation(hi-HSCT) and MMUDT.</p><p><b>METHODS</b>The clinical date of 93 patients with hematologic malignancies who received UCBT (n = 22), hi-HSCT (n = 42) and MMUDT (n = 29), and the days of hematopoietic reconstration and engraftment, rate of acute graft-versus-host disease (GVHD), relapse rate, and overall survival (OS) were analysed.</p><p><b>RESULTS</b>The median days of hematopoietic reconstitution (WBC>1.0×10(9)) among UCBT recipients were significantly longer than those among hi-HSCT/MMUDT recipients, (19 in UCBT, 12 in hi-HSCT and 12 in MMUDT)(P < 0.001), whereas the median days of full engraftment (STR >95%) among hi-HSCT recipients were longer than those among UCBT/MMUDT recipients (26 in hi-HSCT, 15 in UCBT and 20 in MMUDT, P = 0.028), the implant failure rate of UCBT recipients was higher than others (26% in UCBT, 5% in hi-HSCT, 3% in MUUDT)(P < 0.05). Multivarite analysis demonstrated no apparent differences in the rate of aGVHD (50% in UCBT,57.1% in hi-HSCT and 72.4% in MMUDT) (P = 0.498), and the rate of III-VI aGVHD also was no significant defference (27.3% in UCBT, 28.6% in hi-HSCT and 17.2% in MMUDT)(P = 0.543), the rate of chronic GVHD of UCBT recipients was lowered (19.0% in UCBT, 45.5% in hi-HSCT, 58.3% in MMUDT, P = 0.026). Overall survival at 2 years was 79.9% in UCBT, 80.9% in hi-HSCT and 88.0% in MUUDT (P = 0.097), and the TRM in 100 days was 23.8% in UCBT, 20.0% in hi-HSCT and 11.1% in MMUDT (P = 0.245) respectively.</p><p><b>CONCLUSIONS</b>The UCBT is characterised by lowest rate of cGVHD, but its hematopoietic recostruction is slow; the hi-HSCT has more alternative donors for using in clinic and can achieve post-transplant adoptive cellular immunotherapy, but its TRM has been found to be higher; the first important problem for MMUDT is to decrease the higher incidence of aGVHD and cGVHD.</p>

Advanced bone graft combined with locking compression plate for the treatment of middle and distal tibia nonunion / 中国骨伤

<p><b>OBJECTIVE</b>To explore methods of treating middle and distal tibia nonunion with the treatment of advanced bone graft combined with locking compression plate.</p><p><b>METHODS</b>From January 2011 to December 2012, 12 patients with middle and distal tibia nonunion were treated with advanced bone graft combined with locking compression plate. Among patients, there were 8 males and 4 females aged from 20 to 69 with an average of 47 years old. The time from first injuries to bone nonunion was from 9 months to 5 years, avergaed 19 months. Four cases were treated with external fixation, 6 cases were treated with plate fixation, 2 cases of 12 patients occurred broken of plate and nail. Eleven patients were non-infective bone nonunion and 1 patient was infective bone nonunion. Preoperative X-ray and CT showed all patients had sequestration and formation of ossified bone with different degrees. Operative time, blood loss, wound healing were observed, fracture healing time was evaluated by postoperative X-ray. Johner-Wruhs scoring standards was used to evaluate ankle joint function after operation at 10 months.</p><p><b>RESULTS</b>Operative time ranged from 90 to 185 min with an average of (125.00±20.15) min; blood loss ranged from 225 to 750 ml with an average of (415.00±120.00) ml. All patients were followed up from 10 months to 2.5 years with an average of 1.5 years. Postoperative X-ray showed bone union was formed around fracture after operation at 4 months in all patients, 3 cases obtained bone healing within 6 months after operation, 9 cases obtained from 8 to 12 months. No infection, injury of nerve and vessles, and broken of plate and nail were ocurred. According to Johner-Wruhs scoring at 10 months after operation, 10 cases obtained excellent results, 1 good and 1 moderate.</p><p><b>CONCLUSION</b>Advanced bone graft combined with locking compression plate, which can build fracture multi-point supporting based on full compression of bone nonunion to get effective fixation, is an effective method in treating middle and distal tibia nonunion.</p>

Anatomic measurements and quantitative analysis of posterior acetabular wall / 中国骨伤

<p><b>OBJECTIVE</b>To explore morphological character and clinical significance of superior-posterior acetabular wall by anatomically measuring and quantitatively analyzing thickness of posterior acetabular wall, then provide a theoretical reference for clinical treatment of acetabular fracture.</p><p><b>METHODS</b>Fifteen adult formalin-preserved cadaveric pelvises (8 males and 7 females) were used for this investigation. Excess soft tissue was removed and the whole acetabular posterior walls were marked with "angle" sector method and the thickness was measured with caliper in different levels of the different split points. The measurement results were validated and analyzed statistically.</p><p><b>RESULTS</b>At 5 mm away from acetabular rim, the average thickness of superior-posterior acetablar wall fluctuated between (6.47±0.61) mm and (7.43±0.71) mm; the average thickness of inferior-posterior acetabuluar wall fluctuated between (5.62±0.51) mm and (6.33±0.61) mm; the average thickness of acetabular roof fluctuated between (7.71±0.74) mm and (8.27±0.99) mm. There was no statistical difference between average thickness of superior-posterior wall of acetabulum and inferior-posterior wall of acetabulum (P>0.05), but the average thickness of acetabular roof was significantly larger than superior-posterior acetabular wall (P<0.05). At 10 mm away from the acetabular rim, the average thickness of superior-posterior acetabular wall fluctuated between (8.81±0.67) mm and (13.35±0.89)mm; the average thickness of inferior-posterior acetabular wall fluctuated between (7.02±0.63) mm and (7.66±0.69) mm; the average thickness of acetabular roof fluctuated between (14.46±0.97) mm and (17.05±1.35) mm. Comparatively, the average thickness of superior-posterior acetabular wall was significantly larger than inferior-posterior wall of acetabulum (P<0.05), and the average thickness of acetabular roof was significantly larger than superior-posterior acetabular wall (P<0.01). At 15 mm away from the acetabular rim, the average thickness of superior-posterior acetabular wall fluctuated between (12.08±0.78) mm and (19.84±1.03) mm; the average thickness of inferior-posterior acetabular wall fluctuated between (10.17±0.76) mm and (11.12± 0.77) mm; the average thickness of acetabular roof fluctuated between (23.23±1.12) mm and (26.01±1.53) mm. Comparatively, the average thickness of superior-posterior wall of acetabulum was significantly larger than inferior-posterior acetabular wall (P<0.01), and the average thickness of acetabular roof was significantly larger than superior-posterior acetabular wall (P< 0.01).</p><p><b>CONCLUSION</b>The thickness of entire acetabular posterior edge revealed an increasing tendency from inferior-posterior wall to the superior-posterior wall to acetabular roof. And this trend became more obvious with increasing distance away from acetabular rim. Therefore, the superior-posterior acetabular wall could not only maintain the stability of hip joint but also bear loading.</p>

Application of Ni-Ti patellar concentrator combined with Herbert screw and wirerope for the treatment of comminuted patellar inferior pole fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the surgical techniques and clinical effect of Ni-Ti patellar concentrator combined with Herbert screw and wirerope in treating comminuted patellar inferior pole fractures.</p><p><b>METHODS</b>From March 2008 to June 2010,34 patients with comminuted patellar inferior pole fracture were treated with Ni-Ti patellar concentrator combined with Herbert screw and wirerope. Of them, there were 19 males and 15 females with an average age of 38.6 years old(ranged from 22 to 75). Early functional exercise was guided postoperatively and the patients were regularly followed up and their outcomes were assessed.</p><p><b>RESULTS</b>All patients were followed up with an average of 13.5 months (ranged,7 to 20). All fractures healed. According to Böstman Clinical Rating System, the average score was 28.43 +/- 2.34,and excellent results in 21 cases,good in 13 cases and no poor case.</p><p><b>CONCLUSION</b>Ni Ti patellar concentrator combined with Herbert screw and wirerope for the treatment of comminuted patellar inferior pole fracture is an effective method and of great value to clinical application.</p>

Application of cannulated compression screws for the treatment of tibial tubercle avulsion fractures of Ogden type III in adolescents / 中国骨伤

<p><b>OBJECTIVE</b>To review the clinical outcome of the application of cannulated compression screws for the treatment of tibial tubercle avulsion fractures of Ogden type III in adolescents.</p><p><b>METHODS</b>From January 2003 to October 2010,11 adolescent patients with tibial tubercle avulsion fractures were treated with open reduction and internal fixation. There were 9 boys and 2 girls with an average age of 15.2 years old (ranged, 12.4 to 17 years old). According to Ogden classification, there were 9 patients with type IIIa and 2 patients with type IIIb. Postoperative functional exercise and regular follow-up were done and outcomes were evaluated by the Mosier clinical assessment system.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 7 to 69 months, with a mean of 25.5 months. All fractures healed at the first stage. According to the Mosier clinical assessment system, the final outcome was evaluated as excellent in all. One patient had infrapatellar hypoesthesia, and one patient had prominency of tibial tubercle without any symptoms.</p><p><b>CONCLUSION</b>The cannualted compression screws in the treatment of tibial tubercle avulsion fractures of Ogden type III in adolescents have an excellent outcome without deformity or functional loss.</p>

Introduction to and inspiration from international research on the standard of physician competence / 中华医学教育探索杂志

Medical institutes in the United States,the United Kingdom and Canada have systematically explored and published standard of physician competence,such as ACGME six-critical-components,GMC good medical practice and CanMEDS,which has led to changes in the content,item format and clinical skill test of foreign medical incensing exam.Foreign research inspires Chinese counterparts to study and develop the Chinese standard of physician competence so as to continuously enhance the medical licensing exam.

Posterior partial trochanteric osteotomy for the treatment of the roof involved acetabular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof.</p><p><b>METHODS</b>Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction.</p><p><b>RESULTS</b>All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5.</p><p><b>CONCLUSION</b>Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.</p>

Plutella xylostella granulovirus PP31 interacts with two host proteins / 病毒学报

Protein-protein interactions between viruses and hosts are common during viral infection and replication. In this study, a cDNA library from larvae of Plutella xylostella was constructed and used for screening of genes encoding proteins interacting with Plutella xylostella granulovirus (PlxyGV) proteins. Two cDNA clones containing genes encoding proteins interacting with PlxyGV PP31 were identified by yeast two-hybrid assays. Sequence analysis showed that the genes encoded homologues of receptor for activated protein C kinase (RACK) and methionine aminopeptidase 2 (MetAP2), respectively. The P. xylostella rack gene and the PlxyGV pp31 was expressed in an E. coli strain to produce proteins fused with a 6-His or a GST tag. It was shown that the rack was expressed as a 38kD peptide as prospected. The 38kD His-tagged peptide was co-purified with GST-PP31 by GST-bind resin in GST-pulldown assays, confirming interaction between the PlxyGV PP31 and the RACK protein of P. xylostella.