Exploration of critical values of monitoring indexes for perioperative major adverse cardiac events in elderly patients with biliary diseases / 中华老年医学杂志

Objective:The purpose of this study was to explore the critical values of monitored indexes of perioperative major adverse cardiac events(MACE), so as to take effective prevention and treatment measures in time to maintain the stability of perioperative cardiac function to further improve the perioperative safety of elderly patients with biliary diseases.Methods:The clinical data of 246 elderly patients with biliary diseases in our hospital from May 2016 to February 2022 were collected.According to whether MACE occurred during the perioperative period, they were divided into the MACE group and the non-MACE group.The differences of clinical data, the monitoring indexes of postoperative cardiac function, and the coagulation function between the two groups were compared and analyzed.Logistic regression was used to analyze the independent risk factors of perioperative MACE, the cut-off value of the receiver operating characteristic(ROC)curve was calculated, and the Logistic multivariate prediction model was established.Results:In the MACE compared with the non-MACE group, age, postoperative complications and mortality, postoperative hospital stay, and the levels of postoperative high sensitivity troponin-I(Hs-TnI), creatine kinase isoenzyme(CK-MB), myoglobin(MYO), B-type natriuretic peptide(BNP), and D-dimer(D-D)were significantly increased(all P<0.05). Multivariate Logistic regression showed that postoperative BNP and D-D were two independent risk factors for perioperative MACE, and their cut-off values in the ROC curve were 382.65 pg/mL and 0.975mg/L respectively.The Logistic multivariate prediction model established by the Logistic regression equation was P= ex/(1+ ex), X=-5.710+ 0.003X 1+ 0.811X 2, where X 1 was the postoperative BNP level and X 2 was the postoperative D-D level.The accuracy, specificity and sensitivity of this prediction model for predicting perioperative MACE were 96.3%(237/246), 100.0%(235/235), and 18.2%(2/11). Conclusions:The Logistic multivariate prediction model established in this study can effectively predict the occurrence of perioperative MACE in elderly patients.Postoperative BNP and D-D were two independent risk factors for perioperative MACE.The cut-off values of BNP and D-D in the ROC curve could be used as critical values for monitoring perioperative MACE.Therefore, it is of great clinical significance to take effective prevention and treatment measures in time to maintain the stability of perioperative cardiac function, and further improve the perioperative safety of elderly patients with biliary diseases.

Self-assembly and mineralization of full-length human amelogenin and its functional fragments / 华西口腔医学杂志

OBJECTIVES@#To investigate the dynamic process of the self-assembly behaviors of a full-length human amelogenin (AM) and its functional fragments tyrosine-rich amelogenin peptide (TRAP) and leucine-rich amelogenin peptide(LRAP) @*METHODS@#The full-length human AM and its functional fragments, TRAP and LRAP, were reassembled and purified @*RESULTS@#When pH=8, the full-length human AM and TRAP assembly started spontaneously and formed "nanospheres" after 15 min.The nanospheres formed by TRAP existed independently, with a uniform size but without obvious internal structures. The full-length AM was assembled hierarchically, which formed "nanospheres" and further extended in all directions, formed a chain structure, and then aggregated into a net. The self-assembly behavior of LRAP was not obvious. Proteins mostly existed in the form of monomers without "nanosphere" formation. Only few oligomers were observed. The full-length AM was induced independently for 3 days to form rod-shaped HA crystals. TRAP and LRAP proteins were added, after 3 days the crystal elongation was obvious in the c axis, but the growth in plane A and plane B was poor.@*CONCLUSIONS@#The self-assembly and mineralization behaviors of full-length human AM, TRAP, and LRAP were consistent with the directional growth mechanism of HA crystals

Primary Study on Chronic Myeloid Leukemia in NCG Mice from Qinba Mushroom / 中国实验血液学杂志

OBJECTIVE@#The present study was to evaluate the anti-tumor effects of acidic RNA protein complex (FA-2-b-β) extracted from the wild edible Qinba mushroom in inducing of apoptosis and immunoregulation of tumor cell.@*METHODS@#Cell proliferation inducing rate of FA-2-b-β to K562 cell was measured using CCK-8. Apoptosis rate was detected by using flow cytometry. Chronic myeloid leukemia model was developed by tail vein injection/subcutaneous inoculation of K562 cells in NCG mice. The tumor burden of mice was observed. The general condition of the mice was monitored twice daily. The peripherivcal full blood counts of mice was tested daily. RT-qPCR and Western blot was FA-2-b-β performed to determine involvement of apoptotic-related gene and protenin, Immunofluorescence and immunohistochemistry was used to detected the expression of CD3, CD4 and CD8.@*RESULTS@#The proliferation and apoptosis of K562 cell could be inhibitied and induced by FA-2-b-β, there was 100% successful in the tumor formation in vivo, after treated by drug for 21 days there were significantly increased peripheral leucocytes, but decreased hemoglobin of mice treated by FA-2-b-β as compared with those in control group. The CD3, CD4 and CD8 showed positive in mice, and the propotation was imbalance, but it showed reserved after treated by FA-2-b-β.@*CONCLUSION@#FA-2-b-β is strong anti-leukemia effect in vitro and in vivo, suggesting the traditional Chinese medicine maybe contribute to the anti-cancer and immunoregulation research.

Investigation of gross alpha & gross beta radioactivity in surface water of Lixiating in 2014—2019 / 中国辐射卫生

Objective To carry out the gross alpha and gross beta radioactivity monitoring in Lixiating surface water in Daming Lake from 2014 to 2019, so as to understand the current situation of radioactive environmental quality of surface water in Daming Lake. Methods The water samples were collected at Lixiating site during the wet water (March to June) and dry water (September to December). After the pre-treatment process of evaporation, carbonization and ashing, the samples were measured by the ultra low background level α and β counter. Results During 2014 to 2019, the gross alpha activity in the surface water of Lixiating water in Daming Lake was 0.030-0.066 Bq/L, with an average of 0.048 Bq/L, and the gross beta activity was 0.085-0.126 Bq/L, with an average of 0.102 Bq/L. Conclusion The surface water of Lixiating in Daming Lake water was not contaminated by radionuclide and it was safe for public health.

Inhibitory Effects of Agaricus Blazei Murrill (FA-2-b-β) on Proliferation of Chronic Myeloid Leukemia Cells in vivo and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigated the anti-tumor in vivo effect and mechanism of the acid RNA protein complex (FA-2-b-β) of Agaricus blazei Murrill extract.@*METHODS@#CCK-8 method was used to detected the inhibitory effect of FA-2-b-β on proliferation of primary CML cells from newly diagnosed CML patients, the CML mouse model was established by trail-venous injection of primary CML cells, and the survival time, blood cell count and body weight were observed, the immunoflouresence and immunehistochemistry analysis, RT-qPCR, Western bolt were used to detemine the expression of caspase-3 signal pathway-related apoptosis genes and proteins.@*RESULTS@#The experiments in vitro showed that the proliferative inhibitory rate in drug-treated group increased with concentration- and time-dependent manner (r@*CONCLUSION@#The FA-2-b-β can induce apoptosis of primary CML cells and prolong the survival time of CML model mouse, which may be related with the caspase-3 signal pathway related genes and proteins.

Expression of the NMDA receptor in the rat model of orchialgia / 中华男科学杂志

Objective@#To explore the expression of the N-methyl-D-aspartate (NMDA) receptor in the rat model of orchialgia and its possible mechanisms.@*METHODS@#According to Yoshioka's method, the male rats in the control group were injected with 0.2 ml saline, and those in the experimental group with 0.2 ml 2% acetic acid solution. Then we tested the behavioral responses of the rats and determined the expressions of the subunits NR1 and NR2B of the NMDA receptor in the dorsal root ganglion and spinal dorsal horn by Western blot, RT-qPCR and immunofluorescence staining.@*RESULTS@#The withdrawal latency was decreased in the model rats, reaching the lowest value at 4 hours after modeling, significantly lower than in the controls (［4.15 ± 0.84］ vs ［12.32 ± 1.05］, P 0.05).@*CONCLUSIONS@#The NMDA receptor plays an important role in pathogenesis of orchialgia in rats. In the early stage of pain, upregulating the expression of the subunit NR2B of the NMDA receptor can mediate peripheral hyperalgesia and consequently orchialgia.

Comprehensive surgical treatment for complicated obstructive azoospermia / 临床外科杂志

Obstructive azoospermia(OA)is a common cause of male infertility.In recent years, most of patients can successfully nurture the next generation with the development of male microsurgery technology and assisted reproductive technology.However,there are very some group of patients with com-plicated obstructive azoospermia that obstructive tract stenosis occurs in different parts due to multiple rea-sons.These patients cannot be treated by conventional microsurgery,while comprehensive surgical treat-ment can achieve this goal.Here is an introduction for the etiology,diagnosis and comprehensive treatment of complicated obstructive azoospermia.

Influence of Rivaroxaban on Vascular Endothelial Function and p38MAPK/NF-κB Pathway in Rats with Lower Extremity Arteriosclerosis Obliterans / 中国药师

Objective:To explore the influence of rivaroxaban on vascular endothelial function and p38MAPK/NF-κB pathway in the rats with arteriosclerosis obliterans. Methods:The rats were divided into the sham operation group,the model group,rivaroxaban low dose group,rivaroxaban medium dose group and rivaroxaban high dose group. The contents of nitric oxide (NO) and endothelin (ET-1) in serum were detected, the number of endothelial cells in serum was studied, and the expression level of p38MAPK, p-p38MAPK and NF-κB were measured. Results:Compared with that of the model group, the number of endothelial cells in venous blood of rivaroxaban groups decreased. The content of NO in serum of rivaroxaban groups was significantly higher than that of the model group,and the content of ET-1 was significantly lower than that of the model group(P<0.05). The expression level of p-p38MAPK in arterial vessels of rivaroxaban groups was significantly lower than that of the model group,and the expression level of NF-κB was sig-nificantly higher than that of the model group(P<0.05),and the effects were all in a dose-dependent manner. Conclusion:Rivarox-aban can improve vascular endothelial function in the rats with arteriosclerosis obliterans,and the effects may be achieved by modula-ting the p38MAPK / NF-κB pathway.

Advances in research on the effects of microenvironment on the differentiation of stem cells into cardiomyocytes / 中华胸心血管外科杂志

Microenvironment has a major impact on stem-cell differentiation. Stem-cell differentiation achieved by controlling the microenvironment is more similar to physiological characteristic than the traditional chemical induction, which will undoubtedly have a broader clinical application prospect. The impact of microenvironment on stem cell to cardiomyocyte differentiation is reviewed in this paper.

Study of human leucine-rich amelogenin peptide and its regulation of mineralization by cryogenic transmission electron microscopy / 华西口腔医学杂志

<p><b>OBJECTIVE</b>Recombinant human leucine-rich amelogenin peptide (LRAP) was studied by cryogenic transmission electron microscopy (TEM); evaluation focused on its self-assembly and crystal growth in vitro.</p><p><b>METHODS</b>Human LRAP was recombined through prokaryotic expression vector pCold-SUMO and transformed into Escherichia coli BL21plys to acquire purified proteins. Cryogen TEM recorded assembly and self-assembling of LRAP from pH 3.5 to pH 8.0, and the hydroxyapatite crystal growth in the mixture of LRAP protein solution and artificial saliva was observed using TEM and selected area electron diffraction.</p><p><b>RESULTS</b>More than 90% purity LRAP was expressed, purified and identified as described in methods. LRAP linked into oligomers, nanospheres, nanochains, and microribbons, whereas pH value increased from 3.5 to 8.0. Mature hydroxyapatite crystal growth was guided in artificial saliva filled with calcium phosphate.</p><p><b>CONCLUSIONS</b>LRAP is simplified amelogenin functional domain and conserved the basic characters of amelogenin such as self-assembling and inducing crystallization along c axis. In the area of acellular synthesis of hydroxyapatite using extracellular enamel matrix protein, LRAP is one of candidate repair materials for irregular hard tissue defection.
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Expressions of TRPV1 and TRPA1 in the dorsal root ganglion in the rat model of orchialgia / 中华男科学杂志

Objective@#To explore the expressions of transient receptor potential vanilloid 1 (TRPV1) and TRP ankyrin 1 (TRPA1) in the dorsal root ganglion (DRG) and their action mechanisms in the rat model of orchialgia.@*METHODS@#The models of orchialgia were established in male SD rats by injection of 2% acetic acid into the testis. Then the number of spontaneous pain responses and withdrawal latency in the model rats were recorded by behavioral tests and the expressions of TRPV1 and TRPA1 in T13－L1 DRGs determined by RT-qPCR, Western blot and immunofluorescence staining.@*RESULTS@#Compared with the normal control rats, the orchialgia models showed a significant increase in the number of spontaneous pain responses (0.13 ± 0.35 vs 22.63 ± 3.42, P<0.01) and a decrease in the withdrawal latency at 4 hours after injection (［12.75 ± 1.50］ vs ［4.85 ± 1.00］ s, P<0.05). The mRNA expressions of both TRPV1 and TRPA1 were observed in the membrane of the neurons in the DRG, the former increased by 1.77 times and the latter by 1.75 times that of the control (P<0.05).@*CONCLUSIONS@#The expressions of TRPV1 and TRPA1 were up-regulated in the DRG of the rat models of orchialgia, which may be involved in the allodynia and hyperalgesia of the rats.

Investigation of the present situation and demand of nurses training in the different level hospitals of a suburb / 中国基层医药

[Abstract ] Objective To investigate the present situation and demand of nurses training in the different level hospitals of a suburb,so as to provide reference to the building of nursing team.Methods Stratified random sampling was taken in 764 nurses in 20 different level hospitals of a suburb of Beijing.Results In recent 3 years, 31.9% of nurses went out to short -term training and 15.58% of nurses went out to further study for a longer time. The continuous education scores came mainly from own hospital(88.22%),suburb training center(77.75%)and networks(42.54%).About training needs,over half of nurses chose training inside themselves areas,58.38% of nurses chose special short duration training,53.66% of nurses chose further study,48.04% of nurses chose WeChat network platform.About the training content,the first need of training for nursing administrators was nursing safety management (4.65 ±0.54)points,the first need of training for clinical nurses was emergency techniques training (4.41 ±0.69)points.89.14% of nurses would like to have two -way feedback.Conclusion The present situation of nurses training should be improved.Integrating resources and flexible and multiple training methods should be adopted to satisfy nurses training demand.

Nrf2-NF-κB pathway axes, epigenetic regulation and traditional Chinese medicine (natural medicine) to treat type 2 diabetes / 中国中药杂志

Diabetes mellitus is a characterized by high blood sugar metabolic disease, is a lifelong disease with a high incidence of major hazards. Prevention and treatment of diabetes and its complications has become a serious challenge and arduous task facing the world pharmaceutical researchers. Oxidative stress, Nfr2-NF-κB signaling axis related epigenomic genes have the apparent close relationship with type 2 diabetes,those have become one of the key focus and effective way to explore its pathogenesis, mechanism and drug screening. This paper systematically summarizes the current stage research regulating the key proteins, mRNA about Nrf2-NF-κB axis pathway and epigenomics for treatment of type 2 diabetes and the mechanism of traditional Chinese medicine and natural medicine (component) in the treatment of type 2 diabetes, hoping to provide some innovative research ideas for finding new drugs of the treatment of diabetes from traditional Chinese medicine and natural medicine.

Changes and significance of aquaporin 4 expression in mice models of fat embolism syndrome / 中华创伤杂志

Objective To investigate the role of aquaporin 4 (AQP4) in partial pathologic process of lung injury in rat models of fat embolism syndrome (FES).Methods A total of 120 healthy male C57BL/6J mice were assigned to control group and FES group which was subgrouped at 4,6,12,24,and 48 hours with 20 mice per group,according to the random number table.Allogeneic perinephric fat was injected to rat caudal veins in FES groups.Lung samples were harvested from each group to examine pathological morphology and lung weight to dry ratio (W/D) to verify the FES models and observe the pathologic process.Expression of AQP4 was detected by western blot and immunohistochemistry.Additional 36 C57BL/6J mice were divided into control group,DMSO group,FES 12-hour group,and AQP4 inhibitor group according to the random number table,with 9 mice per group.Pathologic process of FES-induced lung injury was detected after the inhibition of AQP4.Results Damage to lung tissues was notable in FES group compared with control group.Lung W/D value was 5.06 ± 1.23,5.22 ± 1.58,6.18 ± 1.65,and 5.07 ± 0.31 at 6,12,24,and 48 hours respectively,which was higher than 3.16 ± 1.58 in control group (F =3.62,P ＜ 0.05).Expression of AQP4 was 1.71 ± 1.05 at 12 hours and 1.28 ± 0.68 at 24 hours in FES group,which showed significantly increase when compared with 0.65 ±0.08 in control group (F =4.12,P ＜0.01),whereas at 4 hours (0.76 ± 0.36),6 hours (1.17 ± 0.60),and 48 hours (0.85 ±0.45) in FES group,no statistical difference was observed when compared to control group.W/D value in FES 12-hour group (5.22 ± 1.17),DMSO group (4.96 ±1.66),and AQP4 inhibitor group (3.25 ± 1.19) was higher than 3.03 ± 1.68 in control group (F =3.69,P ＜ 0.05).Meanwhile,there was no statistical difference between DMSO and FES 12-hour groups,but significantly lowered W/D value was observed in AQP4 inhibitor group than in FES 12-hour group.Conclusion AQP4 may be implicated in mitigating lung injury induced by FES.

Research progress on Huang Fu-mi's A-B classic of acupuncture and moxibustion / 中国针灸

In order to understand the research status of HUANG Fu-mi's A-B Classic of Acupuncture and Moxibustion, 83 pieces of literature that have been publically published since 1978 were analyzed. A summary was performed according to 7 aspects including version origin, emendation, arrangement and summary, theory discussion, clinical research, value evaluation, the rest questions, etc. It is believed that deep research work has been done on explanations, emendation and translation regarding A-B Classic of Acupuncture and Moxibustion. However, the exploration work on the theory and application is far from enough. Therefore, beginning from historical and cultural background, we should analyze the humanistic spirit of HUANG Fu-mi combined with A-B Classic of Acupuncture and Moxibustion to perform a deep exploration, so we could have a thorough and comprehensive research on HUANG Fu-mi's academic thoughts.

Chitosan-collagen polymer induced remineralization of tooth hard tissue through self-growing methods / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To modify biomacromolecules, such as chitosan and collagen, to synthesize a mineralized template that will induce self-growing remineralization of tooth enamel.</p><p><b>METHODS</b>Natural polycation polysaccharide chitosan was modified through phosphorylation to synthesize the polyanion derivative ofphosphorylated chitosan. Parent hydrogels com- bined with chitosan and collagen I were built through peptide binding reaction using genipin as a crosslinker. The gels self- assembled on the tooth's inert surface, which was stimulated by ultraviolet radiation. The bionic saliva provided mineralized ion, and then the hydroxyapatite assembled and grew in situ on the tooth.</p><p><b>RESULTS</b>The functional group P04(3-) (3,446 cm(-1)) was grafted on chitosan as confirmed by the Fourier transform infrared spectroscopy. The porous polyelectrolyte complex hydrogel formed by the interaction between the polycation chitosan and the polyanion phosphorylated chitosan could induce hydroxyapatite crystal nucleation and growth on the hydrogel fiber surfaces. The neonatal crystal was hydroxyapatite as confirmed by X-ray diffraction and was tightly connected to the tooth. A continuous structure of column crystals with sizes ranging from 30 nm to 60 nm was observed. The structure was in parallel direction similar to the direction of the enamel rod, and its hardness was close to dentin.</p><p><b>CONCLUSION</b>The parent hydrogels that were easily obtained and controlled could mimic the template of the enamel mineralization and induce a self-growing hydroxyapatite, which is an important step in the structural bionics of enamel.</p>

Expression and relationship of Beclin1 and Bci2 in invasive pituitary adenomas / 中华内分泌外科杂志

Objective To detect the expression of Beclin1 and Bcl2 in invasive pituitary adenomas and to explore the relationship of Beclin1 and Bci2 in invasive pituitary adenomas and the relativity between the 2 genes.Methods 61 specimens were classified into invasive group (32 cases) and non-invasive group (29 cases) according to the comprehensive evaluation of invasive pituitary adenomas.lmmunofluorescence analysis and RT-PCR were adopted respectively to detect the protein and mRNA expressions of Beclinl and Bcl2.The difference and relativity of Beclin1 and Bcl2 expression in invasive group and non-invasive group were analyzed.Results 32 specimens of pituitary adenoma were invasive and 29 were non-invasive.Beclin1 protein and mRNA expressions were lower in the invasive group than in the non-invasive group (P ＜0.01 ).Bcl2 protein and mRNA expressions were higher in the invasive group than in the non-invasive group (P ＜0.01 ).Pearson related analysis showed that Beclin1 mRNA expression was negtively correlated with Bcl2 mRNA expression in the invasive group ( r =-0.42,P =0.028 ).Conclusions Beclinl expression is decreased in invasive pituitary adenomas.The invasiveness of pituitary adenoma is closely related to the high expression of Bcl2 protein and mRNA,and the low expression of Beclin1 protein and mRNA.The inhibition of the autophagy may lead to the enhancement of the invasiveness of pituitary adenomas and that inhibition may come from the interaction of Beclin1 and Bcl2.

Evaluation of GE7-transferring system-mediated HSV(1)-tk gene transfer in a rat model of ovarian tumor via intra-arterial route / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the gene and protein expression of herpes simplex virus type I-thymidine kinase (HSV(1)-tk) in the ovarian tumor tissues and other organs after arterial infusion of HSV(1)-tk gene mediated by GE7 delivery system.</p><p><b>METHODS</b>GE7-polylysine/pCMV-HSV(1)-tk/polylysine-HA20 complexes were constructed. Nine rats with induced ovarian tumor were divided into 3 groups, injecting the 4-element complexes or saline buffer through the ovarian artery and complexes through the tail vein, respectively. The ovarian tumors, hearts, livers, spleens, lungs and kidneys were obtained at 72 hours after injection. RT-PCR and Western Blot were preceeded to determine the expression of HSV(1)-tk gene and protein in the tumor tissues and other organs.</p><p><b>RESULTS</b>In the group of arterial injection with 4-element complexes, the HSV(1)-tk gene and protein were expressed strongly in the tumor tissues, while little or none was detected in other organs. In the group of arterial injection with saline buffer, no HSV(1)-tk gene and protein was detected in both tumor tissues and other organs. In the group of tail vein injection, none was detected in tumor tissues and only little was found in the livers, spleens, lungs and kidneys.</p><p><b>CONCLUSION</b>High target and gene transfer rates can be obtained when HSV(1)-tk gene is transferred via the artery route mediated by GE7 delivery system. HSV(1)-tk protein can be expressed after the gene transfer. The results may provide a new strategy for target killing of HSV(1)-tk/GCV system in ovarian tumors.</p>

Clinical research on repairing alveolar cleft with osteoinduction active material / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the feasibility and authenticity of repairing alveolar defects in alveolar cleft patients with osteoinduction active material (OAM) in clinic.</p><p><b>METHODS</b>Twenty-seven cases of alveolar defect chosen from clinic were divided into two groups (test group and control group). For test group (12 cases), OAM was transplanted to repair the alveolar cleft. For control group (15 cases), autogenous ilium cancellous bone were transplanted into the defect region to repair alveolar cleft. At 6 months after operation, CT and three-dimensional reconstruction were used to observe alveolar appearance, and the effect and clinical success rate of recover alveolar cleft by using different repair material were compared.</p><p><b>RESULTS</b>In the 27 cases, all the maxillary continuity was restored except two of test group and two of control group. There was no significant difference between test group and control group regarding the clinical success rate of the alveolar cleft repair (P = 1.000).</p><p><b>CONCLUSION</b>OAM was used to repair the alveolar cleft that can result in new bone formations and the burgeon of canines from the bone grafted areas. There is no significant difference between OAM and autogenous ilium cancellous bone regarding the effect of the alveolar cleft repair.</p>

Surgical treatment of tibia plateau fractures with external fixator and the locking plate / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical effect of the treatment for complex fractures of the tibial plateau through the application of the external fixator and the locking plate.</p><p><b>METHODS</b>From Feb. 2006 to Oct. 2008,12 patients with tibial plateau fractures were treated with external fixator and locking plate included 8 males and 4 females with an average age of 38 years ranging from 23 to 59. According to Schatzker type, 7 cases were type V and 5 cases were type VI. Using an anteromedial incision and an anterolateral approach, the locking plate were fixed in the tibia lateral. The collapse and height lossing of tibial plateau was observed through X-ray film before and after operation. The function of knee joint was evaluated according to HSS scoring.</p><p><b>RESULTS</b>These patients were followed up for 4 to 18 months (means 9.79 months). Eleven cases had bone primary union,and 1 delayed union. No deep phlebothrombosis and osteofascial compartment syndrome occurened. The average healing time was 3.1 months. Between the preoperative and postoperative X-ray film there were no second stage depression fracture of the tibial plateau,postoperative reduction loss and bad alignment. The range of knee flexion was 90 degrees to 110 degrees. The HSS knee functional scoring was(75.50 +/- 10.01)scores after operation and (21.50 +/- 11.68) scores before operation.</p><p><b>CONCLUSION</b>The treatment with the external fixator and the locking plate for complex fractures of the tibial plateau could provid continuous stability of fixation,prevent the fracture from second stage displacement and the knee force line change, protect the soft-tissue around the knee, reduce the postoperative complications. The knee joint function is satisfied.</p>