Osteotomy of non-core weight-bearing area of the lateral tibial plateau, reduction, and internal fixation in treatment of tibial plateau fractures involving posterolateral column collapse / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of osteotomy of non-core weight-bearing area of the lateral tibial plateau, reduction, and internal fixation in the treatment of tibial plateau fractures involving posterolateral column collapse.@*METHODS@#A clinical data of 23 patients with tibial plateau fractures involving posterolateral column collapse, who had undergone osteotomy of non-core weight-bearing area of the lateral tibial plateau, reduction, and internal fixation between January 2015 and June 2021, was retrospectively analyzed. There were 14 males and 9 females with an average age of 42.6 years ranging from 26 to 62 years. The causes of injury included traffic accident in 16 cases, falling from height in 5 cases, and other injuries in 2 cases. According to Schatzker classification, there were 15 cases of type Ⅴ and 8 cases of type Ⅵ. The time from injury to operation was 4-8 days with an average of 5.9 days. The operation time, intraoperative blood loss, fracture healing time, and complications were recorded. The depth of articular surface collapse of posterolateral column and posterior inclination angle (PSA) of the tibial plateau were compared before operation and at 2 days and 6 months after operation; fracture reduction of tibial plateau fracture was evaluated by Rasmussen anatomic score. The recovery of knee function was evaluated by Hospital for Special Surgery (HSS) score at 2 days and 6 months after operation.@*RESULTS@#All 23 patients were completed the operation successfully. The operation time was 120-195 minutes, with an average of 152.8 minutes; the intraoperative blood loss was 50-175 mL, with an average of 109.5 mL. All patients were followed up 12-24 months, with an average of 16.7 months. One patient had superficial wound infection after operation, and the incision healed after dressing change; primary healing of incision of other patients was obtained. The fracture healing time was 12-18 weeks, with an average of 13.7 weeks. No failure of internal fixation, varus and valgus deformity of the knee joint, and instability of the knee joint was found at last follow-up. One patient developed joint stiffness and the range of motion of the knee joint was 10°-100°; the range of motion of the knee joint of other patients was 0°-125°. At 2 days and 6 months after operation, the depth of articular surface collapse of posterolateral column, PSA, and Rasmussen anatomic scores significantly improved when compared with those before operation ( P<0.05). There was no significant difference between the two postoperative time points ( P>0.05). The HSS score at 6 months after operation was significantly higher than that at 2 days after operation ( P<0.05).@*CONCLUSION@#For tibial plateau fractures involving posterolateral column collapse, reduction and internal fixation through osteotomy of non-core weight-bearing area of the lateral tibial plateau has the advantages of fully expose the posterolateral column fragment, good articular surface reduction, sufficient bone grafting, and fewer postoperative complications. It is beneficial to restore knee joint function and can be widely used in clinic.

Efficacy of miniplates plus reconstruction plate fixation assisted by preoperative digital design in the treatment of comminuted posterior acetabular wall fracture / 中华创伤杂志

Objective:To compare the clinical effect of miniplates plus reconstruction plate fixation assisted by preoperative digital design and conventional miniplates plus reconstruction plate fixation in the treatment of comminuted posterior acetabular wall fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 35 patients with comminuted posterior acetabular wall fracture admitted to General Hospital of Central Theater Command of PLA from January 2012 to June 2019, including 26 males and 9 females, aged 25-63 years [(45.5±9.8)years]. A total of 16 patients received miniplates plus reconstruction plate fixation assisted by preoperative digital design (digital design group) and 19 patients received conventional miniplates plus reconstruction plate fixation (conventional group). The operation time, intraoperative blood loss, hospitalization time and fracture healing time were compared in the two groups. Matta radiological standard score was performed to assess the quality of fracture reduction at postoperative 2 days. Modified Merle d′Aubign-Postel score was used to evaluate hip function at postoperative 3 months, 6 months and final follow-up. Postoperative complications were observed.Results:All patients were followed up for 12-48 months [(30.1±8.9)months]. The operation time and intraoperative blood loss were (114.7±16.1)minutes and (323.4±26.1)ml in digital design group, significantly less than (179.8±67.3)minutes and (392.6±87.8)ml in conventional group (all P<0.01). There were no significant differences in hospitalization time, fracture healing time, excellent and good rate of quality of fracture reduction between the two groups (all P>0.05). The modified Merle d′Aubign-Postel score was higher in digital design group [(14.1±2.3)points, (15.4±2.3)points and (17.1±1.8)points] than those in conventional group [(13.7±2.2)points, (15.0±2.5)points and (16.8±2.1)points] at 3 months, 6 months and last follow-up, but there were no significant differences (all P>0.05). The modified Merle d′Aubign-Postel score showed significant differences within each group at each time point (all P<0.01). In digital design group, one patient was found with heterotopic ossification and one with traumatic arthritis. In conventional group, two patients were found with heterotopic ossification, one with traumatic arthritis and one with avascular necrosis of the femoral head. The rate of postoperative complications was 12.5% (2/16) in digital design group and was 21.1% (4/19) in conventional group ( P>0.05). Neither of the two groups had complications such as penetration of screws into the articular cavity, failure of internal fixation or iatrogenic sciatic nerve injury. Conclusion:Both miniplates plus reconstruction plate fixation assisted by preoperative digital design and conventional miniplates plus reconstruction plate fixation can achieve satisfactory clinical efficacy in the treatment of comminuted posterior acetabular wall fracture, but the former can significantly reduce operation time and intraoperative blood loss.

Miniplates combined with reconstruction plate for the treatment of comminuted posterior wall acetabular fractures / 中华创伤杂志

Objective:To evaluate the clinical results of miniplates combined with reconstruction plate in treating comminuted posterior wall acetabular fractures.Methods:A retrospective case series study was conducted for 27 patients with comminuted posterior wall acetabular fractures treated in General Hospital of Central Theatre Command of PLA from October 2015 to June 2019. There were 18 males and 9 females, at age of 23-61 years［（45.9±10.9）years］. All patients were treated by using miniplates combined with the reconstruction plate. The operation time, intraoperative blood loss, intraoperative blood transfusion, length of hospital stay and time of fracture healing were recorded. The reduction quality was evaluated according to Matta radiographic standard at 2 days postoperatively. The modified Merle D'Aubigné-Postel score was adopted to evaluate the hip function at 3, 6 months postoperatively and the final follow-up. Postoperative complications were observed, and heterotopic ossification was assessed by Brooker grading standard.Results:All patients were followed up for 12-48 months［36（24, 36）months］. The operation time was 123-242 minutes［（165.4±29.8）minutes］; the intraoperative blood loss was 170-550 ml［（358.3±111.3）ml］; nine patients required intraoperative blood transfusion of 300-500 ml［（377.8±66.7）ml］. The length of hospital stay was 12-29 days［（21.4±4.7）days］. The fracture healing time was 12-24 weeks［（16.3±3.0）weeks］. According to Matta radiographic standard, the reduction quality was excellent in 21 patients, good in 3 and poor in 3 at 2 days postoperatively, with the excellent rate of 89%. The modified Merle D'Aubigné-Postel score was 9-16 points［（13.1±1.9）points］at 3 months postoperatively, was 10-18 points［（15.4±2.0）points］at 6 months postoperatively, and was 12-18 points［（16.9±1.8）points］at last follow-up（ P<0.01）. The modified Merle D'Aubigné-Postel score between 3 months and 6 months was significantly different（ P<0.01）, and the difference between 6 months and the follow-up was statistically significant（ P<0.01）. The modified Merle D'Aubigné-Postel score was graded as excellent in 0 patient, good in 7, fair in 11 and poor in 9 at 3 months postoperatively, with the excellent rate of 26%; graded as excellent in 3 patients, good in 19, fair in 2 and poor in 3 at 6 months postoperatively, with the excellent rate of 81%; graded as excellent in 18 patients, good in 5, fair in 3 and poor in 1 at the last follow-up, with the excellent rate of 85%（ P<0.01）. No iatrogenic sciatic nerve injury, deep vein thrombosis or wound infection occurred after operation. No hardware loosening or loss of reduction occurred during the follow-up. The post-traumatic arthritis was identified in 2 patients. The avascular necrosis of femoral head was observed in 1 patient and thereafter underwent total hip replacement. The heterotopic ossification occurred in 3 patients, among which 2 patients were graded as Brooker class I and 1 as class II, but there was no adverse effect on hip function. Conclusions:Miniplates combined with reconstruction plate in the treatment of comminuted posterior wall acetabular fractures have reliable fixation effect and attain good reduction, high fracture healing rate, less complications and satisfactory functional recovery.

Chemical constituents from ethyl acetate-soluble extraction of Valeriana jatamansi / 中国中药杂志

Application of a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, macroporous adsorbent resin, and reversed-phase HPLC, led to the isolation of 173 compounds including irdidoids, monoterpenes, sesquiterpenes, triterpenes, lignans, flavonoids, and simple aromatic derivatives from the ethyl acetate-soluble fraction of the whole plants of Valeriana jatamansi(Valerianaceae), and their structures were elucidated by spectroscopic methods including 1D, 2D NMR UV, IR, and MS techniques. Among them, 77 compounds were new. In previous reports, we have described the isolation, structure elucidation, and bioactivities of 68 new and 25 known compounds. As a consequence, we herein reported the isolation and structure elucidation of the remaining 9 new and 71 known compounds, the structure revision of valeriotriate A(8a), as well as cytotoxicity of some compounds.

Progresses in therapeutic strategies for thymic rejuvenation / 生理学报

The thymus is a vital primary lymphoid organ that provides unique microenvironments for the proliferation, differentiation, and maturation of T cells. With advancing age, however, the thymus gradually undergoes age-related involution and reduction in immune function, which are characterized by decreases in tissue size, cellularity, and naïve T cell output. This dynamic process leads to the reduced efficacy of the immune system with age and contributes to the increased susceptibility to infection, autoimmune disease, and cancer. In addition, bone marrow transplantation, radio-chemotherapy and virus infection also impair the thymus and give rise to the decline in immune function. Therefore, understanding the molecular mechanisms involved in age-related thymic involution and development of novel therapeutic strategies for thymic rejuvenation have gained considerable interests in recent years. This review emphasizes thymic microenvironments and thymocyte-stromal cell interactions and summarizes our current knowledge about thymic rejuvenation in terms of sex steroid, cytokines, growth factors, hormones, transcription factors, cell graft, and microRNAs. At the end of each discussion, we also highlight unanswered issues and describe possible future research directions.

Influence of psychological education on the resourcefulness of perioperative breast cancer patients / 现代临床护理

Objective To discuss the influence of psychological education on the resourcefulness of perioperative breast cancer patients. Methods Two hundred breast cancer patients from a first-class hospital in Fujian province were randomly assigned to the control group, in which routine care was done, and an intervention group, in which psychological education curriculum was employed at three stages on the basis of routine care. The resourcefulness scale was used in both two groups before and after the intervention to evaluate the score of individual and social resourcefulness and the total score of resourcefulness in these two groups. Results As to the control group, the score on individual resourcefulness and the total score on resourcefulness before and after the intervention had no significant differences (P>0.05), but the difference in the social resourcefulness scores before and after the intervention was statistically significant (P<0.05). The differences in the scores on the individual resourcefulness, social resourcefulness and the total score on resourcefulness in the intervention group before and after the intervention were all statistically different (P<0.001). What′s more, the scores of individual resourcefulness, social resourcefulness and the total score of resourcefulness between these two groups after the intervention were statistically different (P<0.001) as well. The scores of the intervention group were significantly higher than those of the control one. Conclusion The psychological education can significantly improve the resourcefulness level of perioperative breast cancer patients, which can help individuals to manage stress effectively.

Antibiotic susceptibility of pathogenic bacteria isolated from 893 children with lower respiratory infection in Guiyang / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution and the antibiotic susceptibility of pathogenic bacteria in children from Guiyang with lower respiratory infection (LRI).</p><p><b>METHODS</b>The nasopharyngeal aspirate samples were obtained from 893 hospitalized children with LRI between August 2006 and June 2008. An antibiotic susceptibility test was performed using the VITEK system and the Kirby-Bauer diffuse method after bacteria were identified.</p><p><b>RESULTS</b>Five hundred and forty-three patients (60.8%) were bacteria-positive. A total of 598 strains (30 kinds of bacteria) were obtained from the sputum samples. Of them, 533 strains (89.1%) were gram-negative and 57 were gram-positive (9.8%). Escherichia coli (E. coli) and Kleb-siella pneumoniae (K. pneumoniae) were common in gram-negative strains. They were susceptive to piperacillin/tazobactam, amikacin, ciprofloxacin, and levofloxacin, especially to imipenem. Streptococcus pneumoniae (S. pneumoniae) and Stapthylococcus aureus (S. aureus) were common in gram-positive strains. S. pneumoniae was susceptive to penicillin and cefazolin sodium, but S. aureus was resistant. Both were high susceptive to vancomycin, and resistant to roxithromycin.</p><p><b>CONCLUSIONS</b>Gram-negative bacteria are the main pathogens in children from Guiyang with LRI, and E. coli and K. pneumoniae are common. The antibiotic susceptibility of pathogenic bacteria varies with different strains of bacteria. A reasonable selection of antibiotics should be based on the antibiotic susceptibility test.</p>

Construction and immunogenicity evaluation of chimerical DNA vaccine of human papillomavirus type 11 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To construct chimerical DNA vaccine plasmid of human papillomavirus type 11 (HPV11) L1-E7, and to evaluate its immunogenicity.</p><p><b>METHODS</b>Molecular cloning techniques were used to construct recombinant plasmid pcDNA3 L1-E7 as a DNA vaccine. BALB/c mice were vaccinated with DNA recombinants through muscle injection.IL-2 and gamma-INF secreted by immunized spleens lymphocyte and HPV 11 L1 or E7 specific antibodies were assayed by ELISA method. Spleens lymphocyte proliferation was measured by MTT assay.</p><p><b>RESULTS</b>The chimerical DNA plasmid of pcDNA3 L1-E7 was constructed correctly. Specific anti-HPV11 E7 and L1 antibodies, specific lymphocyte proliferation and secretions of IL-2 and gamma-INF were detected in vaccinated mice.</p><p><b>CONCLUSION</b>Specific immune response, including cellular immunity and humoral immunity, could been detected in mice vaccinated with chimerical DNA vaccine of pcDNA3 L1-E7.</p>

Effect of breast serf-examination on early detection of breast cancer and its prognostic value:a meta-analysis / 中华健康管理学杂志

Objective To assess the efficacy of early detection of breast cancer and the prognostic value of breast self-examination(BSE).Methods Randomized controlled trials(RCTs)involving BSE were included the present meta-analysis based on their qualities.The pooled analysis was performed with RevMany 4.2.8.Results Three RCTs were identified and then they were included the present metaanalysis.In women who conducted a BSE.the rate of biopsy fora lump in breast was 1.27%in the first 5 years,2.47%in more than 5 years but less than or equal to 10 years,and 2.50%in more than 10 years, respectively,all of which were significantly higher than in those who could not conduct a BSE(P<0.05) There was no significant difierence in the rate of final diagnosis and the mortality for breast cancer between the two populations in any follow-up time(P>0.05).Conclusion The rate of biopsy for a lump in breast in women could be increased by a BSE.which should not have been discarded from the early detection of breast cancer completely despite it is not helpful in increasing the rate of final diagnosis and decreasing the mortality for breast cancer.

Clinical analysis of completion pneumonectomy for pulmonary disease / 中华外科杂志

<p><b>OBJECTIVE</b>Completion pneumonectomy (CP) is widely known to be associated with a high morbidity and mortality. However, in certain instances, CP offers the only chance for a cure. Now to explore the indications, prevention and management of complications as well as late outcomes of CP.</p><p><b>METHODS</b>During a period of 21 years from January 1985 to August 2006, 24 patients received CP, representing 2.3% of 1026 patients who had undergone pneumonectomy in the same period. There were 17 right and 7 left CPs done in 20 male and 4 female patients with an average age of 58 years (range from 42 to 67 years). Lung malignancy accounted for 22 of these cases in which the indication included local recurrence in 18, second primary tumors in 2 and primary malignancies that developed after right upper lobectomies for pulmonary tuberculoma and pulmonary cyst respectively in 2 cases. Benign disease was progression or recurrence of bronchiectasis in 2 cases. Before CP, 17 patients had had a lobectomy, 5 a bilobectomy, 1 sleeve lobectomy and 1 wedge resection. There were 16 of 20 lung cancer patients receiving postoperative chemotherapy and 3 with positive residues having radiotherapy. The mean interval between the two procedures was 65 months for the whole group (5.5-360) and 32 months for lung cancer patients (5.5-120). They all underwent CP, included sleeve CP in 1 patient.</p><p><b>RESULTS</b>For all patients, the previous thoracotomy incision was reopened and maneuvers such as rib resection, intrapericardial blood vessel ligation, division of the bronchus first, local application of glues and hemostatic agents, and bronchial reinforcement were routinely used. Intrapericardial route was used in 10 patients (41.7%). Two patients had right pulmonary artery injured. The operation lasted 4-7 hours, with blood loss of 300 to 3000 ml. Overall respectability, morbidity and hospital mortality were 95.8%, 29.2% and 4.2%. No intraoperative deaths occurred. There was 1 early postoperative death after 40 days from adult respiratory distress syndrome. There was no occurrence of bronchopleural fistula, and the 25% associated morbidity rate was a result of bleeding necessitating reexploration in 1 case, chronic empyema in 1 case, arrhythmia in 1 case, anemia in 1 case and fever of unknown reason in 2 cases. Actuarial 1-, 3-, 5-year survival rates from the time of completion pneumonectomy for patients with lung cancer were 77.3%, 50.0% and 29.4%. And 1-, 3-, 5-year survival rates for patients with recurrent lung cancer were 72.2%, 47.1% and 29.4%.</p><p><b>CONCLUSIONS</b>CP can be performed with an acceptable operative mortality and morbidity rate in selected patients. For patients with local recurrence, first and second primary bronchogenic carcinoma as well as benign pulmonary disease, treatment should be surgical when a less invasive procedure is not available and the patients are in good health. In addition, patients undergoing CP have a reasonable prospect for long-term survival.</p>

Chemical constituents in root of Zanthoxylum nitidum / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of Zanthoxylum nitidum.</p><p><b>METHOD</b>Column chromatography on Silica gel and Sephadex LH - 20, and recrystallization were applied for the isolation and purification of the constituents. The structures were elucidated on the basis of spectral analysis, chemical evidences and by comparison with the data reported in literature.</p><p><b>RESULT</b>From the CHCl3 fraction and n-butanol fraction of the EtOH extract of the roots of Z. nitidum, 10 compounds were isolated and identified as 2, 4-dihydroxypyrimidine (1), syringic acid (2) , 2, 6-dimethoxy-1, 4-benzoquinone (3) , 4-hydroxybenzoic acid (4), ethylparaben (5), (Z)-3-(2, 3, 4-trimethoxyphenyl) acrylic acid (6), 5, 6, 7-trimethoxycoumarin (7), stigmast-9 (11) -en-3-ol (8), daucosterol (9), beta-sitosterol (10).</p><p><b>CONCLUSION</b>Compounds 1-9 were isolated and identified from the roots of Z. nitidum for the first time. Furthermore, we note here the first isolation of compound 6 as a natural product.</p>

Comprehensive evaluation on the quality of life among rural elderly population in Anhui province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the feasibility of multi-dimensional and comprehensive evaluation on the quality of life among rural elderly population in Anhui province.</p><p><b>METHODS</b>5652 rural elderly people aged above 65 in Anhui province were selected by cluster sampling method and were studied by cross-sectional study through a questionnaire on health information. The quality of life was evaluated by comprehensive evaluation method.</p><p><b>RESULTS</b>The total score of satisfactory quality of life in the studied rural elderly people was 0.1432 +/- 0.5170, while not satisfied was -0.2521 +/- 0.6081, with significant difference between the two groups (F = 666.221, P < 0.0001). There was positive correlation between subjective satisfaction and total score of quality of life, with r(s) = 0.345 (P < 0.0001). The results of logistic regression analysis between comprehensive index of quality of life and subjective satisfaction indicated that filial piety, income, sleeping condition, chronic disease, nutrition status, economic dominance in the family, amusement activities etc. were important factors influencing the quality of life.</p><p><b>CONCLUSION</b>It was feasible to evaluation on the quality of life by comprehensive evaluation method.</p>

Microcalorimetric study on host-guest complexation of naphtho-15-crown-5 with four ions of alkaline earth metal / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Thermodynamic parameters of complexation of naphto-15-crown-5 with four alkaline earth ions in aqueous media was determined using titration microcalorimetry at 298.15 K. The stability of the complexes, thermal effect and entropy effect of the complexation is discussed on the basis of the guest ions structure and the solvent effect. The stability constants tendency to vary with ion radius was interpreted. Complex of naphtha-15-crown-5 with calcium ion is very stable due to the synergism of static electric interaction and size selectivity between the host and the guest.

Early screening of cerebral palsy during infancy using 'Infant Motor Malfunction Profile' in the communities of two cities / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the prospective validity and predictive value of cerebral palsy during infancy, using 'Infant Motor Malfunction Profile'.</p><p><b>METHODS</b>Items of motor milestone in the profile was used as the first step to screen cerebral palsy on 8137 infants who were screened at 3, 6, 9, 12 months of age. The positive cases who had one of 7 developmental abnormal motor milestone items were examined using the items of primitive reflexes or postural reaction as the secondary step of cerebral palsy screening. The cases who had at least one abnormal item of primitive reflex or postural reaction received neurological examination by doctors to diagnose cerebral palsy.</p><p><b>RESULTS</b>According to our data, sensitivity, specificity, positive prospective value, positive and negative likelihood ratio of the profile in screening cerebral during infancy were 94.1%, 99.8%, 48.5%, 449.6 and 0.06, respectively.</p><p><b>CONCLUSION</b>The profile seemed to be an acceptable instrument for early identification of cerebral palsy.</p>

A prospective cohort study on injuries among school-age children with and without behavior problems / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the annual incidence of injuries and the relationship between behavior problems and injuries among school-age children.</p><p><b>METHODS</b>A prospective cohort study on injuries for 1-year follow-up period was conducted among 2 005 school-age children selected by cluster sampling from three primary schools in Maanshan city. They subjects were divided into two groups with or without exposure according to behavior problems rated by the Rutter Child Behavior Questionnaire at the beginning of the study. Nonparametric test was performed to analyze the differences in injuries between the two groups of children, and the influential factors for injuries were analyzed with multi-classification ordinal response variable logistic regression model.</p><p><b>RESULTS</b>The overall incidence rate for injuries in school-age children was 42.51%, while among children with and without behavior problems were 64.87% and 38.85%, respectively. There were significant differences between the two groups (u = -6.054, P = 0.000). However, the incidence rates of injuries in school-age children with antisocial (A) behavior, neurotic (N) behavior and mixed (M) behavior were 66.99%, 67.41% and 61.40%, respectively. No significant differences were found among them (u(A,N) = -0.052, P = 0.958; u(A,M) = -0.400, P = 0.689; u(N,M) = -0.364, P = 0.716). Multivariate analysis indicated that injuries in school-age children were associated with children behavior problems, maternal age at childbirth, bad conditions during mother pregnancy, education background of mother, prevention measures for safety at home and the child accompanied to travel between school and home by adults. Behavior problems of children seemed to be the major risk factors for injuries.</p><p><b>CONCLUSION</b>Children with behavior problems represented a significant risk group for injuries among school-age children. When planning intervention strategies on injuries, behavior problems should be emphasized to ensure optimal effectiveness of intervention.</p>