Comparison between tension band and cerclage with X-Plate and lag screws in treatment of comminuted patellar fractures

BackgroundComminuted patellar fractures are not rare, and the ideal treatment method remains controversial. The present study was conducted to evaluate effects and compare complications of two different methods used to treat comminuted patellar fractures.MethodsFrom March 2010 to August 2016, 102 cases of 34-C2 or 34-C3 comminuted patellar fractures were treated at our hospital, wherein patients received two different treatments: titanium cable tension band with cerclage method (group A) and intrafragmentary screws with X-shaped plating technique (group B). At follow-ups, articular step-off, range of motion (ROM), Lysholm scores, time of union, and complications were recorded and analyzed. Radiographic and clinical data as well as rate of complications were statistically analyzed.ResultsIn total, 87 patients were included in the final analysis (n = 47 in group A and n = 40 in group B). No significant differences were noted in terms of cost of implant, age, gender, rate of 34-C3 fractures, rate of layered inferior pole fractures, postoperative articular step-off and union time. At 2-year follow-up, average Lysholm scores, ROM and rate of complications were (89.0 ± 4.5), (122°±12°) and (27.7%) in group A and (90.2 ± 3.9), (124°±11°) and (17.5%) in group B, respectively, with no significant differences (p > 0.05). The mean time of surgery in group B was shorter than that in group A with significant difference (p < 0.05).ConclusionsTreatment using the intrafragmentary screws and plate method for amenable comminuted patellar fractures achieved similar complication rate and favorable functional outcomes at the 2-year follow-up, which was comparable to the titanium cable tension band with cerclage method. Thus, the intrafragmentary screws and plate method is effective, safe and convenient for 34-C2/C3 comminuted patellar fractures, especially appropriate for patients with layered fragments.     

中医药调控IL-1治疗肿瘤机制的研究进展

炎症已成为影响肿瘤细胞增殖转移的第七大因素,而白细胞介素-1(IL-1)是炎性微环境的重要因子之一。中医药在治疗肿瘤时具有多途径、多靶点的优势,同时炎性微环境致病特点与现代中医学"癌毒"的理论相吻合。查阅近年中医药调控IL-1家族分子治疗肿瘤机制的文献,对其进行梳理,并做出概括及评价,从中医药主要调控IL-1α、IL-1β和IL-18因子治疗肿瘤展开综述,为中医药更系统化治疗肿瘤提供参考。     

基于网络药理学的济脉通片降压机制研究

目的 采用网络药理学阐明济脉通片多成分-多靶点-多途径的作用理念，为进一步研究济脉通片降压药效物质基础和机制提供一定理论参考。方法 通过TCMSP数据库，结合口服利用度（≥ 30%）和类药性分析（≥ 0.18）参数，筛选济脉通片的活性成分；通过Drugbank和TCMSP数据库进行靶点预测分析；通过GENCARD数据库筛选出高血压疾病相关基因；结合DAVID和KEGG数据库进行GO分析和通路分析；使用Cystoscope软件构建"化合物-靶点-作用通路"网络图。结果 经筛选后得到济脉通片的33个化合物，148个潜在靶基因并映射到了223条信号通路，其中31条信号通路与高血压的发生发展密切相关，其中AGE-RAGE signaling pathway in diabetic complications、PI3K-Akt signaling pathway、TNFsignaling pathway、Adrenergic signaling in cardiomyocytes和Focal adhesion为重要的通路枢纽。结论 济脉通片主要通过多成分、多靶点、多通路调节血管内皮功能、炎症反应、钙钠离子转运、糖脂代谢等参与血管舒张、改善炎症、调节机体代谢、调节离子转运等而产生降压作用。     

不同频率电刺激对神经痛的干预作用

神经痛是由周围神经病变引起并放射至该神经支配范围内的疼痛，其临床症状重，持续时间长，治疗困难。本文总结近年来应用疏波、密波与疏密波电针和经皮电刺激于神经痛治疗的临床研究，结合相关实验对电针频率与补泻的关系研究，探索针灸治疗神经痛的可能应用前景。     

Looking Ahead in Renal Cell Carcinoma: Integrating New Agents in the Armamentarium of the Urologist

Urologists play a pivotal role in many aspects of the care of patients with renal cell carcinoma (RCC). However, until recently, in some European countries, they have rarely been involved in the systemic treatment of this disease or in the design of clinical trials. This is undoubtedly set to change with the emergence of new oral, molecularly targeted therapies for RCC. Sorafenib (Nexavar^®; Bayer Healthcare, West Haven, CT, USA) is one such therapy, which has already been shown to be efficacious and well tolerated for the treatment of RCC. Although targeted agents show great promise for the treatment of RCC, their precise role in the treatment of metastatic disease, and in adjuvant and neoadjuvant settings has yet to be defined. Drawing from their extensive experience of RCC, urologists will be instrumental in the design and application of clinical studies to define the role of targeted therapies in all settings of RCC and, ultimately, to integrate targeted therapies into clinical practice. Through increased understanding of the molecular pathways involved in RCC, research into diagnostic and prognostic markers, and commitment to clinical trials, urologists can be at the forefront of this progress.     

放射性~(125)I粒子组织间植入对家兔尿道损伤的实验研究

目的:研究不同剂量的放射性125I粒子对家兔尿道的放射性损伤。方法:麻醉下将放射性125I粒子植入雄性家兔尿道旁1.0cm处。125I粒子的放射性粒子活度分别为14.8MBq(A组)、29.6MBq(B组)和44.4MBq(C组),对照组(D组)仅尿道旁种植相当于粒子大小无放射性的无菌铅管1粒。植入后4周,摄尿道片,观察粒子位置等情况;原手术切口切开,取放射粒子周围2.0cm范围内的家兔尿道组织作肉眼、光学显微镜和电子显微镜观察,进行放射性损伤的评价。结果:术后4周,肉眼及光学显微镜观察,实验组与对照组粒子周围的尿道粘膜、粘膜下及肌层所见基本一致;C组少部分电镜视野中观察到尿道上皮胞质出现较多空泡变性、空化、嵴稀疏等超微结构的损伤。光镜下尿道入射性损伤评分,A、B、C、D组分别为(2.20±0.18)、(2.23±0.15)、(2.27±0.10)、(2.10±0.17)分,A、B、C组与D组相比,差异无显著性(P>0.05)。对线粒体作FlaMeng半定量分析,A、B、C、D各组评分分别为(1.23±0.13)、(1.34±0.25)、(1.41±0.30)、(1.12±0.13)分,A、B、C各组与D组(对照组)相比,差异无显著性(P>0.05)。结论:放射性125I粒子对尿道放射性损伤随粒子的放射性活度的增加而逐渐加重,呈明显的放射性活度效应关系;正常剂量的放射性粒子对尿道的损伤是很轻微的,是安全可行的。     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

基于复杂网络的《新针灸学》与《经络腧穴学》比较分析研究（英文）

提取《新针灸学》《经络腧穴学》中穴位名称、主治病症信息,基于复杂网络建立穴-症网络,分析两者穴位数量、相互关联程度及主治规律变化,借助拓扑学数据解释变化原因,为传统针灸知识体系的结构化、标准化研究提供具体思路和方法。共纳入《新针灸学》386穴、773种症状、形成152163个穴位配伍对,《经络腧穴学》403穴、253种症状、28755个穴位配伍对。两本教材的穴-症网络存在丰富的差异性,其所载的病症结构化程度随医学知识的更新而提升。《新针灸学》模型具有更加典型的小世界效应,或因其以病症为主要分类手段的优势体现。两本教材穴位定位与主治方面发生许多变化,学科发展、时代背景等方面是变化的主要原因。