BACKGROUND:The most important influence caused by patel ar fracture is the breakage of knee extension apparatus continuity and potential uncoordination of patel ofemoral joint. The aim of patel ar fracture surgery is to restore the smoothness of patel ar articular surface and to maintain the continuity of knee extension apparatus, to provide stable effective fixation, so as to do early functional exercises. OBJECTIVE:To evaluate the clinical effectiveness of a fixation technique for patel ar fractures using QWIX combined with Kirschner wire and wire. METHODS:From September 2011 to September 2012, 30 patients with patel ar fractures were treated using QWIX screws combined with Kirschner wire and wire in the First Affiliated Hospital of Chongqing Medical University, China. There were 17 males and 13 females, at the age of 47.7 years on average. In accordance with the situation of comminuted fracture and the degree of displacement, QWIX screws or QWIX screws+tension band wire or QWIX screws+Kirschner wire+tension band wire were used for fixation. Active and passive knee motion exercises began at 1 day after surgery, without any external fixation. At 6 weeks, 3, 6, 12 months, and 1 year after surgery, the patients were fol owed up in out-patient clinic to identify fracture healing and to make sure whether complications appeared or not. The range of flexion and extension of bilateral knee was measured. The knee function of the affected side was evaluated using Bostman score at 1 year postoperatively. RESULTS AND CONCLUSION:Al patients were fol owed up for 12 to 24 months. 24 cases were healed within 3 months after surgery, and 6 cases were healed within 4 months after surgery, with an average healing time of 3.2 months. With time prolonged, the range of flexion and extension of bilateral knee gradual y increased. The knee function of patients recovered to the level before injury at 1 year after surgery. During fol ow-up, one patient experienced knee pain due to Kirschner wire loosening. No infection, knee pain, fixation failure, or flexion dysfunction occurred in the remaining patients. In accordance with Bostman score, there were excellent in 27 cases, good in 3 cases, and poor in 0 case, with an excellent and good rate of 100%at 1 year fol owing surgery. Results data suggested that QWIX screws combined with Kirschner wire and wire fixation in repair of patel ar fracture have some advantages such as continuous dynamic and static pressure at the broken ends of the bones, early flexion and extension exercises, and reducing the fixation-related complications. It is an effective method to repair patel ar fracture.

Objective: To confirm the effectiveness of fluoxetine in treatment of depression associated with apparent life events Method: Sixty-two depressive patients who had a total score of the Life Event Scale of more than 30 were treated with fluoxetine for 6 weeks, diazepam was added if necessary CGI, HAMD and HAMA were used to assess the result Result: At the endpoint, the total score of HAMD decreased from 23?4 at baseline to 10?6, the total score of HAMA was also decreased significantly (23?5 to 10?6) At the meantime, the HAMD sleep factor and CGI severity score were also decreased significantly All above measurements showed improvement at the first week of treatment The adverse effects were mild, with lose of appetite, dry mouth and nausea as the most frequently seen, which had no influence on treatment process Conclusion: Fluoxetine plus diazepam is effective in depressive patients with apparent life events with quick response and mild adverse effects

Objective To investigate optimum dose of anesthesia in pediatric axillary brachial plexus branch block under ultrasound-guided. Methods Forty-eight children from May 2012 to May 2013 in hand surgery of our hospital,whose age was from 6 to 12 years,were randomly divided into four groups, each group has 12 cases. The doses of Ropivacaine were different in different groups. Group A was 0. 25 mL/kg,group B was 0. 2 mL/kg,group C was 0. 15 mL/kg,group D was 0. 10 mL/kg. And Ketamine was added to the treatment ac-cording to the incidence of anesthesia intraoperative. Evaluating the effect of anesthesia according to the situation of nerve block,observing an-esthesia duration time,dosage of anesthesia and rates of complications. Results The blocking effect of group A,B and C in each nerve area was correspond after 30 min,and anesthesia efficiency was higher than group D,but additional rate was lower than group D,the differences were statistically significant (P<0. 05). The block time in group D was shorter than the other groups,and the dose of Ketamine was most, and the block onset,perfect time were longer than the other groups (P<0. 05). But the differences between group A,B,C were not signifi-cant. Two cases in group D converted to general anesthesia. Four groups did not occur complication related narcotic drug. Conclusion In pediatric brachial plexus block used Ropivacaine under ultrasound-guided would get complete branch block,the exact effect of anesthesia, smaller dosage of local anesthesia. When the dosage of Ropivacaine was 0. 15 mL/kg could achieve a better anesthesia effect.

Objective To design an adjustable frame for four limbs disinfection, and applied it to clinic, to prevent skin damage of eatagmatic limb due to heighten the limb for the preoperative disin-fection.Methods 180 patients who need to heighten limb for diaplasis were divided into the observation group and the control group averagely according to the sequence of operation time.Patients in the observa-tion group were heighten limbs by using the adjustable frame, while the control group were heighten limbs onto the fluid frame by traditional methods.Skin lesions, the contamination of the limb and the time for disinfection were observed.Results Skin lesions of the observation group and the control group were 2% and 20%, re-spectively,the difference was statistically significant.There was no case in the observation group was contami-nated and 16 cases were contaminated in the control group, the difference was statistically significant.The aver-age time for disinfection in the observation group was (17.6 ± 2.4)minutes, in the control group,(21.3 ± 3.2) minutes, the difference was also statistically significant.Conclusions Using the adjustable frame for limbs disinfection can reduce the skin damage, shorten the disinfection time and improve work efficiency.

BACKGROUND: With the development of biotechnology, the electrophysiology of repairing heart tissues of myocardial infarction or myocardial hypertrophy by using bone marrow mesenchymal stem cell has become a hot spot. OBJECTIVE: To overview the research progress of cardiac electrophysiological characteristics after transplantation of induced differentiation of bone marrow mesenchymal stem cells into cardiomyocytes. METHODS: The databases of PubMed, Springer Link, Science Direct and CNKI were retrieved for papers published from January 2000 to October 2010 with the key words of bone marrow mesenchymal stem cells, cardiac/heart, electrophysiology/electrophysiological characteristics. The relevant articles concerning cardiac electrophysiological characteristics of induce differentiation and transplantation of bone marrow stem cells were collected. RESULTS AND CONCLUSION: Totally 208 papers have been searched. Preliminary screening by reading abstracts to exclude 162 papers that study purpose do not coincident with this review either contents duplicated, and internalized 46 papers at last. Bone marrow mesenchymal stem cells after induced differentiation and transplantation could improve heart function of animal experimental model and myocardial infarction or myocardial hypertrophy patients. Although the cardiomyocyte-like cells from bone marrow mesenchymal stem cells could help to improve heart function, the cardiac electrophysiological characteristics may be influenced by them.

Objective:To investigate the effects of moxibustion on the serum metabolism in healthy human body based on the 1H nuclear magnetic resonance (1H NMR) metabolomics technology, and to find the differences in metabolites, as well as to elucidate the effects of moxibustion on healthy human body from the viewpoint of global metabolism. Methods:Sixty subjects of healthy young men from the enrolled students were randomly divided into a moxibustion group and a control group using random number table, with 30 cases in each group. Subjects in the moxibustion group accepted mild moxibustion on the right Zusanli (ST 36), once a day, 15 min for each time, and continuous treatment for 10 d; those in the control group did not receive any intervention. There were 28 cases in the moxibustion group and 23 cases in the control group after interventions. On the 1st day, 5th day and 10th day of the intervention, serum samples were collected from subjects of the two groups, and metabolic spectra were obtained by the1H NMR technology. Results: Before and after the intervention, serum1H NMR of the moxibustion group was significantly different, while the difference was insignificant in the control group. Metabolite changes in the moxibustion group were mainly in low density lipoprotein (LDL)/very low density lipoprotein (VLDL), valine, isoleucine, leucine, lactic acid, glutamine, citric acid, polyunsaturated fatty acids, creatine, glycine, glycerol, glucose, tyrosine, histidine, formic acid, alanine, lysine, acetic acid, and glutamic acid. Conclusion:Moxibustion can cause changes of serum metabolic patterns in healthy human by influencing the concentrations of branched-chain amino acids, polyunsaturated fatty acids, and other metabolites to strengthen body's metabolisms of amino acids and fatty acid.

OBJECTIVETo analyze the reason of biochemical suboptimal response in CHB patients with complete virological response after more than 2 years standard treatment with Nucleos(t)-ide analogs (NUCs).To evaluate the efficacy and safety profiles of bicyclol tablets plus on the basis of the original treatment and lifestyle intervention. in CHB patients complicated with fatty liver.

METHODSIn 40 patients with chronic hepatitis B meeting the inclusion criteria,the liver biopsy was conducted.And patients complicated with fatty liver were treated with bicyclol tablets (25 mg, t.i.d) additional consecutive 48 weeks. The changes of serum biochemistry indexes and liver fibrosis index were observed before and after treatment.

RESULTSAmong 40 patients, 27 were complicated with fatty liver(69.23%), fatty degree in liver cell and liver inflammatory were closely related to the advanced fibrosis (x² =4.746, P=0.029; x² =5.072, P=0.024). The expression of HBsAg in serum and liver tissue showed no correlation with the advanced fibrosis (x² = 0.273, P=0.601; x² = 0.020, P =0.887) After bicyclol tablets treatment, serum biochemistry of patients complicated with fatty liver significantly decreased (F=58.045, P =0.000), plasma GST-PX significantly increased (t=15.109, P =0.000), plasma MDA significantly decreased (t=-10.786, P=0.000); LSM significantly decreased (t=2.255, P=0.036; t =5.376, P =0.002).

CONCLUSIONFor the antiviral purpose of guide treatment, CHB patients treated with Nucleos(t)-ide analogs (NUCs) with biochemical suboptimal response, other risk factors should be considered as early as possible. Bicyclol plus lifestyle intervention was effective for chronic hepatitis B combined fatty liver patients with poor biochemical responses.

Based on the understanding of TCM and western medicine on diabetes mellitus (DM) and diabetic peripheral neuropathy (DPN), the relationship between DPN pathogenesis and blood stasis of TCM is discussed from the perspective of modern medicine. It is indicated blood stasis is the key pathogenesis to DPN, and a two-step acupuncture treatment of DPN from the theory of blood stasis is proposed. The first step is to analyze the pathogenesis of blood stasis, which could block the progress of the disease and diminish the symptoms. The second step is to apply acupuncture for pathological result of blood stasis by following the principle of, as a result, the purpose of treating both symptoms and root cause is achieved.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.