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[Objective]To explore the treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation.[Method]From February 2001 to August 2005,21cases of acute Lisfranc fracture-dislocations were treated with open reduction and cannulated screw fixation.[Result] According to the AOFAS for mid foot,1 case scored 70 to 80,3 cases scored 80 to 90 and 17 cases scored 90 to 100.[Conclusion]Treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation in early stage can lead to satisfactory reduction and clinical results,it is a satisfying method.

Objective To observe the sedative and analgesic effects of local anesthesia with midazolam and sufent-anil for patients in ophthalmologic plastic surgery. Methods A total of 160 patients (ASA I-II) were randomly divided into two group using a random number table, 80 cases in each group, groupⅠ: local anesthesia and groupⅡ: local anesthesia with midazolam (0.05 mg/kg) and sufentanil (0.1μg/kg). Values of bispectral index (BIS), systolic blood pressure (SBP), dia-stolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), oxyhemoglobin saturation(SpO2) and visual analogue scale (VAS) were recorded after patients entered into the operating room, during the time of injection of local anesthesia, at the beginning of the procedure, 20 min after the surgery and after operation. It was also recorded including hypoxemia, ap-noea, restlessness, nausea and vomiting and the duration of surgery. Results There were no significant differences in age, gender, weight and duration of surgery between two groups of patients. There was a significantly lower BIS value before inject-ing local anesthesia, at the beginning of the surgery and 20 min after the surgery compared with that of time point that pa-tients entered into the operating room in groupⅡ(P<0.05). In groupⅠthere were significantly higher values of SBP, DBP and HR during the injection of local anesthesia, at the beginning of the procedure, 20 min after the beginning of the proce-dure and after the surgery than those of time point that patients entered into the operating room;the value of RR was signifi-cantly increased during the injection of local anesthesia, at the beginning of the procedure and 20 min after the beginning of the procedure than that of time point that patients entered into the operating room (P<0.05). Compared with before anesthe-sia induction, values of SBP, DBP, HR and RR were significantly decreased in groupⅡ(P<0.05). There were significantly lower levels of SBP, DBP, HR and RR during the local anesthesia injection to the time after surgery in groupⅡthan those of groupⅠ. The value of VAS was significantly higher during the time of injection of local anesthesia and during the surgery in groupⅠthan that of groupⅡ(P<0.05). There were 15 patients with restlessness in group I, which were higher than those of groupⅡ(3 patients with restlessness). There were 3 patients with nausea and 3 patients with anoxemia and no apnea in group Ⅱ. Conclusion The conscious sedation with midazolam and sufentanil is an effective anesthetic technique for patients in ophthalmo-logic plastic surgery.

Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.

Objective To investigate the role of p38MAPK in the differentiation of murine osteoblasts, and to observe the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). Methods The calvarial osteoblasts of newborn BALB/c mice were cultured in MEM medium containing 10% NCS. Raloxifene (10~(-7) mol/L) and 17β-estradiol (10~(-8) mol/L) were added respectively when cells reached 70%-80% confluence combined with or without 5 μmol/L SB202190, an inhibitor of p38MAPK. The osteoblasts alkaline phosphatase activity assays were performed 72 hours later using PNPP method, and mRNA levels of alkaliphosphatase (ALP), OPG and RANKL were determined by RT-PCR. Results 17β-estradiol and raloxifene increased ALP activity and ALP mRNA level in osteoblasts in vitro which were blocked by p38MAPK inhibitor.The mRNA levels of RANKL and OPG were up-regulated by 17β-estradiol and raloxifene while the ratio of OPG/RANKL kept constant. SB202190 (5 μmol/L) inhibited the highly expressed RANKL and OPG in osteoblasts, and obviously decreased the ratio of OPG/RANKL. Conclusions p38MAPK inhibition blocked the differentiation of osteoblasts and decreased the up-regulated OPG and RANKL expressions in osteoblasts significantly (P<0.05).

Objective To investigate the Th1/Th2 polarization of T lymphocytes in human peripheral blood stimulated by CpG-ODN2216,and the secretion of cytokines in supernatant of cultured PBMCs after stimulation of CpG-ODN2216.Methods Human PBMCs were isolated from blood of donors.The PBMCs were incubated with CpG-ODN2216 for 24 hours.Th1/Th2 subsets in the cultured PBMCs were examined by flow cytometry,and IFN-?,IL-2,IL-4 and IL-10 in the supernatant were assayed by ELISA.Results The percentage of Th1 and Tc1 increased significantly after stimulation of CpG-ODN2216 compared with control group (P0.05).Conclusion The Th1 cells and Tc1 cells in T lymphocytes of peripheral blood could be polarizated by CpG-ODN 2216.IFN-? secretion in PBMCs could be induced by CpG-ODN2216.

Background and purpose: Ductal carcinoma in situ (DCIS), is precursor lesions of invasive breast cancer, belongs to non-systemic ductal lesions, which is similar to other ductal lesions on imaging. This study aimed to investigate the differential diagnostic value of MRI in DCIS between DCIS with microinvasion (DCIS-MI) and breast intraductal papilloma (BIDP). Methods:All the cases were surgico-pathologically conifrmed. Twenty-four patients were DCIS, 9 patients were DCIS-MI, and 20 patients were BIDP. The MRI charateristics of DCIS, DCIS-MI and BIDP were analyzed and compared. Results:DCIS and DCIS-MI’s performance in the form of MRI is dififcult to differentiate (P<0.05). Compared with BIDP, the ductal and segmental enhancement, typeⅢtime-signal intensity curve (TIC), and the red pseudo-color image were associated with the DCIS. The local area enhancement, typeⅡTIC, and no-red pseudo-color image were associated with BIDP. Conclusion:MRI is a useful for differentiate between DCIS and BIDP, but is dififcult for DCIS and DCIS-MI.

Objective To study the effectiveness of subfascial endoscopic communicating branch vein ablation in treating communi cating branch vein insufficiency.Methods Fifty-seven cases of primary lower ext remity vein valve insufficiency complicated by communicating vein insufficiency diagnosed by venography and color duplex were treated with subfascial endoscopic communicating branch vein ablation, and their information was analyzed retrosp ectively.Results Swelling was observed in leg of 7 cases after operation, and disappeared within one week spontaneously. Incision infec tion occurred in 2 cases and skin ambustion happened in 2 cases. Superficial vei n varicosis disappeared in all case, skin pigmentatin declined significantly and ulcers healed in 2-3 weeks.Conclusion Subfascial endoscopic communicating branch vein ablation is an excellent choice in treating communicating branch ve in insufficiency.

Objective To evaluate the predictive performance of propofol target-controlled infusion (TCI) system incorporating the Schnider pharmacokinetic parameters in Chinese patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 25-45 yr, with body mass index 20-25 kg/m2 , scheduled for gynecological laparoscopic surgery un der general anesthesia, were enrolled in this study. Anesthesia was induced with TCI of propofol (target plasma concentration (Cp) 3 μg/ml) and remifentanil (Cp 4 ng/ml) . Propofol was infused by Orchestra TCI system incorporating the Schnider pharmacokinetic parameters. Tracheal intubation was facilitated with rocuronium 0.6 mg/kgafter the patients lost consciousness. The patients were mechanically ventilated. PETCO2 was maintained at 30-40 mm Hg. Anesthesia was maintained with TCI of remifentanil (Cp 4 ng/ml) and propofol (Cp 3-5 μg/ml) and intermittent iv boluses of atracurium 0.2 mg/kg. BIS value was maintained at 40-45. Venous blood samples were obtained at 15, 30, 45 and 60 min after pneumoperitoneum for measurement of blood propofol concentrations by high performance liquid chromatography with fluorescence detector. Performance error, median prediction performance error, median absolute performance error, wobble and divergence of propofol TCI system were calculated. Results The value for performance error was 21 % (13%), for median prediction performance error 6.7 % (37.4%),for median absolute performance error 19% (18%), for divergence - 0.65%/h (0.82%/h) and for wobble 16.3% (15.2% ) . Conclusion The accuracy of propofol TCI system incorporating the Schnider pharmacokinetic parameters is high in Chinese patients and its predictive performance is acceptable clinically.

ObjectiveTo explore the clinical and pathological features of Hainan patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital.Methods A total of 239 clinical cases of Hainan patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital from 2006 to 2010 were retrospectively analyzed.Results The number of thyroid carcinoma cases between 2006 to 2008 was stable.But the cases in 2009 were 72.97％ higher than that in 2008.Female' s peak of onset age was 25 to 55 years and male was 20 to 55 years.The cases of Hant were 231 (96.65％) and the national minority were 8(3.35％ ).So ethnic composition ratio between cases and local population has a very significant difference (x2 =21.376,P ＜0.01 ).The eastern and western regions had 175 cases and 64 cases respectively,138 (78.86％) and 34(46.88％ ) cases from city respectively.Urban and rural ratio between eastern and western areas had a significant difference (x2 =4.420,P ＜ 0.05 ).The 239 cases were composed of 228 cases (95.4％) of papilarry thyroid carcinoma,7 cases (2.92％) of medullary thyroid carcinoma,both 2 cases (0.84％) of follicular thyroid carcinoma and anaplastic thyroid carcinoma.Conclusions The incidence of Hainan nationality patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital has increased from 2006 to 2010,with younger trend and regional difference.Thyroid carcinoma has a difference in race and region.The rank of the rate of pathological type is papillary thyroid carcinoma,medullary thyroid carcinoma,follicular thyroid carcinoma,undifferentated thyroid carcinoma in order.