Objective To evaluate the treatment effects of the olecranon comminuted fracture by the angle stability prin-ciple combined with support under the articular surface. Methods From November 2008 to June 2012, 13 patients (7 male and 6 female, aged from 20 to 77 years) suffered from olecranon comminuted fracture were treated with Synthes anatomy locking com-pression plate and screws combined with Kirschner wires supporting under the articular surface through the posterior median ap-proach. Fractures occurred in the left elbow in 9 and in the right elbow in 4. According to the Mayo classification, 11 cases were classified as Mayo type IIB and 2 as IIIB. According to the Schatzker-Schmeling classification, 2 fractures were type A2, 9 type C, and 2 type D. One patient with type C fracture also had type I coronoid fracture according to Regan and Morrey classification. The Mayo elbow performance index (MEPI) and the shortened disabilities of the arm shoulder and hand (Quick-DASH) were employed to evaluate the functions. All patients took the satisfaction survey and X-ray during the follow-up. Results All patients were fol-lowed-up for 8 to 41 months. The mean ROM of the elbow joint was 112° (range, 65°-140° ), and the mean rotation angle of the forearm was 170° (range, 150°-180°). The mean score for the MEPI was 96 (range, 85-100), excellent 12, good 1. The mean score for the Quick-DASH was 6.2 (range, 0-16.7). In the satisfaction survey, 8 patients were very satisfied, 4 satisfied, 1 common level. All patients took the X-ray during the follow-up and all of them had achieved fracture union completely with the mean time period as 12.7 weeks (range, 11-24 weeks). No cubitus varus, valgus, and instability were found in all patients. No complication, such as infection, ulnar nerve injuries and etc. was found. Five patients complained about mild discomfort caused by internal fixation at 3 months after surgery. Three of them were diagnosed as joint stiffness because of ROM within 100° . One case in 3 elbow stiffness patients developed osteoarthritis after eight months, but no pain during joint activity. Internal fixation was removed in one case;an-other young patient took the operation for removal of internal fixation and release of medial ligament;the third patient refused oper-ation. Conclusion Angle stability principle (Synthes anatomy locking compression plate and screws) combined with supporting under the articular surface (Kirschner wires) can achieve stable fixation in treating olecranon comminuted fracture. It may realize the early exercise of the elbow joint with excellent clinical results. Therefore, it may be an optional choice in clinical practice.

Objective To understand the status of the blood safety in Handan region to provide the basis for recruiting blood do-nors in our region and the data support for meeting clinical blood use.Methods The detection results of 5 legal indicators among unpaid blood donors in Handan region during 2002-2012 were investigated and analyzed.Results The total positive rate of indica-tors detection was 5.52%,in which alanine aminotransferase(ALT)was 4.06%,hepatitis B surface antigen(HBsAg),hepatitis C virus antibody(anti-HCV)was 0.54%,human immunodeficiency virus(HIV)antibody(anti-HIV)was 0.24% and treponema palli-dum antibody(anti-TP)was 0.12%.Conclusion This survey is conducive to the blood donor recruitment work and strengthening the screening of blood donors is helpful for safety of clinical blood use.

Objective To evaluate clinical efficacy of tigecycline alone or in combination with other antimicrobials in treating infection caused by carbapenem-resistant Acinetobacter baumannii (CRAB).Methods Patients with hos-pital-acquired pneumonia (HAP)and/or bloodstream infection in the intensive care unit of a hospital between Janu-ary 2013 and June 2014 were selected,efficacy of tigecycline treatment was analyzed.Results Of 25 patients with CRAB infection,21 were with HAP,2 with bloodstream infection,and 2 with both HAP and bloodstream infec-tion.13 cases were multidrug-resistant Acinetobacter baumannii (MDRAB), 10 cases were extensively drug-resistant Acinetobacter baumannii (XDRAB).The susceptibility rate of 25 CRAB isolates to tigecycline was 84%. After treated with tigecycline,white blood cell count(WBC),C-reactive protein (CRP),and procalcitonin (PCT) all significantly decreased (all P<0.01).The clinical effective rate,bacterial clearance rate,and 30-day mortality were 68.00% (17/25),66.67%(14/21),and 28.00% (7/25)respectively;effective rate of 21 cases of HAP was 76.19% (16/21),1 case of bloodstream infection was effective,2 cases of HAP combined bloodstream infection died.Conclusion Tigecycline is effective in the treatment of HAP caused by CRAB,but the therapeutic effect on bloodstream remains uncertain,further research is needed.

r diagnosing the disease to combine pathology, immunohistochemistry and SYT-SSX gene detection.

AIM:To investigate the regulation mechanism for insufficient KChIP 2 expression induces Ito,f downregulation and arrhythmogene-sis in cardiac hypertrophy .METHODS:Bidirectional manipulations of MG 53 expression were performed by adenoviral overexpression of MG53 or knockdown of MG53 with RNA interference in neonatal rat ventricular myocytes with or without PE stimulation .Ito,f was re-corded with patch clamp in whole-cell mode 48 h after adenoviral transfection .Then the WT or MG53 knockout ( MG53 -/-) mouse model of left ventricular hypertrophy induced by transverse aortic constriction ( TAC) were used to detect the susceptibility to ventricu-lar arrhythmia.RESULTS: Here, we show muscle-specific MG53 regulates KChIP2 expression and Ito,f densities, where they are downregulated in hearts from MG53 knockout mice and MG53 knockdown rat cardiomyocytes , but upregulated in MG53 overexpressed cells.MG53 expression is decreased in phenylephrine ( PE)-induced cardiomyocyte hypertrophy and restoration of MG 53 rescues PE-induced downregulation of KChIP2 and Ito,f.Furthermore, MG53 is decreased in a mouse model of hypertrophy induced by transverse aortic constriction and ablation of MG 53 increases the susceptibility to ventricular arrhythmia by exaggerating Ito,f remodeling.CON-CLUSION:These findings establish MG53 as a novel regulator of Ito,f and its central role in arrhythmogenesis in hypertrophy .

Objective To investigate the changes of vital signs and the damage of important organs in dog progressive circulatory failures induced by soman.Method Seven male dogs,weighing(12～15)kg,were injected intramuscularly 1/3 LD sornan(1 LD=10μg/kg)per ten minutes.The moan blood pressure decreased to (40～45)mmHg was defined as circulatory failure.The changes of heart rate,blood pressure.and hemodynamic parameters were evaluated by an eight-channel direct-witing oscillograph,blood gas,pH value,electrolyte,and the damage of important organs were observed before and after sornan injection.Statistical analysis of the data was performed using the self control t test with the SAS 6.12 Software Program.Results In anesthetized dogs intoxicated with sornan,the circulatory failure was characterized by the significant decreases in blood pressure,heart rate and hemodymrnic parameters(P<0.05).Partial pressure of oxygen was less than 60 mmHg,saturation of oxygen Was less than 90% and partial pressure of carbon dioxide was greater than 50 mmHg in arterial blood of the dog model.These results showed mix respiratory failure occurred during intermittent positive pressure.Significant metabolic acidosis was induced by soman[pH(7.345±0.064)vs.(6.956±0.022),P<0.01].The concentralion of sodium ion and chloride ion in blood were changed gently.The concentrations of GTP,GOT,Cr,BUN,CK-MB and LDH were increased significantly(P<0.05),which showed multiple important organs including liver,kidney and heart were damaged by sornan.Conclusions The severe progressive circulatory failure induced by cholinesterase inhibitor sornan leads to the darnage of vital signs and important organs significantly.

ObjectiveTo evaluate the clinical feasibility of low dose MSCT for quantitative assessment of pulmonary function in smokers.MethodsOne hundred and forty-six patients with chronic objective pulmonary disease ( COPD ) including 109 smokers ( 74.6％ ) and 37 non-smokers ( 25.3％ )underwent pulmonary function test and low-dose MSCT scan.All data were analyzed using computer-aided lung anlysis software.Pulmonary function parameters from low-dose MSCT were compared between smokers and non-smokers and also compared with pulmonary function test in non-smokers ( Pearson test).Results In smokers,the average volume at full inspiratory phase (Vin) was (5125 ± 862 ) ml,mean lung attenuation was ( - 902 ± 26 ) HU,mean lung density was (0.0984 ± 0.0260 ) g/cm3,emphysema volume was (2890 ±1370) ml.The average volume at full expiratory phase (Vex) was (2756 ±1027) ml,mean lung attenuation was ( -811 ±62) HU,mean lung density was (0.1878 ±0.0631 ) g/cm3,emphysema volume was (685 ±104) ml.In non-smokers,the average Vin was (3734 ± 759) ml,mean lung attenuation was ( -876 ±40) HU,mean lung density was (0.1244 ±0.0401 )g/cm3,emphysema volume was ( 1503 ± 1217) ml.The average Vex was ( 1770 ± 679 ) ml,mean lung attenuation was ( - 765 ± 56 ) HU,mean lung density was (0.2360 ± 0.0563 ) g/cm3,emphysema volume was ( 156 ± 45 ) ml.There were significant differences between smokers and non-smokers (P ＜0.01 ).The Vex/Vin was correlated with residual volume/total lung capacity ( RV/TLC,r =0.60,P＜0.01 ),and Vin was correlated with TLC ( r =0.58,P ＜ 0.01 ),Vex with RV ( r =0.59,P＜0.01 ).Pixel index ( PI ) -950in was correlated with FEV 1％ pre and FEV1/FVC％ ( r =- 0.53,- 0.62,respective,P ＜ 0.01 ),Pl-950ex was correlated with FEV1 ％ pre and FEV1/FVC％ ( r =-0.71,-0.77,respective,P＜0.0l).ConclusionLow-dose MSCT can be a potential imaging tool for quantitative pulmonary function assessment in smokes.

BACKGROUND:Intervertebral disc degeneration is caused by damage and degeneration of the nucleus pulposus and annulus fibrosus tissues inside the intervertebral disc,resulting in structural and functional changes of the intervertebral disc.However,there is yet no effective drug treatment for intervertebral disc degeneration. OBJECTIVE:To investigate the inhibitory effect of syringin on intervertebral disc degeneration. METHODS:A total of 10 male Sprague-Dawley rats were selected,and the coccygeal intervertebral disc(Co4/Co5)of each rat was set as model group,Co5/Co6 intervertebral disc as syringin group,and Co6/Co7 intervertebral disc as control group.The control group did not receive any treatment.In the model group and syringin group,a miniature puncture needle was used to puncture the annulus fibrosus to establish an intervertebral disc degeneration model.Immediately after modeling,2.5 μL of normal saline and syringin solution(5 μmol/L)were given in the model and syringin groups,respectively.Four weeks after injection,the samples were taken.The degree of intervertebral disc degeneration in rats was observed by hematoxylin-eosin and safranine O-fast green staining.The expressions of type Ⅱ collagen,aggrecan and matrix metalloproteinases 3 and 13 in intervertebral disc tissue were analyzed by immunohistochemical staining. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that in the model group,the height of intervertebral disc decreased,the cartilage endplate became thinner and cracked,the fibrous ring structure was disordered and cracked,and the nucleus pulposus disappeared;in the syringin group,the height of intervertebral disc was normal or slightly lower than that in the control group,the degree of cartilage endplate degeneration was lighter than that in the model group,the fiber circle permutation was relatively regular with no cracks,and the nucleus pulposus was partially shrunk.Safranine O-fast green staining showed that in the model group,the cartilage endplate of the intervertebral disc was defective and the calcified layer of cartilage became thinner,showing obvious degeneration.The structure and morphology of intervertebral disc cartilage endplate in the syringin group recovered to some extent.Immunohistochemical staining showed that,compared with the control group,the expressions of type Ⅱ collagen and aggrecan in the intervertebral disc cartilage were decreased in the model group(P<0.000 1),while the expressions of matrix metalloproteinases 3 and 13 increased(P<0.000 1).Compared with the model group,the expressions of type Ⅱ collagen and aggrecan in the intervertebral disc cartilage tissue were increased in the syringin group(P<0.001,P<0.000 1),while the expressions of matrix metalloproteinases 3 and 13 decreased(P<0.001,P<0.000 1).These results showed that syringin could improve the structure and function of intervertebral disc by inhibiting the expression of matrix metalloproteinases 3 and 13 and increasing the expression of type Ⅱ collagen and aggrecan,thus preventing and slowing down the procession of intervertebral disc degeneration.

Objective To compare the effects of different anesthetics on the recovery of neurologi-cal function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18. 5-24. 0 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thick-ness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n= 50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1 ·min-1 , while the end-tidal sevoflu-rane concentration was maintained at 1. 4％-3. 5％ in group S. Immediately before induction (T0 ), imme-diately after the end of induction (T1 ), immediately after successful embolization of aneurysm (T2 ) and at 1, 2, 3 and 5 days after surgery (T3-6 ), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay. The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded. The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postop-erative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and inci-dence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0. 05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracra-nial aneurysm embolization.