[Objective]To discuss the treatment of tibiofibular fracture and soft tissue defects by combination of adjacent tissue flap transplant and external fixation.[Method]Sural neurovascular flaps,saphenous neurocutaneous vascular flaps,gastrocnemius flaps or other tissue flaps were selected to repair soft tissue defects.Among them there were 4.5 cm?3 cm-16 cm?8 cm soft tissue defect respectively,with unilateral or ring external fixators to fix tibia fracture.[Result]In the 15 clinical cases,9 cases were with bone exposure caused by necrosis of soft tissue,3 cases with open tibia and fibula fracture with soft tissue defect,3 cases with non-union of bone fracture with scar.All transplanted flaps survived well.The follow-up time ranged from 12 to 72 months with an average of 36 months.All tibial fracture healed.The function of the lower extremities recovered well.[Conclusion]The application of adjacent tissue flap transplant combined with external fixation technique is very effective in treating tibiofibular fracture with soft tissue defect.

To investigate the mechanisms of the rarity of metastasis to skeletal muscles. Animal models of blood borne metastasis to skeletal muscle and lung were established,VCAM 1 expressions of the microvascular endothelium in these organs were estimated using immunohistochemistry.The effects of skeletal muscle conditioned media(MCM) on several tumor cell lines were tested by MTT assay.Tumor cells or metastatic foci could be seen rarely in the connective tissue beside muscle bundles of the femoral muscles,however, there is no metastatic foci among muscle cells.The difference of metastatic rate between skeletal muscles and lungs was significant( P

After the introduction of origin and significance of field medical card,this paper mainly analyses the field medical card in such aspects as preferable user,information demand,function demand and structure demand.Moreover,this paper briefly introduces the technologies of two-dimensional barcode,magnetic card,IC card,optical card,radiofrequency identification and blue tooth.The radiofrequency identification technology is feasible.

ObjectiveTo evaluate the reliability and clinical value for detecting paraquat (PQ)concentration in serum by spectrometry. MethodsThe determinations of wave length for detecting serum PQ concentration by ordinary spectrometry and second-derivative spectrometry were carried out. When the second-derivative spectrometry was used for detecting PQ in serum, the linear range and precision for PQ concentration were well defined. The results of serum PQ concentration determined by second-derivative spectrometry and by HPLC (high performance liquid chromatography) were compared in 8 patient with PQ poisoning. A total of 21 patients with acute poisoning after PQ ingestion over 4 hours admitted from October 2008 through September 2010 were retrospectively studied. Patients were divided into two groups as per the serum concentrations more than 1.8 μg/mL or less than that by second-derivative spectrometry on the day of admission. The severity of clinical manifestations between two groups was analyzed with t-test or Fisher's exact probabilities analysis. Results ( 1 ) The absorption peak of 257 nm could not be found by using ordinary spectrometry to detect the PQ concentration in serum. (2) The calibration curve in the 0. 4 ～ 8.0μg/mL range for detecting PQ concentration by second-derivative spectrometry observed the Beer's law (r =0. 996) . The average retrieval rate of PQ was within the range of 95.0％～ 99. 5％ with relative standard deviation (RSD) within 1.35％～ 5.41％ ( n = 6), and the lowest detection limit was 0. 05μg/mL. (3) The results of PQ concentrations from 8 patients with PQ poisoning detected by second-derivative spectrometry were consistent with those of the quantitative determinations by HPLC ( r = 0. 995,P＜0. 01 ) . (4) The survival rate of patients with serum PQ concentration more than 1.8 μg/mL was 22. 2％ ,and the incidences of acidosis, oligouria and pneumomediastium in these patients were 55.6％,55. 6％ and 77.8％, respectively. These clinical manifestations were significantly different from those in patients with serum PQ concentration less than 1.8 μg/mL ( P ＜ 0. 05 ) . Conclusions ( 1 ) It was inappropriate to take 257 nm as the determination wave length for detecting serum PQ concentration by ordinary spectrometry. (2) The method of second-derivative spectrometry was reliable for detecting serum PQ concentration. (3) Serum PQ concentration detected by second derivative spectrometry could be used to predict the severity of clinical manifestations of patients with PQ poisoning and was an important predictive factor for poor prognosis if the serum PQ concentration more than 1.8 μg/mL after PQ ingestion over 4 hours.

Objective To investigate the role of the QQ group follow up of nursing education on patients with nasopharyngeal carcinoma after radiotherapy in patients after they discharged. Methods Thirty patients with nasopharyngeal carcinoma hospitalized from January to December 2013 in our department were set as control group and another 30 patients with NPC hospitalized from January to December 2014 in our department were assined to in the experiment group. Patients of two group received health education before discharge . The controls were followed up on phone and the experimental group received QQ group follow up of education for one year, besides phone follow-up. The two groups were compared in terms of incidence of adverse reactions one year after discharge. Results One year after discharge , the incidences of side effects in the experiment group were lowered than those in the control group , and the differences were siguificant difference ( all P < 0 . 05 ) . Conclusion The QQ group follow up of nursing education can reduce the incidence of adverse reactions by radiotherapy after discharge.

Objective To investigate the clinical value of joint detection of six tumor markers in patients with colorectal cancer. Methods Eighty?six patients with colorectal cancer were included in the study group,86 healthy subjects were selected as the control group at the same period. The difference of tumor markers in different groups,tumor stages and prognosis were compared. Results The levels of carcinoembryonic antigen (CEA),carbohydrate antigen 19?9 (CA19?9),carbohydrate antigen 242 (CA242),carbohydrate antigen 72?4 ( CA72?4) , carbohydrate antigen 125 ( CA125 ) and carbohydrate antigen 50 ( CA50 ) in study group were significantly higher than those in the control group (CEA: (22. 5±6. 2)μg/L vs. (2. 2±1. 0)μg/L;CA19?9:(95. 7±27. 3) U/ml vs. (17. 1±9. 5) U/ml;CA242:(29. 5±8. 3) U/ml vs. (6. 0±2. 7) U/ml;CA72?4:(21. 6 ±5. 1) U/ml vs. (3. 6±1. 2) U/ml;CA125:(95. 4±32. 8) U/ml vs. (18. 9±8. 4) U/ml;CA50:(51. 8±20. 6)μg/L vs. (8. 3±3. 7)μg/L,t=29. 98,25. 22,24. 97,31. 86,20. 95,19. 27,P<0. 05). Among the single index detections,the sensitivity and negative predictive value of CA72?4 were the highest ( 61. 6%, 68. 3%) , the specificity of CA19?9 was the highest( 91. 9%) ,the positive predictive value of CEA was the highest ( 80. 4%) . The sensitivity,positive predictive value and negative predictive value of the joint detection were all higher than those in each single index detection (80. 3%,87. 3%,74. 1%). The levels of CEA,CA19?9,CA242,CA72?4, CA125 and CA50 in patients with stage III and IV were significantly higher than those in patients with stageⅠandⅡ(CEA:(32. 7±7. 1)μg/L vs. (15. 9±4. 4)μg/L;CA19?9:(127. 8±33. 7) U/ml vs. (52. 5±13. 8) U/ml;CA242:(40. 3±12. 7) U/ml vs. (23. 5±8. 6) U/ml;CA72?4:(37. 6±10. 2) U/ml vs. (13. 6±4. 1) U/ml;CA125:(128. 9±38. 4) U/ml vs. (59. 7±12. 8) U/ml;CA50:(88. 3±23. 7)μg/L vs. (41. 8±15. 6)μg/L,t=13. 04,13. 32,7. 11,14. 06,10. 99,10. 64,P<0. 05) . The levels of CEA,CA19?9,CA242,CA72?4,CA125 and CA50 in the recurrent metastasis group were significantly higher than those in the non?recurrent metastasis group ( CEA:( 37. 7 ± 8. 6 ) μg/L vs. ( 3. 8 ± 1. 7 ) μg/L;CA19?9:( 110. 5 ± 29. 4 ) U/ml vs. ( 25. 5 ± 13. 8 ) U/ml;CA242:( 33. 6 ± 10. 3 ) U/ml vs. ( 15. 5 ± 6. 6 ) U/ml;CA72?4:( 33. 1 ± 15. 3 ) U/ml vs. ( 9. 3 ± 3. 0 ) U/ml;CA125:(113. 4±31. 7) U/ml vs. (28. 7±7. 8) U/ml;CA50:(55. 4±14. 6)μg/L vs. (16. 8±9. 6)μg/L,t=29. 04,18. 31,9. 86,11. 47,19. 28,14. 65,P<0. 05) . Conclusion The joint detection of six markers can further improve the sensitivity, positive predictive value and negative predictive value of diagnosis, and can provide a more reliable basis for the auxiliary diagnosis of colorectal cancer.

OBJECTIVETo investigate the reasons for the rarity of metastases in skeletal muscle.

METHODSBy injecting tumor cells (Walker256 rat carcinosarcoma) through the iliac artery (experimental group) and the tail vein (control group), animal models of blood-borne metastases were established. The quadriceps femoris muscle and lungs were observed grossly and microscopically. Immunohistochemistry was applied to investigate the expression of vascular cell adhesion molecule-1 (VCAM-1) in the microvascular endothelium of these organs. Primary culture of rat skeletal muscle cells was established and conditioned medium (MCM) was collected. Effects of MCM on several tumor cell lines and the biochemical characteristics of skeletal muscle delivered tumor factor(s) were tested by MTT assay. Apoptosis and morphological examination were carried out to investigate the antitumor mechanisms of MCM.

RESULTSIn the experimental group, there were no definite metastases observed in muscle cells. In the control group, lung metastases were present in the lungs of all rats that were sacrificed at the 14th day or died spontaneously (17 rats in all). There was no significant difference between the increase in VCAM-1 in quadriceps femoris muscle 7 days after iliac artery injection and that in lungs 7 days after tail vein injection (P > 0.05). In vitro studies showed that the proliferation of tumor cell lines of mouse SP2/0 myeloma, rat Walker256 carcinosarcoma or human chronic granulocytic leukemia K562, human acute lymphatic leukemia HL-60, LS-174-T colon adenocarcinoma, PC3-M prostatic carcinoma and lung giant cell carcinoma with different metastatic potency (PLA801-C with low metastatic potency, PLA801-D with high metastatic potency) was significantly inhibited when cultured with MCM (P < 0.01 - 0.05). Proliferation of malignant cells showed a dose-dependent decrease, to a certain degree. Proliferation of normal rabbit joint epiphysial disk cells (RGP-2) were not affected by MCM. Proliferation of lung giant cell carcinoma cells with high metastatic potency showed a significant decrease even when cultured in highly diluted MCM (6.25% of primary MCM), when compared with the strain of low metastatic potency. Following ultrafiltration, boiling at 100 degrees C, and treatment with trypsin, skeletal muscle delivered tumor factor(s) were found to be a low molecular weight (MW

CONCLUSIONSThe rarity of metastases in skeletal muscles, generally accepted in the clinical setting, can be reproduced in an animal model. It does not seem to be related to VCAM-1 expression in the microvessels of these organs. Skeletal muscle delivered factor(s) play a key role in the mechanism of the rarity of metastases in skeletal muscle.

Animals ; Cell Division ; Humans ; Immunohistochemistry ; Muscle Neoplasms ; pathology ; secondary ; Muscle, Skeletal ; physiology ; Rats ; Rats, Wistar ; Tumor Cells, Cultured ; Vascular Cell Adhesion Molecule-1 ; analysis

This paper was aimed to screen and analyze the genotypes of thalassemia of the residences in Sichuan Province. The phenotypes of thalassemia was screened by hemoglobin electrophoresis, and the genotypes of the phenotype positive cases was analyzed. There were 69 alpha-thal and 115 beta-thal phenotype positive cases in 3185 subjects. A total of 157 cases were diagnosed as thalassemia. These included 53 alpha-thal, 102 beta-thal and 2 alpha/beta-thal cases. The positive rates were 1.66%, 3.20%, 0.06%, respectively. It can be seen that Sichuan is one of the provinces with a high incidence of thalassemia. Hemoglobin electrophoresis is an important method for thalassemia screening, and GAP-PCR and PCR-RDB technology for thalassemia genotype analysis. A combination of both enables a wide range of screening and diagnosis of thalassemia.
Adult ; China ; epidemiology ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Mass Screening ; Prevalence ; alpha-Thalassemia ; epidemiology ; genetics ; beta-Thalassemia ; epidemiology ; genetics

Objective To explore the four tumor markers of alpha-fetoprotein ( AFP ), α-L-fucosidase( AFU), carbohydrate antigen 199 ( CA199) and carcinoembryonic antigen ( CEA) and their combined use for primary hepatocellular carcinoma (HCC) diagnosis and treatment value. Methods From February 2016 to August 2018,92 patients with primary hepatocellular carcinoma (HCC group),79 patients with benign liver disease (chronic hepatitis and cirrhosis group) and 99 healthy adults (control group) were selected as subjects. The serum levels of four tumor markers in different populations were compared. Results The serum levels of four tumor markers ( AFP ( 192. 4 ± 89. 3) μg／L、AFU( 78. 6 ± 25. 8) U／L、CA199 (107. 2 ± 59. 5) U／mL、 CEA ( 37. 9 ± 14. 9) μg／L) were significantly higher than those of benign liver disease group(AFP( 17. 4 ± 6. 3) μg／L、AFU( 35. 4 ± 17. 2) U／L、CA199( 29. 3± 15. 2) U／mL、CEA( 4. 9 ±1. 7) μg／L) and normal people( AFP(4. 8±1. 1) μg／L、AFU(12. 2±3. 6) U／L、CA199( 6. 4± 2. 3) U／mL、CEA(1. 8±0. 4) μg／L) . There differences had significant ( all P＜0. 05) . The abnormal rate of single factor in hepatocellular carcinoma group ( AFP 84. 8%, AFU 52. 2%, CA199 41. 3%, CEA35. 9%) was significantly higher than that in benign liver disease group ( AFP 15. 2%, AFU 19. 0%, CA19916. 5%, CEA13. 9%) and normal group (AFP 4. 0%,AFU 5. 0%,CA199 3. 0%,CEA 6. 0% ug／L),the difference was statistically significant ( all P＜0. 05) . The highest sensitivity was AFP ( 84. 8%) and the highest specificity was AFP and CA199 (91. 0%). The sensitivity of combined detection was 94. 6% higher than that of single index ( AFP 84. 8%, AFU52. 2%, CA199 41. 3%, CEA35. 9%) . Conclusion The combined detection of AFP,AFU,CA199 and CEA can increase the sensitivity of diagnosis of hepatocellular carcinoma and reduce the rate of missed diagnosis, which will be beneficial to the early diagnosis and treatment of hepatocellular carcinoma.

Objective To analyze the biomechanical effects of gravity loading countermeasure garment on human lumbar intervertebral disc in microgravity environment. Methods Based on CT images of a healthy adult volunteer, the finite element model of L4-5 vertebrae was established. Through the empty load and 400 N axial loading for 4 hours on lumbar finite element model, the biomechanical effect of the non-intervention and gravity loading countermeasure garment were simulated respectively in microgravity environment. Results The central pore pressure, radial displacement and water content of the human lumbar intervertebral disc increased with time in microgravity environment. In the case of wearing gravity loading countermeasure garment, the central pore pressure, axial stress, radial displacement and water content of the lumbar intervertebral disc were reduced after 72 hours of cyclic loading compared with the non-intervention group. Conclusions Wearing gravity loading countermeasure garment can help astronauts to prevent the adverse effects of microgravity on the spine to some extent in microgravity environment.