Objective　Exploring how to check the proportional hazards assumption of the Cox model,and the solutions to non-proportional hazards between the covariates and the hazard function.Methods　With a example data set of Ⅲc stage ovarian serous cystadenocarcina,illustrating how to use graphical methods to check the proportional hazards assumption of the Cox model.Results　the predictor of post-surgery administering medicine times violated the proportional hazards assumption of the Cox model.Conclusion　when using the Cox model to analyze the predictors of survival time,checking whether the predictors violate the proportional hazards assumption of the Cox model or not should be paid attention to.

Objective To compare the medium-term clinical effects of oblique T-shaped volar locking compression plate (LCP) and external fixation (EF) treating type C distal radial fractures.Methods Data of 60 patients with type C distal radial fractures who underwent surgery in our hospital from May 2010 to November 2012 were retrospectively analyzed.36 patients received open reduction with LCP fixation (LCP group),among which there were 21 males and 15 females,and there were 20 left wrists and 16 right wrists with an average age of 45.94±16.29 years old (range,17-80 years old).24 patients received close reduction and external fixation (EF group),among which there were 16 males and 8 females,and there were 15 left wrists and 9 right wrists with an average age of 43.63±14.55 years old (range,16-79 years old).The clinical results of wrist joint were assessed by range of wrist activity,VAS,Gartland-Werley wrist score,postoperative radial tilt angle,radial inclination angle and radial height.Results All the 60 patients were followed up successfully.The LCP group was followed up for 24 to 55 (42.03 ± 8.62) months.The EF group was followed up for 24 to 54 (37.24±9.77) months.In the LCP group,the average VAS score was 1.28±0.78,Gartland-Werley score 2.28±0.78,wrist flexion angle 50.89°±5.53° and wrist dorsiflexion angle 50.69°±5.38°.In the EF group,the average VAS score was 1.38±0.71,Gartland-Werley score 2.92± 1.69,wrist flexion angle 50.96°±5.01° and wrist dorsiflexion angle 51.08°± 5.73°.No statistically differences were found in wrist joint function between two groups.In LCP group,radiological evaluation 2 years after operation showed that the average radial tilt angle was 10.69°±2.29,radial inclination angle 22.53°± 1.95° and radial height 10.63±1.14 mm.In the EF group,radial tilt angle was 6.63°±2.76°,radial inclination angle 16.96°±4.41° and radial height 9.06±0.98 mm.Significant differences were found in radial tilt angle,radial inclination angle and radial height.No statistically differences were found in postoperative complication rates.Conclusion Locking compression plate (LCP) fixation and external fixation (EF) can obtain similar satisfactory medium-term clinical outcome in treating type C distal radial fractures.Comparison with EF,LCP can achieve anatomic reduction under direct vision,and its radiological assessments including radial tilt angle,radial inclination angle and radial height were significantly better than external fixation.

ObjectiveTo investigate the expression and clinical significance of myeloperoxidase (MPO) in patients with chronic ischemic cerebrovascular disease.Methods70 carotid atherosclerotic plaques patients with plasma MPO level in our hospital were measured and taken ultrasound examination at the same time.ResultsThere was no significant difference for those with contrast-enhanced imaging and without increase in the general information (P ＞0.05).The enhanced infarct rate was 80.5％ (33/41).The non-enhanced infarct was 44.8％ (13/29).The carotid plaque ultrasound contrast enhancement in patients with cerebral infarction group was significantly higher than non-enhanced group(P ＜ 0.01 ).In the plasma levels of MPO detection,contrast-enhanced carotid ultrasound group was significantly higher than non-enhanced group( P ＜ 0.01 ).The cerebral infarction patients was significantly higher than non-cerebral infarction group (P ＜ 0.01 ).ConclusionThe atherosclerotic plaque instability in patients with high expression level of MPO was significantly higher,which indicated high level expression of MPO in the diagnosis of chronic cerebrovascular disease had a very important role.Supplemented by the results of ultrasound imaging may had a clear diagnosis.

Objective To determine the diagnostic and therapeutic approach of cute cardiac perforation and tamponade complicating percutaneous balloon mitral valvuloplasty. Methods and Results Percutaneous balloon mitral valvuloplasty was performed in 772 patients with rheumatic mitral stenosis from May 1992 to Dec. 2001, 9 were diagnosed cardiac perforation, 2 which developed pericardial tamponade which was successfully controlled by contrast and X ray guided pericardiocentesis using a subxiphoid approach. Conclusions Only a minority of cardiac perforation resulted from PBMV developed pericardial tamponade. The latter could be controlled safely and effectively by contrast and X ray guided pericardiocentesis using a subxiphoid approach.The diagnosis of pericardial tamponade during or after PBMV relies on a strong clinical suspicion, and contrast and X ray guided pericardiocentesis should be carried out without echocardiography for patients in unstable state.

OBJECTIVE:To establish the quality standard for Xiaoer Zhike oral liquid(XZOL).METHODS:The Herba Ephedrae,Pericarpium Citri Reticulatae and Radix Glycyrrhizae in XZOL were identified by TLC.The chlorogenic acid in the liquid was determined by HPLC,The mobile phase was methanol-water(10∶90)with a flow rate of1ml/min,the detection wavelength was254nm.RESULTS:The Herba Ephedrae,Pericarpium Citri Reticulatae and Radix Glycyrrhizae in XZOL could be identified on TLC chromatograms.The linear range of chlorogenic acid was0.2?g～1.2?g(r=0.9996),the average recov?ery was96.67%,RSD was1.04%.CONCLUSION:The method is simple,reliable and accurate.The method can be used for quality control of XZOL.

BACKGROUND:Open fractures often present soft-tissue defects, high-risk infection, and fracture with bone defect, often lead to more postoperative complication, defect of limb function, and bring great difficulties to clinical treatment. There is some controversy in the treatment of such fracture. Relevant animal experiment and clinical study become the hotspot in recent years. OBJECTIVE:To review some controversy about open fracture treatment and latest research. METHODS:A computer-based online search of China National Knowledge Infrastructure database and PubMed was performed for articles published from January 2005 to January 2015. Key words included “Open fracture, Evaluation and prognosis of injury, Antibiotics, Debirdement, Treatment of fracture, Wound repair”. More than 100 literatures were retrieved, and 47 articles met the inclusion criteria. RESULTS AND CONCLUSION:After a large number of animal experiments and clinical application, open fracture debridement, prevention of infection, implant selection and evaluation of prognosis had been deeply studied, especialy the study of implant treatment of bone defects. Metal three-dimensional printer has changed the traditional concept of implant. Nano titanium dioxide /PEEK bioactive composite materials have become a hot research in recent years.

Objective To investigate the expressions and clinical significances of Runt-domain-related 3 (Runx3) and chromodomain helicase DNA-binding protein 5 (CHD5) in colorectal cancer.Methods Ninety-six colorectal cancer tissue samples and matched adjacent normal tissues and 72 colorectal adenoma tissues were collected.Real-time quantitative polymerase chain reaction (qRT-PCR) and Western blotting were used to detect the mRNA and protein expression of Runx3 and CHD5.The associations of Runx3 and CHD5 expression with clinical pathological characteristics,diagnostic value and prognosis relationship of patients were further analyzed.Results Runx3 and CHD5 relative expressions of mRNA and protein were 0.35 ± 0.00,0.28 ± 0.02 and 0.26 ± 0.02,0.31 ± 0.01,which were significantly lower than those in the matched adjacent tissues 0.95 ± 0.02,0.92 ± 0.02 and 0.89 ± 0.03,0.93 ± 0.02 (t =2.36,P ＜ 0.05;t =1.25,P ＜ 0.05;t =1.37,P ＜ 0.05;t =1.13,P ＜ 0.05) and colorectal adenoma tissues 0.89 ± 0.02,0.90 ± 0.02 and 0.85±0.02,0.87±0.04 (t=2.27,P＜0.05;t=2.16,P＜0.05;t=1.25,P＜0.05;t=2.65,P＜0.05).Runx3 and CHD5 expressions differed significantly between tumors with different TNM stages (x2 =4.65,P =0.031;x2 =7.89,P =0.005),depths of tumor invasion (x2 =4.17,P =0.041;x2 =4.86,P =0.028),lymph node statuses (x2 =4.20,P =0.040;x2 =7.02,P =0.008),or histological differentiation (x2 =7.31 P =0.036;x2 =9.54,P =0.023).Linear correlation analysis showed that the expressions of the two genes were positively correlated (r =0.572,P =0.001).Receiver operating characteristic (ROC) curve showed that Runx3 and CHD5 had diagnostic value (AUC were 0.712,0.745;sensitivity and specificity were 45.9％,52.5％ and 83.6％,81.4％ respectively).Runx3 and CHD5 both low expression group compared with the other patient groups in overall survival time (x2 =8.156,P ＜ O.05) and progression-free survival (x2 =6.325,P ＜ 0.05) had statistically significant differences.Conclusion Runx3 and CHD5 are low expressed in colorectal cancer and may prove useful as biomarkers for diagnosis target and prognostic indication in patients with colorectal cancer.

OBJECTIVE:To compare the efficacy and safety of Sodium hyaluronate versus Carbomer,Polyethylene glycol,To-bramycin and Dexamethasone in the treatment of glaucoma with cataract. METHODS:464 glaucoma patients with cataract were randomly divided into group A(116 cases),group B(116 cases),group C(116 cases)and group D(116 cases). All patients re-ceived intraocular lens implantation;1-1.5 cm to Tramycin and Dexamethasone eye ointment,3-5 times a day. Based on it,group A received 1-2 Sodium hyaluronate eye drops,4 times a day. Group B received 1 Carbomer eye drop,3-5 times a day. Group C re-ceived 1-2 Polyethylene glycol eye drops,3-5 times a day. Group D received Tobramycin and dexamethasone eye ointment,1-1.5 cm every times,1-3 times a day. They treated for 1 month. Clinical efficacy,recovery of visual acuity and ocular surface functions [dry eye symptom score,tear film break-up time(BUT),corneal fluorescein staining(CFS),basal tear secretion(SIt),ocular sur-face disease index(OSDI)] and the incidence of adverse reactions in all groups were observed. RESULTS:The total effective rate sorted,patients with visual acuity higher than 0.6,BUT,OSDI by group A>group B>group C>group D,with significant differenc-es (P<0.05). patients with visual acuity in 0.3-0.6,0.1-0.3 and lower than 0.1,drycye symptom score,CFS,SIt in group A was less than group B,which was less than group C and group D,with significant differences(P<0.05). The incidence of adverse re-actions in group A was lower than group B,C,D,with significant differences(P<0.05),but there was no significant difference in group B,C,D(P>0.05). CONCLUSIONS:Sodium hyaluronate shows superior efficacy and safety to Carbomer,Polyethylene glycol,Tobramycin and Dexamethasone in the treatment of glaucoma with cataract,it can significantly improve visual acuity and ocular surface function.

目的探讨校园意外伤害发生的原因、特征和危险因素,为伤害预防与控制、残疾补偿、社会康复的有机结合提供参考依据。方法以1990—2002年因校园意外伤害造成脊髓损伤的 26例残疾学生作为个案调查研究对象。为了解校园意外伤害事故的致残原因及受伤后的处理情况,对仍在院接受治疗的残疾学生进行随访。结果伤害致残者中男生多于女生;初高中学生是伤害致残的高发人群(69%);校园意外伤害致残原因依次为:①体育训练;②跳水、潜水;③嬉闹摔伤;④高处坠落;⑤坠落物撞击;⑥钝器、刀砍击伤。医疗费用73%由校方支付。结论校园不安全隐患是危害学生生命安全的主要危险因素;提高青少年自我保护意识和自我防卫能力、加强安全教育、建立环境安全检查制度、定期对学校设施进行检查和维护是减少校园意外伤害事件的重要措施

Objective To investigate the effects of human immunodeficiency virus (HIV) infection on the pregnancy outcome and the incidence of vertical transmission in HIV positive pregnant women Method 86 cases of HIV positive pregnant women and their infants were evaluated retrospectively, and HIV antibody in peripherial blood was detected using enzyme linked immunosorbent assay (ELISA) Results Compared with normal control group, the incidences of abortion, preterm birth, low birth weight and small for gestational age babies were 9 3%, 14 0%, 16 3% and 10 5%, respectively ( P