Objective To establish a perfect method that is based on the complexes of DNA-binding-C/EBP? for detection of nuclear transcription factor C/EBP? (CCAAT enhancer binding protein ?). Methods To search specific oligonucleotides sequence and establish a labeling method of consensus oligonucleotides and the standard curve was regressed.The electrophoresis conditions were optimized.Results The combination of 20pmol of ?- 32 P-ATP and 4 pmol of C/EBP? oligonuleotides in reaction can express the highest probe activity and corporation effect.The linearity was established (r2=0.975). 0.5?g of nuclear extract can be detected and bands are clear and specific.Conclusion The method is good at specificity. It can be a method to detecting nuclear factor C/EBP? or its DNA-binding site.

Objective To discuss the surgical treatment of delayed acetabular fractures and factors that affect the clinical outcomes. Methods From February 2001 to July 2005, 37 cases of delayed acetabular fractures were surgically treated. There were 22 males and 15 females, with an average age of 36.8 years (17 to 58). 10 cases were simple fractures and 27 complicated ones. The interval between injury and surgery averaged 44.8 days (21 to 399 days). 6 cases were treated through Kocher- Langenbeck approach, 1 ilio- inguinal approach, 2 extended ilio- inguinal approach, and 28 combined approaches. The mean operation time was 226 min (120 to 490 min). The average blood loss was 1 798 mL. Results The mean follow- up period was 18.9 months (6 to 56 months). Evaluation was conducted with Matta' s reduction criteria and modified D’ Aubigne and Postel clinical scoring. Reduction was anatomical in 31 cases, unsatisfactory in 4 and poor in 2. Clinical outcomes were rated as excellent in 21, good in 9, fair in 5 and poor in 2. There was 1 case of femoral head necrosis. Heterotopic ossification developed in 11 cases. In addition, transient paralysis of the sciatic nerve happened in 4 patients. Conclusions In principle, combined or extended ilio- inguinal approach should be reserved for the delayed acetabular fractures with the exception of simple fractures of posterior wall or/and posterior column, anterior wall and anterior column which can be managed by a single approach. The occurrence of arthritis correlates with the severity of the fracture. No direct relation has been found in this series between femoral head necrosis and femoral head dislocation before operation. Severity of fracture, interval between injury and surgery, and skills of orthopedists determine the clinical outcome, operation duration, and perioperative blood loss.

OBJECTIVE:To explore the effects of Xuesaitong injection on related indexes of patients with acute ST segment el-evation myocardial infarction(STEMI)before percutaneous coronary intervention(PCI). METHODS:112 STEMI patients under-went PCI were analyzed retrospectively and divided into control group (48 cases) and observation group (64 cases) according to different treatment methods. Control group was given Clopidogrel sulfate tablets 300 mg and Aspirin enteric-coated tablets 300 mg orally before PCI;given conventional treatment according to patients'condition after surgery. Observation group additionally re-ceived intravenous push of Xuesaitong injection 8 mL before surgery,and Xuesaitong injection 8 mL added into Sodium chloride 250 mL intravenously,once a day after surgery,on the basis of control group. Treatment course of 2 groups lasted for 14 d. TIMI level,MPG level,the serum levels of cTnT,CKMB were observed in 2 groups before surgery,24 h after surgery;serum level of PTX-3,hs-CRP were observed before surgery,one week after surgery;LVEF,LVEDD,serum level of BNP were observed before surgery and one month after surgery;the occurrence of ADR was observed to. RESULTS:Before surgery,there was no statistical significance in TIMI level,MPG level,the serum levels of cTnT,CKMB,PTX-3 and hs-CRP,LVEF,LVEDD,serum level of BNP between 2 groups (P>0.05). 24 h after surgery,TIMI level and MPG level of 2 groups were significantly higher than be-fore,and the observation group was significantly higher than the control group;the serum levels of cTnT and CKMB in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical sig-nificance(P<0.05). One week after surgery,the serum levels of PTX-3 and hs-CRP in 2 groups were significantly lower than be-fore surgery,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). One month after surgery,the level of LVEF in 2 groups were significantly higher than before surgery,and the observation group was significantly higher than the control group;LVEDD and se-rum level of BNP in 2 groups were significantly lower than be-fore surgery,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on convention-al treatment,Xuesaitong injection can effectively improve myocardial blood supply before PCI,decrease the level of inflammatory factor,relieve myocardial injury,improve cardiac function without increasing the incidence of ADR.

China’s existing laws and regulations in telemedicine fall behind practice.As a result, telemedicine is confronted with such vague constraints as permission,legal relations and legal liability, validity of electronic medical records,telemedicine equipment standards,patients’right to know and their right to privacy,as well as disputes settlement.On such basis,the authors propose to improve the laws and regulations in this regard as soon as possible.

The paper introduces the mutual relationship among the innovation of four dimensions including new medical service concept,new patient interface,new service transmission system and new technology of telemedicine based on the illustration of four-dimensional model of service innovation to the telemedicine service,and makes an analysis by taking the telemedicine service innovation of remote medical center in Henan Province as an example,thus providing reference for the innovative development of telemedicine service.

ObjectiveTo prepare artificial viscoelastic agent used in ophthalmic operation as a substitute of Healon. MethodsPolyacrylamide was synthesized in aqueous solution of acrylamide. Residual monomer(Am) was separated from polymer by a novel method, extraction by semi permeable film. Results and ConclusionsArtificial viscoelastic agent prepared has advantages on cost of manufacture, processing repeatability and stability of storage comparing to Healon.

Objective:To analyze the usage intention and key issues of medical staff to use telemedicine, for improving telemedicine service system in China.Methods:From October to November 2019, medical workers of both the inviting party and invited party who experienced telemedicine in seven provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai were selected for an online questionnaire survey. Areas covered included their usage intention, satisfaction and cognitive appraisal of telemedicine. Descriptive statistical analysis and non-parametric test were used to discuss the intention of further use, satisfaction and challenges of medical workers in various provinces and regions.Results:1 084 valid questionnaires were recovered. The data found the overall satisfaction was 98.62%, and the proportion of their intention of further use was 98.25%, and those from the eastern and western provinces presented higher intention of usage. The top challenges as reflected by these medical workers were named as follows: timeliness of consultation progress and information feedback; long latency time; low Internet speed, poor and interrupted Internet signal; inadequate system equipments and inconvenient operation; difficulties in remote physical checkup and overall understanding of patient conditions; as well as substandard, incomplete and poor medical records.Conclusions:These medical workers are satisfied with the telemedicine services and willing to continue to use telemedicine.For those existing problems, it is suggested to strengthen the infrastructure and optimize the process of telemedicine services, so as to encourage them in greater use of telemedicine.

Objective:To analyze the actual and expected incentives and key issues of telemedicine providers in China and to provide important references for optimizing telemedicine incentive policies.Methods:The sample data came from a questionnaire survey of 1 084 providers in 7 provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai in October and November 2019 and a semi-structured interview data at 6 hospitals in Henan province in January 2020. Descriptive analysis was used to sort such data into text data for classified summation.Results:The greatest gaps were found between actual incentives and expected ones in expense subsidies, title promotion and excellence awards, with such gaps as high as 18.65, 28.26, 29.28 percentages among providers of junior, deputy senior and senior academic titles respectively. Hospitals fall short in providing adequate incentives for telemedicine providers, not to mention lack of differentiation and diversification in personnel incentives, and poor implementation of incentive policies.Conclusions:It is suggested to strengthen incentive demand analysis, break the homogenization bottleneck of incentive policies, and consolidate internal publicity and implementation of incentive policies.

Objective To discuss the clinical application of reverse dorsal metatarsal artery perforator flap for reconstruction of forefoot soft tissue defects.Methods Since January,2008 to March,2016,43 patients with forefoot soft tissue defect due to various causes were reconstructed with the flap based on dorsal metatarsal artery perforator.Dorsal pedis was used as a donor site with dorsal metatarsal artery perforator as the donor artery.The flap size varied from 2.0 cm × 4.0 cm to 6.0 cm × 8.0 cm.Among them,27,8,4 and 4 cases were reconstructed with flap based on first,second,third and fourth dorsal metatarsal artery perforator flap respectively.Results All the patients were followed-up which ranged from 3 months to 24 months.Six flaps suffered from post operative venous congestion.Out of 6,4 survived with early emergency management while the remaining 2 suffered epidermal necrosis which survived with regular dressing change.Eventually,all the flaps survived.They had good texture and they were elastic,good-looking and very wear-resisting.Walking function was normal.Conclusion Reverse dorsal metatarsal artery perforator flap is an ideal choice in reconstruction of small to medium sized soft tissue defects of forefoot.

Objective To discuss the surgical technique of delayed acetabular fractures and its possible prognosis factors.Methods From April 2001 to November 2008,61 patients with delayed acetabular fractures were surgically treated.There were 47 males and 14 males,with an average age of 38 years.According to Letourael classification,16 simple fractures included 7 cases of posterior wall fractures,2 of posterior column fractures,1 of anterior column fractures and 6 of transverse fractures.Forty-five patients with mixed fractures included 3 cases with both fractures posterior column and wall,7 of transverse and posterior wall fractures,4 of T-shape fractures,6 of posteriorly semi-transverse fractures and 25 of both-columns fractures.Fifty-two patients suffered from traffic accident;6 patients were caused by falling from height and 3 suffered from crush injuries.Brain injuries occurred in 11 cases,thorax-abdominal injuries in 15,urinary tract injuries in 7,multiple fractures in 25.The injury of sciatic nerve was found in 3 patients preoperatively.The average interval form injury to surgery was 39 days.A single approach was employed in 13 cases,and combined antero-posterior approaches were employed in 48.The operation time was (248±45) min with a blood loss of (2160±100) ml averagely.Results The average follow-up was (61±8) months.The clinical result was evaluated by Matta reduction criteria,modified Merle d'Aubingne and Postel scoring system.Anatomical reduction was achieved in 45 cases;however,13 were unsatisfactory and 3 were poor.For clinical results,38 were graded as excellent,13 as good,6 as fair and 4 as poor.Osteonecrosis of the femoral head occurred in 3 cases (4.9%),and heterotopic ossification developed in 28 cases (45.9%).Additionally,4patients (6.6%) had a transient sciatic nerve paralysis.Conclusion Open reduction and internal fixation is a liable method for delayed acetabular fractures.Single approach is suitable for simple fractures;in principle and combined approaches are for compound delayed acetabular fractures.The reduction quality is closely related to surgeon's experience.