BACKGROUND:Traditional studies on foot and ankle biomechanics have limitation. Ankle joint was complicated and had big range of motion, so it is difficult to establish finite element models and to analyze the type of fracture.
OBJECTIVE: To construct the finite element models of distal tibial fractures and analyze the stability.
METHODS: CT data of ankle were colected from a normal male volunteer and the three-dimensional reconstruction of volunteer was made by Mimics software, and the effectiveness was verified. The ratio of different joint involvement and height of fracture block were assumed with Solidwork software, and finite element models of distal tibial fractures were established. Fracture stability was analyzed by ANSYS software using finite element method.
RESULTS AND CONCLUSION:The distal tibia fracture model was consistent with the relevant literature data, and finite element analysis could be further conducted. The ratio of articular surface involved was positively associated with fragment height and fracture displacement, and negatively associated with fracture stability. These results indicate that the three-dimensional finite element models of distal tibial fractures were successfuly established. Fracture stability was associated with the ratio of articular surface involved and fragment height.

Objective To compare the clinical efficacy of minimally invasive percutaneous pedicle screw fixation and posterior paraspinal muscle space approach pedicle screw fixation for the treatment of thoracolumbar fractures.Methods Retrospectively analyzed the clinical data of 29 patients treated via minimally invasive percutaneous pedicle screw fixation(minimally invasive group) and 28 patients treated via posterior paraspinal muscle space approach pedicle screw fixation(paraspinal muscle approach group) from March 2013 to October 2015.The anterior vertebral height ratio,sagittal Cobb angle,surgical incision,operation time,number of fluoroscopy,intraoperative blood loss and ODI and VAS scores were compared between the two groups.Results All patients were followed up for an average period of 12.6 months (ranged from 6 to 18 months).At the end of 3 days,3 months and 12 months after operation,vertebral sagittal index and Cobb angle of the two groups were significantly recovered compared with the preoperative data(P<0.05),and the ODI and VAS scores were significantly lower than those before the operation,but the above indicators had no significant difference between the two groups(P>0.05).The surgical trauma and intraoperative blood loss of patients in the minimally invasive group were significantly lower than those of the paraspinal muscle approach group,while the operation time and fluoroscopy times were significantly higher than those of the paraspinal muscle approach group,and the differences were statistically significant(P<0.05).Conclusion Minimally invasive percutaneous and paraspinal muscle approach pedicle screw fixation are both effective,safe and reliable.Paraspinal muscle approach pedicle screw fixation has shorter operation time and easier operation,while minimally invasive percutaneous pedicle screw fixation has less trauma,less bleeding and faster postoperative recovery.

Objective To know the implementary circs and short-dated effects of cooking stoves improvement in reducing fluoride level in the endemic fluorosis areas and to offer the background information and scientific basis for continuing the development of cooking stoves improvement in reducing fluoride level. Methods To do the surveys in the households, 769 families were selected and investigated from 38 000 peasant families in the program, by cluster sampling with 2% sample rate and 70 families were randomly selected from them, the fluoride levels in the air, foodstuff, non-staple food was determined. Results 98.7% of the families in the cooking stoves improvement areas could rightly use the improved stove. The fluoride levels in corn and hot peppers were greatly improved in county A compared with that in 2000, but the fluoride levels in the air, foodstuff, non-staple food still exceeded the standard limit, not all reached the national standard. Conclusion The headstream interventions measure in coal-burning type endemic fluorosis areas is effective. Controlling the fluoride pollution of capsicum and tea is necessary, the production methods must be improved. The health education and management should be strengthened for reducing fluoride level in the investigated areas.

Objective To know the quality of drinking water produced by deep treatment systems in Guangdong Province.Methods The unified investigation form was used,the water supply systems were selected from 4 cities,Guangzhou,Shenzhen,Zhuhai,Dongguan.pH value,conductivity,ozone,COD,TOC,heavy metals,bacteria were determined in 2004.Results Having investigated 169 systems,reverse osmosis,nanofiltration and ultrafiltration equipment used to treat water accounted for 74.40%,19.05% and 6.55 % respectively.The use of ozone disinfection was 70.7%.45.8% of the systems,the water cycled twice per day,and 29%,no water quality test was conducted according to the regulation.The quality of water with deep treatment was satisfactory compared with the common tap water.Conclusion The quality of water produced by deep treatment systems is considered better than the common tap water and the applicable water treatment units should be selected,the routine water quality test and management should be conducted.

Fifteen cases of malignant melanoma,17 cases of acquired nevus,18 cases of congenital small nevus,and 3 cases of congenital giant nevus were labeled with anti-human prolifera-tive cell antibody Ki-67 with ABC labeling method.It was found that 13 out of the 15 cases of malignant melanoma were positive and the positive rate of the tumor cells was ranged between 2% to 33%.After culture,the positive rate of the melanoma cells was 88%.But all the 3.types of melanocytic nevi were negative.The findings suggest that the labeling of anti-human proliferative cell antibody Ki-67 is a sensitive and specific method to identify melanocytic tumors and it is not sensitive enough to differentiate the minor changes of the 3 types of nevi.

ve To explore the methods for sanitary safety test of water purifier. Methods The water purifiers using active carbon, KDF and molecular sieve as absorptive materials and hollow fibers as filter materials were collected for sanitary safety test. The water purifiers were irrigated by pure water continuously for 15, 30, 45 and 60 min respectively first, and then were immersed continuously for 24 h by pure water, the variations of turbid-ity, pH value, total dissolved solid and chemical oxygen demand (COD), etc, of the immersing water were observed. The water purifiers were also irrigated continuously for 1 h at first, and then were immersed continuously for 5, 15, 24, 48, 72 h and 1 week by pure water respectively, in the end, the variations of those 4 sanitary indexes mentioned above were also detected. Results Significant differences were observed in those 4 indexes between the immering water samples obtained after 15 min-irrigation and 30 min-irrigation, 30 min-irrigation and 45 min-irrigation (P

Objective To study the effect of valsartan on expression of MCP-1 in the myocardium of diabetic rats,to investigate the protective effect of valsartan on the myocardium of diabetic rats.Methods 30 rats were divided into at random:normal control group(NC group),diabetic model group(DM group),diabetic model plus valsartan therapy group(DV group).Diabetic rats were induced by STZ,at 8th week,expression of MCP-1 in the myocardium of diabetic rats,and diabetic rats treated with valsartan was detected respectively by using immunohistochemistry.Results At 8th week,the expression of MCP-1 of DM group was much higher than in both DV group and NC group(P

A case study of a 76-year-old man with end-stage chronic obstructive pulmonary disease (COPD) with refractory breathlessness and the challenges in managing the dyspnoea he had been experiencing are described. A multi-modal approach is the mainstay of management, encompassing pharmacological agents, home oxygen therapy, and non-pharmacological approaches, namely, breathing techniques and smoking cessation. As this patient was at an advanced stage of disease, integration of palliative care with disease care was needed. Administering oxygen therapy for a patient who is still smoking and has household members who are current smokers need firm adherence to rules. The AIC HOME Programme is also briefly described.

Objective To determine whether the AT, All66C gene polymorphism is associated with CHD in type 2 diabetes patients. Methods Investigating the allele frequency and the genotype distribution of the AT1 All66C gene in the group of normal control (n= 73),simple diabetes (n= 80),diabetic CHD (n=43) by means of PCR-RFLP. Results The group of diabetic CHD had a significant higher frequency of C allele of the AT1 All66C gene than normal control (X2 = 6. 02,P＜0. 05) and diabetes (X2= 5. 71,P＜0. 05). Conclusion The result indicated that there was an association between the 1166C allele of the AT1 gene polymorphism and CHD in type 2 diabetes patients.

Objective To evaluate the effect of dexmedetomidine on the efficacy of patient-controlled intravenous analgesia (PCIA) with morphine after elective radical gastrectomy. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients aged 41-64 yr weighing 50-80 kg undergoing elective radical gastrectomy were randomly divided into 2 groups of 60 patients, according to the composition of PCIA solution:group I morphine (group M)and group Ⅱ morphine + dexmedetomidine (group MD). In group M the PCIA solution contained morphine 100 mg in 200 ml of normal saline (NS), while in group MD the PCIA solution contained morphine 100 mg+dexmedetomidine 200 μg in NS 200 ml. PCIA was started immediately after operation. A loading dose of 6 ml was given iv at the end of operation. PCIA setting was as follows:background infusion 1 ml/h, bolus dose 3 ml and lockout interval 10 min. VAS score was maintained at ≤4 and Ramsay score at 2-3. The total amount of morphine consumed, the number of attempts and successfully delivered doses within 24 and 48 h after operation were recorded. Postoperative complications including nausea, vomiting, bradycardia, hypotension, oversedation and respiratory depression were recorded. Results The total amount of morphine consumed, the number of attempts and successfully delivered doses within 24 and 48 h after operation were significantly smaller and the incidence of nausea and vomiting and pruritus was significantly lower in group MD than in Sroup M. No bradycardia,hypotension, oversedation or respiratory depression was observed in either group. Conclusion Dexmedetomidine added to intravenous morphine PCA can improve the analgesic efficacy after radical gastrectomy with less adverse effects.