Objective To investigate the effect of Celebrex on hemorheology and levels of serum intercelluar adhesion molecule-1 (sICAM-1),serum vascular cell adhesion molecule-1 (sVCAM-1),tumour necrosis factor-α (TNF-α),interleukin-6 (IL-6) in patients with delayed fracture healing.Methods 201 patients with delayed fracture healing in our hospital were randomly divided into observation group (n =101) and control group (n =100).The patients in control group received conventional surgical internal fixation,while patients in observation group received conventional surgical internal fixation combined with Celebrex.The clinical efficacy was observed,while the changes of hemorheology and levels of sICAM-1,sVCAM-1,TNF-α,IL-6 were compared between two groups before and after treatment.Results The effective rate of observation group was 94.1％,which was significant higher than that of control group 70.0％ (P＜0.01).There were no significantly differences between two groups in the indexes of hemorheology and levels of sICAM-1,sVCAM-1,TNF-α,IL-6 before treatment (P＞0.05).The indexes of hemorheology and levels of sICAM-1,sVCAM-1,TNF-α,IL-6 were significantly reduced after treatment,while the decreased degrees of observation group were better than those of control group,with statistically significant difference (P＜0.05).Conclusions Celebrex can improve the indexes of hemorheology,reduce the levels of sICAM-1,sVCAM-1,TNF-α,IL-6 and improve the clinical effect in treatment of delayed fracture healing.It is worth of popularization and application.

Objective To observe the contrast sevoflurane anesthesia and propofol intravenous anesthesia in children hernia surgery anesthesia on blood flow dynamics in children to assess the quality of anesthesia, anesthesia program aims for the future choose to provide important reference for basis . Methods The surgical treatment of pediatric hernia patients from January 2012 to June 2016 was prospectively selected as the study group, and the rats were divided into two groups by random drawing method. Results There were other children point and T1 relatively SBP, DBP were significantly lower (P<0.05), the observation group were significantly lower than the control group (P<0.05), the control group of children with T2, T3 compared with T1 point HR significantly increased (P<0.05). Conclusion Pediatric hernia surgery using laryngeal mask sevoflurane anesthesia exact effect, maintaining hemodynamic stability, safety, and can be widely used in clinical.

Objective To investigate the effect of p 38 mitogen-activated protein kinase ( MARK) on expression of matrix metalloproteinase-9(MMP-9) and formation of cerebral edema in rats with cerebral ischemia-reperfusion. Methods Fifty-four SPF male SD rats were randomly divided into sham operation group ( Sham group ) , ischemia-reperfusion group(I/R group) and p38 inhibitor group(SB group).Middle cerebral artery ischemia-reperfusion model was made by modified line plug method .The neurologic exams were assessed at 24 h after reperfusion , Evans Blue method was used tomeasurement Blood-brain barrier`s permeability,the wet-dry ratio was used to measured to estimate cerebral edema ,Western blot was used to detect the expression of phosphorylation p 38 ( p-p38 ) and MMP-9 in the infarct region .Results Compared with Sham group , I/R group had aggravated neurological deficits ( P<0.05 );compared with the I/R group, SB group had alleviate neurological deficits (P<0.05).Compared with Sham group, blood-brain barrier permeability and brain water content of I /R group were significantly increased ( all P<0.05 );compared with the I/R group, blood-brain barrier permeability and brain water content of SB group were significantly decreased(all P<0.05).Compared with Sham group , the expression of p-p38, MMP-9 in margin of ischemia of I/R group were significantly increased (all P<0.05);compared with the I/R group, the expression of p-p38, MMP-9 in margin of ischemia of SB group were significantly decreased (all P<0.05).Conclusions p38 MAPK involved in the formation of brain edema in rats with cerebral ischemia-reperfusion , and its mechanism may be cerebral ischemia-reperfusion activates p38MAPK,and it make the expression of MMP-9 in margin of ischemia up-regulated,damaging blood-brain barrier permeability ,leading to cerebral edema .

Objective To evaluate the diagnostic approaches and influencing factors of prognosis after repeated hepatectomy for recurrent liver cancer. Methods Fifty seven cases of recurrent liver cancer underwent surgical resection. The disease free survival, cumulative survival and possible influencing factors of prognosis were studied. Results The 1-, 3-, 5- and 10-year disease free survival rates after first resection were 63.9%, 38.3%, 26.6% and 12.8%, respectively. The 1-, 3-, 5- and 10-year survival rates of resection for recurrent liver cancer were 56.6%, 37.7%, 31.9% and 16.2% and the 1-, 3-, 5- and 10-year cumulative survival rates were 82.1%, 60.85, 47.6% and 19.5%, respectively. The influencing factors of prognosis after repeated hepatectomy for recurrent liver cancer size, number of nodules, tumor-free duration and weather when the patients underwent curative resection. Conclusions For early detection of recurrent liver cancer, AFP test, sonography each month and computed tomography every 3 months should be conducted for patients after the first hepatectomy. For the recurrent liver cancer, surgical resection is an effective treating measure when it is possible. The influencing factors of prognosis after repeated hepatectomy for recurrent liver cancer are tumor size, number of nodules, tumor-free duration, tumor capsule and manner of repeated hepatectomy.

Objective To explore the clinical efficacy of low-dose cytarabine and harringtonine (LD-HA) regimen in the induction therapy of acute myeloid leukemia (AML) except M3. Methods 52 AML patients who received LD-HA were analyzed retrospectively. The patients were graded according to molecular biological and cytogenetic risk degree. The clinical efficacy, toxicity of LD-HA and long-term survival followed-up were compared with those of idarubicin and cytarabine (IA) regimen in 49 patients. Results After one cycle, the overall remission (OR) rates of LD-HA group and IA group were 71.2%(37/52) [CR rate 50.0%(26/52), PR rate 21.2%(11/52)] and 53.1%(26/49) [CR rate 44.9%(22/49), PR rate 8.2%(4/49)], respectively, with no statistical significance of OR between the two groups (P= 0.068). OR rates were not statistically significant in either low-risk group or intermediate-risk group between LD-HA group and IA group (P> 0.05), but OR of high-risk group in LD-HA was much higher than that in IA group [100 % (11/11) vs 66.7 % (12/18), P<0.05]. Cardiac toxicity and bone marrow suppression in LD-HA group were much milder than those in IA group. The patients unfit for standard chemotherapy could tolerate to LD-HA regimen. Conclusions LD-HA regimen as induction for high risk AML patients can improve the OR rate, and reduce the side effects, which is beneficial for high-risk AML patients.

Leptin,the product of the obese gene,is a protein produced and secreted primarily by adipose tissue.Leptin initiates several biological effects by binding to its receptors.Many studies have shown that leptin can reduce fat accumulation,but its mechanism is still unclear.This article reviewed the effects of leptin on lipogenesis,and especially on proliferation and differentiation of preadipocytes.

Objective To evaluate the effect of velocity of inspiratory flow on the severe asthma patients.Methods Twenty patients were ventilated thirty minutes respectively when the peak velocity of flow was 40L/min,60 L/min,80 L/min,100 L/min and 120 L/min,and then we measured their airway peak pressure(Ppeak),plateau pressure(Pplat)and intrinsic positive end expiratory pressure(PEEPi)and arterial blood gas analysis,accounting shunt fraction(QS/QT)and Dead space value(VD/VT).Results When velocity of flow enhanced from 40L/min to 60L/min,Ppeak increased while Pplat,PEEPi,VD/VT decreased obviously.When velocity of flow enhanced from 60L/min to 80L/min,Ppeak increased also but Pplat,PEEPi,QS/QT and VD/VT changed no significant.When velocity of flow enhanced from 60L/min to 100L/min,Pplat and PEEPi increased indistinctly while Ppeak,QS/QT and VD/VT increased distinctly.Conclusions The velocity of inspiratory flow,60~80L /min,can reduce PEEPi、QS/QT 及VD/VT and improve respiratory status.

[Objective]To analyze reason of congenital infantile coxa vara to be misdiagnosed as infantile dislocation of hip joint.[Method]There were 6 patients(6 hip join)congenital infantile coxa vara being misdiagnosed as infantile dislocation of hip join in 54 patients(73 hip join)and treated by expectant treatment as infantile dislocation of hip join.The curative effect of 6 patients were not good,after serious medical examination,careful reading image data,paying attention to curative effect,6 patients were confirmed to be diagnosed as infantile dislocation of hip join and not infantile dislocation of hip join.[Result]The features for diagaosis of congenital infantile coxa vara were:the big greater trochanter of femur and its position moving up,short spacious neck of femur,spacious medial blank in hip joint,superposed neck of femur and lesser trochanter of femur,praeter propter exponent of acetabulum,acceptable succession of Shenton’s line,enlarged angle of femoral head epiphysis,late center of ossification,incorporated abnormity such as breves femoral bone,bowing of femoral bone,abortive clavicle and bones of cranium,equines.[Conclusion]The second center of ossification of femoral head is appeared 6～9 monthes after birth,and it is difficult to discriminate congenital infantile coxa vara and infantile dislocation of hip join before this.Early to realize symptom,physical sign and character of image of congenital infantile coxa vara is significant for correct diagnosis and can avoid misdiagnosis and mistreatment.

Objective To evaluate the potentiation of neuromuscular block produced by rocuronium during isoflurane anesthesia. Methods Sixty ASA Ⅰ -Ⅱ patients (39 male, 21 female), aged 18-56 yr, weighing 42-88 kg undergoing ENT, oral or facial plastic surgery were enrolled in this study. The patients were premedicated with atropine 0.01 mg?kg-1 . Anesthesia was induced with diazepam 0.1 mg?kg-1 , pethidine 1mg?kg-1 and droperidol 50?g?kg-1. Oro- or naso-tracheal intubation was accomplished under topical anesthesia. After intubation the patients received hydroxydione 2.5 g and fentanyl 5 ?g?kg-1 . The patients were mechanically ventilated. Anesthesia was maintained with inhalation of 50% N2O in O2 alone (groupⅠ) or combined with 0.6% isoflurane (group Ⅱ ) or 1.2% isoflurane (group Ⅲ ) . A bolus of rocuronium 0.6 mg?kg-1 was given during maintenance of anesthesia. Neuromuscular function was monitored using TOF response measured by accelerography (Biometer, Denmark). (1) Onset time (time from the end of injection to maximum depression of T1 ) , (2) the duration of T1 = 0, (3) time from the end of injection to recovery of T1 to 25% , 50% and 90% control, (4) recovery index (time from T, 25%-75%) were recorded. End-tidal isoflurane concentration was monitored.Results The onset time was significantly longer in group Ⅰ[ (1.7?0.2) min] than that in group Ⅱ[ (0.9?0.1) min] and groupⅢ[(0.8?0.1) min] ( P