Objective To analyze the clinical effects of sinus tarsi approach with minimal-inva-sive percutaneous screw fixation of calcaneal fractures. Methods From February 2014 to July 2015,28 ca-ses of calcaneal fracture patients(Sanders Ⅰ ~ Ⅲ)were treated with minimal-invasive percutaneous screw fixation via sinus tarsi approach in our department. There were 18 males and 10 females with age ranging from 16 to 68 years(mean,32 years). According to the classification of Sanders,six cases were classified as Type I,twelve as Type Ⅱ,and ten as Type Ⅲ. The Bohler angle and Gissane angle were compared be-fore and after operation. Clinical results were evaluated with the Maryland foot scoring system. Results All the patients were followed up for 14 to 20 months(mean,15. 5 months). Anatomic or almost anatomic reduction was achieved in all patients according to the results of postoperative images. All fractures healed,and the healing time ranged from 4 to 7 months(average,5. 3 months). There was no wound infec-tion,necrosis or bone nonunion. According to the Maryland foot scoring system,16 cases were defined as excellent,10 cases as good,and 2 cases as poor. The good and excellent rate was 92. 8% . Conclusion For calcaneal fractures,sinus tarsi approach with minimal-invasive percutaneous screw fixation has the ad-vantages of small trauma,safe operation,limited complication,and stable fixation,which is a satisfactory clinical treatment.

Objective To explore the method and effects of operative treatment of superior shoul-der suspensory complex(SSSC)injury.Methods A total of 18 patients with SSSC injury were enrolled. There were six cases of scapular neck fracture combined with comminuted clavicle fracture,five cases of scapular neck fracture combined with acromial fracture,and two cases of comminuted clavicle fracture com-bined with acromial and glenoid fracture.These patients were treated with open reduction and internal fixa-tion.Three patients had acromioclavicular joint dislocation combined with coracoclavicular ligament rupture and they were given hook plate fixation and ligament repair.One patient with scapular neck fracture com-bined with acromioclavicular joint dislocation,and one patient with comminuted clavicle fracture combined with coracoclavicular ligament rupture,were treated with the open reduction,internal fixation and the liga-ment repair.Results All patients were followed up for 3 to 14 months,with an average of 9 months.Ana-tomical reduction and healing were all achieved within 7 to 12 weeks,with an average of 8.6 weeks.Con-clusion Anatomical structure of SSSC is very complex and surgery is given priority to internal fixation, which restores the stability good therapeutic effect.

Osteosarcoma is the most common maligant in skeletal system.Its treatment is always the focus of most clinical research workers.This article is a brief overview of the research progress of the therapy for osteosarcoma.In addition to neoadjuvant chemotherapy,surgical treatment,this article also includes molecular targeted therapy,gene therapy,and immune therapy.These new advances will contribute to the clinical work.

Internal fixation technique is an important surgical method in cervical spine surgery.This article will introduce kinds of internal fixation techniques,discuss the differences and problems of them.Posterior screw-rod system and anterior odontoid screw technique have more advantages to provide solid fixation and high fusion rate in upper cervical trauma according to the latest reports.they are the effective and creditable surgical methods for reconstructing the stability of upper cervical spine.

BACKGROUND:Many studies have demonstrated that in order to achieve the endothelialization of the polymer materials, surface loading of bioactive factors is an important means and the introduction of human endothelial cells on the surface of the polymer materials wil contribute to increase the biocompatibility of materials. OBJECTIVE:To synthesize the polyethylene glycol hydrogel packaging vascular endothelial growth factor, basic fibroblast growth factor and endothelial progenitor cells, and to observe the sustained release of growth factors and culture status of endothelial progenitor cells. METHODS:The polyethylene glycol-modified hydrogel containing arginine-glycine-aspartic acid peptide was synthesized, and then, rat endothelial progenitor cells, basic fibroblast growth factor, vascular endothelial growth factor, matrix metal oproteinases were successively added. The hydrogel were immersed in PBS, and ELISA was used to test the levels of growth factors in supernatants every 12 hours. Matrix metal oproteinases-2 (100, 1 000 ng) and matrix metal oproteinases-9 (100, 1 000 ng) at different mass were added into the PBS containing hydrogel after 72 hours. ELISA was also used to test the levels of growth factors in supernatants every 12 hours. The hydrogel encapsulating endothelial progenitor cells was cultured in a culture medium for 5 days, and the number of survival cells was counted by a flow cytometer after digestion. RESULTS AND CONCLUSION:Within 12-72 hours, the release percentage of basic fibroblast growth factor and vascular endothelial growth factor remained at about 41%. After 72 hours, the release percentage of both growth factors was found to grow steadily when matrix metal oproteinases-2 (100, 1000 ng) and matrix metal oproteinases-9 (100, 1 000 ng) at different mass were added, which reached 95%. The release percentage was increased with the increasing mass of matrix metal oproteinases. After 5 days of culture, 88.17%cells stil survived in the hydrogel. These findings indicate that sel-assembly polyethylene glycol-modified hydrogel can realize the control ed release of basic fibroblast growth factor and vascular endothelial growth factor, and it can also support the proliferative growth of endothelial progenitor cells.

BACKGROUND:Iron overload as a new etiological factor participate in the pathogenesis of senile osteoporosis, but its mechanism remains unclear. But the mechanism of iron overload cause senile osteoporosis pathogenesis remains unclear. Osteogenic/adipogenic differentiation homeostasis of bone marrow mesenchymal stem cel s (BMSCs) plays an important role in the maintenance of normal human bone mass, and its imbalance can lead to senile osteoporosis. Iron effects on the osteogenic/adipogenic differentiation of BMSCs remain unclear. Therefore, we clarify the role of iron overload in the pathogenesis of senile osteoporosis by studying the effect of iron overload on BMSCs osteogenic/adipogenic differentiation. OBJECTIVE:To explore the effect of iron overload on the osteogenesis and adipogenesis of human BMSCs (hBMSCs) in vitro and to explicit the role of iron overload in the pathogenesis of senile osteoporosis. METHODS:hBMSCs were isolated by using density gradient centrifugation method. Isolated cel s were treated with normal saline as normal control group, treated with 10, 20, 30μmol/L ferrous citrate to mimic iron overload conditions, or treated with 30μmol/L ferrous citrate fol owed by 0.5 mmol/L N-acetylcysteine as an antioxidant. RESULTS AND CONCLUSION:Iron overload did not remarkably inhibit the proliferation of hBMSCs, but it could promote the generation of reactive oxygen in hBMSCs. After treatment with ferrous citrate, the expression of c-Maf and Runx2 decreased, and the expression of peroxisome proliferator-activated receptorγincreased;moreover, formation of calcium nodules decreased, but lipid droplets were produced. N-acetylcysteine could inhibit the production of reactive oxygen and increase the expression of c-Maf induced by iron overload. These findings indicate that iron overload inhibits osteogenesis and promotes adipogenesis in hBMSCs through the generation of reactive oxygen. Meanwhile, c-Maf plays an essential role in the iron-overload induced differetiation imbalance.

ObjectiveTo learn the oral health cognitive behaviors and impact factors of the elderly people in Jining.MethodsThe number of 1026 elderly people were investigated by stratified cluster sampling method using the self-made questionnaire of oral heahh behaviors of the elderly people.Results ①In the number of 1026 elderly people,denture lost teeth accounted for 5.3％.There was no gendr differece in denture lost teeth( χ2=0.162,P ＞ 0.05 ) but age( t =- 9.089,P ＜ 0.01 ).②Brush teeth every day of the test total 86.3％,56.4％after dinner would gargle,0.6％ daily flossing,35.4％ used shaft brush.③The oral health behavior was related to the elderly pepole＇ gender,cultural level,economic income and participate in the oral health education activities based on the binary logistic.ConclusionThe old oral health behaviors are affected by various factors.To improve oral health awareness and promote oral health,the further strengthening community propaganda and education about oral health and control measures should be reinforced on the basis of the old oral health cognitive and behavioral status.

Objective To investigate the clinical characteristics and the treatment of pancreatic encephalopathy (PE) and Wernicke's encephalopathy (WE). Method A retrospective study was conducted on 596 cases of acute pancreatitis. Results There were 93 cases of severe acute pancreatitis (SAP),among them encephalopathy was discovered in 10 patients (1.7%). All 6 patients of PE developed in SAP (6.5%);3 patients died (3% of SAP,50% of PE). Four cases of WE developed in AP (0.7%);2 patients died (0.3% of AP,50% of WE). Two patients of WE were treated with parenteral thiamine (vitamin B_ 1 ),and they survived. Conclusions PE occurred in early stage of SAP or recrudescence,while WE usually occurred in convalescent stage of SAP/AP. Long fasting,repeated vomiting,and total parenteral nutrition (TPN) without VitB_ 1 were main causes of VitB_ 1 deficiency,which might be the main causative factor in WE.

Objective To study the effects of integrated liposomal prostagladin E 1(Lipo PGE 1) and fosinopril on early diabetic nephropathy (DN) and clinical DN.Methods 86 patients of type 2 diabetic patients with DN were randomly divided into control group (fosinopril) and treated group(fosinopril+Lipo PGE 1).UARE,Scr and BUN figures were compared between two groups before treatment and eight weeks after treatment.Results UAER had been decreased significantly in both groups(P0.05).Furthermore,no significant decrease of BUN、FBG、MPA、TC and TG had been found in both groups.Conclusion Integrated Lipo PGE 1and fosinopril can ameliorate proteinuria and improve renal function of the patients with early DN and clinical DN of normal renal function.