[Objective]To explore the operating methods and key points of bysteel-wire guiding fixative steel-wire repearing tibial intercondylar eminence avulsion fractures under arthroscope.[Method]From February 2006 to August 2006,14 patients with tibial intercondylar eminence avulsion fractures were treated in bysteel-wire guiding fixative steel-wire method.Among them,there are 9 males and 5 females with an average age of 32.6 years,aged from 5 to 40 years.Injury cause:7 of road accident,5 of falling down while moving and 2 of falling from height.The results of preoperative x-Ray and Artoscan of all patients suggested the avulsion fracture of anterior cruciate ligament from the tibial spine.In the operation,firstly,fixative steel-wire cross the avulsion fracture tendon-bone joint zone.Then,make each side of avulsion fracture a bone tunnel on the tibial plateau.Finally,guide fixative steel-wire out of these two bone tunnels and then fix this steel-wire with the help of guiding steel-wires.After operation,fix the knee joint with plaster slab bended at 20? in three or four weeks.Remove the plaster slab and do functional exercise after 4 weeks.And move with walking stick 8 weeks later.[Result]All 14 patients were available at follow up with mean duration of 10.5 months.The X-Ray suggested bone healed at about 5.5 months after operation.We got the excellent in 8 cases,good in 4 and fair in 2 according to the advanced Lyshdm's classification at the last follow up.The excellent and good rate was 85.1%.[Conclusion]The technique needn't traditional cut,and has many advantages,such as micro injury,rapid recovery and few complications.And it is good to master the main points of this technique for applying it.

Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.

Objective To observe the protection effect of ischemic preconditioning to small intestines injury after limbs ischemia reperfusion ,and investigate the role of nitrogen monoxidum in the process .Methods 52 male Wistar rats were randomly divided in-to Sham group ,limbs ischemia-reperfusion (IR) group ,IPC + IR group and Nω-nitro-L-arginine methylester (L-NAME) group . The value of diamine oxidase (DAO) and nitrogen monoxidum (NO) in plasma and gut tissue ,the content of fluorescein isothiocya-nate lipopolysaccharide (FITC-LPS) in plasma ,and the value of cyclic guanosine monophosphate (cGMP) and malondialehyde (MDA) in gut tissue were measured ,respectively .The expression of P-selection and Caspase-3 were measured by immunohisto-chemistry .The apoptosis of intestinal cells was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labe-ling (TUNEL) and the results were analysed quantitatively by automatic image analytical system .Results Compared with the LIR group ,the values of DAO and FITC-LPS in plasma decreased obviously in the IPC group ,and the level of NO in plasma increased obviously (P<0 .01) .The values of DAO ,NO and cGMP in gut tissue increased obviously ,the level of MDA and the expression of Caspase-3 and the apoptosis index (AI) were significantly decreased in IPC group (P<0 .01) .Compared with the IPC group ,the value of DAO and FITC-LPS were higher and the level of NO was lower in plasma of the L-NAME group (P<0 .01) .The values of DAO ,NO and cGM P in gut tissue obviously decreased ,the level of MDA significantly increased ,and the expression of Caspase-3 and the AI significantly upregulated in L-NAME group than those in IPC group (P<0 .01) .Conclusion IPC can improve the small intestine injury and the apoptosis following hind limbs ischemia reperfusion which may correlated with the increase in the level of NO .

Objective To evaluate diffusion weighted imaging (DWI) sequence and apparent diffusion coefficient (ADC) in dif-ferentiation of various solid focal liver lesions (SFLL )commonly encountered .Methods 142 cases with 158 SFLLs underwent breath-hold diffusion weighted imaging (DWI)(b = 500 s/mm2 ) using a 1 .5 Tesla MR scanner .The cases included 7 cases of imma-tured abscesses ,12 cases of FNHs ,74 cases of hepatic cell cancer ,26 cases of cholangiocarcinomaes and 39 cases of metastasises . The signal intensity on DWI ,ADC value and the difference for each type of SFLLs were measured and analyzed .Results 24 cases of SFLLs were manifested as high signal intensity ,132 cases of SFLLs manifested as slightly high signal intensity and only 2 cases of SFLLs manifested as iso-signal intensity on DWI sequence .The mean ADC value ( × 10 - 3 mm2 /s)for immatured abscesses , FNHs ,HCCs ,cholangiocarcinomaes ,metastasises were (1 .48 ± 0 .23) ,(1 .75 ± 0 .26) ,(1 .23 ± 0 .43) ,(1 .47 ± 0 .35) ,(1 .36 ± 0 .33) ,respectively .The difference in ADC values between FNH patients and other SFLLs patients showed statistically significant (P< 0 .01) ,while HCCs immatured abscesses and malignant SFLLs showed no statistical significance (P> 0 .05) .Conclusion The signal intensity on DWI and ADC values may be helpful for diagnosing solid focal liver lesions .

Objective The aim of this study was to analyze risk factors which may affect prognosis of patients with hepatits B virus (HBV)-related liver failure,and to construct a model for prognostic evaluation and further assess its predictive ability.Methods In this retrospective cohort study,569 hospitalized patients who were diagnosed with HBV-related liver failure from January 2007 to December 2010 were enrolled.All the patients were followed up and survival analysis was performed using the Kaplan-Meier method.Univariate and multivariate COX proportional hazards regression analyses were applied to variables such as age,sex,complications,biochemical markers,coagulation markers,and HBV DNA levels to construct a model for prognostic evaluation,and 79 independent cases of HBV-related liver failure were used to confirm the model's predictive ability.Accuracy of the constructed model and model for end-stage liver disease (MELD) was evaluated by receiver operating characteristic (ROC) curves.Results The median survival time for all the patients was 59 days.The survival rates at 1,3,6 months were 58.9％,46.2％ and 45.5％,respectively;and survival rates at 1 and 3 years were 44.9％ and 44.5％,respectively.Hepatic encephalopathy,pulmonary infection,upper gastrointestinal bleeding (UGIB),albumin (Alb),aspartate aminotransferase (AST),creatinine (Cr),international normalized ratio (INR) were determined to be independent risk factors (all P＜0.01) which may affect survival of patients with HBV related liver failure.Accordingly,the prognostic index (PI) of the constructed model for prognostic evaluation 4.98 × assignment of hepatic encephalopathy + 4.57 × assignment of pulmonary infection + 4.41 ×assignment of UGIB-9.69 ×lm[Alb (g/L)]+2.46 ×ln[AST (U/L)]+5.18×ln[Cr (mmol/L)]+3.35×ln (INR) 15.36.The area under receiver operating characteristic curve was 0.838 for the constructed model assessing 90-d survival of the patients,and was 0.751 for model for end-stage liver disease,with no significant difference between the two models (Z=1.085,P =0.278).Conclusions Prognosis of patients with HBV-related liver failure can be accurately predicted by the constructed prognostic assessment model,which is consisted of hepatic encephalopathy,pulmonary infection,UGIB,Alb,AST,Cr,and INR as independent risk factors,and is able to predict the 90 d survival.

Objective To investigate the risk factors for the presence of hepatic encephalopathy in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) in the midphase.Methods A total of 287 patients with HBV-related ACLF in the mid-phase were recruited.Clinical data (age,gender,diabetes,liver cirrhosis,upper gastrointestinal hemorrhage,spontaneous bacterial peritonitis,and pulmonary infection) and laboratory findings [albumin,globulin,total bilirubin (TBil),alanine transaminase (ALT),aspartate aminotransferase (AST),glutamyl transpeptidase (γ-GT),alkaline phosphatase,total cholesterol,cholinesterase,creatinine,prothrombin activity (PTA),international normalized ratio,alpha-fetoprotein (AFP),loads of HBV DNA,serum potassium,serum sodium,white blood cell,and platelet count] were included as potential risk factors and analyzed with univariate and multivariate Logistic regressions.Results Multiple Logistic regression analysis indicated that serum potassium(B =-2.006,P =0.000,OR =0.135,95％CI:0.051-0.353),serum sodium(B=-0.096,P=0.014,OR=0.908,95％CI..0.841-0.981),pulmonary infection (B =1.648,P =0.018,OR =5.199,95 ％ CI:1.326-20.386),AFP (B=-0.010,P =0.024,OR =0.990,95％ CI:0.982-0.999) were correlated with hepatic encephalopathy.Conclusion Hypokalemia,hyponatremia,pulmonary infection and low levels of AFP are independent risk factors of the presence of hepatic encephalopathy in patients with HBV-related ACLF in the mid-phase.

Objective To compare early-stage clinical features and hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine function in first-episode and untreated major depressive disorders with suicide and without suicide. Methods Untreated patients who had a diagnosis as major depression according to ICD-10 were allocated to suicide with major depressive disorder group or non-suicide with major depressive disorder group according to whether the pa?tients had suicidal ideation or behaviours. Patients were assessed before treatment using the 17-item Hamilton Depres?sion Scale (HAMD-17), the Hamilton Anxiety Scale (HAMA), the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the suicide assessment scale. The cortisol (CORT) and adrenocorticotropic hormone (ACTH) levels in serum were measured using a chemiluminescence immunoassay. Results There was no significant difference in demographic data be?tween the two groups (P>0.05). In early-stage clinical features, there were significant differences in changes of sexual ac? tivity and feeling of despair (P<0.05). HAMD total scores were significantly higher in the suicide group (P<0.01), whereas HAMA total scores and Y-BOCS total scores were not significantly different between the two groups (P>0.05). There were no significant differences in CORT or ACTH levels between two groups (P>0.05). There were no significant correlation of suicidal scores with early-stage clinical features, symptom scales scores, CORT or ACTH levels (P>0.05). Conclusion De?creased sexual desire and feeling of despair are more severe in depressed patients with suicide than those without. There is no correlation of early-stage clinical features or HPA axis functions with suicide in patients with depression.

OBJECTIVE:To establish the quality standard for Gentiana scabra dispensing granule. METHODS:TLC was ad-opted to identify G. scabra in the preparation;HPLC was adopted to determine the content of gentiopicroside in the preparation:the column was Dionex C18 with mobile phase of methanol- water(25∶75,V/V)at a flow rate of 1.0 ml/min,the detection wave-length was 270 nm,column temperature was 30 ℃,the injection volume was 10 μl. RESULTS:TLC showed clear spots and good separation. The linear range of gentiopicroside injection volume was 0.302 6-3.026 μg (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 98.27%-99.56%(RSD=0.68%,n=6). CONCLUSIONS:The estab-lished standard can be used for the quality control of Gentiana scabra dispensing granule.

Objective To complete an information chain to support stomatological materials purchase and providing manage-ment.MethodsThe main problems of the materials management information chain were analyzed.The system construction,technical architecture and function design were designed based on B/S and C/S structure.Results The vendor cloud platform completed the information chain for purchase and distribution of stomatological materials,and provided technical support to hospital consumables management.Conclusion The system normalizes stomatological materials management,guarantees the safety,timeliness and accuracy of materials supply,and thus is worthy applying practically.

Objective To explore the MSCT characteristics of adhesive abdominal internal hernias and its complication of strangulated intestinal necrosis.Methods The CT data of 21 cases with adhesive abdominal internal hernias proved by operation were analyzed retrospectively.Raw data of CT images were reconstructed with MPR and/or CTA procedure for visualizing the hernia ring, intestinal mesentery and ansa interstinalis.Results Adhesive bands (hernia ring), crowding of distended and fluid-filled bowel loops with an abnormal location was visualized in 19 cases, among which the transitional segment from stenosis to dilation of the intestine was visualized in 17 cases.The crowded and engorged mesenteric vessels, edematous mesentery were visualized in 17 cases,among which mesenteric torsion was visualized in 11 cases.Varying amounts of ascites was visualized in 15 cases.All adhesive abdominal internal hernias in our study were classified according to their image manifestation.Dilated intestinal loop with thickened bowel wall was classified to type Ⅰ (7 cases).Dilated intestinal loop with normal bowel wall was classified to type Ⅱ (9 cases).Normal size of the intestinal loop with thickened bowel wall was classified to type Ⅲ (5 cases).The difference of CT values of the intestinal wall on non-contrast CT,enhancement CT values in arterial and portal phase of contrast-enhanced CT among three types of adhesive abdominal internal hernias showed statistical significance (P<0.05).The CT values and CT enhancement for type Ⅰ and Ⅲ were lower compared to type Ⅱ, while the difference of CT values between type Ⅰ and Ⅲ showed no statistical significance (P>0.05).8 cases of adhesive abdominal internal hernias were accompanied by intestinal necrosis (5 cases for type Ⅰ,3 cases for type Ⅲ).The necrotic intestine loop manifested as markedly thickened and blurred bowel wall with reduced enhancement, while thrombosis embolism of SMV was visualized in 4 cases and thrombosis embolism of SMA in 3 cases,respectively.Massive ascites was visualized in 8 cases.Conclusion The adhesion bands,transitional segment of small intestine,gathered and translocated intestinal loops are the clue to the diagnosis of adhesive abdominal internal hernias.Edema of mesentery, gathered and engorged mesenteric vessels, occlusion of SMV or SMA and the conspicuously thickened bowel wall with reduced enhancement are the image characteristics of intestinal necrosis.