[Objective]To seek for a method to rebuild radial head for comminuted radial head fractures,and recommend a new technique of bipolar radial head replacement.[Method]Five patients with fresh comminuted radial head fractures were treated by Tornier cement stem and bipolar radial prothesis.Among them,three were females and two were males,with the average age of 37.4Y(29-48Y).Four cases were to Mason type Ⅲ and one Mason type Ⅳ.All the patients underwent operation within 3-11 days with an average of 6 days after injury.Rehabilitation began in Mason type Ⅲ radial head fracture patients 48 h postoperatively.Both medial and lateral ligaments were repaired in one case of Mason type Ⅳ fracture.Plastic brace were used for 3 weeks during functional rehabilitation.The postoperative elbow joint was evaluated clinically by Broberg and Morrey score.[Result]All the patients healed by first intention were followed up for 7 to 50 months,with an average of 30 months.According to elbow functional evaluation criteria by Broberg and Morrey scores,there were excellent results in three and good in two respectively with an average of 92.2 points.[Conclusion]Cement stem and bipolar radial head prothesis replacement is a good technique for treating comminuted radial head fractures because it meets the designing principle of modern orthopaedics.

Objective To evaluate the efficacy of α2 adrenergic agonists for the prevention of postoperative adverse cardiac events in patients with coronary disease.Methods MEDLINE,EMBASE,CINHAL,Web of Science,CBM and CNKI were searched to identify all randomized controlled trials on the efficacy of α2 adrenergic agonists for the prevention of postoperative cardiac complications following operation performed under general anesthesia in patients with coronary artery disease.The incidence of myocardial ischemia,myocardial infarction,bradycardia and hypotension were evaluated.Meta-analysis was conducted using the RevMan 5.1 software.Results Fifteen trials included 9 high-quality trials,4 medium-quality trials and 2 low-quality trials.A total of 3422 patients were included in this meta-analysis.1790 patients received α2 adrenergic agonists (clonidine and dexmedetomidine) and 1632 patients received placebo; 724 patients underwent non-cardiac surgery and 2698 patients underwent cardiac surgery.Meta-analysis indicated that α2 adrenergic agonists reduced incidence of myocardial infarction following non-cardiac surgery and myocardial ischemia following non-cardiac surgery and cardiac surgery.Alpha-2 adrenergic agonists significantly increased the incidence of postoperative bradycardia.Conclusion Alpha-2 adrenergic agonists can decrease postoperative cardiac adverse events in patients with coronary disease,but can induce bradycardia,and the efficacy of clonidine is consistent with that of dexmedetomidine.

Objective To systematically review the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery.Methods PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,CBM and CNKI were searched to identify all randomized controlled trials involving the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery under general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the incidences of postoperative cardiac death,myocardial infarction and ventricular arrhythmias and postoperative inotropic drug requirement.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Twelve randomized controlled trials (8 high-quality trials and 4 medium-quality trials) involving 626 patients were included in our Meta-analysis.Meta-analysis indicated that ischemic proconditioning significantly reduced the incidence of postoperative ventricular arrhythmias and postoperative inotropic drug requirement (P ＜ 0.05) and had no effect on the incidences of postoperative cardiac death and myocardial infarction (P ＞ 0.05).Conclusion Ischemic preconditioning can reduce the postoperative ventricular arrhythmias and have no effect on postoperative cardiac death and myocardial infarction in patients undergoing open heart surgery.

Objective To study the curative efficacy of dydrogesterone in treatment of Climacteric syndrome and its effects on sex hormone, blood fat.Methods104 patients of Climacteric syndrome who received therapy from February 2014 to November 2016 in our hospital were selected as research objects, according to different divided into observation group and control group, treatment group used to bend progesterone therapy, the control group using a placebo.one month after treatment to observe the two groups of clinical curative effect, compare two groups before and after the treatment and testing level of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH),total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C).ResultsAfter treatment, the clinical total effective rate in the two groups to compare have no significant difference;Compared with before treatment, the control group in estrogen level and blood lipid levels in patients with no significant change, the observation group of patients with E2 and HDL-C level increased significantly, and significantly higher than the control group (P<0.05);FSH, LH, TC, TG, LDL levels significantly decreased, and significantly lower than the control group (P<0.05).ConclusionUsing of dydrogesterone short time the clinical curative effect of treatment of menopausal syndrome with placebo, but can effectively improve patient sex hormone levels, adjust blood lipid levels, to reduce the incidence of cardiovascular disease (CVD) patients, improve their quality of life.

Objective To investigate the value of prothrombotic state (PTS) in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.Methods One-hundred and twenty-eight ASA physical status Ⅰ or Ⅱ elderly patients (NYHA class Ⅰ or Ⅱ) of both sexes,aged 6575 yr,undergoing elective abdominal surgery,were enrolled in the study.Total intravenous anesthesia was performed during surgery.Venous blood samples were collected for detection of the levels of D-dimer,thrombus precursor protein and P-selectin (molecular markers of PTS).Detection of PTS was based on the three indexes mentioned above.The patients were divided into 2 groups according to the cardiac events occurred during surgery and within 3 days after surgery:non-cardiac event group and cardiac event group.The general data of patients and each index during surgery were recorded.Logistic regression analysis was used to pick out the potential risk factors for cardiac events.Results Twenty-nine patients developed cardiac events.There was no significant difference in age,obesity,ratio of diabetes,duration of operation,and ratio of PTS between non-cardiac event and cardiac event groups (P ＜ 0.05 or 0.01).Logistic regression analysis showed that old age,diabetes,prolonged duration of operation,and PTS were independent risk factors for cardiac events (P ＜ 0.01).Conclusion PTS produces some value in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.

Objective To investigate the regulation of metabolize characteristic of some antibiotics in ACST in human bile, and provide the theoretic basis for physician selecting antibiotic rationally when biliary tract has been infected. Methods Samples of ACST in human bile were obtained by ERCP + ENBD, contents of Cefradine, Cefoperazone, Ceftriaxone, Ciprofloxacin and Lomefloxacin in human bile were simultaneously measured by HPLC method. Results After antibiotics were given through iv 0. 25 ～ 1. 5 hour, an increase was observed in contents of all antibiotics in bile, and the changes of Ceftriaxone and Ciprofloxa-cin were the most significant ( P <0.01). Ceftriaxone and Ciprofloxacin had a higher Cmax than other antibiotics, and Cefoperazone had a longer tl/2. Conclusion As maintaining a little time to tmax , a higher Cmax and a longer tl/2 in the bile by iv, Cefradine and Ciprofloxacin are recommended in the patient with ACST.

Objective To find early diagnostic biomarkers for colorectal carcinoma by comparing differential(expressing) proteins from colorectal carcinoma and normal colorectal tissues.Methods Colorectal carcinoma tissues and paired normal tumor-adjacent colorectal tissues were collected,and tissue total protein was (extracted);differential proteome profiles were established and analysed by means of immobilized pH(gradient-based) two-dimesional polyacrylamide gel electrophoresis(2D-PAGE) and matrix-assisted laser(desorption)/ionization time of flight mass spectrometry(MALDI-TOF-MS).Results Well-resolved,(reproducible) 2-DE profiles of human colorectal carcinoma tissues and paired normal tumor adjacent colorectal tissues were obtained.For tumor tissue,a total of 1098?28 spots were detected,and for normal tissue,760?45 spots were detected.For normal tissue,The average deviation of spot position was(0.542?(0.12))mm in IEF direction and(0.933?0.098)mm in SDS-PGE direction for tumor tissue.The average deviation of spot position was(0.745?0.130)mm in IEF direction and(1.233?0.272)mm in(SDS-PGE) direction.30 differential expressing proteins were analysed by mass spectrometry and bioinformation,16 of them were well characterized including Apolipoprotein A1(apoA1),calreticulin precursor,glutathione(S-transferase),hepatic fatty acid-binding protein、heat shock protein 27 ect.Conclusions Differential expression proteins can be candidate biomarkers for early diagnosis of colorectal carcinoma;and proteomic technique is valuable for screening the diagnostic biomarkers.

Objective:The study aims to screen chemosensitivity-associated proteins in colorectal carcinoma tissues by using two-dimensional gel electrophoresis (2-DE) and mass spectrometry,then identify some differentially-expressed proteins. Methods:The patients with advanced colorectal carcinoma were confirmed by clinical diagnosis. Fresh carcinoma specimens were collected by biopsy and preserved in liquid N2. The tissues were classified into two groups: high sensitivity group (HS) and low sensitivity group (LS) based on drug sensitivity test. The total proteins were extracted and separated by 2-DE. The images were composed, compared, and differentially analyzed to identify the proteins with differential expression in HS and LS groups. Then the differentially-expressed protein spots were incised from the gels and digested by trypsin. The peptide mass fingerprintings (PMF) was acquired after matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascot database. Two proteins with differential expression were detected by Western blotting.Results:The 2-DE spectrum of HS and LS groups were established. Most protein spots were distributed in the area with pH 4-8 and relative molecular weight of (20-100)×10~3. The average number of the protein spots was 842±23 in HS group and 793±19 in LS group,respectively. The mean matching rate was 90.7%. The number of differentially-expressed dots between HS and LS group was 79.00±13.56. Thirty protein dots were selected for mass spectrum and bioinformatic analysis, and 9 proteins were identified. Conclusion:Colorectal carcinoma with different chemosensitivity had differential protein expression profiles. The differentially expressed proteins may be associated with chemosensitivity and could be used for prediction of chemosensitivity of colorectal carcinoma.

Objective To evaluate the efficacy of different doses of glucocorticoid for prevention of postoperative complications in patients undergoing coronary artery bypass grafting (CABG).Methods We searched PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,Chinese Biomedical Database,and CNKI from 2000 to 2010 for randomized controlled trials involving the efficacy of different doses of glucocorticoid for prevention of postoperative complications in patients undergoing CABG.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included development of fibrillation,requirement for insulin treatment because of hyperglycosemia,infection,and death (during stay in hospital or within 30 days after discharge from hospital) after operation and mechanical ventilation time.Meta-analysis was conducted using the RevMan 5.1 software.Results Twenty-one randomized controlled trials involving 1737 patients were included in our meta-analysis.Different doses of glucocorticoid decreased the risk of fibrillation,and did not increase the risk of various causes-induced infection and death.Moderate and large doses of glucocorticoid increased the risk of requirement for insulin treatment because of hyperglucosemia.Large dose of glucocorticoid resulted in prolongation of ventilation time.Conclusion Different doses of glucocorticoid can decrease the development of postoperative fibrillation without increasing the risk of infection and death,moderate and large doses of glucocorticoid increase the risk of requirement for insulin treatment because of hyperglucosemia and large dose of glucocorticoid increases the risk of prolonged ventilation time in patients undergoing CABG.