Objective To investigate the treatment of complex fractures of distal femur with open reduction and internal fixation with anatomical plate. Methods From January 2001 to June 2004, 67 cases of complex fractures of distal femur were treated with open reduction and anatomical plate internal fixation. The allogeneic bone was grafted for 23 cases, ilium was grafted for 35 cases, ilium and fibula were grafted for 9 cases. Bio- resorbable membranes were used between quadriceps femoris and femur. 13 cases were aided with patella traction. All the patients received fumigation and rinsing with Chinese herbs and CPM(continuous passive motion) after operation. Results All the 67 cases were followed up for 10 to 26 months. All the fractures got united. The postoperative knee functions were excellent in 36 cases, good in 23 cases, fair in 5 cases, and poor in 3 cases according to Kolment standards. The excellent and good rate was 88.1% . Conclusions Open reduction, internal fixation with anatomical plate, bone grafting, local use of bio- resorbable membranes, patella traction when necessary, fumigation and rinsing with Chinese herbs and CPM after operation are good measures to treat complex fractures of the distal femur, because they can provide stable fixation, allow early postoperative functional training, and prevent adhesion of quadriceps femoris and stiffness of the knee joint

BACKGROUND:Liver fibrosis is a kind of chronic and active disease that is caused by various causes and characterized by the excessive accumulation of extracelular matrix. At present, use of Chinese herbs for the treatment of hepatic fibrosis has obvious advantages. Salvia miltiorrhiza has been shown to be highly effective in the treatment of hepatic fibrosis. However, the underlying mechanism needs further investigation. OBJECTIVE:To investigate the effects of TanshinoneⅡA on the expression levels of transforming growth factor-β/Smads signaling pathway related factors transforming growth factor-β, bone morphogenetic protein 7, Smad6 and Smad7 in the liver tissue of rats with hepatic fibrosis. METHODS:SD rats were randomly divided into three groups (n = 10): normal control, model and TanshinoneⅡA-treated groups. Rats in the model and TanshinoneⅡA-treated groups were subtaneously injected with olive oil-diluted 10% CCl4 ( 5 mL/kg) twice a week, 8 weeks in total, to build rat models of hepatic fibrosis. Four weeks after hepatic fibgrosis induction, rats in the TanshinoneⅡA-treated group received subtaneous injection of TanshinoneⅡA til eight weeks. Rats in the normal control group were subcutaneously injected with olive oil. RESULTS AND CONCLUSION: Western blotting and reverse transcription-polymerase chain reaction (RT-PCR) detection showed that in the model group, the expression of transforming growth factor-β in the rat liver tissue was significantly increased (P < 0.01) and the expression of bone morphogenetic protein-7, Smad6 and Smad7 was significantly decreased (P < 0.01) compared with the normal control group. TanshinoneⅡA could obviously reverse the expression of those factors above-mentioned (P < 0.01). The results suggest that TanshinoneⅡA can be used for treatment of hepatic fibrosis by decreasing the expression of transforming growth factor-β and increasing the expression of bone morphogenetic protein-7, Smad6 and Smad7.

Objective To evaluate the application of interferon-γ release assay T-SPOT.TB in diagnosis and efficacy assessment of pulmonary tuberculosis. Methods T-SPOT.TB assay was used to determine spot-forming cells (SFCs) formed by T-cells when stimulated by Mycobacterium tuberculosisspecific antigens in 55 patients with active tuberculosis,14 patients with non-tuberculosis lung diseases and 12 healthy controls. Meanwhile 20 sputum culture-positive and qualitative assay-positive pulmonary tuberculosis patients were tested with T-SPOT.TB before and at 2-month and 6-month after treatment.Kruskal-Wallis H and Mann-Whitney U test were used in group comparison.Wilcoxon test was used in comparison between pre- and post-treatment.Results The positive rate of T-SPOT.TB was significantly higher in patients with tuberculosis (85.5％,47/55 ) than that in patients with non-tuberculosis lung diseases (2/14) and the healthy controls (1/12) (x2 =40.926,P ＜0.05).The SFCs of hole A in response to ESAT-6 and hole B in response to CFP-10 in pulmonary tuberculosis group were 70.00 (27.00 -125.00) and 80.00 ( 17.00 - 180.00),respectively,which were all significantly higher than those in nontuberculosis lung diseases group and the healthy controls (x2 =35.376 and 30.485,P ＜ 0.05 ).The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in diagnosis of smear-positive tuberculosis were 88.6％,88.5％,91.2％ and 85％,while in diagnosis of sputum smearnegative tuberculosis,the sensitivity was 80％,specificity was 88.5％,positive predictive value was 84.2％ and negative predictive value was 85.2％ ( P ＞ 0.05 ).SFCs of hole A and hole B in 20 patients with sputum culture-positive and qualitative assay-positive pulmonary tuberculosis were 75.50 (41.25 -116.25 ) and 56.25 ( 105.00 -225.00) before the treatment.After 2-month antituberculosis treatment,the SFCsofhole A and hole B were 41.0 (18.0-68.75) and 72.50 (42.25- 158.75),which were significantly lower than those before treatment (Z =- 3.213 and - 3.622,P ＜ 0.05 ).Ater 6-month antituberculosis treatment,the SFCs of hole A and hole B were 25.00 (5.75 - 52.25) and 55.00 (6.25 -122.50),which were significantly lower than those before and 2-month after antituberculosis treatment (vs.before treatment:Z =- 3.921 and - 3.923,P ＜ 0.05 ; vs.2-month antituberculosis treatment:Z =- 3.926 and - 3.884,P ＜ 0.05 ).Conclusions T-SPOT.TB assay possess satisfactory sensitivity and specificity in diagnosis of tuberculosis infection,especially for sputum-negative pulmonary tuberculosis.It is also of value in monitoring antituberculosis treatment.

OBJECTIVE To investigate the prevalence of sulfamethoxazole/trimethoprim(SXT)-resistance genes and drug resistance in Escherichia coli isolates from the old patients.METHODS Drug resistance of 20 E.coli strains were analyzed.The SXT-resistance genes(sul1,dfrA1,dfrA12 and dfrA17)were detected by polymerase chain reaction(PCR).The PCR products were purified and sequenced.RESULTS In 20 E.coli strains,95.0% were SXT resistant.The positive rate of genes of sul1,dfrA12 and dfrA17 were 80.0%,20.0% and 65.0%.Gene of dfrA1 was not detected out,17 strains of E.coli were found dfrA gene.The SXT-resistance gene dfrA or sul1 was detected in 18 of the 20 strains.CONCLUSIONS The SXT resistance of E.coli can be caused mainly by gene expression of dfrA and sul1,and the genes of sul1,dfrA12 and dfrA17 are all firstly found and reported in China.

OBJECTIVE To investigate the antimicrobial-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA).METHODS Forty strains of MRSA were clinically isolated.Nine kinds of antimicrobial-resistant genes were analyzed by polymerase chain reaction(PCR).RESULTS The positive rates of mecA,aac(6′)/aph(2′)and tetM were all 100.0%.The positive rates of ermA/B/C,aph(3′)-Ⅲ,qacA/B,PVL and ant(4′,4″) were 82.5%,67.5%,45.0%,10.0% and 2.5%,respectively.CONCLUSIONS There are higher positive percentages of relevant resistance genes in MRSA isolates clinically.MRSA can induce clone transmition in hospital which should pay,and attention to the disinfection and isolation.

OBJECTIVE To investigate the ?-lactamases in Klebsiella pneumoniae strains isolated from the elderly patients.METHODS We had an observation on 20 strains of Klebsiella pneumoniae about 15 kinds of ?-lactamase gene test(blaTEM,blaSHV,blaLEN,laOKP,blaCTX-M-1 group,blaCTX-M-2 group,blaCTX-M-9 group,blaOXA-1 group,blaOXA-2 group,blaOXA-10 group,blaGES,blaPER,blaVEB,blaDHA,and blaACT-1).RESULTS Six kinds of ?-lactamase genes had been found out from these 20 strains of K.pneumoniae,namely,blaTEM,blaSHV,blaCTX-M-1 group,blaCTX-M-9 group,blaOXA-1 group,and blaDHA.Their positives were 95%,30%,50%,5%,5% and 15%.Among these 20 strains of K.pneumoniae,there were 19 ones of K.pneumoniae which at least contained 1 kind of ?-lactamase genes.Fifteen strains of K.pneumoniae were found containing more than 2 kinds of ?-lactamase genes,at the same time.Some were even tested out having 4 kinds of ?-lactamase genes.CONCLUSIONS The resistance of ?-lactamase antibiotics of these 20 strains of K.pneumoniae has a close relative to the number of ?-lactamase.

OBJECTIVE: To evaluate the improvement of speech perception in Chinese-native cochlear implant (CI) children using frequency modulated system (FM system). METHOD: The mandarin speech perception (MSP) system was used to evaluate 11 cases with severe and profound hearing loss who were fitted cochlear implants. Listeners were asked to repeat MSP words presented in quiet and several different signal-to-noise ratio (SNR) conditions and percent correct word repetition was determined. Performance was evaluated under FM system and without FM (CI only). In addition, the listeners' subjective performance changes in the experiment were also observed. RESULT: (1) There was significant main effect of the device condition (with FM and no-FM) (F = 72.938, P < 0.01), a significant main effect of signal level (F = 230.715, P < 0.01), a significant interaction effect between the signal level and the device condition (F = 40.893, P < 0.01). (2) Listeners answered the question in a louder voice, showed more confidence, when using with FM system. CONCLUSION FM system could improve the speech reception in a complex environment for Chinese-native CI children.
Child ; Cochlear Implantation ; Cochlear Implants ; Humans ; Noise ; Signal-To-Noise Ratio ; Speech ; Speech Perception ; Speech Therapy

The nucleocapsid protein VP15 of white spot syndrome virus (WSSV) is a basic DNA-binding protein. Three canonical bipartite nuclear localization signals (NLSs), called NLS1 (aa 11-27), NLS2 (aa 33-49) and NLS3 (44-60), have been detected in this protein, using the ScanProsite computer program. To determine the nuclear localization sequence of VP15, the full-length open reading frame, or the sequence of one of the three NLSs, was fused to the green fluorescent protein (GFP) gene, and transiently expressed in insect Sf9 cells. Transfection with full-length VP15 resulted in GFP fluorescence being distributed exclusively in the nucleus. NLS 1 alone could also direct GFP to the nucleus, but less efficiently. Neither of the other two NLSs (NLS2 and 3) was functional when expressed alone, but exhibited similar activity to NLS1 when they were expressed as a fusion peptide. Furthermore, a mutated VP15, in which the two basic amino acids (11RR12) of NLSI were changed to two alanines (11AA12), caused GFP to be localized only in the cytoplasm of Sf9 cells. These results demonstrated that VP15, as a nuclear localization protein, needs cooperation between its three NLSs, and that the two residues (11RR12) of NLS1 play a key role in transporting the protein to the nucleus.

Objective To investigate the clinical characteristics, diagnosis and treatment of placenta increta.Methods A retrospective analysis was carried out on 13 admitted cases of placenta increta from 1989～2006. Results Among the 13 cases analysed, 5 cases with a history of Caesarian section had a 0% success rate of treatment with conservative care (0/5), 100% less than that of cases with no history of Caesarian section (8/8), P＜0.05; the success rate of treatment of partial placenta increta with methotrexate with Jia Wei Sheng Hua Tang was 100%. Conclusion Caesarian section is a risk factor of placenta increta, and its prognosis is poor; however, Jia Wei Sheng Hua Tang has proven satisfactory as a supplementary treatment for placenta inereta.

Comparing the Psychiatry teaching among Jinan University,Sum-Yan-San University and The Chinese University of Hong Kong,we found the time,contents and methods of teaching were significantly different among them,so we suggested that Jinan University should reconstruct teaching mode,raise teaching time,optimize teaching contents,change practice teaching methods and examination way in psychiatry teaching.