Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.

Objective To apply six sigma management method to optimizing flow,enhancing treatment quality,prolonging service life and decreasing purchase cost of the non-coated surgical instrument.Methods The treatment flow of the noncoated surgical instrument was optimized through five steps of six sigma method including defining,measuring,analyzing,improving and controlling.The treatment results before and after flow optimization were compared,analyzed and evaluated.Results The rates for corrosion and rejection were both decreased significantly after flow optimization,while the quality was increased obviously (P＜0.05).Conclusion Six sigma management method involved in the treatment of the non-coated surgical instrument saves purchase cost,enhances the efficiency of disinfection supply room and facilitates effective supervision and monitoring.

Background Glycogen synthase kinase-3β (GSK-3β)plays an important role in glucose metabolism,and it may be affect the occurrence of diabetic retinopathy(DR).ObjectiveThe present study was to investigate the effect of valsartan and fluvastatin on the expression of GSK-3β in retina of diabetes rat model.MethodsDiabetes mellitus models were induced by intrapenetoneal injection of streptozotocin(STZ) in 47 clean Sprague-Dawley(SD) rats and were then randomedly divided into 4 groups.Ten other normal rats were served as normal control group.Sodium carboxy methyl cellulose solution,valsartan,fluvastatin,valsartan+fluvastatin and sodium carboxy methyl cellulose solution was given by oral once per day for 12 weeks respectively in diabetes control group ( n =12),valsartan group ( n =12 ),fluvastatin group ( n =11 ),valsartau + fluvastatin group ( n =12 ) and normal control group.Twelve weeks after administration of drugs,blood glucose was measured and compared among various groups,and the expression of p-GSK-3β ( Ser-9 ) protein in retina was quantified and located by Western blot and immunohistochemistry,respectively.Results Twelve weeks after use of drugs,the level of blood glucose was(5.28±0.30),(26.08±3.33 ),(26.03 ±2.66 ),(25.90± 2.86 ),(25.99 ± 2.14 ) mmol/L in the normal control group,diabetes control group,valsartan,fluvastatin,valsartan + fluvastatin group,respectively,showing a significant difference among the 5 groups ( F =110.74,P＜0.01 ).Western blot showed that the grey value of p-GSK-3β ( Ser-9 ) /β-actin in retina in the diabetic control group was significant higher than the normal group(2.774±0.139 vs 1.927±0.111,q =15.79,P＜0.01 ),and that in valsartan,fluvastatin,valsartan+fluvastatin group was lower than the diabetic control group ( 1.895 ±0.090,2.051 ± 0.113,1.537 ± 0.071 vs 2.774 ± 0.139 ) ( q =1 3.69,13.48,23.06,P ＜ 0.01 ).The grey value of p-GSK-3β (Ser-9)/β-actin in the valsartan+fluvastatin group was declined in comparison with the valsartan group and fluvastatin group ( q =6.67,9.58,P＜0.01 ).Immunohistochemistry showed that the p-GSK-3β(Ser-9) protein was expressed all over the retinal layers and obviously in retinal ganglion cell layer(GCL) in normal control group.But the p-GSK-3β(Ser-9) protein was expressed significantly in diabetic control group.The expression of p-GSK-3β (Ser-9)protein was attenuated both in valsartan and fluvastatin groups and further attenuated in valsartan + fluvastatin group. Conclusions p-GSK-3β (Ser-9) protein is overexpressed in GCL of retina of diabetes rat.Both valsartan and fluvastatin can inhibit the expression of p-GSK-3β (Ser-9) and even getting stronger when they combined.

BACKGROUND:Fructus Zipiphi Jujubae,with certain cyclic adenosine monophosphate(cAMP) and cyclic guanosine monophosphate(cGMP),has effects on hypertension,diabetes,cancer and cardiogenic shock.But there has been rare report on the influence of Fructus Zipiphi Jujubae on blood lipid. OBJECTIVE:To study the effects of juice of Fructus Zipiphi Jujubae on body function and blood lipid level in mice. DESIGN:A completely randomized basic study taking experimental animals as the subjects. SETTINGS:Department of bioengineering,school of life science and technology in a university;Department of endocrinology in a university hospital. PARTICIPANTS:The experiment was completed in the Department of Bioengineering,School of Life Science and Technology in Xi'an Jiaotong University from March to May 2003.ICR mice of clean grade, weighing 20 g to 40 g,were provided by the Shaanxi Academy of Traditional Chinese Medicine[Certification No.08-004]. Juice of Fructus Zipiphi Jujubae:The Chinese date was picked, cleaned,heated and fractured moderately,mixed with water of 10 times and pectinase with the quantity percentage of 0.70% ,soaked at 50 ℃ for 6 hours,then the juice was filtered and condensed into 16% soluble solids,then sterilized for use later.Forty-eight mice (24 male and 24 female) were randomly divided into 4 groups according to body mass with 12 in each group:normal control group(group A), normal date juice group(group B),model control group(group C) and model date juice group(group D). INTERVENTIONS:Mice in group A were fed with basic diet,drank water for 24 hours;Mice in group B were fed with basic diet,drank water and date juice for 12 hours respectively;Mice in group C were fed with high-fat diet,drank water for 24 hours;Mice in group D were fed with high-fat diet,drank water and date juice for 12 hours respectively.Changes of body mass,indexes of thymus gland and spleen were measured after treated with date juice for 30 days.High fat mice models were established,and blood lipid indexes were determined. MAIN OUTCOME MEASURES:Food efficiency of mice,index of thymus gland,spleen index,growth index of mice. RESULTS:The food efficiency and the indexes of thymus gland and spleen in group B were(9.93± 0.473) g/100 g,3.27± 0.35 and 2.93± 0.51 respectively,which were all obviously higher than those in group A[(7.56± 0.382) g/100 g,(3.14± 0.54),(2.87± 0.33)](t=2.55,2.37,2.41,P< 0.05).The body mass was obviously higher in group B [(36.73 ± 4.70) g] than in group A[(34.92 ± 5.12) g] (t=2.32,P< 0.05);while those were very significantly higher in group C and group D [(39.83 ± 6.00), (37.63 ± 2.73) g] than in group A and group B[(34.92 ± 5.12), (36.73 ± 4.70) g](t=4.13,2.48,P< 0.01),and that in the group D[(37.63 ± 2.73) g] was obviously lighter than that in the group C[(39.83 ± 6.00)g](t=2.26,P< 0.05).The serum levels of total cholesterol(TC) in the in group C and group D were significantly higher than those in group A and group B(P< 0.01), while that was significantly lower in group D than in group C(P< 0.05). The serum levels of triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C),arteriosclerosis index(AI),high-density lipoprotein-cholesterol(HDL-C) and HDL-C/TC were significantly higher in group C than in group A(P< 0.01,P< 0.05).TC, HDL-C,AI,HDL-C/TC,TG and LDL-C in group D were lower than those in group C(P< 0.05,P< 0.01). CONCLUSION:Juice of Fructus Zipiphi Jujubae can obviously increase the body mass,promoting food efficiency and indexes of thymus gland and spleen of mice, and has the significant effect on the reinforcement of body function in mice.Juice of Fructus Zipiphi Jujubae can decrease the serum levels of TC,TG and LDL-C in mice with hyperlipidemia,and has the remarkable ameliorating effect on hyperlipidemia of mice induced by high-fat feed.

Objective To explore the effect of long-term chronic mild stress on depression-like behaviors and the expression of heat shock protein 70(HSP70) in rats.Methods The standard SD rats were divided into two groups as following:one group (n =6) was treated with chronic mild stress for 3 weeks,and another group (n =5) was treated with chronic mild stress for 6 weeks.Depression-like behaviors of rats was observed by sucrose consumption test and open field test before and after chronic mild stress.And Western Blot,RT-PCR and immunohistochemistry were utilized to detect the HSP70 expression in the hippocampus and frontal lobes of rats after chronic mild stress.Results The sucrose favoritism in sucrose consumption test,the scores of crossing and the time for rats' retention in the center grid of open field test in long-term group were higher than those in short term group(P＜ 0.05).HSP70 expression in the hippocampus and frontal lobes of long-term group (0.81 ± 0.08,0.85 ± 0.08)detected by Western Blot and immunohistochemistry was higher that of short-term group (0.60 ± 0.06,0.85 ±0.07).HSP70 expression in the hippocampus of long-term group (0.90 ± 0.05,1.37 ± 0.38)detected by RT-PCR was higher that of short-term group(0.78 ± 0.04,1.08 ± 0.14) (P ＜ 0.05).Conclusion After long-term chronic mild stress,the depression-like behaviors decrease,and at the same time HSP70 mRNA and protein increase.

Objective To observe the clinical effect of modified Zhisou powder and Symbicort Turbuhaler simultaneously on patients with Cough Variant Asthma. Methods 120 patients with Cough Variant Asthma were randomly recurited into two groups. 60 patients in the treatment group were treated with modified Zhisou powder and Symbicort Turbuhaler; 60 patients in the control group were treated with Symbicort Turbuhaler. 4 weeks was a therapeutic course in both group. Results The markedly controlled rate (MCR) (clinical control+excenence)of the treatment group was 83.3%, obviously surpassed the control group (70.0%) (P＜0.05); There was obvious improvement of cough, expectoration, breath lessness and throaty pruritus after the therapy in both groups, but it was much better in the treatment group than the control group(P＜0.05). The pulmonary function was significantly improved after treatment in both groups(FEV1, FEV1% and PEF, P＜0.05). The improvement showed significant difference between the two groups(P＜0.05). There was obvious decrease of EOS, IL-5 and ECP in both groups. The decrease of ECP and IL-5 in the treatment group was greater than the control group(P＜0.01). Conclusion The therapy of modified Zhisou powder and Symbicort Turbuhaler has advantage over pure western therapy.

Objective To investigate the influence of lentivirus mediated short hairpin RNA(shRNA)target to human papilloma virus(HPV)16 E6 on invasive ability of cervical cancer Caski cells.Methods Lentivirus was produced after shRNA target to human papilloma virus(HPV)16 E6 and to nonsense was cloned to lentivirus work vector.Infection ratio was assessed by assay of EGFP positive cells of Caski.Total mRNA of E6 was determined by RT-PCR after Caski cells were infected by lentivirus.The change of E6 protein expression was analyzed by Western blot.The invasive ability of Caski cells was assayed employing Transwell.Results The optimal MOI (Multiplicity of infection)of lentivirus to Caski was 2.5.Total mRNA and protein of E6 were decreased (by 70%and 63%)in interfering group compared with control group.The invasive ability of Caski cells also reduced after infected by lentivirus.Conclusion shRNA mediated by lentivirus can inhibit expression of HPV16 E6 and invasive ability of cervical cancer cells.

Objective To investigate the prevalence and its major risk factors of NAFLD among enterprises employees of Rizhao region. Methods 8 259 employees aged over 18 were selected by multi-stage stratified random cluster sampling method in the enterprises of Rizhao region. The data were analyzed, such as height, weight, blood pressure,blood lipids,blood sugar,hepatitis series,and ECG,abdominal ultrasound,chest χ ray were conducted in the fasting state. The diagnosis of NAFLD was in line with diagnostic criteria adopted by China Institute of Liver Disease and alcoholic liver disease group, and the prevalence and major risk factors of NAFLD were investigated. Results The prevalence of NAFLD was 18. 1% (male 23.0% ,female 7. 6%;the ratio of male to female:3. 03:1) ,The prevalence of NAFLD reached a peak from 40 to 50 in male and after the age of 70 in female,and there was no statistically difference after the age of 50 between male and female. The close correlation was demonstrated by Logistic regression analysis between sex, hyperuricemia, HDLC, overweight or obesity, hyperglycemia, hypertriglyceridemia and NAFLD. Conclusion The prevalence of NAFLD was high, especially in older persons in enterprises employees of Rizhao region, and sex,hyperuricemia,HDLC,overweight or obesity,hyperglycemia and hypertriglyceridemia were closely associated with NAFLD.