Objective To observe the effect and its factors of open reduction and internal fixation of calcaneal fractures,and the influencing factors.Methods A retrospective analysis of 116 cases of calcaneal fracture were made.All patients were treated with open reduction and internal fixation,the effect was evaluated by Maryland foot score.The relation of the data before surgery (sex,age,cause of injury,associated injuries,injury and surgery,frac-tures sanders classification,opening and closing,diabetes,smoking history)and the effect,the surgical data (graft case,fixation,fractures,postoperative Bohler angle)and the effect were analyzed.The independent factors of the effect were analyzed by Logistic regression analysis.Results 116 patients with calcaneal fracture had been followed up for 6 -12 months,the excellent -good rate of Maryland foot score was 74.14%.Univariate analysis showed that different types of fractures,open and closed,with or without diabetes,with or without a history of smoking,different fixation methods,different fractures,patients with different postoperative Bohler angle foot function excellent rate differences were statistically significant (χ2 =17.194,4.077,6.766,9.116,5.136,6.919,4.458,all P <0.05).Logistic regres-sion analysis showed that the type of fracture,fixation,fractures,postoperative Bohler angle were independent risk factors for foot function excellent rate(OR =0.052,0.048,0.056,0.386,all P <0.05).Conclusion It has exact efficacy for open reduction and internal fixation with calcaneal fractures,the fracture type,fixation,fractures,postoper-ative Bohler angle are independent risk factors for affecting the calcaneal fractures patients.Perioperative treatment should take appropriate measures to avoid adverse factors affecting the efficacy of improved clinical efficacy.

Objective:To evaluate the anti-tumor immune responses of nureplicable recombinant vaccinia virus-based vaccine expressing HPV16 L1 and L2E7 proteins.Methods:The anti-tumor effects of the vaccine were observed using mouse models of prophylactic,therapeutic and tumor excision.The cell-mediated immunity induced by the vaccine was assessed by enzyme-linked immunospot (ELISPOT) and cytotoxic T lymphocyte (CTL) assay.Results:The vaccine could protect 60% and 50% mice from the challenge of HPV16-positive tumor cells in prophylactic and therapeutic mouse model,respectively.It could protect from recurrence of the tumor in 70% mice of the excision model.The differences among the groups were significant.Strongly specific cell-mediated immunity was found using ELISPOT and CTL assay.Conclusion:The ideal anti-tumor immune responses can be induced by NTVJL1/L2E7 vaccine in mice and it can be considered to be one candidate vaccine of cervical cancer.

[Objective] To investigate the surgical method of transforminal lumbar interbody fusion(TLIF)technique in treatment of upper lumbar intervertebral disc herniation.[Methods]From January 2002 to December 2006,a retrospective analysis on TLIF surgery treatment of 45 patients with upper lumbar intervertebral disc herniation were carried out and they acquired 12~24 months(mean,15 months)follow up.There were 29 males,and 16 females aging from 30~55 years(mean,39.2 years).Eleven intervertebral spaces were T12-L1 hernination,25 intervertebral spaces were L1、2 hernination,and 18 intervertebral spaces were L2、3 hernination of the space.Nine were double disc herniation.All cases were treated with TLIF technique.A retrospective analysis on surgical therapeutic effect was made.[Results]Five patients developed complications after operation and recovered by symptomatic treatment.Patients moved around in 2~3 d after surgery.Oswestry score improved from(52.32 ?9.17)to(20.33 ?5.72)in an average 15-months follow-up.X-ray showed that all cases had bone graft fusion and no adjacent segment degeneration occurred.[Conclusion]TLIF technique is an effective method in treatment of upper lumbar intervertebral disc herniation.It can offer satisfactory clinical effects.

Objective To study the occurrence of BRCA1 MSI in endometrial cancer and its relationship with clinic pathologic features; to explore the correlation between MSI and protein expression in BRCA1 gene. Methods Application of PCR-SSCP and DNA sequence analysis method was used to study D17S579 and D17S1349 in 49 sporadic endometrial cancer tissues, 20 cases with endometrial atypical hyperplasia and 28 cases with normal endometrial tissues. Results In the total samples of D17S579 and D17S1349, the three groups were significantly different: 34.69%(17/49) in the endometrial cancer group, 10%(2/20) in the endometrial atypical hyperplasia group and 7.14%(2/28) in the normal endometrium group (χ2= 11.208, P = 0.004). BRCA1 MSI positive rate related to the pathology grade and clinical stage, but no relationship was found in muscular infiltration depth, lymph node metastasis and histopathology types. In the endometrial cancer group, BRCA1 MSI positive rate and BRCA1 protein expression were in moderate correlated negatively (r = -0.779, P = 0.000). Conclusion BRCA1 MSI might play a role in the development of endometrial cancer, and low expression of BRCA1 protein. BRCA1 MSI might be associated with pathology grade and clinical stages in EC.

Object To study the chemical constituents of Schizonepeta tenuifolia (Benth.) Briq.. Methods The monoterpenoid constituents of S. tenuifolia were separated on silica gel column and their structures were elucidated by spectral. Results Two new compounds and three known compounds were obtained. Conclusion The new compounds were identified as 3-hydroxy-4(8)-ene-p-menthane-3(9)-lactone and 1, 2-dihydroxy-8(9)-ene-p-menthane.

Objective To investigate the clinical efficacy of different treatment in 35 chronic lymphocytic leukemia (CLL) patients. Methods Patients were treated with different regimen according to Binet stage. Patients at stage A were subcutaneously injected with interferon (3-6) MU/day, consecutive for 5 days every week. The dosage could be reduced to 2-3 times a week in long term maintenance phase after the 6 months loading treatment if there was no disease progression. Those at stage B or C were initially treated with chemotherapy regimen of FC/FC -R or CHOP/COP, and interferon were administered during chemotherapy interval, after complete remission (CR) or partially remission (PR) as maintenance therapy.Results Twenty patients were at stage A and treated with interferon, with 5 patients(25%) achieving partial remission (PR), 14 patients at stable status while no patients acquiring CR. Three of the 5 patients who achieved PR collapsed after 36.3 months at average. Eight of the 14 patients at stable status deteriorated to stage B and received chemotherapy after mean 74 months interferon maintenance treatment. In total, 27 patients in the current observation were finally included at stage B or C. Patients at stage B or C in FC/FC-R chemotherapy regimen achieved CR at 38.9% and total effective rate 77.8%, which were superior to that of CHOP/COP prescription (CR 11.1 %). The mean survival time for patients at stage A, B and C were 155.2,97.5 and 82.9 months, respectively and were statistically significant via Kaplan-Meier analysis method (P =0.032). Ten patients died in this observation, 2 at stage A, 4 at stage B and C, respectively, among whom 9died of infection and 1 for gastric cancer bleeding. The side effects of interferon were generally mild during the long term treatment. Conclusion Patients with CLL need to be individually treated with different regimen by considering disease stage and other prognosis criteria. Interferon could be applied at early phase of CLL and may reduce occurrence of infection after long term treatment.

ObjectiveTo evaluate the application of 18fluoro-deoxyglucose positron emission tomography (FDG-PET) to the staging and predicting outcome in patients with lymphoma.Methods 41 patients with newly diagnosed lymphoma(median age 57 years)were explored with FDG-PET prior to and after 4 cycles of chemotherapy.With a median follow-up of 30 months (range 10-68 months),the value of FDG-PET to staging and predicting clinical outcome was assessed. Results The maximum standardized uptake value (SUVmax) of nodal and extranodal lesions was 9.7±6.9 and 8.4±6.8 respectively prior to treatment.There were significant difference (P＜0.05) in aggressive non-Hodgkin's lymphoma and indolent non-Hodgkin's lymphoma,no significant difference(P＞0.05)in non-Hodgkin's lymphoma and Hodgkin's lymphoma(HL), B-cell neoplasms and T-cell neoplasms,germinal center B-cell-like DLBCL and activated B-cell-like DLBCL. In 41 patients, 22 patients (54 ％)were detected extranodal focus by FDG-PET before chemotherapy. FDG-PET imaging upstaged in 6(15％)of initial lymphoma patients.There were 15 patients (37 ％) in stage Ⅰ and Ⅱ and 26 patients(63 ％)in stage Ⅲ and Ⅳ by FDC-PET scan.1 patient (7 ％) in stage Ⅰ and Ⅱ,6 patient (23 ％) in stage Ⅲ and Ⅳ died of disease progression during follow-up.After 4 cycles of chemotherapy,the FDG-PET was negative in 41％(17/41),positive in 59 ％(24/41) respectively.1 patient(6 ％)died of disease relapse among 17 patients who were FDG-PET negative, 6 patient (25 ％)died of disease progression among 24 patients who were FDG-PET positive during follow-up. Conclusion FDG-PET scanning plays an important role in the pretreatment staging and prediction of the prognosis after 4 cycles of chemotherapy in patients with lymphoma.Thus it may offer the potential for change in treatment paradigms.

Objective To analyze the effects of individualized lifestyle intervention on compliance and metabolic status of patients with type 2 diabetes mellitus (T2DM).Methods Two hundred T2DM patients were selected and randomly divided into experimental and control groups of 100 patients respectively.The experimental group was given individualized lifestyle intervention for 6 months in addition to conventional oral medications.The intervention was to prescribe diet control and exercise therapy according to the patients' individual conditions.The control group was given conventional treatment and verbal lifestyle intervention for 6 months.Comparison was made in patients compliance and various metabolic markers between the two groups.Results The percentage of conduction of diet control and exercise therapy in experimental group was significantly higher than control group ( Diet control:80 vs.52,x2=7.08,P=0.029;Exercise therapy:78 vs.44,x2=11.207,P=0.004).After intervention,the fasting plasma glucose (FPG),2-hour postprandial blood glucose (2hPG),glycated hemoglobin ( HbA1c),body mass index ( BMI),triglyceride ( TG),total cholesterol (TC),low-density lipoprotein ( LDL-C ),and insulin resistance index ( HOMA-IR ) in experimental group decreased significantly,and high-density lipoprotein ( HDL-C ) increased significantly [FPG:( 8.45 ± 1.46 ) mmol/L vs.(6.66 ± 0.67) mmol/L,P=0.000;2hPG:( 12.76 ± 2.25 ) mmol/L vs.(8.22 ± 1.79) mmol/L,P=0.000;HbA1c:(7.68 ± 1.06 ) ％ vs.( 6.48 ± 0.69 ) ％,P=0.000;BMI:( 25.90 ± 1.72 ) kg/m2 vs.( 22.81 ±1.41 ) kg/m2,P=0.016;TG:(2.57 ±0.68) mmol/Lvs.( 1.88 ±0.35) mmol/L,P=0.006;TC:(5.72 ±0.13) mmol/L vs.(5.14 ± 1.38) mmol/L,P=0.043;LDL-C:(3.28 ±0.10)mmol/L vs.(2.81 ±0.57)mmol/L,P=0.009;HOMA-IR:7.58 ± 0.19 vs.4.58 ± 1.98,P=0.000;HDL-C:( 1.29 ± 0.04) mmol/L vs.( 1.62 ± 0.27 ) mmol/L,P=0.003].The levels of FPG,2hPG,HbA1c,BMI,TG,HOMA-IR also decreased in control group after intervention compared with before intervention [FPG:( 8.67 ± 2.71 ) mmol/L vs.( 7.26 ± 1.21 ) mmol/L,P=0.001;2hPG:( 12.82 ± 2.15 ) mmol/L vs.( 10.85 ± 1.98 ) mmol/L,P=0.000,HbA1c:( 7.75 ± 1.08 ) ％ vs.( 7.01 ± 0.87 ) ％,P=0.002;BMI:( 25.82 ± 1.74 ) kg/m2 vs.( 24.23 ± 1.36 ) kg/m2,P=0.024;TG:(2.47 ±0.75) mmol/L vs.(2.13 ± 0.43 ) mmol/L,P=0.018;HoMA-IR:7.88 ± 0.20 vs.6.15 ± 2.01,P=0.042].No significant difference was found on the values of TC,HDL-C and LDL-C before and after intervention in control group (P ＞ 0.05).The effect of intervention of experimental group was more obvious when compared with control group ( FPG:P=0.036;2hPG:P=0.000;HbA1c:P=0.045;BMI:P=0.037;TG:P=0.022;HoMA-IR:P=0.000).Conclusion Individualized lifestyle intervention can improve the compliance of T2DM patients,and was in favor of control metabolic status of T2DM patients to delay the occurrence and development of complications.

Objective To summarize the etiologic factors and evaluate the clinical outcome of reoperations on 119 limbs of recurrent varicose veins.Methods Retrospective analysis was made on etiologic factors of 119 limbs (113 patients) of recurrent varicose veins admitted to our hospital from January 2007 to June 2013.All patients underwent color duplex ultrasonography and anterograde venography of the lower extremity and were treated by reoperations.Results In the 119 limbs,102 limbs (85.7％) had residual main great saphenous veins or tributaries,97 limbs (81.5％) had incompetent perforator veins,23 limbs (19.3％) had neovascularization,9 limbs (7.6％) had incompetent small saphenous veins,21 limbs (17.6％) had incompetent femoral veins,6 limbs (5.0％) had iliac vein compression syndrome,and Budd Chiari syndrome was found as the cause of recurrence in 1 limb (0.8％).Postoperative patients were followed-up for 6-72 m (32-± 7 m).The cure rate of varicose veins were 100％.There was not recurrence of varicose veins,postoperative VCSS was 0-5 (1.2 ±0.5) vs preoperative 1-17 (6.2 ±2.5)(P ＜ 0.01).Conclusions Residual and incompetent great saphenous veins or tributaries and incompetent perforator veins were the main etiologic factors of postoperative recurrent varicose veins.Therapeutic principle for recurrent varicose veins is to eliminating the reverse flow of superficial vein system and ligate incompetent perforator veins.

Objective To investigate the methylation status in the promoter region of Dickkopf-3 (Dkk3) gene in patients with myelodysplastic syndromes (MDS),and to initially explore the relationship between the methylation of this gene and survival time.Methods Methylation-specific PCR (MSP) was applied to measure the promoter methylation of Dkk3 gene in 43 bone marrow or peripheral blood samples of MDS patients.As controls,70 normal peripheral blood samples from general outpatients were examined.Results In 43 patients with MDS,7 patients (16.3 ％) showed Dkk3 gene methylation.And 5 of them were semi-methylation status,2 of them were exhaustive methylation status.In 70 controls,1 showed Dkk3 gene semi-methylation.The frequency of methylation in MDS patients was significantly higher than that of controls (x2 =8.93,P =0.005).In the Dkk3 methylation group,2/7 were from bone marrow and 5/7 were from peripheral blood.Meanwhile,2 patients were RA,1 patient was RCMD,4 patients were RAEB.There was no significant difference between the different sample source (bone marrow or peripheral blood) for the results of the methylation status (x2 =0.051,P =0.821).Either between the different sex,age,type,chromosome and WPSS score (P ＞ 0.05).The progress of disease didn't influence the methylation frequency (P ＞ 0.05).The smvival analysis showed no relationship between the methylation of this gene and smvival time.Conclusions In this MDS group,there is high level of methyl-modification in Dkk3 gene.The methylation of Dkk3 might be one of the molecular mechanisms that contribute to the progress of patients with MDS.The peripheral blood sample maybe a better substitute in detective of Dkk3 with MDS.