Objective To evaluate the efficacy and safety of cellular bone allograft(CBA)in ankle arthrodesis.Methods The clinical data of 56 patients with traumatic ankle joint injury and ankle joint injury treated in our hospital from April 2013 to April 2016 were retrospectively analyzed.Imaging was performed at 3 months after surgery,and the visual analogue(VAS)score of the patients,the ankle and foot surgery score(AOFAS),and the SF-36 health status questionnaire score were recorded.The group included 33 patients who were treated with CBA,and patients with simple fusion in the treatment group(n=23).Results 2 months after operation,the fusion rate of CBA group was 87.9% and the fusion rate of without CBA group was 52.2%.3 months after operation,the fusion rate of CBA group was not higher than that of group CBA,and the fusion rate was in group.The data showed a significant improvement in pain,function,and quality of life.No adverse events caused by CBA were observed during the study.Conclusion The rate of fusion was higher in patients treated with bone allograft(CBA)than in patients with autologous bone graft,and the fusion rate was not affected by high risk factors.CBA is a safe and effective graft material for the bone healing of damaged joints,which can provide an effective bone graft substitute for ankle arthrodesis.

Objective To explore the clinical effects of therapeutic methods on child distal fracture of radius.Methods Totally 180 children with distal 212 fractures of radius from January 2012 to December 2015 in some hospital were enrolled into three treatment groups and a control group,of whom,there were 58 ones in a treatment group with external fixation support (external fixation group),58 ones in a treatment group with T-shaped plate internal support (T-shaped plate group),56 ones in a treatment group with Kirschner wire internal fixation (Kirschner wire group) as well as 40 ones in the control group with manual reduction and plaster external fixation.The clinical effects in the four groups were observed,and function scoring was carried out according to Dienst standard.Results The excellent rates in the external fixation group,T-shaped plate group,Kirschner wire group and control group were 72.41％,53.57％,82.76％ and 45％ respectively.The external fixation group had the excellent rate with no significant difference with that in T-shaped plate group (P＞0.05),while obviously higher than that in Kirschner wire group (P＜0.05),and Kirschner wire group had the excellent rate statisticallyhigher than that in the control group (P＜0.05).The external fixation group,T-shaped plate group and Kirschner wire group had the satisfaction significantly higher than that in the control group (P＜0.05).Conclusion Compared with the traditional reduction and Kirschner wire fixation,the external fixation and T-shaped plate fixation have better clinical effects.The treatment of child distal fracture of radius should be planed according to the type of fracture,stability,age,economic condition and substance of the bones of the patient.

Objective To explore the effect of simple active respiratory training method on lung function for cervical spinal cord injury. Methods 24 male patients with cervical spinal cord injury were divided into two groups, the control group (n=14) and the treatment group (n=10). 2 groups all received the same rehabilitation training, while the treatment group was added simple active respiratory training method. Lung function was assessed after eight-week intervention. Results 2 groups improved in percentage of expected value of maximum vital capacity (VCmax), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV) 8 weeks after the treatment(P<0.05), while the treatment group was better than the control group(P<0.05). Conclusion Rehabilitation training can improve lung function of the patients with cervical spinal cord injury, and simple active respiratory training method has better effect.

Objective To investigate the effects of biological characters of the human ovarian cell line (OVCAR) by stable transfection short hairpin RNA into the target HMGA1 gene. Methods Experiments were divided into two groups: transfected the OVCAR cells with pSilence4. 1-CMV-Hs plasmid as group A, while transfected OVCAR cells with pSilence4. 1-CMV-Hn plasmid as group B, in which stably transfected cells were gained by antibiotic screening. The comparative expressions of HMGA1 were detected by RT-PCR and western blot. Methyl thiazolyl tetrazolium (MTT) method was applied to measure cell proliferation and at the same time, the cell growth curve was also be mapped. Vitro invasion assay was used to observe the invasion ability of the cancer cells, and the tumor growth of the nude mice inoculated of tumor cells were compared with before and after transfection. Results In group A, the expression level of mRNA and protein HMGA1 gene in OVCAR cells were remarkably reduced before and after the stable transfected with HMGA1 siRNA, in which the percents of mRNA expression were [(86.3±2.7) % vs. (35.8± 3.1) %, P<0.05], the expression of protein were [(68.6±2.8) % vs. (22.3±4.2) %, P<0.05)]. The OVCAR cell growth in stable transfection status was more significantly decreased than that in non-transfection status (P<0.05). In group B, there were no statistical difference in the expression of HMGA1 siRNA, protein and the cell growth between before and after transfection states (P>0.05). The invasion cell numbers were reduced from before to after transfection state in group A [(53±6)vs. (21±6), P< 0.05] ,while there was no significant difference in group B [(51±6)vs. (47±8), P>0.05]. After inoculated transfected cells into nude mice, it took (6.0±0.9) days to grow the planed tumors in group A, which was much shorter than that (12.3±3.9) days in group B (P<0.05 ). After 5 weeks, the tumor weight and volume in group A was were significantly lower than those in group B [(0.8±0.3)g vs. (2.1± 0.4)g, (205±34)mm~3 vs. (987±82) mm~3, all P <0.05]. Conclusion HMGA1 siRNA could remarkably reduce the expression of HMGA1 gene in ovarian cell and also inhabit the ovarian cell growth.

Objective To explore the value of peak systolic displacement of tricuspid annulus(TAD)in evaluation of right ventricular systolic function by speckle tracking imaging(STI).Methods The study population consisted of 24 healthy subjects(control group)and 16 patients with congestive heart failure(CHF).The apical four-chamber view was obtained and imput to Qlab 6.0 workstation. The TAD at the right ventricular free wall (TADla)and the midpoint of tricuspid annulus(TADmid)were measured and calculated automatically.Right ventricular ejection fraction(RVEF)was measured by real-time three-dimensional echocardiography.The correlation of displacement parameters with RVEF was analyzed.Results In all 40 subjects, the mean value of TADla was(19.3±5.9)mm with s range from 7.8 to 28.4 mm while the mean value of TADmid was(15.3±4.6)mm with a ranging from 7.2 to 22.2 mm.The parameters in CHF group were significantly lower than those of the control group(P<0.01).TADla and TADmid showed an excellent correlation with RVEF(r=0.87 and 0.91 respectively,P<0.01).The cut-off value of TADla for RVEF<45%was 17.2 mm with a sensitivity of 89%and a specificity of 93% while the cut-off value of TADmid for RVEF<45% was 13.1 mm with a sensitivity of 96%and a specificity of 1 00%.Conclusions TAD by STI showed an excellent correlation with RVEF, and it may be a new promising method for routine evaluation of right ventricular systolic function.

Cdx2 plays an important role in the proliferation and differentiation of normal intestinal cells. It has been suggested that Cdx2 is a master regulator of the intestinal differentiation program and is therefore not usually expressed outside the intestinal organs. Loss of Cdx2 expression leads to focal gastric differentiation in the colon, whereas aberrant expression of Cdx2 in the upper digestive tract may induce the initial trans-differentiation to intestinal metaplasia. The detection of a strong nuclear immunoreactivity for Cdx2 in metaplastic cells suggests that the protein is a major transcription factor in the development of intestinal metaplasia.Abnormal expression of Cdx2 is also correlated with early stage of adenocarcinoma in different organs, indicating that the protein may play an anti-oncogenic role in cancer development. The Inflammation-metaplasia-cancer'sequence is a frequent event in the lower esophagus, stomach, uterine cervix and the bladder. In all these specific anatomical sites, the noxious stimuli leading to metaplasia may have direct and/or indirect carcinogenic effects on chronically injured cells and Cdx2 plays a key role in the cascade process. Detection of Cdx2 expression in adenocarcinoma may be useful in the evaluation of malignancy and prognosis.

Objective To evaluate the global contractile function of the left ventricle (LV) by speckle tracking imaging (STI) in patients with myocardial infarction (MI), in order to determine the feasibility of evaluation of LV funtion with mitral annular displacement (MAD).Methods The systolis parameters including longitudinal strain (GLs) ,circumferential strain (GCs) and MAD were obtained using STI and LV ejection fraction (LVEF) was acquired by three-dimensional echocardiography in control group and MI group,and the correlation between these parameters and LVEF was analyzed respectively.Results The parameters in MI group were significantly lower than those in the control group(P ＜0.01).GLs was the independent predictors of LVEF in control group and MI group.A good correlation was showed between MADin control group and MI group (r = 0.84, P ＜0.01 and r = 0.87, P ＜0.01, respectively).Conclusions MAD may be a promising modality to evaluate the global systolic function of LV in patients with MI for clinical routine practice.

Objective To discuss the influence of Doula delivery and non -Doula delivery on cesarean section(CS)morbidity. Methods796 cases with Doula delivery and 800 cases with non-Doula delivery were compared in CS morbidity, CS causes, dystocia morbidity in vaginal delivery and neonatal distress. ResultsThe main causes of CS in both groups were fetal distress, fetal malposition and cephalopelvic disproportion and uterine inertia (problems of"power"), The CS morbidity in Doula delivery group(24.37%) was significantly lower than that in non-Doula group(38.25%) (P<0.01). In Doula delivery, CS due to uterine inertia was significantly less than that in non-Doula delivery (P<0.05). However, CS rate due to fetal distress was higher in the former group (P<0.05). In the vaginal delivery cases of the two groups, dystocia morbidity in Doula delivery group(6.00%) was statistically lower than that in non-Doula delivery group(9.72%) (P<0.05). The rates of neonatal distress in the two groups were not significantly different (P>0.05). ConclusionDoula delivery can decrease the CS morbidity without increasing the rate of neonatal distress. Therefore, Doula delivery is worth administering in clinical practice.

Objective To investigate the effects of malnutrition, nephrosis itself and glucocorticoid therapy on serum IGF-l and liver IGF-l mRNA, and illustrate relationship between growth failure in nephrotic rats and turbulence of serum IGF-l. Methods Twenty-four male SD rats were randomly divided into control, pair-fed, doxorubincin-induced nephrotic(nephrotic) and dexamethasone-treated nephrotic (des-treated) rats. Serum IGF-1 and liver IGF-l mRNA were measured by RIA and RT-PCR respectively. Results 1. Serum IGF-l was reduced and liver ICF-l mRNA was increased in pair-fed and nephrotic rats, but no significant difference was found between two groups. 2. Serum IGF-l and liver IGF-l mRNA were lower in des-treated rats than in nephritic rats. 3. There was a positive correlation of serum IGF-l with nose-tail length and weight. Conclusions Reduced serum IGF-1 induced by secondary malnutrition is the cause of growth failure in nephrotic syndrome. Glucocorticoid therapy deteriorates growth failure in nephrotic syndrome by further decreased liver IGF-1 synthesis.

Objective To investigate the Th1/Th2 cells imbalance in childhood primary nephrotic syndrome(PNS)and its relation to disease activity. Methods Percentage of T-helper-1(Th1) and T-helper-2 (Th2) cells was examined by three-color flow-cytometry in 21 cases of first-onset PNS, 16 cases of remission PNS and 10 healthy children. Results The percentage of Th1, Th2 and Th0 cells in healthy children was (13. 42?4. 36)% , (2. 53 ? 1. 97)% and (1. 25?0. 92)% respectively. In the patients with first-onset PNS, the percentage of Th1, Th2 and Th0 cells was significantly decreased as compared to healthy children [(2. 34 ?2. 09)%, (1.02?0.96)% and (0.40?0.38)% respectively, all P 0. 05]. Because of relatively low percentage of Th1 cells in contrast to Th2 cells in the patients with first-onset PNS, Th1/Th2 ratio was also significantly reduced in those patients, as compared to the patients with remission PNS and the healthy children (2. 43 ? 2.65 vs 4. 17?2. 32 and 5. 41?2. 77, both P