Objective To outline the characteristics of fractures of the coronoid process of the ulna in children and distinguish them from that of the adult. Methods Twenty eight cases of fractures of the coronoid process of the ulna in children in the past five years were reviewed. There were 18(64%) boys and 10(36%) girls. According to the extent of involvement, the fractures were classified as 3 types based on modified Regan and Morrey method. Of those, 10 cases were associated with other injuries such as dislocation of the elbow, fracture of the radial neck, fracture of the olecranon and so on. In this series, open reduction and internal fixation were applied in only 2 cases with type Ⅲ injury and conservative treatment including immobilization of the elbow in flexion with long arm plaster splint were done in all of the rest cases. Results Seventeen patients were followed up for an average of 14 months(range, 4 months to 5 years). The clinical results were evaluated according to pain, range of motion, muscular strength and stability of the elbow. The overall excellent result were achieved in 94%of the patients. No complaint and late complication were found in this series. Conclusion There are some obvious differences in the coronoid process fracture of the ulna between children and adult: 1)fewer cases associated with dislocation of the elbow in the children than in the adult; 2)the clinical results were relatively better in children than that in the adult whatever the surgical or conservative treatment was performed; 3)the prognosis of fractures of the coronoid process of the ulna was better and the complications were less in children than that in the adults.

Objective To explore the clinical effect of pressured rapid volume expansion in the treatment of hemorrhagic shock under the monitoring of central venous pressure(CVP).Methods Forty patients with hemorrhagic shock were randomly divided into two groups: the study group (groupⅠ,n=20) and the control group(groupⅡ,n=20).In groupⅠ,the patients were treated with rapid intravenous infusion by pressured soft fluid in bags under the CVP,and the patients received traditional transfusion method in groupⅡ.Results The average amount of transfusion in 30 minutes and the total amount in perioperative period were(1271?170) ml and(5311?410) ml in groupⅠrespectively,and in groupⅡ,the results were(721?140) ml and(3273?330) ml respectively.The recovery of systolic blood pressure(SBP),diastolic blood pressure(DBP),central venous pressure(CVP) and pulse oxygen saturation(SpO_2),the time of recovered urination and cure rate in groupⅠ were significantly better than those in groupⅡ.The mortality reduced in the study group.Conclusion With the monitoring of CVP,the pressured rapid volume expansion is an effective treatment for hemorrhagic shock.With the pressured rapid volume expansion,the circulating blood volume of patients can be recovered rapidly and the perfusion of important organs,tissues and cells be maintained.

A description of the implementation strategy and methodology of clinical medicine as a discipline in terms of building clinical technology features, making scientific research centering on clinical questions, building technical and academic branding, and building discipline bases.Authors also emphasized human resource cultivation, and held that the clinical discipline development should be carried out by means of organization and culture management for the discipline.

ObjectiveTo investigate the expressions ofheparinase,matrix metalloproteinase 2 (MMP2) and tissue inhibitor of metalloproteinase 2(TIMP2) in malignant melanoma lesions and their significance.MethodsSkin specimens were obtained from the lesions of 30 patients with malignant melanoma,30 patients with melanocytic nevus and the normal skin of 15 healthy controls.Immunohistochemical SP method was used to detect the protein expression of heparinase,MMP2 and TIMP2.ResultsThe malignant melanoma tissue specimens significantly differed from the melanocytic nevus and control tissue specimens in the expression rate of heparinase (63.33％ vs.6.67％ and 0.00,x2 =21.172,27.805,both P ＜ 0.01 ),MMP2 (70.00％ vs.13.33％ and 0.00,x2 =19.817,19.866,both P＜ 0.01) and TIMP2(60.00％ vs.6.67％ and 0.00,x2 =19.200,15.000,both P ＜ 0.01 ).ConclusionThe expression of heparinase,MMP2 and TIMP2 is significantly higher in malignant melanoma lesions than in melanocytic nevus lesions and normal skin tissue.

Objective To determine low-concentration clenbuterol in edible meat based on the solidphase extraction coupled with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).Method The homogenated sample was acidized to remove proteins,and purified using the liquid-liquid extraction and MCX Oasis solid prepared extraction column,then further treated with gradient elution with the mobile phase of ammonium formate (10 mmol/L and pH 3.5) and acetonitrile.The clenbuterol was completely separated on Eclipse C18 (1.8 μm,4.6×100 mm) column and detected in multiple reaction monitoring (MRM) mode.Results A good linearity was achieved for clenbuterol in the arrange of 0.01～0.2 μg/kg based on the internal standard calibration of D9-clenbuterol,with the linearity correlation coefficient greater than 0.99 and the detection limit of 0.005 μg/kg.The relative recovery of target compounds spiked in blank sample at three levels ranging from 78.8 to 114.8％,with the relative standard deviations less than 10％.Conclusion The method in this research is simple,rapid,reliable and suitable to confirm low-concentration clenbuterol in edible meat.

Yttrium vanadate:europium nanoprobes (YVO4∶Eu NPs) with good fluorescence properties and water solubility were synthesized by solvent thermal method.Due to the overlapping of the excitation spectrum of YVO4∶Eu NPs and the absorption spectrum of tryptophan, fluorescent internal filter effect (IFE) occurred, in which YVO4∶Eu NPs were the fluorophore and tryptophan was the absorber, leading the fluorescence of YVO4∶Eu NPs was quenched.Therefore, a new method for the determination of tryptophan was established by using fluorescent YVO4∶Eu as nanoprobes based on IFE.Some experimental parameters, such as the adding amount of YVO4∶Eu NPs, pH value of the reacting solution, and reacting time, were investigated.Under the optimum reaction conditions, the linear range of the method was 4.0×10-6-4.0×104 mol/L and the detection limit was 1.0×10-6 mol/L (3σ).The content of tryptophan in the soy sauce was determined with the recovery of 95.2% and 97.3%.This method is simple, rapid, sensitive and accurate.

Objective To quantify the right ventricular (RV) function in patients with left heart disease (LHD) related pulmonary hypertension (PH) by two-dimensional speckle tracking imaging (2D-STI),and explore its potential value in diagnosis of reactive PH.Methods Forty healthy volunteers and 65 patients with LHD related PH were enrolled.PH patients were further divided into two subgroups according to pulmonary vascular resistance(PVR):passive PH group and reactive PH group.A complete 2D-STI derived longitudinal strain of RV free wall was performed,and the basal,middle,apical longitudinal peak systolic strain (LS) and RV free wall global LS (RVLSbas,RVLSmid,RVLSapi and RVLSfw) were measured.Results Compared to control group,RVLSbas and RVLSfw in reactive PH group decreased significantly (all P ＜0.05).Compared to passive PH group,RVLSbas and RVLSfw in patients with reactive PH decreased significantly (all P ＜0.05).The differences of RVLSbas and RVLSfw between control group and passive PH group had no statistical significance (all P ＞0.05).No significant differences in etiology and left ventricular ejection fraction (LVEF) were observed between PH subgroups (all P ＞0.05).The area under the ROC curve of RVLSbas in predicting reactive PH was 0.93,the cut-off value was-21.86,and the sensitivity and specificity were 83 ％ and 89 ％,respectively.The area under the ROC curve of RVLSfw was 0.79,the cut-off value was-13.84,and the sensitivity and specificity were 59％ and 89％,respectively.Conclusions 2D-STI can realize quantitative assessment of RV function in patients with LHD related PH.RVLSbas and RVLSfw may have important clinical value in diagnosing patients with reactive PH,and differential diagnosis value between patients with passive PH and patients with reactive PH.

Objective To observe the effect of light emitting diode (LED) red light irradiation on serum lipid in experimental hyperlipidemia rats. Methods 36 healthy male Sprague-Dawley rats were randomly divided into normal control group (n=12) and hyperlipidemic model group (n=24). The normal group was fed with normal diet while the hyperlipidemic model group with fat-rich forage for 6 weeks. The hyperlipidemic model group rats were randomly divided into the hyperlipidemic control group (n=12) and LED treatment group (n=12), and the latter accepted LED red light irradiation for 28 d. The levels of serum lipid including total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), and the activities of lipoproteinesterase (LPL) and hepatic lipase (HL) were detected with biochemical assay. The expression of 3-hydroxy-3-methylglutaryl coenzyme A reducase (HMG-CR) of hepatic tissue were measured with immunohistochemical staining. Results Compared with the hyperlipidemic control group, the levels of serum TC, TG and LDL-C decreased while the serum HDL-C increased significantly in the LED treatment group (P<0.01) after treated with LED. The levels of LPL and HL in serum increased (P<0.01) while the activity of HMG-CR decreased (P<0.05). Conclusion LED red light irradiation might play a regulating effect on serum lipid by enhancing the activities of LPL and HL and inhibiting the expression of HMG-CR to interfere the metabolism of TC, TG, LDL-C and HDL-C.

Objective To introduce our experiences of reconstruct the first web space using flaps.Methods One hundred and twelve patients sustained contracture of the first, summarized the indications of different flaps in coverage of the first webspace and their prognosis of these flaps were retrospectively reviewed.Results The local flaps, such as double Z-plasty or Z-plasty, were suitable to cover minor contracture of the first webspace; the dorsal flap arising from the index finger was suitable for the coverage of the medium contracture, and the posterior interosseous artery flap or the reverse antebrachial island flap based on the dorsal branch of the anterior interosseous artery suitable for the severe cases. Conclusion The usage of flaps is important to resume the cosmetic shape and function of the first webspace after release of the contracture of the first webspace.

Objective To investigate whether the macromolecular materials could enter cerebrospinal fluid and brain tissues in craniotomy with incision or non-incision of dura and arachnoid. Methods Adult male SD rats were randomly divided into three groups according to the random number table. The dura and arachnoid of rats in group A were cut open during craniotomy after general anesthesia; epidural craniotomy was done in rats in group B after general anesthesia; rats in group C (control group) were only generally anesthetized. All the rats were injected with Evans blue, a tracer used to detect the results, half an hour before each time point (1,3, 6, 12, 24, 72 hours and 1 week) via vein. The rats were executed at each time point to obtain the specimens of brain. The content of Evans blue in brain tissue was measured by fluorescence spectrophotometer for statistical analysis. The water content in the brain tissue was measured in a part of rats selected in groups A and B preoperatively and at postoperative 3 and 27 hours. Results It was found that some regions of the brain tissue were stained light blue in group A at 1,3, 6 and 24 hours. The blue was much lighter in brain tissue obtained at 72 hours in group A, and no blue stained at 1 week in group A . The contents of Evans blue in the brain tissues of rats in group A at 1,3, 6, 12, 24, 72 hours and 1 week were (18.07±1.25) μg/ml, (36.21±0.78) μg/ml, (25.73±1.14) μg/ml, (16.53±0.84) μg/ml, (23.34±1.91) μg/ml, (43.34±2.25) μg/ml and (25.27±1.88)μg/ml respectively, which were significantly higher than (3.15±0.45)μg/ml, (3.36±0.33)μg/ml, (2.98±0.54)μg/ml, (3.47±0.55)μg/ml, (3.54±0.37) μg/ml, (2.88± 0.42) μg/ml and (2.85±0.22) μg/ml respectively in group B and (2.97±0.37)μg/ml in group C (P<0.01). There was no significant difference in water content in brain tissue before and after operation (P>0.05). Conclusion After craniotomy with incision of dura and arachnoid, some macromolecular materials can enter the subarachnoid space and the brain parenehyma through blood-brain barrier of the wound of the scalp if the dura is sutured loosely.