BACKGROUND: Finite element method has become an important means for biomechanical study against sideways falls because of its unlimited sample size, small experimental error and good repeatability.OBJECTIVE: To establish three-dimensional normal pelvis and brace-covered pelvis models and then to analyze the stress, strain and displacement distribution during sideways fall and to verify the effectiveness of hip brace.METHODS: Digital human Abaqus 6.51 software was used to build three-dimensional normal pelvis and brace-covered pelvis models. The rigid constraint surface was fixed. The whole pelvic model was loaded with 2 m/s loading. The stress, strain and displacement variation with time and contours were detected prior to and after wearing the hip brace. RESULTS AND CONCLUSION: Compared with the normal model, the contact force between the pelvis and the ground, the maximal compression strain of the cancellous bone when the maximal contact force between the pelvis and the ground generated, the maximal strain of the greater trochanter and femoral neck, the maximal von-Mises stress of the greater trochanter and femoral neck, and the mean stress of the greater trochanter and femoral neck were significantly reduced in the brace-covered pelvis model during sideways falls. These findings indicate that the hip brace can play a protective role in the greater trochanter, and effectively reduce the incidence of intertrochanteric fractures during sideways fall.

Objective:To investigate the effect and safety of sertraline tablets with oral administration in the diabetes patients com-plicated with depression. Methods:Totally 74 diabetes patients complicated with depression were randomly divided into 2 groups with 37 ones in each. All the patients were orally given dimethyldiguanide 500 mg,tid,and the observation group was given sertraline tablets additionally,50-100 mg,qd. The treatment course was 8 weeks. The changes of sugar metabolism and the scores of self-rating depres-sion scale( SDS)and quality of life scale( DMQLS)in the two groups were compared. Results:After the 8-week treatment,the blood sugar,SDS scores and DMQLS scores in the two groups were significantly improved when compared with those before the treatment( P<0. 05). The levels of FBG,2hPG and HbAlc and SDS scores in the observation group were significantly lower than those in the con-trol group(P<0. 05),while the scores of DMQLS disease,psychology,society and satisfaction dimension were significantly higher in the observation group(P<0. 05). The incidence of adverse reactions showed no statistically significant difference between the two groups(P>0. 05). Conclusion:Sertraline tablets can improve the depression of diabetes patients and enhance the blood sugar control and quality of life.

Objective To discuss the effective nursing method of severe erythema multiforma exudativum children patients complicated with bronchopneumonia.Methods Two cases of erythema multiforma exudativum were reviewed,and the nursing methods were summarized,including protective isolation,care of wound surface,care of intravenous infusions,psychological care,oral care,eyes care,perineal care,care of fever,and discharge instructions.Results Two children patients were both cured.Conclusions For severe erythema multiforma exudativum children patients complicated with bronchopneumonia,proper nursing method and careful observation can decrease the complications and help patients to cure quickly.

BACKGROUND:Posttraumatic osteomyelitis is bone infection after surgery of open fractures or other joint, which leads to more secretions in antrum or bone exposed wounds, long treatment cycle, delayed healing of fracture, even disunion. The key link in the treatment is complete debridement, adequate drainage, and the use of external fixators with low interference and far away from lesions. ＜br> OBJECTIVE:To observe the clinical efficacy of external fixator combined vacuum sealing drainage (VSD) in the treatment of post-traumatic osteomyelitis, and compared with conventional catheter drainage. ＜br> METHODS:Since June 2010 to June 2013, 21 patients of post-traumatic chronic osteomyelitis were included in this study and divided into VSD group (n=11) and conventional catheter drainage group (n=10). Al patients in VSD groups underwent debridement and VSD was used to fil dead space, then the wounds were sutured. Cases appeared nonhealing fractures underwent external fixation, 10 cases using external fixators and 1 case retained original external fixator. Al patients achieved the closed wounds at the second phase, 9 cases were directly sutured, and 2 cases received skin flap transplantation. Among them, 1 case received autologous bone graft at the third phase because of bone defects. In the conventional catheter drainage group, al patients underwent debridement and conventional catheter drainage to rinse the wounds after surgery, 3 cases failing to close the wounds changed to receive ordinary dressing and skin flap transplantation at the second phase. Cases appeared nonhealing fractures underwent external fixation. Local swel ing, pain and fever were observed after treatment. The time of total hospitalization stay and fracture healing was recorded. ＜br> RESULTS AND CONCLUSION:The VSD group quickly control ed preoperative symptoms such as swel ing and pain and fever than the conventional catheter group (P＜0.05). The length of hospital stay showed no significant difference between the two groups (P>0.05). Al patients were obtained through clinic service and fol owed up for 24-36 months. The healing time in the VSD group was shorter than that in conventional catheter group (P＜0.05). Until the end of fol ow-up, no patients in the VSD group appeared infection recurrence, and two cases in the conventional catheter group had recurrent infection. The results suggest that VSD combined with external fixator can repair post-traumatic chronic osteomyelitis due to rapid control of infection, easy care, shortened treatment time, and reduced rate of postoperative recurrence. In addition, external fixator can be used as the final fixation for post-traumatic chronic osteomyelitis.

Thyroid hormones are known to influence the activities of sympathetic nerve by modifying the P-adrenoceptor numbers in several peripheral organs. In order to find out whether similar changes exist in central nervous system ( CNS ) , the changes of ?-adrenergic re-cetors in mouse brain during experimental hyperthyroidism and the effects of some Yin Tonice( Rehmannia ) on that were investigated by method of radioligand binding. The results were as follows: 1 . The maximum Binding capacity (Bmax ) value of hyperthyroid mouse brain was 29% higher than the control's. No significant difference in KD value between the control and hyperthyroid animals was found . 2. By administration of rehmannia, the Bmax of hyperthyroid mouse was reduced to control value.

Objective: To understand the effects of different expansion ways on collagen and actin of skin and to provide an experiment foundation for the suitable expansion method clinically. Methods: The rabbits were divided into five groups. The expanders were embedded in experimental group. The sirius-red specific staining method was applied to observe the changes of type I collagen and type III collagen and their proportion. Immunochemistry method was used to detect the expression of actin. Results: 1: In group A, B and C, type I collagen arranged turbulently and was thicker and type III collagen decreased relatively at earlier maintaining period. After 4 week, type I collagen arranged regularly and type III collagen was relatively increased. 2: Comparisons of the area about type I, III collagen: At the same maintaining period, there were no significant difference among the group A,B and C. With the extension of maintaining period, the area of type I, III collagen increased gradually, but there was inclined to stabilize at the fourth week in group A, B and at the third week in group C. Comparison of the proportion of collagen I and collagen III: There were significant difference between group A, B and group D, but no significant difference was observed after the fourth week. There were significant difference between group C and control group, but no significant difference was observed after three week. 3. With the extension of maintaining period, the positive expression rates of actin decreased gradually in group A, B, C. At the same maintaining period, significant difference were observed among group A, B, C. The positive expression rates of actin in group C were lower than that of group A at the same maintaining period. Conclusion: The repeated rapid expansion can not only shorten the clinical period but also promote the quality of skin flap. It is a safe and feasible method in clinic.

Objective To evaluate the effect of propofol on interleukin-1β (IL-1β)-induced increase in monolayer permeability of human umbilical vein endothelial cells (HUVECs).Methods Primary HUVECs were cultured and purified by immuno-magnetic separation.The expression of VE-cadherin in endothelial cells was determined by immunofluorescence.The HUVEC monolayer permeability was detected by the Transwell system.The cells were seeded on the upper chamber (2 × 105 cells/well) and cultured for 3 days after confluence.The cells were treated in two ways.The cells were randomly divided into 6 groups (n =36 each) and 5 of the 6 groups treated with 1,2,5,10 and 20 ng/ml IL-1β for 24 h except for control group.The cells were also randomly divided into 5 groups (n =30 each) and 4 of the 5 groups were pretreated with 0,10,50 and 100 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h except for control group.The cells were radomly divided into 3 groups (n =18 each) and 2 of the 3 groups were pretreated with 50 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h or 30 min.The expression of occludin protien,p38 mitogen activiated protienkinase (p38 MAPK) and phosphorylated p38 MAPK (p-p38 MAPK) was determined by Western blot.Results Compared with control group,5,10 and 20 ng/ml IL-1β significantly increased HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.05 or 0.01).10,50 and 100 μmol/L propofol inhibited IL-1 β-induced increase in the permeability of HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.01).IL-1β could down-regulate HUVEC occludin protein expression,and activate p38MAPK signaling pathway,and propofol inhibited IL-1β-induced down-regulation of HUVEC occludin protein expression and activation of p38 MAPK signaling pathway (P ＜ 0.01).Conclusion Propofol can alleviate IL-1β-induced increase in the permeability of HUVEC monolayer via inhibiting activation of p38 MAPK signaling pathway.

Objective To study the expressions of S100A4 and urokinase plasminogen activator(uPA) in pancreatic cancer cells and their correlation with patients prognosis.Methods The expressions of S100A4 and uPA were examined in 63 surgical specimens of primary pancreatic carcinoma by suing immunohistochemistry PV methods,and correlation of their expressions and prognosis of pancreatic cancer was analyzed.Results ( 1 ) Positive immunostaining for S100A4 and uPA was observed in 74.6％ (47 cases) and 65.1％ (44 cases) of 63 pancreatic cancer samples respectively.(2) The positive expressions of S100A4 and uPA were significantly correlated in pancreatic cancer( P =0.000,r =0.567 ).( 3 ) The expression of S100A4 significantly correlated with TNM stages( P =0.002 ),lymph node metastasis ( P =0.002 ) and distant metastasis ( P =0.007 ).The expression of uPA had a significant correlation with TNM stages ( P =0.002),lymph node metastasis ( P =0.001 )and differentiation(P =0.003).(4) Kaplan-Meier survival analysis showed that the median survival (21 months) of patients with S100A4 ( - ) was significantly longer than the median survival ( 9 months) of the patients with S100A4( + )(P=0.000) ;the median survival(9 months) of patients with uPA( + ) was significantly shorter than the median survival ( 18 months) of the patients with uPA ( - ) ( P =0.000) ; the median survival(23 months)of 13 patients with S100A4( - )/uPA( - )was significantly longer than the median survival of other cases ( Log-rank test,x2 =54.444,P =0.000).( 5 ) Cox regression model ( x2 =53.974,P =0.000 )analysis suggested:the differentiation(P =0.004),lymph node metastasis(P =0.017) 、S100A4( + ) expression ( P =0.000) and uPA ( + ) expression ( P =0.001 ) were independent prognostic factors for pancreatic cancer.Conclusion S100A4 and uPA are highly expressed in pancreatic cancer cells,and S100A4 expression has positive correlation with uPA expression,which indicates that the overexpression of S100A4 and uPA maybe poor prognosis factors for pancreatic cancer patients.S100A4 maybe promote extracellular matrix and basement membrane degradation by up-regulation of uPA protein expression,and ultimately promote tumor invasion and metastasis,which is not favorable to prognosis.They may be potential indicators of metastasis and predictors for prognosis of pancreatic cancer.

BACKGROUND: Skidproof wrist protection devices can well protect the waist.OBJECTIVE: To analyze the efficacy of wrist protectors against fracture using three-dimensional finite element analysis.METHODS: Based on original data of Mechanical Virtual Human of China, three-dimensional finite element models of wrist with normal soft tissues and wrist wearing protectors were established using Abaqus6.51 software. The model was subjected to loading of 2 m/s. Stress-strain distribution of finite element model of the wrist before and after protectors wearing was compared, and maximum stress variation with time in the distal ulna was analyzed.RESULTS AND CONCLUSION: Compared with wrist not wearing protectors, the equivalent stress at soft tissues of hypothenar eminence, dorsal wrist, inferior segment of the radioulna, and distal radioulna was significantly decreased, which the stress at the second and fourth metacarpal bone, proximal segment of the index finger, and hamate bone was significantly increased, indicating the wrist protector can disperse, or transfer some stress from the distal radius and ulna to the wrist, palm or digital bone, thereby playing a positive role in preventing dital radial and ulnar fractures.

Objective To investigate the clinical features of sepsis caused by gram negative or positive pathogens and funguses in preterm infants.Methods The clinical data of 140 premature infants with sepsis admitted to preterm neonatal intensive care unit of Bayi Children's Hospital from October 2008 to June 2011 were collected and analyzed retrospectively.The clinical features of sepsis caused by different types of pathogens in preterm infants were compared by SPSS 18.0 software.Comparison of measurement data was conducted by one way ANOVA,and comparison between groups was performed by LSD method.Rates among groups were compared by Chi-square test or Fisher's exact test.Results Of 140 preterm infants with sepsis,70 cases were caused by gramnegative bacteria,36 by gram positive bacteria,and 34 by funguses.The top three gram negative sepsis pathogens were Klebsiella pneumonia (55.7 ％,n =39),Escherichia coli (20.0 ％,n =14) and Acinetobacter baumannii (12.9％,n =9).The top three gram positive sepsis pathogens were Staphylococcus epidermidis (36.1％, n =13), Staphylococcus hominis (22.2％, n =8) and Staphylococcus haemolyticus (19.4％,n=7).The top four fungus sepsis pathogens were Candida parapsilosis (44.1％,n=15),Candida albicans (23.5％,n=8),Candida famata (8.8％,n=3)and Cryptococcus laurentii (8.8％,n=3).There were no significant differences in delivery mode,fetal distress, asphyxia, fetal growth restriction, meconium-stained amniotic fluid, maternal infection,hypertensive disorder complicating pregnancy,gestational diabetes mellitus,peripherally inserted central venous catheter,mechanical ventilation before infection,cortical hormon（e） (e)xposure,intraventricular hemorrhage, periventricular leukomalacia, peripheral blood immature-to-total neutrophil ratio,recovery time of platelet,the time of infection onset,fever and hypothermia among the three groups (P＞0.05).While there were differences in gestational age [(30.4 ± 2.3) weeks,(31.0±2.4) weeks and (29.5±1.8) weeks,F=4.317,P=0.015],birth weight [(1512.5±406.0) g,(1563.8±485.4) g and (1328.8±303.2) g,F=3.190,P=0.044],premature rupture of membranes rate [24.3％ (17/70),16.7％ (6/36) and 44.1％ (15/34),X2 =7.241,P=0.034],rate of surgery during neonatal period [12.9％ (9/70),38.9％ (14/36) and 11.8％ (4/34),X2 =10.430,P=0.005],the incidence of lowperfusion [64.3％ (45/70),30.6％ (11/36) and 50.0％ (17/34),X2 =10.922,P=0.004],rate of frequent apnea [67.1％ (47/70),36.1％ (13/36) and 55.9％ (19/34),X2=9.341,P=0.009],incidence of low white blood cell [21.4％ (15/70),8.3％ (3/36) and 32.4％ (11/34),X2=6.267,P=0.042],thrombocytopenia rate [64.3％ (45/70),16.7％ (6/36)and 67.6％ (23/34),X2 =25.576,P=0.000],white blood cell count [(19.9± 17.8) × 109/L,(19.9±14.3) ×109/L and (12.0±8.1)×109/L,F=3.553,P=0.031],platelet count [(159.1±169.1) ×109/L,(311.8±179.7) ×109/L and (121.4±123.4) ×109/L,F=14.140,P=0.000],C-reactive protein [(76.8±70.1) mg/L,(16.6±27.2) mg/L and (31.8±27.5) mg/L,F=17.248,P=0.000],incidence of central nervous system infections [1.4％ (1/70),2.8％ (1/36) and 11.8％(4/34),X2 =5.066,P=0.043],retinopathy rate of premature infants [38.6％ (27/70),50.0％(18/36) and 67.7％ (23/34),X2 =8.780,P=0.012],bronchopulmonary dysplasia rate [8.6％ (6/70),11.1％ (4/36) and 26.5％ (9/34),X2=5.837,P=0.044] and mortality [11.4％ (8/70),0.0％ (0/36) and 2.9％ (1/34),X2 =5.361,P =0.042] among the three groups.Conclusions There are significant differences among sepsis caused by different types of pathogens in risk factors (gestational age,birth weight,premature rupture of membranes and neonatal surgical procedures),clinical manifestations,infection indexes and prognosis in preterm infants.Sepsis caused by gram negative bacilli liked to present shock with obvious increasing of C-reactive protein; and the prognosis is the worst.Central nervous system infection is more common in fungal infection; and the rates of retinopathy of prematurity and bronchopulmonary dysplasia are higher.Sepsis caused by gram positive cocci have mild clinical manifestations and infection indexes variations and better prognosis.