BACKGROUND:Traditional treatment of tibia and fibula fractures complicated with skin soft tissue defect is mainly external fixation, wound debridement and dressing plus skin graft or skin flap transplantation after the infection is control ed and granulation grow. This method is disadvantageous due to high cost, great pain, long hospitalization stay, infection and necrosis, even the possibility of amputation.
OBJECTIVE:To explore the clinical efficacy of vacuum sealing drainage (VSD) and external fixator in the treatment of tibia and fibula open fractmes complicated with skin defects.
METHODS:A total of 38 patients with severe open fractures of tibia and fibula complicated with skin defects were selected from Benxi Central Hospital between January 2009 and September 2013. The size of skin defects was more than 5 cm2. After external fixation, the patients underwent complete debridement and dressing, fol owed by VSD treatment for 5-7 days. After granulation tissue grew and the wound became fresh, the patients received intermedite thickness skin graft. And 15 cases treated without VSD were retrospectively selected, serving as control group. The infection control rate and wound healing time in the two groups were compared.
RESULTS AND CONCLUSION:After 5-7 days of VSD treatment, VSD dressings were removed, wound infection was control ed, local wound granulation tissue was fresh. Both the wound and fractures were healed wel , no osteomyelitis or amputation occurred. Among the involved 38 patients, 23 cases were cured, 12 cases were effective, and three cases were ineffective. The total effective rate showed significant differences compared with the control group (92%vs. 53%;P<0.05). VSD can completely remove the wound secretions and necrotic tissue, improve local microcirculation, eliminate the infection, VSD plus external fixator and skin grating is a simple and effective method in treatment of tibia and fibula open fractures with soft tissue defects.

Objective We aim to investigate the association between peptidylarginine deiminase type 4 (PADl4) and colorectal cancer by genotyping threetag single nucleotide polymorphisms (tagSNP) genetic maker, to explore the role of polymorphism of PAD14 gene in development of colorectal cancer. Methods A case-control study was conducted using TaqMan-PCR methods to analyze the genotypes of three TagSNPs such as rs1886302, rs2477131 and rs1635561 for 515 patients with colorectal cancer and 549 health controls. Results There is significantly different in allelic frequencies and genotype frequencies of rs1886302 between cases and controls (P=0.039 and 0.040,respectively). The OR value of A allele and AA genotype is 0.796 and 0.731,respectively,and A allele may reduce the probability of incidence of colorectal cancer. No association Was found among SNPs of rs2477131 and rs1635561 within intronl and intron 15 in terms of coloretal cancer. Conclusion Rs1886302 on PADI4 might be a susceptible SNP to coloretal cancer.

Objective:To determine aristolochic acid A. in Caulis Aristolochiae Manshuriensis and its preparation. Methods: TLCS Refleciton Saw Tooth Method was used. ? s=323nm. narrow slot: 0.4?0.4nm S X=3.Results: The recovery was 99.86%. RSD was 2.04%. Conclusion: This method is suitable for the content determination of aristolochiae acid A in various traditional Chinese medicine comprising Caulis Aristolochiae Manshuriensis.

OBJECTIVE:To study the methods for determination of the content of ca lcium dobesilate METHODS:The determination was carried out by complexometric t itration,UV-spectrophotometry,precipitation or cerimetric titration RESULTS & CONCLUSION:The cemetric titration is simple in operation,accurate in result and sharp in end point

5,6 or 7 respectively,the specificity became gradually higher.But the sensitivity and the diagnoses according rate became lower.Conclusion Holter is a simple shortcut useful tool as a non-invasive means of assessing and filtrating OSAS.

ObjectiveTo investigate the association between cuplike nuclei morphology and FLT3-ITD mutation, so as to provide evidence for the minor classification of AML. MethodsThe articles on the association of cuplike nuclei morphology and FLT3-ITD mutation were retrieved by searching international and national databases from 1999 to 2011. The relationship was assessed by meta analysis with Statal 1 software.The OR value and confidence interval(CI)were calculated, and the publication bias was assessed by Begg test and Egger test.ResultsThere was significant difference between cuplike nuclei morphology appearance and FLT3-ITD mutation (OR =2.59,95 ％ CI 1.55-4.33,P =0.00).Results from both Begg' s test and Egger’ s test did not show significant difference indicating that there was no publication bias existed.ConclusionThe uncommon morphologic variant of AML with cuplike nuclei is highly associated with FLT3-ITD mutation, and the presence of cuplike nuclei in AML represents a distinctive morphologic finding that can be used to prioritize the molecular workup of patients with AML.

Objective: To investigate the influence of high-fat diet on glucose metabolism and fatty acid composition of serum phospholipid in OLETF rats, a model of spontaneous type 2 diabetes mellitus. Method: Twenty male OLETF rats of 14 w age were divided into 2 groups randomly. The dietary fat in two groups contained identical percentages of saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids. Oral glucose tolerance test and measurement of insulin level were performed after 10 w treatment. The fatty acid composition of serum phospholipid in rats was observed as well. Results:The food intakes were comparable in 2 groups. The body weight gain in high-fat group was higher than standard group during the experiment. The result of oral glucose tolerance test and measurement of insulin level showed that the glucose metabolism in two groups had no significant difference. Only the percentage of total n-6 polyunsaturated fatty acids, 18:3(n-3) of serum phospholipid were comparable, percentages of other fatty acids were significantly different in two groups. Conclusion:With the comparable fatty acid composition, higher dietary fat lead to more body weight gain, but had no significant influence on glucose metabolism in OLETF rats. The amount of dietary fat had significant effect on fatty acids composition of serum phospholipid in OLETF rats.

To find a way to improve the effects of clinical health education,the clinical health education nurses collocating qualifications to hold their posts, job duties, examinations of training, and practical efficacies were recommended. The setup of clinical education nurses had the advantages as follow: First, the clinical health education with high levels and high qualities can effectively strengthen the patients attending consciousness;second,scientific trainings of health education nurses were useful to pre control the qualities of the health education and improve the level; At last, respecting and caring for patients were the key points to make the patients satisfy the health education.

Objective To screen the proteins with decreased expression in the synovial tissues of rheumatoid arthritis (RA) patients by comparing their expression profiles with that of osteoarthritis (OA) and ankylosing spondylitis (AS) patients by a proteomic approach,and to explore the association of reduced expression with disease susceptibility by a single nucleotide polymorphism (SNP) analysis.Methods Proteins extracted from the synovial membranes (n=10 for each disease) were separated by 2-D electrophoresis.The proteins with significantly decreased expression in the RA samples were subjected to MALDI-TOF-MS.The results were verified using Western blotting.Tag SNPs located in the targeted gene were assessed using the Taqman assay in a cohort of 267 Chinese patients with RA and 160 healthy controls.The genotyping results were confirmed in a large cohort of 389 patients with RA and 371 healthy controls.SPSS 11.5 software package was used for one way ANOVA and Fisher's exact test.Results The expression of vitamin D-binding protein (VDBP) in the synovial membranes from patients with RA was significantly decreased when examined by proteomic approach.This result was confirmed by Western blotting analysis.The rs2282679 was significantly associated with RA (P=0.026 794).This result was confirmed in a large cohort of RA( OR=0.678 639,95％CI 0.54l 113-0.851 118,P=0.000 776).Conclusion Compared with samples from patients with OA and AS,RA patients' synovial tissues have low VDBP expression when examined by the proteomic method.The tag SNP rs2282679 located in VDBP is significantly associated with RA.The decreased expression and the genetic effect of VDBP in RA suggest that a novel pathogenic pathway,in which vitamin D contributes,may be involved in the arthritis process of RA.

Objective To investigate the clinical and cytogenetic features of myelodysplastic syndrome (MDS) ,and to investigate the application of the International Prognostic Scoring System Revised (IPSS-R) in myelodysplastic syndrome .Methods A retro-spective analysis was conducted on 112 patients diagnosed with MDS on basis of French-American-British(FAB) and World Health Organization(WHO) criterion .Conventional cytogenetics are performed to investigated the cytogenetics changes .Results Karyo-type abnormalities are found in 46(41 .1% ) patients .Cytogenetics subgroups are devided into 5 groups according to IPSS-R criteri-on :very good ,good ,intermediate ,poor ,very poor ,which account for 2 cases(1 .8% ) ,48 cases (42 .9% ) ,41 cases (36 .6% ) ,10 ca-ses (8 .9% ) ,11 cases (9 .8% ) ,with a median survival time(MS) 59 ,36 ,15 ,10 month respectively ,except for very good .Conclusion It is of great guiding significance of IPSS-R criteria for prognostic stratification .