Objective:To establish a 3 dimensional finite element model of calcaneus and talus for analysing their stress distribution during different gait phases. Methods: CT scanning and computer image processing system were used to establish the model to simulate the situation of calcaneus and talus for 3 phases (heel strike, midstance, push off) during the gait. A finite element solver was used to calculate stress. Results: A three dimensional finite element model of calcaneus and talus was established. And the stress distribution within the bone was obtained and regions with elevated stress at 3 phases were located. The stress distributions of 3 phases were significantly different. The stress increased gradually from heel strike to push off. Conclusion:The model can be used to study biomechanics of calcaneus and talus. The regions of elevated stress of calcaneus and talus are important, which provide an insight into the factors contributing to the fractures and arthritis.

Objective:To explore diagnostic value of basic head-up tilt table test (HUT)and sublingual nitroglycerin head-up tilt table test (SNHUT)on vasovagal syncope (VVS).Methods:A total of 61 patients,who collapsed be-cause of unknown causes and were highly suspected as VVS,were regarded as VVS group,received HUT,and an-other 22 healthy subjects were regarded as healthy control group.Results:Among the 61 cases of VVS group,57 ca-ses were tilt test positive and the positive rate was 93.44%.Among them,there were 16 cases (26.23%)with posi-tive basic HUT and 41 cases (67.21%)with positive SNHUT.The 22 cases in healthy control group also received basic HUT and SNHUT,one case (4.54%)was basic HUT positive and three cases were SNHUT positive.Positive rates of SNHUT was higher than that of HUT,but there was no significant difference in VVS group (χ2 =0.175,P =0.683).Conclusion:HUT is a noninvasive,repeatable method easily accepted by patients for diagnosing VVS currently.It can elevate positive rate of test when combined with SNHUT.

Post-traumatic osteomyelitis is painful and challenging disease.High success rate of antimicrobial therapy in most cases has not been achieved in skeleton due to its physiological and anatomical characteristics.The key to successful management is early diagnosis and treatment.Different types of post-traumatic osteomyelitis require different medication and different surgical therapeutic strategies.Post-traumatic osteomyelitis is associated with avascular necrosis of bone and formation of sequestrum(dead bone).Surgical debridement is necessary in addition to antibiotic therapy.Generally,multidisciplinary techniques are required,including orthopaedic surgery,plastic surgery,as well as vascular surgery,especially for complex cases with soft-tissue defect.

Objective To explore the the application of sternocleidomastoid lateral path for thyroid cancer surgery lateral neck lymph node cleaning.Methods 40 patients with thyroid carcinoma were detected in the lateral neck lymph node cleaning using sternocleidomastoid lateral path(experimental group)and 40 cases of patients with thyroid cancer in the lateral neck lymph node cleaning cleaning scope with traditional operation method(control group),comparing with success rates,operation time,quality of life and incidence of complications.Results Experimental group can achieve the purpose of curing in the operation,operation field showed more clearly,the lymph node zone Ⅱ,Ⅲ,Ⅳ,Ⅴ number (32,58,50,35)were higher than traditional surgery group(17,35,33,20).Experimental group can significantly shorten the operation time[(30.0±1.20)min vs(45.0±3.10)min].The difference of incidence of near and forward future overall complications was statistically significant between the two group(P<0.05).Conclusion Sternocleidomastoid lateral path in thyroid carcinoma in the lateral neck lymph node cleaning can achieve the purpose of curing,significantly improve the lymph node zone Ⅱ,Ⅲ,Ⅳ,Ⅴ,shorten the operation time,reduce the recent and long-term complications and improve patient's quality of life.

Objective To study the dynamic changes of posttraumatic focal brain edema. Methods 120 patients who underwent multiple CT scans after head injury with hematoma or brain contusion in our hospital from 1998 to 2002 were enrolled in this study. Their CT image parameters and clinical data were recorded, and statistically analyzed. Results 96.7%(116/120) patients had perihematoma or pericontusion edema. Edema appeared 7 hours after head injury and reached its climax at the ninth day. Edema shape trended taper during its development, and cortex escaped from edema. Conclusion Focal brain edema was very common in the patient with head injury. Taper shape's formation and escape of cortex may mainly attribute to the difference in construction topology and blood supply between cerebral white and gray matter.

OBJECTIVE To analyze occupational risk factors onto Central Sterile Supply Department(CSSD) staff caused by actual working conditions and provide correspondingly protective measures.METHODS Take actions,such as circulating the air inside working site,eliminating contamination which brought into by biological and chemical methods,and avoiding physical fatigue etc,which summarized by practical study and analysis on the(various) factors during daily work routine,e.g.physical factor,chemical factor,biological factor and psychological factor.RESULTS All methods mentioned in this article could improve self-protection awareness of CSSD staff and(enhance) the physical condition of staff as well as reduce pollution on environment.CONCLUSIONS For preventing the threats of occupational risk factors,it′s critical to reduce or eliminate the negative factors in CSSD.

Objective To analyze the stress distribution of calcaneus and talus with posterior facet after compression fracture during gait by finite element method. Methods A wedge was resected to simulate the malunion calcaneus with compression fracture of posterior facet. The Bo?hler’s angle was reduced from 35? to 10?. The calcaneus and talus malunion were used to simulate for three phases of the stance during the gait (heel strike, midstance, push off). A finite element solver to calculate. The results were compared with normal condition. Results The stress distribution within the bone in condition of malunion was obtained, and sites of enhanced stresses for three phases were located. The results were significantly different from that of normal condition. Conclusion The results revealed the importance of reconstruction of calcaneal structure and helped us understand the cause of sequela of calcaneal fractures

From air bacteria capable of decomposing creatinine, three single independent strains K9510、K9511 and K9512 have been isolated. The highest creatinine amidohydrolase (EC 3.5.2.10; creatininase) producing strain K9510 was screened out. The strain K9510 was identified as Pseudomonas sp. The results of culture condition for creatininase formation by strain K9510 were obtained as follows: creatinine and creatine were found to be the effective inducers for enzyme formation; the solution of mixed metallic salts could stimulate cell growth and enzyme formation. The suitable medium for creatininase formation was consisted of 0.9% creatinine、 0. 15% yeast extract、 0. 09% malt extract、0.05% NH4C1 and some amount of the solution of mixed metallic salts at pH5. 5. When the bacterium was grown in 250mL conic flask containing 50mL of the medium mentioned above on the rotary shaker(250r/min) at 35℃ for 33 h, about 50 u creatininase was obtained.

BACKGROUND: There is lack of effective method for treating humerus nonunion, lilac plate can maintain the compact contact between fracture end and bone graft, accelerate bone union, as well as provide stability for bone union. OBJECTIVE: To evaluate the clinical effects of treating humerus nonunion by using lilac bone graft as plate combined with the external fixation.METHODS: Thirteen patients with nonunion of the humorous at Department of Orthopedic Trauma Surgery, Jinan Command General Hospital of Chinese PLA were selected, including 11 males and 2 females, aged 20 51 years, mean aged 35.5 years. All the patients were treated with Uiac bone graft and screws combined with the mono lateral external fixation. The bone healing was observed by X-ray film. Shoulder function and complications were measured by Neer score.RESULTS AND CONCLUSION: All patients were followed up for 7-64 months, mean 38 months. Bony union was achieved in all patients within 6-10 months (mean 8.1 months). The activity function of shoulder and elbow was normal; and Neer scores were 71-96 (mean 87 scores). No infection, pain, prevalent fracture or nonunion occurred. The results demonstrated that using lilac bone graft as plate combined with the mono lateral external fixation is a good salvage operation for nonunion of the humerus.

Aim To study the pharmacokinetics of faropenem sodium for injection after a single and multiple intravenous dose in 12 healthy volunteers.Methods Multiple-dose regiments used 12-hour dosing intervals for 5 doses.Plasma and urine faropenem sodium concentrations were measured using high-performance liquid chromatography.The concentration-time curves of faropenem sodium were fitted to a two-compartment open model.The excretion data in urine were disposed by the method of excretion rate in urine.Results The pharmacokinetic parameters obtained from the single-dose study were as follows: C_(max) =(45.20±8.73) mg·L ~(-1); T_(1/2α) =(0.401±0.096) h; T_(1/2β) =(1.419±0.267) h;AUC_(0-12) =(59.216±11.886) mg·h·L~(-1) .The steady-state pharmacokinetic parameters were: C ss min =(0.03±0.02) mg·L~(-1) ; C ss max =(44.60±9.08) mg·L~(-1) ; C_(av)=(4.939±1.048) mg·L~(-1) ; T_(1/2α) =(0.340±0.105) h; T_(1/2β) =(1.257±0.173) h;AUC~(ss)_(0-12) =(59.268±12.571) mg·h·L~(-1) .The amount of cumulative recovery of faropenem sodium in urine for single and multiple dose within 12 h was(30.48±12.77)% and (40.55±17.53)%, respectively.The pharmacokinetic parameters in urine of the single-dose study were: T_(1/2) =(0.993±0.088) h, K_e=(0.227±0.097) h~(-1) .The steady-state pharmacokinetic parameters in urine were: T_(1/2) =(1.085±0.069) h, K_e=(0.296±0.136) h~(-1) .Conclusions The distribution and elimination rates of faropenem sodium for injection are not changed after multiple intravenous administrations.Effective concentrations in vivo can be achieved after the repeated administration with 400 mg twice a day regiment.The dosing schedule can be recommended.