[Objective]To discussthe clinic effective and the application value of the fibula fixation in treating the complex and comminuted fracture of the tibiofibular.[Method]At first,we reduced and fixed up the fibula fracture anatomically as the support to reduce the tibia fracture indirectly,then we fixed up the tibia fracture by using intramedullary nail or external fixators.[Result]In the 23 cases of the tibiofibular fracture,10 cases of the fibula fracture were almost anatomically reduced,13 cases were reduced functionally,the wounds were cured without parenchyma infection or bone infection.The follow-up time was 13 months averagedly.The time of clinical healing was from 13 weeks to 21 weeks.The cases which were excellently cured was 20,which were well cured was 2,which was tolerably cured was 1 by the Johner-Wrushs grade standard.[Conclusion]This method was designed reasonably,operated simply,acceded with the minimal-invasive and biological rule of the bone fractuer treatment,profited to the heal of the fracture,it was a prefect mean to cure the complex and comminuted fracture of the tibiofibular.

[Objective]To explore the curative effect of the three diamen sional external fixation frame and limited internal fixation in treating the comminuted fracture of the shaft of humerus.[Method]Twenty-eight patients of the comminuted fracture of the shaft of humerus were treated from Jan 2000 to May 2006.According to the AO/ASIF,there were 5 cases of the B1 type,3 cases of the B2 type,9 cases of the B3 type,6 cases of the C1 type,4 cases of the C2 type,1 case of the C3 type.All of them were treated by the three diamensional external fixation frame and limited internal fixation of the screws or wires,and all of them were given the reasonable rehabilitation training at 3 day after the operation.The curative effect of the operation,the complications,the fracture healing and the function appraisal were analyzed.[Result]The 28 patients were followed-up for 10～15 months(average 13 months),27 cases had the frature healed and the healing rate was 96.4%.The healing period of the fracture lasted from 12 weeks to 33 weeks,average 19.5 weeks.Only 1 case was not healed.The functions of the shoulder and the elbow were normal,the excellent rate was 92.8%.[Conclusion]The three diamensional external fixation frame and limited internal fixation is a better method in treating the comminuted fracture of the shaft of humerus.It fits the rule of minimal-invasive-biology. The operation is simple,and the fixation is reliable,the function is satisfactory.

Objective To investigate the relationship among the plasma levels of fibrinogen and the lung cancer,and its clinical significance.Methods From 2011 to 2013,121 cases newly diagnosed lung cancer patients(lung cancer group) and 37 cases healthy individuals(control group) were evaluated.The patients had no history of coagulation system disorders or anticoagulant therapy.Plasma prothrombin time (PT), activated partial thromboplastin time(APTT), thrombin time (TT), fibrin original (FIB), platelet (PLT) of the patients were obtained.The relationship between the plasma levels of fibrinogen and clinical characteristics, therapy modalities (surgery, chemotherapy and radiotherapy), therapy outcomes and survival durations of the patients were analyzed.Results (1) Serum levels of fibrinogen at stage Ⅱ A, stage Ⅱ B, stage Ⅲ A, stage Ⅲ B, stage Ⅳ were (2.001±0.813) g/L, (2.191±0.827) g/L, (3.121 ±2.016) g/L, (4.174±0.595) g/L, (4.332 ± 1.534) g/L, a significant difference was observed between the fibrinogen levels of patients with stage Ⅱ A and those with stage Ⅳ disease (P＜0.001), and there were no significant differences among other stages (P＞0.05).(2)The mean fibrinogen level was significantly higher in the patient group with ECOG performance status 2 than in the other groups(r=0.613,P＜0.05).The mean fibrinogen level was (3.780±1.731) g/L (95％CI,3.122-4.439,P＜0.001) in the group with ECOG 0, (4.182 ± 1.661) g/L(95％CI 3.583-4.781 ,P＜0.001) in the group with ECOG 1 ,and (4.725±2.153) g/L(95％CI,4.007-5.443,P＜0.001) in the group with ECOG 2.(3) The treatment responses of 81 patients who received chemotherapy and/or radiotherapy without surgical intervention were evaluated, serum levels of fibrinogen in 39 patients with partial remission (PR) were (4.005 ±1.177) g,/L,42 patients with stable disease(SD) were (3.192±0.479) g/L, 17 patients with progressive disease(PD) were (7.530± 1.885) g/L,fibrinogen levels were found to be significantly higher in cases with progression,and the difference was significant(P =0.015).(4)Correlation analysis on fibrinogen and chnical indicator: clinical stage (r =0.529, P =0.008), ECOG score (r =0.273, P =0.031), therapy response (r =0.529, P=0.012) were positively correlated with fibrinogen levels.(5)Fibrinogen levels in patients with lung cancer were higher than those of the control group ((2.891 ± 0.484) g/L vs.(3.586± 1.692) g/L, t =-4.620, P ＜0.05), and the difference was statistically significant (P＜0.01).(6)The survival duration was significantly longer in patients with lower fibrinogen levels(321 d vs.435 d,P＜0.05).The mean fibrinogen concentration in patients who were still alive at the end of a 2-year follow-up was (3.531 ± 1.482) g/L, whereas the meanfibrinogen level of patients who died was (3.725± 2.063) g/L, and the difference between the two groups was significant(P =0.015).Conclusion The results suggest that Fibrinogen plasma levels might be useful to predict the clinical outcome and survival of patients with lung cancer.

Objective To investigate the safety and efficacy of low-dose recombinant tissue plasminogen activator (rtPA) in Chinese patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke received rtPA intravenous thrombolysis within 4. 5 h after symptom onset were enrol ed retrospectively. According to the dosage of rtPA, they were divided into either a low-dose group (0. 5-0. 8 mg/kg, the maximum dose 50 mg) or a standard dose group (0. 9 mg/kg, the maximum dose 90 mg). The incidences of symptomatic intracranial hemorrhage ( sICH) ( the National Institute of Neurological Disorders and Stroke [NINDS], and European Cooperative Acute Stroke Study Ⅱ [ECASSⅡ] , European Safe Implementation of Thrombolysis in Stroke-Monitoring Study [ SITS-MOST ] ), 90 d mortality, 90 d good outcome (the modified Rankin Scale [mRS] score 0-1), and life self-care ability (mRS score 0-2) were compared between the two groups. Results A total of 163 patients were enrol ed, including 74 patients in the low-dose group and 89 in the standard dose group. The constituent ratios of hypertension (44. 6% vs. 68. 5%; χ2 =9. 490, P=0. 002) and diabetes (5. 4% vs. 28. 1%; χ2 =14. 216, P<0. 001) in the patients of the low-dose group were significantly lower than those of the standard group, while the constituent ratios of smoking (56. 8% vs. 38. 2%; χ2 =5. 590, P=0. 018 ) and smal artery occlusive stroke (21. 6% vs. 10. 1%; χ2 =4. 122, P=0. 042 ) in patients of the low-dose group were significantly higher than those of the standard group. After adjusting for age, National Institutes of Health Stroke Scale (NIHSS) score, hypertension, diabetes, smoking, and ischemic stroke typing, multivariate binary logistic analysis showed that there were no significant differences in NINDS defined sICH (10. 8% vs. 9. 0%, odds ratio [OR] 1. 077, 95%confidence interval [CI] 0. 338-3. 436), ECASS Ⅱdefined sICH ( 9. 5% vs. 9. 0%; OR 0. 976, 95% CI 0. 296- 3. 221 ), SITS-MOST defined sICH (8. 1% vs. 4. 5%; OR 2. 269, 95% CI 0. 522-9. 852), 90 d mortality (17. 6% vs. 14. 6%; OR 1. 720, 95% CI 0. 578-5. 119), 90 d good outcome (35. 1% vs. 32. 6%;OR 0. 780, 95% CI 0. 356-1. 709), and life self-care ability (48. 6% vs. 42. 7%;OR 0. 936, 95% CI 0. 441-1. 987) between the 2 groups (al P>0. 05). Conclusions The program of intravenous thrombolysis for the treatment of Chinese patients with acute ischemic stroke with low-dose rtPA is safe and effective.

Objective:To investigate the existence condition of hepatitis B surface antigen(HBsAg) termina-tion codon bias.Methods: A total of 174 reference sequences of all kinds of Hepatitis B virus(HBV) genotypes were chosen from GenBank,and compared by BioEdit.Then secondary structure of RNA was constructed and analyzed together.Results:(1) There were two types of HBsAg termination codon: TAA and TGA in 174 reference sequences.TAA was in 124 cases(71.26%);and TGA in 50 cases(28.74%).(2) There was codon bias selection in HBsAg termination codon,and it could affect the secondary structure of RNA and amino acid sequence encoding protein.Conclusion: HBsAg termination codon bias exists and may be related to RNA structure and the conservatiom of protein function in the evolutionary progress.

Objective:To investigate the clinical efficacy of budesonide formoterol combined with tiotropium bromide in the treatment of asthma chronic obstructive pulmonary disease(COPD) overlap (ACO).Methods:From January 2016 to December 2018, 160 ACO patients who met the inclusion criteria in the Department of Respiratory Medicine, Linxi Hospital, Kailuan General Hospitalwere selected as the observation objects.Prospective cohort study was used for observation and analysis.The patients were divided into study group and control group with 80 cases in each group by random number table.Both groups received conventional treatment, on this basis, control group received budesonide and formoterol powder inhalation, 1 inhalation/time, 2 times/d, study group received tiotropium bromide 1 granule/time, once a day based on the control group.Both groups were treated for 12 months.The clinical efficacy, lung function, blood gas analysis, inflammatory factors and T lymphocyte levels were compared between the two groups.Results:The total control rate in study group was 87.5%(70/80), significantly higher than that in control group (70.0%(56/80)), the difference was statistically significant (χ 2=7.32, P<0.05). After treatment, the asthma control test (ACT) scores in both groups increased significantly, while ACT scores in study group((23.12±3.12) point )was significantly higher than that in control group ((20.45±4.28) point, t=4.51, P<0.05). After treatment, the COPD assessment test (CAT) scores in both groups decreased significantly, while CAT scores in study group ((14.25±3.03) point ) was significantly lower than that in control group ((18.69±3.52) point, t=8.55, P<0.05). After treatment, the forced expiratory volume in 1s (FEV1), FEV1%, FEV1 /Forced vital capacity (FEV1/ FVC) and Inspiratory capacity / total lung capacity (IC/TLC) levels in both groups increased significantly, while FEV1((2.20±0.47)L), FEV1%((68.62±7.89)%), FEV1/ FVC((67.63±7.59)%)and IC/TLC levels(48.84±4.86)%) in study group were significantly higher than those in control group ((1.93±0.49)L, (61.88±7.65)%, (62.88±8.41)%, (43.22±5.15)%)(t value were 3.56, 5.49, 3.75, 7.10, all P<0.05). After treatment, the level of partial pressure of oxygen (PaO 2) in both groups increased significantly, while PaO 2 level in study group((78.12±6.45) mmHg) was significantly higher than that in control group ((72.45±7.52) mmHg)( t=5.12, P<0.05). After treatment, the arterial partial pressure of carbon dioxide (PaCO 2) level in both groups decreased significantly, while PaCO 2 level in study group((46.73±7.13) mmHg) was significantly lower than that in control group((49.81±8.02) mmHg) ( t=2.57, P<0.05). After treatment, the levels of IL-6, hs CRP and TNF-α in the two groups were decreased significantly, while IL-6, hs-CRP and TNF-α levels in study group((15.35±6.72) ng/L, (18.14±7.62) mg/L, (56.84±4.92) ng/L) were significantly lower than those in control group((21.42±5.35) ng/L, (23.35±8.64) mg/L, (69.45±8.51) ng/L) (t value were 6.32, 4.05, 11.47, all P<0.05). After treatment, the levels of CD4 + and CD4 +/CD8 + levels in both groups increased significantly, while CD4 + and CD4 +/CD8 + levels in study group((44.20±6.02)%, (1.82±0.31)) were significantly higher than those in control group((38.52±5.56)%, (1.43±0.29)) ( t=6.20, 8.22, all P<0.05). CD8 + level in both groups decreased significantly, while CD8 + level in study group((23.62±7.89)%) was significantly lower than that in control group((27.42±7.65)%)( t=3.09, P<0.05). Conclusion:Budesonide and formoterol combined with tiotropium bromide in the treatment of ACO has good clinical efficacy, reduce the level of inflammation, relieve the clinical symptoms of COPD and asthma, improve the respiratory function and lung function of patients, and have a good effect on improving the cellular immune function.

OBJECTIVE To investigate the factors influencing the effects of disinfection of HBV on dental hand piece. METHODS After polluted with HBV positive serum,the dental hand piece was disinfected with sterilizer at the condition of 134℃ for 5 minutes according different treatment procedures.The samples were then taken and detected HBsAg by the automatic enzyme immune analyzer using the third generation EIA agent.The efficacy of disinfection of HBV was presented by the reaction of HBsAg detection. RESULTS If the dental hand piece was sterilized directly not cleansed using clean water after pollution and dried in room temperature,there were 96.87% of the samples being HBsAg positive,and the polluted but dried hand piece,even cleansed there were 87.5% of positive result, even if prolonged the time of sterilization and the frequencies of vacuumization,the HBsAg positive rate of the sample was still up to 56.25%.But if the hand piece was irrigated and cleansed immediately after pollution and sterilized,all samples were HBsAg negative. CONCLUSIONS Whether or not cleansed immediately is the most important factor influencing the efficacy of hand piece sterilization after pollution.

Based on the investigation and analysis of industry dynamics of health maintenance Applications (APP) of Traditional Chinese Medicine (TCM),the paper designs and develops health maintenance APP of TCM,and describes its architecture,operating principle,functions,innovativeness,applicability scope,etc.

Objective To investigate the diagnostic value of serum brain natriuretic peptide(BNP)in chron-ic cor pulmonale of different period.Methods According to the inclusion criteria,we recruited 216 cases from heart and respiratory medicine(including outpatients and inpatients)of Qingyuan People 's Hosptial from April 2013 to December 2014.All the cases were divided into healthy control group(group A,n =48),cor pulmonale heart function compensatory period group(group B,n =43),cor pulmonale right heart failure group(group C,n =45),the simple left heart failure group(D group,n =40)and the whole heart failure group(group E,n =40).The serum BNP value,pul-monary function,echocardiography were detected.We compared the differences amomg them with correlation analysis, and drew the ROC curves to obtain the best cutoff point.Results The BNP value was higher in group C(495.44 ± 219.90)ng/L than group B[(182.44 ±69.71)ng/L,P <0.001],while the value was higher in group D(882.57 ± 288.56)ng/L and E(891.78 ±256.45)ng/L than group C(P <0.001).In cor pulmonale groups,BNP was positive-ly correlated with RV,RVOT,and PASP,negatively correlated with FEV1 ,and not correlated with LVEF %.In group D and E,BNP was negatively correlated with LVEF %.The best cutoff point of BNP was 285.3ng/L between cor pul-monale heart function compensatory period group(group B)and cor pulmonale right heart failure group(group C). The best cutoff point of BNP was 764.2ng/L between cor pulmonale right heart failure group(group C)and the whole heart failure group(group E).Conclusion There is certain correlation between serum BNP level and the progress of chronic cor pulmonale.Dynamic monitoring of serum BNP level in the judgement of treating cor pulmonale is of certain reference significance.

Objective Based on the traditional Chinese medical knowledge service and sharing system, to explore the application of famous doctor Yu Ying'ao's regulating the liver method. Methods The medical records of Yu Ying'ao from the outpatient department of Chinese Academy of Sciences were used as the data source. The traditional Chinese medical knowledge service and information sharing system(V1.1.5) was applied to construct database. The regulating liver core combination of drugs, drug application mode, and combined treatment of diseases and syndromes were determined by analysis methods of frequency and association rules. Results The use of regulating liver method was often used in the treatment of irregular menstruation, cirrhosis, pain and other diseases. Differentiation of liver qi stagnation, blood stasis, liver stagnation and spleen deficiency, liver and kidney deficiency were the main TCM syndromes. Treatment included Tongluo, nourishing Yin treatment. The core drugs were Bupleurum and Rhizoma Cyperi. Conclusions The use of traditional Chinese medical service and knowledge sharing system could explore the clinical diagnosis and medication rules of regulating liver methods.