2.S-TF contained the activity responsible foraugmenting T and B lymphocytes proliferation of mitogen-induced responses innormal and gamma-ray irradiated mice. The HPLC analysis indicated that all TFs contained whole components ofnucleosides and bases.The total amounts of these components per unit of H-TF,P-TF and S-TF were 67.2?g,52.1?g,94.1?g respectively.here were much more in-osine(IR).cytosine(CR)and deoxycytidine(CdR)in S-TF than in H-TF and P-TF.which may play a significant role in DNA repair synthesis of radiation injuri-ed cells.The TFs may act as important mediators in modulating immune regulation.

Objective To explore the clinical characteristics and operative methods of the ankle fracture combined with Tillaux-Chaput and Volkmann fractures.Methods The data of 15 patients who were suffered the ankle fracture combined with the simultaneous fractures of Tillaux-Chaput and Volkmann between Septenber 2005 and January 2012 were analyzed.There were 8 males and 7 females with an average age of 27.3 years (range,16-57 years).All had medial malleolar and fibular fracture with Tillaux-Chaput and Volkmann tubercle avulsed fracture.X-ray film shows that there were 8 cases in which the patients had Tillaux-Chaput fracture,among whom 7 were diagnosed by CT scan.Classified by Lauge-Hansen system,ankle fracture could be divided into pronation-exterual rotation type in 4 cases,and pronation-abduction type in 11 cases.The fracture of fibula and the Volkmann tubercle were treated through the posterolateral approach.The fibular fracture was fixed with plate.The medial malleolar fracture was explored from medial curve approach.Tillaux-Chaput fracture was treated by the mierotubule cut.All patients were assessed with the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS).Results All patients were followed up for 8-20 months (average,12.5 months).The fracture healed 12-36 weeks later in all the 15 patients,with an average of 23.5 weeks.Twelve patients walked normally and 3 with mild claudication in the last follow-up.The AOFAS score was average 85.4 points,9 were excellent,4 were good,2were fair,with the good-excellent rate being 86.7％ (13/15).The movement of ankle joint limited in 3 patients,tenderness occurred when weight bearing in 3 patients.Conclusion The ankle fracture include the simultaneous fractures of Tillaux-Chaput and Volkmann were more seen in the type of pronation-abduction.It is often misdiagnosis by the photograph; CT scan should be helpful to find the fracture fragments.The exact reduction and stable fixation were needed in the treatment of the ankle fracture combined with Tillaux-Chaput and Volkmann fractures.Inferior tibia fibular screw was not routinely used in this fracture.

Objective To estimate the effect of open reduction and internal fixation for treating the trimalleolar fracture in the elderly.Methods 57 aged patients suffered from the trimalleolar fracture and were treated with internal fixation from January 2009 to June 2012.25 males and 32 females with an average age of 71.5 years ranged from 65 to 81 years were involved in this study.The supination-external rotation type were in 41 cases and pronation-external rotation type in 16 cases according to Lauge-hansen's classification.The posterior and lateral approach was taken for surgical procedure of lateral malleolar frature.The routine or locking plates were used to fix the fratures.The posterior malleolar fractures were usually fixed through the posterolateral approach as well.The screws or tension band fixation was selected for fixing the medial malleolar fragments.The parallel screwing fixation could be helpful for fixing the tibiofibular syndesmosis.Results The ankle function was evaluated by the criteria system of the American Orthopaedic Foot and Ankle Society (AOFAS).The efficacy was excellent in 23 patients,good in 24 patients,fair in 7 patients.The skin problems such as super facial infection and delayed union of incision were in 7 cases.Conclusions If choosing reasonable operation method and suitable internal plant,the open reduction and internal fixation has better effect in treating the trimalleolar fracture in the elderly,with fewer complications.

Objective: To investigate the principles of rational drug use for the patients suffering from heart failure complicated with diuretic-induced gouty arthritis.Methods: The clinical pharmacist participated in the diagnosis, treatment and drug adjustment of one patient suffering from heart failure complicated with furosemide-induced gouty arthritis.Taking the disease symptoms and potential gouty-inducing drugs into full consideration, clinical pharmacist suggested the withdrawal of related-drugs and the adjustment of treatment plan.Results: Considering the characteristics of the patient, clinical pharmacist adjusted the rational drug treatment.After the adoption of the suggestions, the gouty symptoms were relieved, heart failure was controlled and the condition was improved.Conclusion: Loop diuretics can easily trigger an acute attack of gout, especially for the patients with heart failure and gout history.Clinical pharmacist can make full use of professional advantages to optimize the treatment plan in order to reduce adverse reactions and promote the rational drug use by participating in clinical practice.

Objective To explore the nursing strategy for the patients with acute ocular surface diseases undergoing amniotic membrane transplantation.Method Nineteen patients with acute ocular surface diseases treated with amniotic membrane transplantation were nursed during transplantation.Results After 6-12 months postoperative follow-up,19 cases(19 eyes)of 13 patients got recovered(68.4%);4 cases(10.5%)had central transparency in the cornea restored with nebula around it;2 cases(10.5%) had nebula or white spots.Conclusion The nursing strategy including preoperative preparation and mental care,postoperative observations of changes in the diseased eyes together with pertinent health education can help promote the rehabilitation of patients.

Objective To investigate the methods and results of reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins for repairing soft tissue defects of the fingers.Methods From March 2009 to June 2011,twenty cases with soft tissue defect distal to the proximal interphalangeal join of fingers were treated by reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins.There were 12 cases of the index finger,eight of middle finger,the largest area of the flaps was 4.5 cm × 3.5 cm,and the smallest area was 3.5 cm × 2.5 cm,an average of the pedical length was 4.0 cm.All cases anastomosis one superficial vein,fourteen cases suture dorsal digital nerve,and the donor area covered with full-thickness skin graft.Results All flaps survived.Postoperative follow-up time ranged from 8 to 16 months,the appearance and texture of the flaps were excellent,the flaps with suture nerves,the two-point discrimination was 7 mm to 9 mm,the other flaps that the nerves were disconnected.The sensation of the flaps recovered to S2-S3,no morbidity of the donor fingers occurred.Conclusion Reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins can form a longer vascular pedicle,to repair the soft tissue defect distal to the proximal interphalangeal joint,through anastomoses superficial venous can reduce the flap venous pressure obviously,improve the survival quality of the flap,the effect is satisfacted.

OBJECTIVE:To discuss the application practice of PIVAS standardization in pharmacy intravenous admixture ser-vice(PIVAS)of our hospital. METHODS:Based on JCI,the design concept and management mode of PIVAS were analyzed and summarized from PIVAS design,management,job and medical order time arrangement,staff management,infusion quality or fault emergency plan,etc. RESULTS:After introducing JCI standards,the improvement was conducted in respects of management system and work flow design,purification system and logistics division design,information system design,etc. Working hour was arranged according to the workload or work flow and the actual needs of clinical departments. Medical orders,1 batch per hour,24 batches one day,were delivered to clinical departments according the time point. The positivity of the staff had been improved, and work quantization and performance appraisal had been achieved. Those improvement optimized drug dispensing process, cleared the responsibility of information management and guaranteed the quality of infusion. Work error analysis and summary were monthly conducted;the number of work error decreased from 562 cases before JCI introduction(2013)to 264 cases after JCI intro-duction (2014),decreasing by 112.87% annually. CONCLUSIONS:JCI standard is of significance to the promotion of PIVAS management,work level and quality,and safe and rational use of drugs in the clinic.

Objective To explore the impact of concentrated teaching, self-help training, intensive training, scenario simulation and other systemic training methods on the health teaching level of community health education staff,and the impact of community health education on cultivation of residents' health behavior before and after training. Methods 60 community doctors and nurses involved in systematic training. Taught concentrated 8 hours every week, and continuous for 4 weeks with medicine, psychology, sociology, pedagogy, aesthetics and production of courseware. Trainees who awarded 80 points or more in examination took part in simulated scene training, which completed a 30-minute design of concentrated health lesson and a 15-minute design of one to one health lesson in written form and multimedia teaching. Teaching effect-site was evaluated by the residents of the community lectures. The impact on cultivation of residents' behaviors was evaluated with ruler evaluation method.Results The community health care workers' teaching ability had significant change after training: plan design (2.32 ± 1.41 vs 4.26 ±0.61 ), lectures (2.63 ±0.89 vs 4.09 ±0.93), teaching skills ( 1.97 ± 1.32 vs 3.89 ±1. 13 ), teaching aids configuration ( 1.68 ± 1. 43 vs 3.97 ± 1. 26 ), educational methods ( 2.01 ± 0. 96 vs 4.03 ±0.82), time control (2.83 ±0.26 vs 4.67 ±0.25), the classroom atmosphere (2.78 ± 1. 13 vs 4.12 ±0.67),courseware ( 2.48 ± 1. 08 vs 3.89 ± 1.02 ) , teaching the image ( 2.15 ± 1.15 vs 4.06 ± 0.78 ), overall evaluation (2.36 ± 1.21 vs 4. 16 ± 0.65 )(P ＜ 0. 0 1 ). After training, community residents' knowledge on community health care workers' one to one health education and collective health education training, and positive evaluation of helpful to students' behavior improved significantly ( x2 = 17.19,36.37 ;8.91,20.98 ;34.14,32.29) ,and all had remarkable difference( all P＜0. 01 ). Evaluating the impact of health care workers' teach on cultivating residents'health behavior after one year, it improved significantly (P ＜ 0. 01 ). Conclusion Systemic training can improve health education ability of community medical staff and the impact on cultivating residents' health behavior is remarkable.

Objective To evaluate the indications,method and prognosis of emergent hepateetomy and tran-scatheter arterial embolization(TAE) for spontaneous rupture of primary liver carcinoma(PLC). Methods Clinical data of 85 cases with PLC were analyzed. Patients were divided into four groups: the group of delayed hepatectomy (group A,n=30);the group of emergent transcatheter arterial embolization (group B,n=22);the group of emer-gent hepatectomy (group C, n=18) and the group of medical treatment (group D, n=15). The hemostasis achieve-ment ratio, operative complications, perioperative morbidity, 1-year and 3-year survival rates among the four groups were compared. Results In group A and B, celiac urteriogram in 52 cases showed that extravasation of contrast media happened in 14 cases (26.9%). The hemostasis achievement ratio was 100% (30/30, 22/22, 18/18) in group A,B and C,respectively,which was remarkably higher than that in group D(40%,6/15) (P<0.05);The in-hospital fatality was 0% (0/30),3.8% (2/52) and 16.7% (3/18),which was lower than that of group D(80.0%, 12/15) (P<0.01). The 1-year survival rate was 76.7% and 3-year survival rate of group A was 53.3%, which was higher than that of group B (45.5 % and 31.8 %) and group C (44.4% and 33.3 %) (P<0.05). The cases in group D did not survive one year(P<0.01). Conclusions Emergent hepatectomy and transcatheter arterial emboli-zation are safe and feasible for spontaneous rupture of primary hepatocellular carcinoma. For those with resectable ca-ses,surgical resection is the first choice after transcatheter arterial embolization.

Objective To discuss external fixation method for the complex diaphyses fracture involving condyles of femur and evaluate its clinical efficacy.Methods A retrospective study was done on 42 patietns with comminuted femur diaphyses fracture combined with distal intra-articular fractures treated surgically from January 2001 to Janurary 2007.There were 24 males and 18 females at mean age of 33 years (20-66 years).According to AO/ASIF classification,there were 18 patients with type C2 fractures and 24 with type C3 ones.Simple internal fixation plus external fixation was performed on patitents with C3 fractures but only external fixation on those with C2 fractures.Four patients were treated with intramedular fixation.Results All patients were followed up for 1-12 months.According to Kotmert's assessment standard on function of proximal femur,the knee function was satisfactory in 35 patients (83% ) ,good in six (14% ) and unsatisfactory in one (2% ).Conclusions Minimally invasive external fixation can utmostly restore relative length of the femur and regulate between articular face of the femur and longitudinal axis of femur shaft to reach a symmetrical relation with middle and inferior part of opposite femur.Postoperative exercise is important for maximal recovery of the knee function.Attention should be paid to reconstruction of tubiform structure of the femur.