Objective To study the ankle-brachial index of the diabetic gangrene. Methods ABI of the sixty cases with type 2 diabetes were measured. The results were divided into four groups: normal, gently abnormal moderate abnormal severely abnormal group. Results 30 cases were normal, occupying 50% (P＞0.05), gently and moderate abnormal attained 5 cases (8.33%) and 4 cases (6.67%) respectively, and the rests 21cases were severely abnormal, occupying 35% (P＞0.05).Conclusion The normal ABI was not always indicating type 2 diabetes without the gangrene or tendency.

Objective To explore the preventive and therapeutic effects of diminazene (DIZE) on pulmonary arterial hypertension (PAH) in rats.Methods Left pulmonary lobectomy combined with injection of monocrotaline was used to establish a rat model of pulmonary arterial hypertension.One hundred adult male Wistar rats were randomly divided into blank control group (group A,n=20),DIZE control group (group B,n=20),PAH model group (group C,n=20),PAH model plus DIZE group (group D,n=20) and PAH model plus DIZE and C-16 group (group E,n=20).Angiotensin-converting enzyme 2 (ACE2),IL-6 and IL-8 levels were determined by fluorescence resonance energy transfer (FRET) and enzyme linked immunosorbent assay (ELISA),and the mean pulmonary arterial pressure (mPAP) and right ventricular hypertrophy index (RVHI) were measured.The wall thickness (WT) and intimal hyperplasia score were calculated,and the pulmonary vascular lesions were analyzed using elastic fiber staining.Results RVHI,ACE2 enzyme activity and WT in the group A were significantly different from those of the groups C,D and E (P<0.05).Those of the group D and E were significantly different (P<0.05).The five groups showed significant differences in the overall analysis of each index (P<0.05).Conclusions Diminazene can increase the ACE2 enzyme activity,and decrease the mPAP,RVHI and WT,while reducing the pulmonary arterial medial hypertrophy,and inhibit intimal hyperplasia of pulmonary arterioles.The results of this study provide an experimental basis for the use of diminazene in the treatment of human pulmonary hypertension.

OBJECTIVETo explore optimal choice of surgical treatment for subtrochanteric fractures in older children.

METHODSA retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded.

RESULTSAll children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications.

CONCLUSIONFor the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which has advantages of reliable fixation, and less complications.

Adolescent ; Bone Nails ; Child ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

Chronic Disease ; Heart Failure ; metabolism ; Humans ; Phosphorylation ; Ryanodine Receptor Calcium Release Channel ; metabolism

Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on mineral density and biomechanics of new-formed bone in distraction gap.Methods The mandibles were subjected to osteotomy and distractors were placed bilaterly in 30 rabbits,which were divided randomly into 2 groups.After 5 days for latency,the mandibles were distracted at a rate of 0.8 mm/day for 10 days,and then for consolidation.After surgery,group A received HBOT with daily distraction,whereas group B only distracted without HBOT served as control group.The animals in groups A and B were sacrificed 1 wk,2 wk,4 wk of consolidation,respectively.The mandibles were harvested and subjected to examination for new bone formation,and bone mineral density (BMD) and biomechanics of newly formed bone in the distraction gap.Results At one week of consolidation,no significant differences were observed between the BMD of newly formed bone in the two groups (P＞0.05);however,at the other time points,BMD of newly formed bone in group A was significantly higher than that in group B (P＜0.05).Moreover,at 4 weeks of consolidation,the strength,maximum fragile energy and modulus of elasticity of newly formed bone in group A were significantly higher than those in group B (P＜0.05).Conclusions The results suggest that HBOT improves mineral density and strength of new formed bone in distraction gap.

Objective:To investigate the impact of conditioned medium of decidual stromal cell culture(DSCM) on proliferation,apoptosis and invasion of trophoblast cells.Methods:lsolution,culturing and indentifying the purity of decidual stromal cells from healthy women of early pregnancy to prepare different concentrations of DSCM (5％,20％,50％ and 100％);Proliferation was evaluated by MTT assay;Cell apoptosis was examined by flow cytometry using annexin V-FITC/PI staining;Cell invasion was assayed using a Transwell chamber;RT-PCR and gelatin zymography were used to explore the mechanism of cell invasion.Results:Using this method we obtained a purity over 90％ of decidual stromal cells.With the concentration of DSCM increased(5％,20％,50％,100％),the OD value of the MTT assay has elevated and the rate of apoptosis declined,the infiltrating cell increased as well (P ＜ 0.05);Compared with control group,DSCM treatment led to a significant increase in the mRNA and protein expression of MMP-2/9(P ＜0.05).Conclusions:Decidual microenviroment may promote trophoblast proliferation and inhibite its apoptosis besides could enhance its ability of invasion by altering the expression of MMP-2 and MMP-9.

This article first introduces the current situation and existing problems of understanding the relation-ship between informed consent and doctor-patient communication in clinical practice,And then discusses from the ethical perspective, strengthen the positive role of the principle of informed consent.This paper under the principle of informed consent presented methods to improve the doctor-patient communication:to guide the doctor-patient communication informed consent, to achieve effective communication way of informed consent, strengthening the positive role of informed consent and some other suggestions.

In October 2015 ,the White House issued a New Strategy for American Innovation which was also concerned with precision medicine initiative , BRAIN initiative and health care .This paper introduces the background , main content and developments of this new strategy ,hoping to facilitate the development of healthcare in China .

ObjectiveTo investigate the expression and localization of midkine (MK) in human hepatocellular carcinoma. MethodsIn situ hybridization and immunohistochemical analysis for MK were performed on samples of both tumor tissues and paratumor tissues from HCC and benign liver tumors. ResultsThe distribution and localization of the MK transcripts′ signals determined by in situ hybridization were similar to those obtained by immunohistochemical analysis. Most HCC tissues showed enhanced positive reaction within cytoplasm to both MK probe and MK immunostaining. There was no significant difference in clinicopathological parameters between MK negative and positive cases of HCC. ConclusionsHuman hepatocellular carcinoma overexpresses MK at the mRNA and protein level.

Objective To analyse the imaging characteristics of solitary pulmonary nodules(SPNs) with the spiral CT, and detection clinical values of the definitive diagnosis to SPNs. Methods 32 cases of SPNs were identified by spiral CT, 9 cases of them were examinated by enhancement scanning. The diffrentical imaging features were analyzed. Results 24 cases were malignant in imaging(18 cases were identified), 8 cases were benign in imaging(6 cases were identified). 15 cases of malignant SPNs by clinical identified were smooth at edge; 6 cases of benign SPNs by clinical identified. 5 cases of them were anomaly;4 cases of them were burr;2 cases of them were bronchial sign and vesiclat sign.6 cases of the SPNs were calcified. 6 cases of SPNs(9 cases with contrasting) were benign in imaging, 3 cases of them were malignant in imaging. Conclusion The differential diagnostic of SPNs is difficult by spiral CT, but enhancement scanning and epidemiology combined with spiral CT is very valuable for definitive diagnosis.