Objective To inoertyate the results of the management of fracture of the proximal tibial epiphysis ,with a particu‐lar reference to the prognosis and complications in children .Methods From January 2002 to June 2012 ,a total of 19 children with fracture of the proximal tibial epiphysis were reviewed ,10 cases were treated with closed reduction and immobilization with plaster cast ,9 patients were operated upon with open reduction and internal fixation .Results All the patients were available at the final follow up with a mean of 2 .8 years (range ,2‐4 .8 years) ,The mean healing time of the fracture was 11 .8 weeks (range ,8 .5‐20 weeks) .According to the assessment system described by Lysholm ,the knee joint function of patients was 13 excellent ,4 good ,1 better and 1 poor .1 case occurred traumatic arthritis ,leading to the pain of keen ,One patient had epiphyseal plate closed early ,and one patient had genu valgum .Conclusion Open reduction and internal fixation should be recommended for the management of the facture with remarkable displacement of type Ⅰ and type Ⅱ ,or the facture involving the articular surface collapses more than 5 mm or separates more than 2 mm of type Ⅲ and type Ⅳ .The treatment with Kirschenel wires or hollow lag screw fixation could achieve good results .

Objective To study the value and the superiority of multi-slice spiral CT angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing pulmonary embolism (PE). Methods CT pulmonary angiography (CTPA) and lower limb deep vein venography were performed in all suspected patients of PE with single or multi-slice spiral CT.The number and type of the embolus were calculated.Results Among the 44 patents of pulmonary embolism,34 patents had both PE and deep vein thrombo embolism (DVT) ,10 patients had only PE.The total ratio of the PE diagnosed with single slice spiral CT and multi-slice spiral CT was 12.1% and 19.0%, respectively , there were statistical significance, (P=0.004); the ratio of the PE upon deuto-segment pulmonary arteries was 25.3% and 29.7%, respectively, there was no statistical significance, (P=0.104); the ratio of the PE below deuto-segment pulmonary arteries was 1.1% and 10.2%, respectively, there was statistical significance, (P=0.000).Conclusion The technique of angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing PE is a non-invasive, fast, sensitive and specific method for PE. Multi-slice spiral CT is superior to single slice spiral CT in the diagnosis of PE.

Objective To investigate the possible biochemical mechanism of cognitive impairment in patients with Obstructive sleep apnea syndrome(OSAS).Methods Polysomnography was administered to eighteen patients with OSAS and fourteen education and BMI-matched controls.All the cases were measured serum nitric oxide(NO)level by spectrophotometry and underwent neuropsychologicol test.Results The scores of visual recognition and digital symbol in the patients with OSAS were respectively 5.33?1.57;6.89?1.23,significantly lower than that in control group(8.57?1.91;9.07?1.00,P

[Objective]To discuss the curative effect of using the DHSN and the sartorial-pedicled ilium bone graft in treating the fracture of neck of femur among young people.[Method]A total of 46 cases of the fracture of neck of femur treated with the DHSN and the sartorial-pedicled ilium bone graft were followed up for 1～8 years.The position of fracture or the area of bony defect was filled with the sartorial-pedicled ilium bone.[Result]The clinical results were assessed according to the functional rehabilitation.So,there were excellent results of 23 hips,good of 19 hips and poor of 4 hips in this study and the satisfactory rate was 91%.There were 44 cases reached osteal healing.The average healing time was 8 months and the average time of taken out was 14 moaths.[Conclusion]In treating the fracture of neck of femur among young people,the DHSN and the sartorial-pedicled ilium bone graft have the advantage of firm fixation and highly healing rate.

Objective To explore the clinical efficacy of rosuvastatin combined with oxycodone sustained release tablets in patients with advanced non-small cell lung cancer and its effects on serum IL-6 and TNF-αlevels.Methods 62 cases with advanced non-small cell lung cancer from May 2014 to May 2016were divided into observation group and control group according to random number table, each group with 31 cases.Control group were treated with oxycodone sustained-release tablets, and observation group were treated with rosuvastatin and oxycodone sustained-release tablets.The levels of serum IL-6 and TNF-αwere compared pre-and post-treatment betweene two groups.The effective dose, the number of painful pain, the NRS score, the improvement of quality of life of oxycodone hydrochloride sustained-release tablets after treatment and adverse reaction rate were observed. Results After treatment, serum IL-6, TNF-αlevels in two groups were significantly lower than pre-treatment (P <0.05), and which in observation group were significantly lower than control group (P<0.05).Compared with control group, the effective dose of Oxycodone Hydrochloride Prolonged-release Tablets, broke out pain, NRS score in observation group were significantly higher ( P <0.05 ) .The effective rate of cancer pain treatment in observation group was 96.77% (30/31), significantly higher than 74.19% (23/31) of control group (χ2 =12.269, P<0.0001).The improvement of quality of life incontrol group was 32.25%, significantly lower than 80.64% in observation group (P<0.05).There was no significant difference in adverse reactions between two groups.Conclusion Rosuvastatin combined with oxycodone sustained release tablets in treatment with advanced non-small cell lung cancer were effective, and can reduce the patient's serum IL-6, TNF-αlevels effectively.

Objective To study and analyze technology of proxy server,VPN and specific remote access system.Methods The application of digital medical library was studied in such four aspects as adaptability,security,accessibility and extensibility.Result Many approaches were put forward to break the limits of IP address and realize remote access to digital resources.Conclusion In order to meet the actual requirements in the remote access of digital medical library,the following rules should be observed: the technical scheme with obvious functional limitations should be avoided;importance should be laid on mutual sharing and remote access between chief library and branch library;the maximum concurrent access should be born;multiple certification methods should be utilized as well as multiple techniques such as information distributing.

Objective To systematically evaluate the risk of BRCA1 mutation in patients with triplenegative breast cancer (TNBC).Methods Articles about the association between the TNBC and BRCA1 mutation were retrieved from database,such as PubMed,CNKI,Wanfang,VIP and CBM databases.The odds ratio (OR) was used to evaluate the risk of BRCA1 mutation in TNBC compared with non-TNBC.Rev Man 5.2 software was applied to perform the Meta-analysis.Results A total of 23 articles were eligible for the Meta-analysis,including 1 104 patients with TNBC and 4 245 patients with non-TNBC.The pooled OR was 7.67 and 95％ CI(6.24,9.42),and the difference was statistically significant (Z =19.38,P ＜ 0.000 01).In the subgroup analysis about the race,the pooled OR for Asian was 6.67 and 95％ CI (4.98,8.95).The pooled OR for Caucasian was 8.83 and 95％ CI (6.61,11.80).There was statistically significant difference in the pooled OR between the Asian and the Caucasian (Z =14.74,P ＜ 0.000 01).Conclusion The patients with TNBC are 7.67 times more likely to have BRCA1 mutation compared with non-TNBC phenotype.Largesample randomized controlled trials are warranted to demonstrate the detection of BRCA1 mutation can be a conven-tional application in clinical for the patients with TNBC.

Objective To investigate the causes and treatment of lymphatic fistulas(LF) after radical operation of gastric cancer . Methods We observed the clinical data of 31 cases of lymphatic fistulas after the radical operation of gastric cancer , including the amount of drainage from the abdominal cavity, the levels of hemoglobin and serum albumin, post operative morbidity and the survival rate. Meanwhile, the difference in the amount of abdominal drainage before and after using octreitide was observed in LF patients. Results The rate of complications in the LF group was significantly higher than that in the non LF group(control group) (P

Arterial thrombosis (AT) is a common disease which usually causes acute myocardial infarction,ischemic stroke and other ischemic cardiovascular and cerebrovascular diseases,which shows high rates of morbidity and mortality,and has become a serious problem to human health.It is increasingly clear that the interactions among platelets,the endothelium and leukocytes are important throughout all stages of the atherothrombotic process.It is of great significance to search for therapeutic targets in the process of AT and developing the therapeutic drugs based on those newly discovered targets.This article reviews the research advances in the discovery of antithrombotic targets and the current situation of drug development based on those antithrombotic targets found in the recent 5 years,in order to provide some references or clues for the development of innovative drugs to prevent and treat AT.

Objective To observe the clinical effects of compound carraghenates cream on edema and pain after mixed hemorrhoid surgery. Methods 180 cases of patients with mixed hemorrhoids divided into the observation group and the control group, 90 cases in each group according to the random number table method. The control group was treated with Vaseline oil gauze to cover wounds after operation, and the observation group was treated with compound carraghenates cream after operation. The clinical efficacy, VAS pain score , the edema symptom scores and the pain relief time, edema symptom relief time, the wound healing time ,untoward effect were compared and observed after treatment between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group (95.56％ vs 85.56％) (P<0.05). The VAS pain scores of the observation group on the 1st day, 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05), and the edema symptom scores on the 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05). The time for pain relief, the time for edema relief and the wound healing time in the observation group were significantly shorter than those in the control group (P<0.05). Conclusion Compound carraghenates cream can effectively relieve edema and pain after mixed hemorrhoid surgery, and it also can shorten the course of disease and promote wound healing with safety.