Objective To evaluate the clinical applied effects of tibial shaft fracture with intramedullary interlocking nail and small incision. Methods From November 2004 to October 2005,47 cases of tibial shaft fracture were treated with intramedullary interlocking nail, all the cases were adopted with small incision and intramedullary interlocking nail, and analysed the curative effects Results 47 cases were followed-up ranged 8 ～ 27 months. All cases resumed normal knee function 6 to 12 weeks after operation,without nonunion and malunion. Conclusion Treatment of tibial shaft fracture with intramedullary interlocking nail and small incision had the advantages of little trauma,good stability, high rate of fracture union and rapid functions recovery. It is worthy deserveed to be put into application and populatization in clinics.

BACKGROUND:At present bone marrow mesenchymal stem cel s act as the main seed cel s in bone tissue engineering, but only 0.001%-0.01%cel s are in the bone with difficulty in cel separation and purification. OBJECTIVE:To explore the biological characterization of human placenta derived mesenchymal stem cel s and biocompatibility with three-dimensional porous hydroxyapatite ceramic scaffold. METHODS:Human placenta derived mesenchymal stem cel s were morphological y observed and identified usingflow cytometry, fol owed by osteogenic, adipogenic, chondrogenic induction for 3 weeks. Afterwards, the potential of multi-directional differentiation was identified by alizarin red S, oil red O and toluidine blue staining. DAPI staining was used to observe the adhesion of cel s on the surface of the hydroxyapatite ceramic scaffold under scanning electron microscope. RESULTS AND CONCLUSION:The human placenta derived mesenchymal stem cel s showed long spindle shape and uniform size under the microscope;they highly expressed CD29 and D90, but did not express CD45 and CD106. Fol owing induction, mineralized nodules were observed by alizarin red S staining, lipid droplets by oil red O staining and blue-dyed toluidine blue staining. These cel s adhered wel to the scaffold surface, indicting they are suitable for bone tissue engineering.

A lipopeptide compound was isolated from the culture of Bacillus subtilis HSO121 by methods of acidic precipitation, solvent extract, fractional precipitation, adsorption and prepared thin-layer chromatography; and its molecular structure was determined by by ninhydrin assay and IR methods following the Amino analysis, MS-MS and ESI-MS. It shows that the isolated lipopeptide consists of two homologues with molecular mass 1,022D and 1,036D and bearing a cyclic structure with the amino acid sequence Leu-Leu-Asp-Val-Leu-Leu-Glu in the peptide chain, which indicates that the isolated lipopeptide falls into the analogs of surfactin.

Antigenic analysis of 10 strains of Coxsackievirus type A 24 (CA24) was carried out by monoclonal antibodies (McAbs) prepared with a China isolate of Coxsackievirus A 24 variant (CA24v).8 McAbs which were positive in indirect immunofluorescent test reacted to 9 CA 24 v detected. Of them, 4 McAbs could react to both CA 24v and CA 24 prototype (Joseph strain),and the others did not react to CA 24 prototype. 5 McAbs possessing virus-neutralizing activity did not neutralized CA 24 prototype (Joseph strain)and only one of them could neutralize EH 24/70 strain weakly, three of them neutralize 2 isolate from Japan in 1985-86 (J140/85 and J 60/86) and one isolate Fujian of China in 1986. However, all 5 McAbs above could neutralize isolate from Henan and Shanghai of China in 1986 as well as Beijing, Liaoning and Fujian of China in 1988.

Establishing medical service payment system reform organization of diagnosis related groups and prospective payment system(DRGs-PPS) based on the theory of matrix management and learning organization.Firstly joint committee mechanism hasbeen established to guide the implementation of DRGs-PPS with the strong support of Beijing local government; Secondly series of related technical standards and organizational systems including AP-DRGs,AR-DRGs Group,Data Dictionary,ICD Group,International Classification of Surgical Operations Group,Pricing Classification Group,Training Group,Supervision Group,Support Group,Data Validation Group,BJ-DRGs Group have been created to support standard maintenance,project inspection and data analysis; Furthermore,learning organization has been realized by setting up various project groups and the establishment of DRGs-PPS platform help ensure performance evaluation of healtheare institutions and payment system reform.

Objective To discuss the diagnostic paradigm of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement.Methods Clinical features of one patient with non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement,manifesting fever of undetermined origin and refractory hyponatremia,were analyzed retrospectively.The related literature was reviewed,and experience in diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement was summarized.Results Clinical manifestations of the patient was nonspecific,and there was definite evidence to support the diagnosis of infectious and autoimmune diseases.However,the abnormal elevation of serum lactate dehydrogenase(LDH)and ?2 microglobulin,which were suggestive of the diagnosis of lymphoma.The diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland involvement was finally established by adrenal gland biopsy under CT.On the other hand,the endocrine evaluation indicated there was pituitarism even though the lesion was not obvious on the MRI image.However,18F fluorodeoxyglucose-positron emission tomography-computed tomography(18F-FDG PET-CT)clearly showed lesions in pituitary,liver and lymph node of neck.With supplementation of hydrocortisone,sodium the serum level gradually elevated to above the normal range,and the lesions in pituitary and adrenal glands disappeared after three courses of CHOP chemotherapy.The functions of pituitary and adrenal gland recovered 3 months later.Conclusions Non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement is a rare disease.Early diagnosis relies on the logical clinical evaluation and 18F-FDG PET-CT image.

Objective To prepare the solid dispersion of ginsenoside Rg3 with different carriers and measure their solubility and dissolution characterisitics. Methods The solid dispersion of ginsenoside Rg3 was prepared by the melted and dissolved methods with Poloxamer 188(F68), PVP k29/32, and PEG 6000 as carriers, respectively. The equilibrium solubility and dissolution characteristics of the solid dispersion in vitro were measured by HPLC. The existing state of ginsenoside Rg3 in the solid dispersion was identified by the differential scanning calorimetery. Results The ginsenoside Rg3 was completely dispersed in carrier and formed a mixture with carriers. The solubility and dissolution rates of all solid dispersion were increased obviously. Conclusion The solid dispersion of ginsenoside Rg3 with Poloxamer 188 as carriers is better on improving dissolution and solubility than those with PVP and PEG 6000 as carriers.

For the problems that 3 first-class ternary hospitals which are not directly affiliated to medical universities are facing in cultivating high-educated staff's scientific abilities,analyze the importance to carry out scientific work in clinic and discuss how to improve their scientific abilities from hospitals,departments and high-educated staff themselves.

Objective To compare the effect of injection with botulinum toxin type A (BTX-A) before serial casting with BTX-A injection alone for the treatment of spastic equinus in children with cerebral palsy (CP).Methods Sixty patients were divided into an experimental group and a control group with 30 patients in each.Those io the experimental group received a BTX-A injection followed by serial casting,while the controls received BTX-A only.Before treatment and 1 month,3 months and 6 months after treatment,the dorsiflexion range of motion (ROM)of the ankle recorded while the knee in flexion and extension were measured,and gait was evaluated with an observational gait scale.Results Before treatment there was no significant inter-group difference in any of the 3 outcome measures.At 1 montb,3 months and 6 months after treatment,there were significant inter-group differences in all 3 measures,and also significant differences compared with before treatment in both groups.Conclusion Lower muscle tone,greater ankle mobility and better gait patterns can be promoted in CP children with spastic equinus using serial casting combined with BTX-A injection.The improvements may last longer than those after BTX-A injection alone.

Objective To explore the impact of high‐load atorvastatin on T cell subsets in patients with unstable angina (UA) after percutaneous coronary intervention (PCI) .Methods One hundred and eighty patients with UA were randomly divided into high‐load atorvastatin group ,ordinary‐load atorvastatin group and routine group ,60 cases in each group .The ratios of CD4+ T cell , CD8+ T cell and the frequencies of CD4+ CD25+ Treg were detected in 3 groups 1 day before PCI and 1 week ,1 month and 6 months after PCI by flow cytometry analysis .Results Different doses of atorvastatin reduced the ratio of CD4+ T cells and in‐creased the ratio of CD8+ T cells and also the frequencies of CD4+ CD25+ Treg after PCI for 1 week ,1 month and 6 months .The longer the time to take atorvastatin ,the more obvious the effect was(P<0 .05) .The ratios of CD4+ ,CD8+ T cells and the frequen‐cies of CD4+CD25+ Treg after PCI for 1 month and 6 months in high‐load atorvastatin showed significant difference compared with those in ordinary‐load atorvastatin group and routine group(P<0 .05) .Conclusion Atorvastatin could regulate the balance of T cell subsets in patients with UA ,and thus it may reduce the UA onset and the treatment effect of high‐load atorvastatin is more sig‐nificant .