Objective To investigate the effectiveness of arthroscopic reduction and percutaneous fixation (ARPF) for the treatment of tibial plateau fractures. Methods Seventeen cases of tibial plateau fractures from April 1999 to June 2002 were reviewed. The fractured tibial plateau was reconstructed by “drag-and-draw” reduction and iliac crest bone graft under arthroscope. And percutaneous cancellous bone screw fixation was conducted. Results Clinical bone union was achieved in all the patients at the third postoperative month. No infection or severe osteoarthritis occurred. Conclusions ARPF for tibial plateau fractures has advantages of reduction under direct view, reliable fixation and facilitation for early activities.

Objective To study the efficacy of treatment of proximal humeral fractures in elderly patients using cloverleaf plate combined with bone cement. Methods 13 aged patients with serious proximal humeral fractures were admitted from 2000.1 to 2001.6. Their X ray revealed displacement and crispation. After anterior reduction through the shoulder joint, the obvious osseous defects were filled with bone cement. Then the fractures were fixed with cloverleaf plates. Sling was applied for the patients postoperatively and the rehabilitation program started 3 weeks after operation. Results All the 13 cases were followed up. The follow up ranged from 5 to 10 months with an average of 8.3 months. The range of motion was satisfactory with a mean abduction over 90 degrees. X ray revealedthat no patient demonstrated osteonecrosis of the humeral head. Union was achieved in all the patients. According to Neers scale, the function of shouder was excellent in 10 cases, and good in 3 cases. Conclusion This methods is recommended for aged patients with osteoporosis, serious osseous defects and difficulty of using internal fixation alone, because it is convenient and reliable and can prevent replacement of joint prosthesis.

Ojective To investigate the clinical application value of low dose contrast agent in computerized tomography pulmonary angiography (CTPA) with spectral CT imaging.Methods Totally 52 patients suspected with pulmonary embolism underwent multi-slice spiral CT pulmonary angiography,and were randomly divided into a control group (n =27) and a research group (n=25).The research group used spectral CT with 35 ml of contrast medium and the control group used 64-slice CT with conventional 80 to 90 ml of contrast medium.The CT values of the pulmonary trunk,left pulmonary artery (LPA),right pulmonary artery (RPA),pulmonary vein and ascending aorta were measured.The contrast to noise ratio (CNR) of the pulmonary artery was also calculated.In addition,the image quality of CTPA was evaluated independently by two experienced radiologists.Results The CT values (HU) of the pulmonary trunk,left pulmonary artery(LPA),right pulmonary artery (RPA) in the research group were (432.2±63.4),(373.5±48.8),(381.4±53.6) and (62.5-±6.4),respectively,and significantly higher than those in the control group,showing statistical differences (P＜0.05).The evaluation results of the CTPA images by two radiologists showed that the image quality in the research group was better than that in the control group (P＜0.05).Conclusion The image quality of pulmonary angiography with spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.

The free membrane of Eudragit L100/S100 which is pH-sensitive, colon-specific was prepared by plane casting films. The film humidity, species and amount of plasticizers, the ratio of membrane material was investigated. The rate of membrane permeability and mechanical properties were used as indicators of orthogonal experiment, and its related properties were studied. The results show that the mechanical properties of the membrane and phragmoid capacity are the best when 30% TEC was used as plasticizer; the ratio of membrane material have little effect on the rate of membrane permeability and mechanical properties. By adjusting the species and amount of plasticizers, the ratio of Eudragit L100/S100, the free membrane which is colon-specific can be obtained.

Objective To understand the current management situation of hand hygiene (HH)among health care workers(HCWs)in stomatology medical institutions in Zunyi,and provide basis for the scientific management of HH.Methods In October-December 2014,the on-site observation and questionnaire survey were adopted to investigate current management situation of HH in 127 stomatology medical institutions in Zunyi.Results The rates of qualified installation of sink,faucet,detergent,alcohol-based hand rub,and hand-drying facilities were 60.63%, 11 .02%,92.13%,22.05%,and 37.80% respectively.Except detergent and sink,the installation of other HH supplies in stomatology medical institutions in Zunyi were not ideal.The correct rate of HH among HCWs was 33.07%(42/127),qualified rates of HH methods among HCWs in departments of stomatology,comprehensive out-patient departments, stomatological clinics,and teeth-cleaning clinics were 50.00%,23.08%,23.53%,and 0 respectively.Conclusion HH facilities are not perfect in primary stomatology medical institutions in Zunyi,health ad-ministrative departments’supervision on HCWs’HH is inadequate,the awareness rate of HH knowledge and com-pliance to HH among HCWs are both low.

Objective To study effects of bivalirudin and heparin plus tirofiban on plasma P-selectin in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and compare the clinical effects on bleeding and thrombosis.Methods 260 hospitalized patients with acute STEMI who accepted emergency PCI were enrolled in the study.They were randomly divided into the bivalirudin group (129 cases) and the heparin plus tirofiban group (131 cases).Blood samples were taken before operation,during operation (about 20 minutes after medicacion injection) and after operation (three hours after the end of operation).Serum P-selectin levels were measured.All patients were followed-up for 30 days.The main events included hemorrhage within 30 days,acquired thrombocytopenia and stent thrombosis.Results The level of P-selectin increased significantly in the heparin group during operation compared to the preoperative level and remained statistically higher at three hours after the end of operation than preoperative level (P ＜ 0.05).Compared with preoperative level,the P-selectin level of the bivalirudin group was significantly lower than that of heparin group (P ＜ 0.05).After 30 days of follow-up,bivalirudin had lower rates bleeding events compared to the heparin group(5.4％ vs.15.3％,P =0.009).The need of medical intervention for bleeding events (BRAC2-5 hemorrhage) was less in the bivalirudin group(0.8％ vs.5.3％,P =0.029).There was no significant difference in the major bleeding events between the 2 groups (BRAC3-5 hemorrhage) (0 vs.0.8％,P =0.32).No significant difference found between the two groups in acquired thrombocytopenia (P ＞ 0.05).Conclusion Bivalirudin may reduce P-selectin levels in STEMI patients undergone emergency PCI during perioperative period.Heparin increases perioperative P-selectin.Bivalirudin may reduce the bleeding events.

OBJECTIVETo prepare Qixian decoction pellets.

METHODThe formulation and technological factors influencing the preparation of Qixian decoction were investigated in tangential spray fluid bed choosing the yield of pellets, particle diameter distribution, repose angle, bulk density as inspecting indexes.

RESULTthe technological parameters for the preparation of blank pellets were as follows: the ratio of starch and dextrin was 2:1, the adhesive agent was 70% syrup, the rotating speed was 200 r x min(-1), the air blow flow was 15 x 20 L x min(-1), the rate of air flow was 15 L x min(-1), the spay air pressure was 0.15 MPa, and the rotating rate of spray solution pump was 20-50 r x min(-1); The optimized technological parameters for the preparation of Qixian decoction were as follows: the relative density of the extract was 1.12-1.15 g x min(-1), the diluent was MCC and its quantity was 8%, the rotating rate of spray solution pump was 10-12 mL x min(-1), the frequency of the rotor disc was 18-20 Hz, the atomizing pressure was 0.2 MPa, the frequency of the fan was 22 Hz, and the spheronisation and drying time was 30 mins.

CONCLUSIONthe appearance of the Qixian decoction pellets prepared in tangential spray fluid bed are smoothing and round, the yield of pellets are high, and pellets of the particle size between 500-700 microm is 90.6%.

Adhesives ; chemistry ; Drug Compounding ; instrumentation ; methods ; Drug Implants ; Drugs, Chinese Herbal ; chemistry ; Rotation ; Temperature ; Time Factors

Objective To investigate the effect of Zhutan Tongluo Tang on the articular cartilage degeneration in a rat osteoar-thritis model ,and explore the potential mechanism .Methods Thirty-healthy SD rats were equally divided into the normal control group ,the model control group and Zhutan Tongluo Tang group .Rats were induced osteoarthritis models with 4% mass fraction of papain .After replication of osteoarthritis models ,Zhutan Tongluo Tang group were given Zhutan Tongluo Tang with 2 mL/(kg · d) ,the model control group were given lavage with normal saline ,the normal control group with rovtine feeding .After treat-ments for 3 months ,the cartilage morphology were observed using HE stains ,and the expression of IL-1β,TNF-α and MMP-3 in synovial fluid were measured by ELISA .Results The degeneration of cartilage in Zhutan Tongluo Tang group was better than the model control group .Compared with the model control group ,the expression levels of IL-1β (12 .13 pg/mL vs .16 .62 pg/mL ) , TNF-α (13 .76 pg/mL vs .18 .26 pg/mL) and MMP-3 (14 .21 ng/mL vs .21 .57 ng/mL) in synovial fluid were significantly de-creased in Zhutan Tongluo Tang group(P<0 .05) .Conclusion Zhutan Tongluo Tang has the function of treating delaying osteoar-thritis cartilage degeneration and decreasing inflammation ,whose mechanism is related to inhibiting the expression of inflammatory cytokines .

BACKGROUND:Exercise is an effective method for preventing and treating osteoporosis,but it is unclear whether its effect on postmenopausal osteoporosis is related to changes in bone autophagy levels. OBJECTIVE:To observe the effects of exercise via cellular autophagy on the morphology and mechanical properties of bone tissue in ovariectomized rats,and to explore the mechanism of exercise on bone mass in ovariectomized rats from the perspective of autophagy. METHODS:A rat model of postmenopausal osteoporosis was established,and a 24-week moderate-intensity exercise was used for intervention.After the experiment,serum estradiol levels were measured by ELISA,and bone mineral density and bone microstructure of the cortical and trabecular bone were detected by micro-CT.The biomechanical indicators of the tibia were tested by a three-point bending test.Autophagosomes were observed by transmission electron microscopy.The expression of LC3 and ATG7 proteins was analyzed by western blot. RESULTS AND CONCLUSION:The serum estradiol level in the ovariectomized group was significantly lower than that of the sham-operation group and ovariectomized+exercise group(P＜0.01).The body mass of rats in each group increased,and the order was the ovariectomized group＞the ovariectomized+exercise group＞the sham-operation group＞the sham-operation+exercise group.The bone mineral density and bone mass of rats in all groups significantly increased(P＜0.01),but the increase in the ovariectomized group was significantly lower than that of the other groups,and the increase in the ovariectomized+exercise group was significantly higher than that of the ovariectomized group.Compared with the sham-operation group,the bone mineral density of the tibial cancellous bone in the sham-operation+exercise group was significantly increased(P＜0.01),while the bone mineral density in the ovariectomized and ovariectomized+exercise groups was significantly decreased(P＜0.01).Compared with the ovariectomized+exercise group,the ovariectomized group showed significantly lower bone volume fraction,number of trabeculae,and bone mineral density of cancellous bone(P＜0.05),extremely significantly lower trabecular thickness(P＜0.01),and significantly higher mean trabecular pattern factor,trabecular separation,and structural model index(P＜0.01).Compared with the ovariectomized group,the LC3-Ⅱ/LC3-I ratio and the relative expression of ATG7 protein significantly increased in the ovariectomized+exercise group(P＜0.05).Compared with the sham-operation and ovariectomized groups,the number of autophagosomes increased in the sham-operation+exercise and ovariectomized+exercise groups,respectively.To conclude,moderate-intensity treadmill exercise can improve the bone microstructure and biomechanical properties of the tibial cancellous bone and increase bone mass in ovariectomized rats by increasing serum estradiol levels and bone autophagy levels.

【Objective】 To compare the efficacy and safety of blue laser en bloc enucleation and traditional plasmakinetic electrocautery in the treatment of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A total of 50 NMIBC patients treated in our hospital during Oct.2018 and Dec.2019 were enrolled. A randomized, incomplete blinding, parallel control design and non-inferior test method was adopted. The control group (electrocautery group) used plasmakinetic electrocautery for transurethral resection, and the experimental group (blue laser group) used semiconductor blue laser for transurethral en bloc enucleation. The effective resection rate, operation time, postoperative catheter indwelling time, length of hospital stay, perioperative hemoglobin changes and obturator nerve reflex were compared. 【Results】 There were 24 patients in the blue laser group and 26 in the electrocautery group. The effective dissection rate and hemostasis rate in both groups reached 100%. The blue laser group had slightly longer operation time than the electrocautery group (55 min vs.42 min, P=0.009), but lesser hemoglobin decrease (5.7 g/L vs. 10.4 g/L, P=0.007). There were no significant differences in urinary catheter indwelling time, length of hospital stay and reoperation rate between the two groups. The electrocautery group had 3 cases of obturator nerve reflex, while the blue laser group had none. 【Conclusion】 Compared with the traditional electrocautery, blue laser has good vaporization cutting and coagulation hemostatic effects on bladder tumor tissue, and can completely enucleate tumors in a front-firing model with less bleeding and no obturator nerve reflex, which can be used as a new, efficient, safe and easy-to-learn method for NMIBC surgery. However, its effects on postoperative recurrence rate and progression rate still need further studies.