Fracture healing consists of four stages: hematoma and inflammation, granulation tissue formation, membranous and endochondral ossification, and remodeling. During these stages, the pathological changes are continuous and overlapping and numerous inflammatory factors and growth factors play a central role in the tissue regeneration and ossification. The fracture will eventually reach primary bone healing or callus healing depending on the stability of fracture site after treatment. The delayed union and nonunion can be assessed according to the treatment time, clinical examination, radiology and biomechanical testing. It is important to understand the differences between hypertropic and atrophic nonunions and the reasons that lead to nonunion. At last, methods to promote fracture healing are summarized and classified into four groups: biological, systemic, mechanical and biophysical ones.

Acute compartment syndrome (ACS) is still an emergent situation in traumatic orthopaedics. Its pathophysiologic mechanism and treatment principles have already been recognized and established widely. The main factors which affect the prognosis are early diagnosis and timing of surgical treatment. This review analyzes the methods of clinical and instrumental diagnosis,rectifies some misunderstandings in clinical evaluation and makes suggestions on appropriate monitoring.

Objective To observe the efficacy of treatment of cirrhosis ascites with integrated traditional Chinese medicine and western medicine. Methods All patients were randomly divided into a treatment group (27 cases) and a control group (25 cases). Patients in the treatment group were treated with integrated traditional Chinese and western medicine, while patients in the control group were treated with western conventional therapy. Resulta The total effective rate in the treatment group was 96.3%, showing significant difference (P＜0. 05) contrasting 72% in the control group. Conclusion It is effective that treating cirrhosis ascites with integrated traditional Chinese and western medicine.

Fulminant myocarditis (FM)is a clinical accidant and emergency,and often endenger the lives of patients.Myocardium damage by virus infection and immune-mediated cellular damage are important for the development of FM.This paper discussed the role of the immune system in the FM,involving cellular immunity,humoral immunity and cytokine.Also this paper discussed the treatment of FM about the immunol-oregulation and immunosuppression.

Objective To observe the effect of interleukin-1β(IL-1β) on expression of Matrix Metalloproteinases 13 (MMP-13) in rat chondrocytes and its regulation of miR-27b. Methods Chondrocytes were extracted from 7 Wistar male rats. Expression of MMP-13 were examined by Western blot at 0 h, 24 h, 48 h after IL-1βstimulation. Differential miRNAs expression profiles were examined by miRNAs microarray. The most obviously down-regulated miRNAs were confirmed by quantitative Real-time PCR. Targeted regulation relationship between miR-27b and MMP-13 was set up by Luciferase re?porter gene experiments. Results Expression of MMP-13 in rat chondrocytes was increased at a timely dependent manner upon IL-1βstimulation(P<0.05);Microarray revealed 36 miRNAs whose expression changed, among which 6(miR-27b, miR-31, miR-26a, miR-26b, miR-23, miR-204)were especially obvious. Real-time PCR confirmed that miR-27b was the one whose expression level were most down-regulated. Transient co-transfection of miR-27b mimics with luciferase expres?sion plasmids resulted in significant repression of luciferase activity in rat chondrocytes (P < 0.05). Conclusion IL-1βstimulation result in down-regulation of miR-27b and up-regulation of MMP-13 expression. MiR-27b and MMP-13 show targeted regulation relationship.

Objective To evaluate the effect of therapeutic communication on perioperative anxiety of cancer patients by using the Meta-analysis.Methods The randomized controlled studies of therapeutic communication for perioperative anxiety of cancer patients were gathered from Pubmed,Embase,Cochrane Library,China Biology Medicine Disc (CBM),China Scientific Journal Database by VIP (CSJD),China National Knowledge Infrastructure (CNKI) and Wangfang Data,while other relative researches were also searched by hand.According to inclusion and exclusion criteria articles were evaluated by two reviewers independently.The studies were assessed according to the Juni assessment.RevMan 5.2 was used for statistical analysis.Results Seven studies with 506 patients were included,of which therapeutic intervention group contained 256 patients,the control group included 250 patients.Meta-analysis showed that compared with the control group,therapeutic communication system could reduce perioperative anxiety of cancer patients [MD=-8.00,95％CI (-8.91--7.10),P ＜0.01],improve positive perioperative coping of patients [MD=5.50,95％CI(4.05-6.95),P ＜ 0.01],reduce negative perioperative coping of patients [MD=-7.62,95％CI (-9.13--6.11),P ＜ 0.01],increase the satisfaction degree of patients [MD=0.55,95％CI (0.33-0.77),P ＜0.01],the differenccs were statistically significant.Conclusions Therapeutic communication can contribute to relieve perioperative anxiety of cancer patients,optimize their coping styles and improve the satisfaction degree of patients with nursing work.

Objective To assess the prevalence and impacts of premenstrual syndrome on female college students,and to provide scientific basis for health education. Methods In the cross-sectional study, a total of 900 female college students from three universities in Jinzhou city were investigated.The data were compiled using the questionnaire of Premenstrual Syndrome Scale by John Bancroft and the general information questionnaire.Results A total of 856 questionnaires were valid among the 900,the validity rate was 95.11%. Premenstrual syndrome was diagnosed in 32.7%(280/856)of all cases,distributed as 22.7%(194/856)mild,7.9%(68/856)moderate and 2.1%(18/856)severe. Binary Logistic regression analysis revealed that premenstrual syndrome was significantly associated with bad sleep condition, animal fat intake, yolk food intake, dysmenorrhea, early age at menarche. Conclusions The results showed that premenstrual syndrome is prevalent among female college students and that life style and nutritional factors may play an important role in this disorder. Therefore,health education and counseling services,as part of the overall health service,should be availed and provided to affected women.

Objective To compare the effect of different treatment methods in the prevention of persistent ectopic pregnancy after laparoscopic tubal pregnancy conservative operation, to provide reference to women's clinical treatment planning needs of choice.Methods 204 patients underwent laparoscopic tubal pregnancy conservative surgery were selected.According to perioperative preventive postoperative persistent ectopic pregnancy in different ways, they were divided into four groups.After the removal of the gestational sac, the methotrexate injected into the fallopian tube was established as A group(48 cases);methotrexate combined with mifepristone on the prevention of persistent ectopic pregnancy after laparoscopic cyst removal was established as B group(56 cases);simultaneous removal of corpus luteum in laparoscopic cyst removal surgery was established as C group(51 cases);after removal of the bursa, methotrexate injected into the fallopian tube in laparoscopic cyst removal surgery was established as D group(48 cases).The operation indicators of four groups (operation time and intraoperative bleeding volume),blood beta-HCG(β-HCG) changes of 1st,3rd,6th and 12th day after surgery, ectopic pregnancy rate continued after surgery, postoperative follow-up of 2 years were compared.Of the four groups, the normal pregnancy again time after operation, the comprehensive evaluation of different treatment methods for the effect of ectopic pregnancy in the prevention of laparoscopic tubal pregnancy conservative surgery were compared.Results Of the four groups, the age, reproductive status, menopause, preoperative 1st day bleeding, tubal rupture cases, tubal mass diameter, gestational sac in the fallopian tube in position, bloodβ-HCG levels, operation methods had no statistically significant differences(all P<0.05).Comparison of four groups of operation indicators, the operation time in B group was significantly shorter than that in the other three groups(F=5.305,P=0.037).The amount of bleeding in C group and D group was similar, which was significantly higher than that of A group and C group(F=7.483,P=0.005).The β-HCG levels of D group of 1st,3rd,6th and 12th day were significantly lower than those of the other three groups(all P<0.05), which of B group at different time were significantly higher than those of the other three groups(all P<0.05).The persistent ectopic pregnancy rate of D group was significantly lower than that of the other three groups(2.08% vs 14.58%,14.29%,11.54%,x2=7.406,P=0.040),and the normal pregnancy again rate of D group was significantly higher than that of A,B and C groups(58.33% vs 32.14%,37.50%,38.46%,x2=5.349,P=0.022).Conclusion The laparoscopic removal of tubal pregnancy sac at the same time, to the fallopian tube injection of methotrexate, enucleation of corpus luteum, although increases operation time and bleeding volume, but can significantly reduce the harm to women of childbearing age of persistent ectopic pregnancy, and it has high clinical value.

OBJECTIVE: To prepare Indomethacin-hydroxypropy-cyclodextrin inclusion complex ointments and establish its assay method. METHODS: The preparation was prepared with O/W type emulsion ointment as base material, and the content of Indomethacin in which was determined by UV spectrophotometry. RESULTS: The calibration curve of Indomethacin was linear in the range of 16.76～41.91?g?mL-1(r=0.999 6),and its average recovery was 99.53%(RSD=1.50%). CONCLUSION: The ointments were convenient in preparation technique, and simple and accurate in determination.

The doctor-patient relationship has become increasingly tense. The requirement of the society for physicians, especially surgeons is higher. Apart from fine professional skills, surgeons must learn some other skills, such as communication, the ability of self-decompression, and the awareness of public relationship to deal with inculpation from the media and society. The medical record is more and more important nowadays, surgeons should pay enough attention to it. The public misunderstanding of the medical profession will surely harm both doctors and patients in the end.
Adaptation, Psychological ; Attitude of Health Personnel ; Communication ; Digestive System Surgical Procedures ; Humans ; Physician-Patient Relations ; Physicians