Nonunion or delayed union remains one of the major complicatio ns of fractures. Repair of fractures involves a sequence of dynamic events which ultimately restore the integrity of bone and its biomechanical properties, incl uding such methods as surgery, internal fixation, bone grafting, external fixati on, electrical stimulation, ultrasound, and high-energy extracorporeal shock wa ve. The preferred management of nonunion and delayed union is autologous bone gr afting. However, the supply of suitable bone is limited and it often results in additional morbidity to the donor site. Recently some advances have been made in the therapeutic principle for nonunion or delayed union. It is aimed at providi ng non-invasion, less complication, and safe treatment. This article introduces the development of some effective and safe therapies for nonunion or delayed un ion.

The elastic-plastic indentation properties of materials with varying ratio of hardness to Young's modulus (H/E) were analyzed with the finite element method. And the indentation stress fields of materials with varying ratio H/E on the surface were studied by the experiment. The results show that the penetration depth, contact radius, plastic pileup and the degree of elastic recovery depend strongly on the ratio H/E. Moreover, graphs were established to describe the relationship between the elastic-plastic indentation parameters and H/E. The established graphs can be used to predict the H/E of materials when compared with experimental data.

AIM:To look for a suitable signal peptide which may effectively conduct hepatopoietin(HPO)secretion,various recombinant eukaryotic expression vectors were constructed.METHODS:Different exogenous signal sequences were spliced with HPO cDNA by PCR,and the spliced genes were cloned into eukaryotic expression plasmids.The different recombinants were respectively tansfected into COS-7 cells by Lipofectamine 2000 method and the secretion of HPO was analyzed by Western blotting.RESULTS:Western blotting analysis indicated that the signal peptides from interleukin-1 receptor antagonist(IL-1ra)and an artifical signal peptide did not secret HPO directly and effectively,but the signal peptide from murine Ig kappa secreted HPO directly with great efficiency.The molecular weight of the secreted HPO was 30 kD,which means that the secreted HPO existed in homodimer.CONCLUSION:Secreted recombinant expression plasmid is successful constructed.The result may pave the way for the gene therapy of hepatic fibrosis.

Objective To investigate the relationship between expression of Survivin gene and biological characteristics in human esophageal carcinoma.Methods The expression of Survivin gene was detected in 62 cases of esophageal carcinoma tissues and tumor-adjacent normal tissues by immunohistochemical technique.Results The positive rate of Survivin expression in esophageal carcinomas was 79 0%,which was higher than that in tumor-adjacent normal tissues(6 5%,P0 05). The positive rate of Survivin expression in lymph node metastasis group (93 1%) was higher than that in the group without lymph node metastasis (66 7%,P

Objective To investigate the effects of inhibiting ubiquitin-proteasome pathway(UPP) on DNA synthesis and cell cycle in gastric cancer cell line SGC-7901. Methods The SGC-7901 cells were treated with MG-132, a specific inhibitor of UPP. The effect of MG-132 on cells DNA synthesis was assayed by 3 H-thymidine( 3H-TdR)incorporation. Cell cycle was analysed by flow cytometry(FCM). Results After treated with MG-132, DNA synthesis of SGC-7901 cells was significantly inhibited, the ratio of G 0/G 1 phase cells increased, and the ratio of G 2/M phase and S phase cells decreased. Conclusions MG-132 can significantly inhibit DNA synthesis of gastric cancer cells SGC-7901 and induce G 1 blocking. The data indicated that inhibiting UPP may be a new strategy to treat gastric cancer.

Objective To investigate the diagnostic significance of cytology and telomerase activity in the exfoliated cells of cardia obtained from endoscopic brushing in the cardiac cancer.Methods The technique of the qualitative TRAP siver staining and quantitative TRAP PCR ELISA were employed to detect telomerase activity in the exfoliated cells of cardiac obtained from endoscopic brushing in 72 cases with cardial lesions,cytological diagnosis was made at the same time.Results Telomerase activity with cardiac cancer group(1\^521?0\^192)was significantly higher than that with cardialitis group(0\^065?0\^014).Positive rate of telomerase activity detected in cardiac cancer group(88\^89%)was significantly higher than that with cardialitis group(11\^11%).Positive rate of telomerase activity detected in cardiac cancer group(88\^89%)was significantly higer than cytological examination(77\^78%).The diagnostic rate of cardiac cancer was improved to 93\^33% if telomerase activity and cytology were examined at the same time.Conclusion Results show that the combination of cytology and telomerase activity in the exfoliated cardiac cells may be an effective and sensitive method in the diagnosis of cardiac cancer.This research can be a basis for the mass screening of cardiac cancer.

Objective Acute poisoning is frequently encountered at emergency department. This study was to investigate the epidemiology and characteristics of patients with acute poisoning who were treated at the Emergency Center, Fujian Provincial Hospital, China. Method We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these patients.Results Altogether 2867 patients with acute poisoning were treated from January 2004 to December 2009. The ratween 18 and 40 years old. The incidence of acute poisoning was as high as 11.33% in January each year. The incidence of poisoning was in a descending order: alcohol poisoning (54.55%), medication poisoning (25.95%), pesticide poisoning (5.65%), and drug poisoning (4.88%). Most (56.44%) of the patients with drug poisoning were under 25 years and their mean age was significantly lower than that of patients with medication poisoning or alcohol poisoning ( P ＜ 0.01 ). Approximately 69.54% of the patients were followed up after emergency treatment, 30.39% were hospitalized, and four patients died. Conclusions Acute poisoning is largely alcohol poisoning and medication poisoning in a city. The emergency green channel "pre-hospital emergency care-emergency department-hospital treatment" can significantly improve the survival rate of patients with acute poisoning.

Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4％ of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7％ vs.33.3％,P ＜0.01 ),whereas difference in gender did not affect the discharge rate ( P ＞ 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P ＜ O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5％ vs.24.5％,P ＜0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2％ vs.18.4％,P ＞ 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.

Objective To investigate the vasopressin (VP) response to increasing osmotic pressure in the late-phase of septic shock patients.Methods Thirty-seven septic shock patients hospitalized in intensive care unit (ICU) of the First Hospital of Hebei Medical Unive~ity from January 2012 to September 2013 were enrolled.All patients received 3％ hypertonic saline solution infusion.Serum concentrations of VP and sodium were measured before and after hypertonic saline solution infusion.Patients with ratio of difference in VP and sodium before and after infusion of 3％ hypertonic saline (△VP/△Na) ≤0.5 pg/mmol were defined as nonresponders,and who ＞0.5 pg/mmol defined as responders.The age,acute physiological and chronic health evaluation Ⅱ (APACHE Ⅱ) score,blood pressure,albumin level,vasoactive drug between the two groups were also analyzed.Results VP level in the nonresponsive group (n=20,54.05％) was markedly lowered before (ng/L:10.41 ± 1.70 vs.18.25 ± 5.90,t=5.29,P＜0.01) and after (ng/L:11.36 ± 1.90 vs.24.33 ± 5.46,t=9.33,P＜0.01) 3％ hypertonic saline solution infusion,compared with that in the responsive group (n =17,45.95％).All patients in the two groups were given dopamine (DA) or norepinephrine (NE) for maintaining blood pressure,and the dose in the nonresponsive group were higher than those in the responsive group [DA (μg· kg-1· min-1):14.91 ± 3.78 vs.8.64 ± 1.69,t =-5.02,P＜ 0.01 ; NE (μg· kg-1· min-1):1.03 ± 0.48 vs.0.38 ± 0.12,t=-3.12,P＜0.01].Three patients were given DA plus NE in the nonresponsive group while patients in the responsive group received only single drug therapy.The age,APACHE Ⅱ score,blood pressure,albumin level,sodium level before and after hypertonic saline solution infusion between the two groups were not statistically different.Conclusion VP secretion to osmotic challenge was impaired and decreased in the late-phase of septic shock,prompting dysfunction in VP synthesis.

Objective: To explore the best method to treat post-stroke depression. Methods:60 Cases of the patients with post-stroke depression were selected and divided randomly into the two groups, 30 cases in each group. The treatment group was treated by scalp acupuncture plus body acupuncture, and the control group was treated by oral administration of Fluoxetine. The therapeutic effects were assessed after 30 d of the treatments. Results: The total effective rate was 90.0% in the treatment group, with average effective time of 5 d, and was 80.0% in the control group, with average effective time of 15 d. The comparison of the total effective rates between the two groups was not significant statistically (P＞0.05). But the comparison of the average effective time was significant statistically (P＜0.05). Conclusion: The therapeutic effect is positive in the treatment of post-stroke depression by scalp acupuncture plus body acupuncture, similar to the therapeutic effect of Fluoxetine, but faster in the effective time.