0.05).The activities degrees of ankle joint also had no statistical difference.[Conclusion]According to the extent of the displacement of Cotton's fracture,we should make the right operative order and the incision,thus we can get results with anatomic reduction and shorten the operative time,which can help the patients make early exercises and get satisfactory effect.

The present study shows that mushroom juice exhibits a significanteffect on growth of L. acidophilus in reconstituted skim milk. When 5% - 10% mushroom juice was added in skim milk, they shorten generation time and the rate of lactic acid production was accelerated. After 10h incubation at 37℃ cell counts of L. acidophilus in test groups were much more than in control group, were up to 108/mL.

Objective To evaluate the efficacy of gasless laparoscopy for totally extraperitoneal(TEP) hernia repair.Methods Between April and August 2007,totally 82 patients with inguinal hernia received TEP in our hospital,in 30 of them the surgery was completed with gasless laparoscopy,while in the other 52,pneumoperitoneum was used for the operation.The operation time,medical cost,hospital stay,complications,and follow-up data of the two groups were compared.Results The gasless group had a longer operation time [(65.3?19.4) min vs(43.6?21.9) min,t=4.501,P=0.000],but less medical cost [(6186.7?1283.7) RMB vs(8391.8?850.8) RMB,t=-9.347,P=0.000].No significantly difference was observed in the hospital stay and rate of complications between the two groups [(2.1?0.8) d vs(1.8?0.9) d,t=1.513,P=0.134;and 6.7%(2/30) vs 5.8%(3/52),?2=0.027,P=0.870].Conclusion Gasless laparoscopy is effective and safe for totally extraperitoneal(TEP) hernia repair.

Objective To prepare novel alkanethiol modified magnetic silver flower nanoparticles as SERS substrate to chloramphenicol for Raman detection and to determine their enhancement effect.Methods An alkanethiol was chosen as a surface modifier of the substrate and was self-assembled onto the magnetic silver flower nanoparticle surface.The chloram-phenicol molecules were enriched to the surface of the substrate by hydrophobic interaction and the effect for detection of chloramphenicol SERS signal was enhanced.Results It was found that the 1-hexanethiol-modified SERS substrate was able to lead to stronger enhancement than 1-dodecanethiol and octadecanethiol.Fe3 O4@SiO2-Ag-C6 was used to detect the chloramphenicol (10 -3 -10 -10 mol/L) and chloramphenicol in milk (10 -3 -10 -9 mol/L) by surface-enhanced Raman spectroscopy.The detection limits were 0.1 nmol/L (32 ppt) and 1 nmol/L (323 ppt) respectively.Conclusion Alkanethiol modified magnetic silver flower nanoparticles are a highly active SERS substrate, which can be used for detection of low concentrations of analytical substances.

Objective To investigate the correlation between ultrasonographie classification, age and lesion in female. Methods One thousand two hundred and eight patients with 2416 mammary gland were comfired by pathologic findings, including 132 benign lesion and 54 malignancy lesion. According various sonographic appearances in the mammary gland structure and involution grade, the mammary glonds were classified into glandular,fibroglandular and fatty types. A single mammary gland is statistic unit. Results To follow age growth, the proportion of glandular type was decrease, 61.7% in under 30 years of age,31.5% in 30-39 years of age,15.3% in 40-49 years of age,8.6% in 50-59 years of age,4.5 in over 60 years of age. To follow age growth, the proportion of fatty type was higher, 1.6 % in under 30 years of age, 5.80% in 30-39 years of age,5.5% in 40-49 years of age,10.8% in 50-59 years of age,38.6% in over 60 years of age. Before 60 years of age, to follow age growth, the proportion of fibroglandular type was higher, which achieved the peak value (79.2%) in 40-49 years and last to 50-59 years of age (80.6%) ,but it was decrease to 56.9% after 60 years of age. There was significant difference of the proportion in any age(P=0.000).The proportion of the benign lesion no difference in three categories. The proportion of malignancy lesion (6.23%, 16/257 mammary gland)in fatty type was higher than that in fibroglandular type (2.18%,37/1698 mammary gland) which was significant difference(P=0.000). There was no malignancy lesion in glandular type. Conclusions Significant correlation were present between uhrasonographic classification, age and malignancy lesion, no significant correlation were found between uhrasonographic classification, age and benign lesion.

Objective To investigate the nutritional state in elderly hospitalized patients(≥70 years old)and provide clinical evi-dence for nutritional support in elderly people .Methods From June to December 2012 ,342 elderly hospitalized patients(≥70 years old)in Daping Hospital ,the Third Military Medical University were included .All of these patients were originally screened by resi-dent doctor ,and were revaluated by dietitians in the Department of Nutrition for the nutritional status .The revaluation was conduc-ted by Nutritional Risk Screening 2002(NRS 2002) ,which recommended by ESPEN ,and combined with the laboratory examina-tion .Results In 342 cases ,the nutritional risk rate was 96 .49% ,the incidence of malnutrition was 28 .79% ,and the incidence of a-nemia was 59 .24% .The incidence of low total serum protein ,low albumin ,and low prealbumin were 51 .40% 、93 .18% and 85 . 30% ,respectively .Conclusion Elderly hospitalized patients(≥70 years old)have high nutritional risk ,high incidence of malnutri-tion ,anemia ,and low blood albumin .Clinical nutritional support is necessary for bad nutritional status elderly patients .

Objective To explore the optimal method of extraction and determination of rhynchophylline and isorhynchophylline in Ramulus Uncariae cum Uncis. Methods A RP-HPLC was performed on a Phenomenex C18 column (4. 6 mm× 150 mm, 5m) at 30℃. The mobile phase consisted of methanol-0. 01 mmol/L triethylamine solution (70: 30, pH 7.0 adjusted by glacial acetic acid) at the flow rate of 0. 5 mL/min. The automatic sample injector was set at 5℃ and the ultraviolet detector was operated at 245 nm. And then, the effect of different extraction condition on the contents of rhynchophylline and isorhyn-ehophylline in Ramulus Uncariae cum Uncis was investigated. ResultsA good linearity of rhynchophylline was in the range of 2. 5μg/mL to 80. 0μg/mL (Y=76. 7170X-0. 0727,r=0. 999 8),the average recoveries were from 99. 84 ％ to 116. 91％, and the RSD (n=6) were less than 8.8 ％. A good linearity of isorhynchophylline was in the range of 2. 0 μg/mL to 80. 0 μg/mL (Y=87. 4729X-0. 3666, r=0.999 7), the average recoveries were from 87.08 ％ to 104. 97 ％, and the RSD (n=6) were less than 7.3 ％. The contents of rhynchophylline and isorhynchophylline in the methanol-extracted solu- tion were approximately ten times as much as those in water-decocted solution. The main factors which had effect on the ex-traction of rhynchophyUine and isorhynchophylline in methanol solution were supersonic time,methanol amount and cold-dousing time, in a decreasing sequence. The best condition selected by orthogonal experiment wasb as follows: extracting the medicinal material with 20-fold volumes of methanol, cold maceration for 24h and supersonic extraction for 1 h. Conclusion The extraction percentage of rhynchophylline and isorhynchophylline in the extraction condition of cold maceration with methanol and supersonic extraction is superior to that in the water-decocting condition. The method is simple, fast and accurate, and it can be used for the quality control of Ramulus Uncariae cum Uncis.

Objective To optimize the experiment conditions of surface-enhanced Raman spectroscopy detection of serum fingerprint spectra.Methods Normal human serum was used as the sample and Ag nanoparticles as the active substrate.The enhanced signals of different optimized experiments were obtained , including serum dose(2.5 to 500 μl), incubation time(10 to 30 minutes) temperature(4℃,room temperature and 37℃),and different treatment(extraction and protein removal).Results and Conclusion Serum doses should not exceed 50μl.The ratio should range from 1∶1 to 5∶1, the incubation time is from 10 to 30 minutes, and the incubation temperature from 4℃ to 37℃.The signals of samples directly mixed with an active substrate are stronger than those of samples which are extracted or protein removed .

Objective To explore the association between acute ischemic stroke and albumin to creatinine ratio (ACR).Methods A case-control study.During January to December in 2013, 127 acute ischemic stroke patients as case group and 150 controls who were similar with case group in age and gender were recruited in Tianjin Union Medicine Center . According to diabetes , hypertension , cardiovascular diseases and patients without these three diseases , case group was divided into A1, B1, C1 and D1 subgroups, control group was divided into A2, B2, C2 and D2 subgroups in the same way.The first morning urine from participants were collected .Urinary albumin concentration was tested by nephelometry , urinary creatinine was examined by using enzymic method , ACR were calculated(≥30 mg/g as the cutoff value). Then difference of ACR between case and control group was compared , the cutoff value of albuminuria for ischemic stroke patients was analyzed by ROC , and the risk factor of ischemic stroke were analyzed by logistic regression analysis.Results The prevalence of albuminuria in ischemic stroke patients was 38.58%(49).According to analysis of covariance, after adjustment for age, gender, cardiac-disease, diabetes, hypertension, lnACR in case group was significantly higher than control group (3.18 mg/g vs 2.78 mg/g, t=2.13 P=0.03), especially D1 was significantly higher than D2 subgroup (3.01 mg/g vs 2.51 mg/g,t=5.56,P=0.009) .If 19.82 mg/g from ROC analysis was used as the cut-off value, the sensitivity and specificity are 68.5% and 61.7%.The odds ratio ( OR ) of ACR >19.82 mg/g was about 2-fold when compared with ACR<19.82 mg/g adjusted for stroke risk factors , and the OR value is 2.43 in comparison of patients without diabetes , hypertension and cardiovascular diseases .Conclusions Urinary albumin excretion is the independent risk factor of ischemic stroke .The increased urinary albumin has important clinical significance to predict the risk of ischemic stroke for the patients without diabetes , hypertension and cardiovascular diseases.

Objective To investigate the biokinetics of 131 I and its absorbed dose in patients with metastatic DTC. Methods Forty?one patients with metastatic DTC who were referred to 131 I therapy were prospectively recruited from September 2009 to September 2011. Scintigraphic images were serially acquired after the ingestion of 131I (3.70-9.25 GBq) to assess the biokinetics. CT was used to measure the masses of the DTC lesions. Calculation of absorbed doses to DTC lesions was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine and Molecular Imaging. Kruskal?Wallis rank sum test was used to compare the differences of absorbed dose among different tumor deposits. Results In total, 59 io?dine?avid metastatic lesions (35 in cervical lymph node, 17 in lung and 7 in bone) in 41 patients were evalu?ated and the mean absorbed dose of DTC lesions was (10.4±6.5) Gy/GBq, with range of 0.1 to 136.2 Gy/GBq. The median absorbed dose was 11.3 Gy/GBq for lymph node metastase, 10.1 Gy/GBq for lung metastases and 9.6 Gy/GBq for bone metastases. There were no statistically significant differences in absorbed doses a?mong the metastases of lymph node, lung and bone ( Z=0.907, P>0.05) . Conclusion A wide inter?lesion variation of absorbed dose to metastatic DTC is observed.