BACKGROUND:In recent years, minimal y invasive percutaneous plate fixation has been a selectable method to repair fracture of lower limbs, especial y complex fracture of lower limbs. Its advantages are to reduce the damage to soft tissues, and do not destroy bone nutrient supply vessels. However, there is no unified criterion to select which method in the repair of distal tibial fractures. OBJECTIVE:To observe clinical effects of minimal y invasive percutaneous plate fixation versus open reduction and plate fixation in the repair of distal tibial fractures. METHODS:A total of 60 cases of distal tibial fractures treated with minimal y invasive percutaneous plate osteosynthesis (n=35) and open reduction and plate fixation (n=25) were selected. The time of surgery was identified by evaluating soft tissue. We should pay attention to the protection of soft tissue in surgery and reasonable fixation method should be selected. After fixation, we guided patients to do active early functional exercise. They were fol owed up and regularly received X-ray reexamination. Operation time, weight loading time, healing time and functional recovery were observed and the clinical therapeutic effects of the two methods were compared. RESULTS AND CONCLUSION:Al patients were fol owed-up after surgery. They were fol owed up for 3 to 15 months. No significant difference in healing time of type A fracture was detected between minimal y invasive percutaneous plate fixation and open reduction and plate fixation. The healing time of types B and C fracture was better in minimal y invasive percutaneous plate fixation group than in open reduction and plate fixation group. These results indicated that minimal y invasive percutaneous plate fixation in repair of tibial fractures, especial y distal complex tibial fractures, is an effective method. The healing rate of fracture was high, but postoperative complications were less.

Objective To explore the efficacy of intervention combined with traditional Chinese medicine for the treatment of early femoral head necrosis. Methods 62 cases of early femoral head necrosis were treated with interventional and traditional Chinese medicine, all patients were assessed for clinical efficacy before treatment and 6 months after treatment. The clinical hip function, pain index evaluation and rating of the femoral head venography were recorded. Results 41 cases were cured, 18 cases improved,no improvement in 3 cases,the total effective rate was 95. 2%. Clinical hip function after treatment compared with before treatment increased by 32.5%,there was a statistically significant difference (P＜0.01); compared with before treatment, significantly reduced pain (P＜0. 01). After treatment, Ⅲ and Ⅳ were significantly increased number of cases, respectively, compared with the preoperative increase of 146.2% and 160.0%,femoral venography ratings before and after treatment had significant difference(P＜0.01). Conclusion Intervention combined with traditional Chinese medicine treatment could significantly improve the early femoral head necrosis.

Objective To investigate the effect of disodium cantharidinateon in vitro lymphocyte immune response in lung cancer patients.Methods Twenty non-small cell lung cancer patients diagnosed by pathological diagnosis were selected.The effects of different concentrations of disodium cantharidinate and vitamin B6 on lymphocyte proliferation and CD4 + CD25 + T cells,CD25 + FOXP3 + T cells,CD4 + and CD8 + T cells were detected by methyl thiazolyl tetrazolium assay and flow cytometry.Results When the concentrations of disodium cantharidinate and vitamin B6 was less than 10 μg/ml,with the growth of concentration,it stimulated the proliferation of peripheral blood lymphocytes.When the concentration was more than 10 μg/ml,with the growth of concentration,the absorbance value decreased,and the stimulating effect weakened.When the concentration of disodium cantharidinate and vitamin B6 injection was less than 10 μg/ml,with the growth of concentration,CD4 +/CD8 + ratio increased significantly,and CD4 + CD25 +/CD4 + and CD25 + FOXP3 + T cells were significantly lower,which showed statistically significant differences (t =2.171,P =0.032 ; t =2.103,P =0.041 ; t =3.662,P =0.002 ; t =3.201,P =0.003 ; t =3.233,P =0.003).But when the concentration was more than 10 μg/ml,The differences of CD4 +/CD8 + ratio,CD4 + CD25 +/CD4 + and CD25 + FOXP3 + T cells in 10,15,20 μg/ml groups were not statistically significant,which showed that disodium cantharidinate and vitamin B6 injection had a positive effect on enhancing the immune function of lymphocytes in lung cancer in a concentration dependent manner,but high concentration was unhelpful.Conclusion Disodium cantharidinate and vitamin B6 injection can promote lung cancer in vitro lymphocyte proliferation as well as increase its immunity in a certain range.

Objective To quantitatively analysis the aortic valve leaf anatomical characteristics in aortic regurgitation(AR) patients by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE),and screening the parameters which significantly affect AR to further reveal the mechanism of AR.Methods 32 patients with AR were enrolled as AR group and 20 cases of non-AR people were involved as control group.RT-3D-TEE was using to collect images in two groups and offline analysis was performed.4 sets of parameters of the aortic valves(left coronary valve,right coronary valve,and non-coronary valve):leaflet edge length(LL,RL,NL),leaflet height (LH,RH,N H),leaflet length/height ratio (LRa,RRa,NRa),leaflet tip plane distance(LTH,RTH,NTH) were acquired.Parameters of two groups were compared,and the parameters were incorporated into the logistic regression model,then the ROC curves were obtained.Results ①Compared with the control group,LL,RL,NL,RH,LRa,NRa,RRa in AR group increased (P ＜ 0.05),while the rest parameters had no statistical differences (P ＞0.05).②Multivariable logistic regression model gradually screening of the significant factors influencing the reflux,and as a result RL and RTH had significant influence on AR,P values were 0.001,0.011.③The ROC curve analysis showed that the area of RL or RTH curve were both greater than 0.5,which were 0.811 and 0.605 respectively.Conclusions The free edge length and free edge length/height ratio have changed unbalanced.Furthermore,right coronary valve parameters changed significantly,and this might be one of the possible mechanism of AR.

Objective: To evaluate the effectiveness and safety of radical nephrectomy and inferior vena cava thrombectomy in the treatment of patients with Mayo Ⅲ tumor thrombus, and to introduce our experience and surgical technique.Methods: The clinical data of 8 patients with Mayo Ⅲ tumor thrombus from October 2014 to September 2016 were analyzed retrospectively.Of the 8 patients, 3 were male and 5 were female.The average age was (50.8±18.7) years (18 to 77 years).The average body mass index (BMI) was (22.7±4.4) kg/m2 (15.2 to 30.8 kg/m2).Imaging suggested the right renal tumor in all the 8 cases.The average tumor size was (7.9±2.5) cm.Open radical nephrectomy and inferior vena cava thrombectomy was conducted in 5 cases and laparoscopic surgery in 3 cases, and 1 case was converted to open surgery.Results: All the 8 surgeries were completed successfully with no death case.The average surgery time was (370.3±101.6) min, ranging from 272-567 min.The average vena cava blocked time was (41.0±12.1) min, ranging from 17-55 min.The blood loss volume was (1 181.3±915.7) mL, ranging from 200-3 000 mL.During the operation, 5 cases were infused with suspended red blood cells, the amount of blood transfusion was 800-2 000 mL.3 cases were infused of plasma with 400-1 000 mL.The average hospital stay was 9-23 d, with an average of (14.1±4.0) d.In the 8 patients, 4 cases underwent inferior vena cava wall resection because of invasion by tumor thrombus.Preoperative serum creatinine was 60-101 μmol/L, with an average of (76.4±15.3) μmol/L.Serum creatinine 1 week after the operation was 74-127 μmol/L, with an average of (100.8±21.1) μmol/L.Pathological diagnosis showed 6 cases of clear cell carcinoma, 1 case of papillary carcinoma type Ⅱ, and 1 case of Ewing''s sarcoma.Among the 8 patients, early postoperative complications occurred in 5 cases.Postoperative complications were graded as level Ⅱ, according to the Clavien classifications.The 8 cases were followed up for 2 to 24 months with an average of 11.3 months.There was 1 patient who suffered from lung metastasis.Conclusion: Our initial clinical results show that radical nephrectomy and inferior vena cava thrombectomy is safe and effective for patients with Mayo Ⅲ tumor thrombus.The wide extension of grade Ⅲ vein tumor thrombus leads to the difficulty of operation technique.Sufficient preoperative preparation, rich operative experience and skills can improve the safety of operation.

Objective To investigate the proportion of different types, distribution of genders, ages as well as the relative factors in inpatient with glaucoma. Design Retrospective case series. Participants 5058 cases of inpatients in Xingtai Eye Hospital, Hebei province from June 2004 to May 2009 were included. Methods Statistical analysis was conducted for 5058 cases of inpatients with glausoma. Main outcome Measures The type of glaucoma, age, gender and their percentages. Results In all 5058 cases, the patients with primary glaucoma, secondary glaucoma and congenital glaucoma accounted for 59.07%, 37.92% and 3.01% respectively. Primary angle-closure glaucoma (PACG) accounted for 88.65% in primary glaucoma, and primary open angle glaucoma (POAG) accounted for 11.35%. In PACG, acute PACG accounted for 53.15%, chronic PACG 46.85%;The female over forty accounted for 69.54%, male 26.95%. In POAG, the female over forty accounted for 69.54%, male 28.02%. From June 2004 to May 2005, POAG accounted for 11.32% in primary glaucoma, 12.44% from June 2008 to May 2009. There was no statistically significant difference. Conclusion In the central part of China, the majority of inpatients with glaucoma was PACG. It may relate to the regional,economic and cultural conditions.

OBJECTIVETo summarize the molecular epidemiology of hemoglobinopathies in Yongzhou area of Hunan province in order to provide a basis for making the guidelines of local thalassemia prevention program.

METHODSTwo thousand and two samples (1001 couples) were randomly recruited based on demographic data and distribution of ethnic groups. All samples were subjected to full blood count and analysis of hemoglobin and 6 common alpha-thalassemia mutations. Known beta-thalassemia mutations were screened in samples with beta-thalassemia trait. The remaining samples with positive phenotype and unknown mutations were subjected to DNA sequence analysis.

RESULTSTwo hundred and forty individuals were found to be carriers of hemoglobinopathic mutations, which included 6 common alpha-thalassemia deletions, 9 common beta-thalassemia mutations and 3 common structural hemoglobin variants. One hundred and seventy-four mutant alleles for alpha-thalassemia were detected, which gave a carrier rate of 8.69%, of which 0.1% was due to HbH disease. Seventy mutant alleles for beta-thalassemia were detected, which gave a carrier rate of 3.50%. Seven subjects (0.35%) were identified as carriers of hemoglobin variants. The overall carrier rate for hemoglobinopathic mutations was 12.54% based on detection of 251 hemoglobinopathy mutant alleles. The overall carrier rate for alpha- and beta-thalassemia among ethnic Yaos was 25.00%, which was significantly higher than that of ethnic Han Chinese (11.14%, P< 0.01).

CONCLUSIONThe prevalence and mutation spectrum of hemoglobinopathies in Yongzhou area has been delineated for the first time.

Adult ; China ; epidemiology ; ethnology ; Female ; Hemoglobinopathies ; epidemiology ; genetics ; Heterozygote ; Humans ; Male ; Molecular Epidemiology ; Mutation ; Young Adult

How to cultivate professional degree postgraduates with independent and innovative research ability has become an important goal of graduate education.In this article,doctoral postgraduates in the department of urology were chosen as subjects who received education of English book report and received education of new style of literature review in different time.In order to explore the effective measures to cultivate the clinical scientific research quality and ability of the professional degree postgraduates in Department of Urology,we evaluated different kinds of research quality of postgraduates under different methods of literature review through the scores of teachers' judges and questionnaires.

Objective To study the morphologic and functional changes of the aortic‐mitral valve coupling ( AMC) after surgical aortic valve replacement ( SAVR) or transcatheter aortic valve implantation ( T AVI ) in patients with severe aortic stenosis ( AS) using three‐dimensional transesophageal echocardiography ( 3D‐T EE) . Methods Ninty‐three severe AS patients were chosed as AS group in which 43 cases underwent SAVR and 50 cases underwent T AVI . T EE was performed before and after operation . T hirty‐one age‐and gender‐matched patients who underwent 3D‐T EE for exclusion of intracardiac thrombus were selected as control group . Cardiovascular quantitative analysis software was used to measure the parameters of aortic valve ,mitral valve and AMC in the the control group ,the SAVR group and the T AVI group before and after operation . Results ① Compared with control group ,the antero posterior ( AP ) diameter of mitral value in AS group increased ,the ellipticity of mitral valve decreased ,the height of the mitral annulus increased ( all P＜ 0 .05 ) . T he open area of aortic valve decreased ,the aortic regurgitation area ,aortic regurgitant flow velocity and the diameter of the aortic annulus increased( all P ＜0 .05) . T here was no statistical difference in aortic‐mitral valvular angle ( AM A ) and other parameters( all P ＞0 .05) . ②After SAVR ,the anterolateral‐posteromedial diameter ,AP diameter ,perimeter and area of mitral valve decreased ,the ellipticity of mitral valve increased( all P ＜0 .05) . T he aortic valve opening area increased ,the aortic regurgitation area and aortic regurgitant flow velocity decreased ( all P ＜ 0 .05 ) . T here was no statistical difference in AM A and other parameters( all P ＞0 .05) . ③After TAVI ,the AP diameter ,height , perimeter and area of mitral valve decreased ,the ellipticity of mitral valve increased ( all P ＜ 0 .05 ) . The aortic valve opening area increased ,the aortic regurgitation area ,aortic regurgitant flow velocity and the diameter of the aortic annulus decreased ( all P ＜ 0 .05 ) . T here was no statistical difference in AM A and other parameters( all P ＞0 .05) . Conclusions After SAVR and T AVI ,the anatomy and function of AMC in patients with severe AS changed to varying degrees after operation . It demonstrates that the impacts of both AS and repairment of AS on the mitral valve were . In addition ,after SAVR and T AVI ,the geometry and function of aortic and mitral valves of the patients recovered to some degrees .

Objective: To explore the value of parameters obtained by dual-pulse wave Doppler to predict the recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation(RFCA) and the value of the technology to evaluate the left ventricular diastolic function of the AF. Methods: Sixty-seven AF patients who were subjected to ablation were selected as the case group, and 47 patients with sinus rhythm were matched as control group. The general clinical data of the case group and the control group was collected, routine ultrasound examination and dual-pulse wave Doppler examination were performed to all of them. A 24-hour Holter examination was performed at 3, 6 and 12 months after radiofrequency catheter ablation in the case group, the patients were divided into two groups with and without recurrence according to the results. Dual-pulse wave Doppler parameters included: ①the time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e′) (TE-e′); ②peak early diastolic transmitral flow velocity (E) and tissue Doppler septal (S) mitral annular early diastolic velocity (e′), peak early diastolic transmitral flow velocity (E) and tissue Doppler lateral (L) mitral annular early diastolic velocity (e′), E/e′(S) and E/e′(L). The differences between the case group and the control group, and between the recurrent and the non-recurrent group were compared. The factors influencing the recurrence of AF after RFCA were analyzed with univariate and multivariate Logistic regression. Results: ①The parameters E/e′(S), E/e′(L) and TE-e′ of case group were higher than those of control group (all P<0.05); ②During follow-up examinations after the ablation, 21 (31.34%) patients recurred. TE-e′ of the recurrence group was higher than that in the nonrecurrence group (P<0.001). The parameters E/e′(S) and E/e′(L) in the recurrence group had no difference compared with those in nonrecurrence group without recurrence(all P>0.05); ③Univariate and multivariate Logistic regression suggested that TE-e′ was an independent predictor for the recurrence of AF patients after the ablation(P=0.001). Conclusions Dual-pulse wave Doppler can evaluate left ventricular diastolic function of atrial fibrillation, TE-e′ is an independent predictor for the recurrence of AF patients after radiofrequency catheter ablation.